The UN Decade of healthy ageing in practice: A qualitative case study on perspectives of healthy ageing among older adults, healthcare professionals, and decision-makers in Norway.

BACKGROUND: Global populations are ageing, making healthy ageing an increasingly important priority. In Norway, the number of people aged 70 and above is expected to double by 2050. The UN Decade of Healthy Ageing (2021-2030) guides Norway's national programs on healthy ageing through its four action areas: combating ageism, age-friendly environments, integrated care and long-term care. The aim of this study is to explore how healthy ageing is understood and interpreted in Norway in light of the four action areas of UN's Decade of Healthy Ageing and the enabler listening to diverse voices and meaningful engagement. METHODS: The study draws on 23 semi-structured interviews with decision-makers, healthcare professionals, and older adults in a large urban Norwegian municipality. Participants were recruited through direct contact and through the municipality. Data from the interviews was transcribed verbatim and analysed collaboratively by the research team, following the principles of collective qualitative analysis. RESULTS: Findings focus on three main themes: strategies for achieving mastery, mixed perceptions of ageing, and health services. Results indicate that while preparing for old age is seen as a collective responsibility, older adults are increasingly expected to prepare for old age. The emphasis on self-reliance risks marginalising vulnerable groups who lack necessary resources or support networks. The rapid digitalisation of everyday life is identified as significant barrier to equitable participation, underscoring the urgent need to foster more inclusive forms of active engagement. Municipal healthcare services are generally perceived as high-quality, but face resource challenges that create uncertainty among older adults. CONCLUSIONS: Healthy ageing in Norway is increasingly framed around participation and shared responsibility for ageing in place, reflecting the UN Decade of Healthy Ageing. However, growing individualisation and rapid digitalisation may reinforce inequities. Addressing this requires digital inclusion, intergenerational approaches, accessible environments, and sustained public investment, alongside efforts to combat ageism and promote more inclusive, collaborative forms of participation. TRIAL REGISTRATION: Not applicable.