By Martha McCully
By now you’ve probably heard that we’re not just getting older, we’re getting better. Yes, that’s a generalization (and rare-but-becoming-more-common marketing message) but maybe you know a 60-year-old today who is running a marathon in Antarctica, relocating to Portugal, or starting a new business in their garage. And aging is a
trend. By 2050, 22% of the world’s population will be over 60.
However, ageism — cultural stereotypes and societal biases against older (or younger) people — is a very real form of discrimination. Perhaps you’ve felt it in the workplace or interview office, when buying a new phone, or hearing “OK, Boomer” from, gasp, your own kids. It doesn’t feel great. There are some very real outcomes of not getting that job or not understanding how to use AI (BTW, old dogs can learn new tricks. See this story about technology as we age.)
Did you know that ageism can also have serious consequences for your health? Yes, both mental and physical health. Ageist attitudes and practices — in society and within ourselves — can lead to internalized negativity, poor medical attention, and less-than-beneficial habits that eventually and seriously damage our health and lives. Ageism is associated with a shorter lifespan, decreasing it by about 7.5 years.
Physical Health Effects of Ageism
Healthcare practices that de-prioritize older people may seem obvious: Older adults are often excluded from major clinical trials (especially women), limiting the understanding of how treatments affect this demographic, and ultimately leading to lower quality healthcare. Ageist attitudes can affect the questions healthcare professionals ask their patients, as well as their decision-making and advice, such as automatically attributing a symptom to age instead of delving into its root cause. Stereotypes about frailty and mobility can discourage older people from staying active. When was the last time you saw an octogenarian at Equinox? Or a weightlifting class for the over-70 set? This kind of thinking hastens ga decline in muscle strength as well as balance and coordination, leading to frailty and falls.
We also do it to ourselves. “Ageism starts very young; you often attribute your health to your chronological age,” says Peter Kaldes, President and CEO of Next50, a private foundation that funds national organizations that deal with aging. “Think of all the ways we dismiss certain health conditions saying, ‘Oh yeah, that’s because I’m getting old,’” he says. “But is it really? It could be a freak bone spur affecting your running or a vitamin deficiency.” Our self-ageist attitudes can manifest in not maintaining healthy diet and exercise habits, not taking prescription meds, or just not going to the doctor.
Physiologically, negative age stereotypes early in life can lead to Alzheimer’s by laying a pathway for amyloid plaques and neurofibrillary tangles in the brain and by reducing the size of the hippocampus. Cardiovascular disease, more common as we age, can be left untreated because older people, women in particular, are less likely to receive appropriate monitoring, from echocardiograms to cholesterol screening. Older people are more likely to be treated medically instead of surgically; and are less likely to get the most effective treatment after a heart attack. In her book Breaking the Age Code: How Your Beliefs About Aging Determine How Long & Well You Live, Becca Levy PhD demonstrates that health issues we think of associated with aging — memory loss, hearing decline — are instead influenced by our deep-rooted negativity about age.
Complicity in the Healthcare System
The system doesn’t always help. “We are not training healthcare workers in how to deal with an older population,” says Kaldes, citing that 96% of medical schools require a rotation in pediatrics, but only 10% require a rotation in geriatrics. In addition, ‘healthcare rationing’ can negatively affect an older person if medical treatment is restricted or made unavailable as younger patients are prioritized. Allocating scarce resources in health care is an issue, according to the American Medical Association Journal of Ethics. Age-based decisions for medical care is understandably a complicated and controversial topic — for example, who benefits the most and longest from a heart valve or knee replacement — and one that can have serious health consequences.
If this sounds to you like discrimination—and therefore illegal—you’re right. The Age Discrimination Act of 1975 (the “Age Act”) says that “no person in the United States shall, on the basis of age, be excluded from participation in, be denied the benefits of, or be subjected to discrimination under, any program or activity receiving Federal financial assistance.” Think Medicaid and Medicare. The Affordable Care Act reemphasizes any ageist practice as discrimination. During Covid, chronological age was often the ‘tiebreaker’ as to which patient received the ventilator at the start of the pandemic, resulting in multiple lawsuits.
Mental Health Effects of Ageism
“Not just our physical health is affected, our mental health is too,” says Kaldes. “If you aren’t happy about aging or don’t feel empowered by it, you are likely to suffer from depression, anxiety, fear of the future, a lack of self-purpose and self-worth,” he says. The UN Department of Economic and Social Affairs released a study through the World Health Organization called the Global Report on Ageism in 2021 that attributes 6.3M cases of depression to ageism globally. They’ve also declared, “Among older people, ageism is associated with poorer physical and mental health, social isolation and loneliness, greater financial insecurity, decreased quality of life and premature death.” Internalized ageism can increase the risk of suicide, especially among men over 85. Conversely, if you have a positive attitude about getting older, there’s a nearly 50% reduced risk of dementia.
Changing Our Society and Ourselves
Our society is ageist, for sure. In media and movies, we glamorize and romanticize youth. In the workplace and advertising, even in families and social gatherings, people can be dismissed or ignored because of a chronological number. “Ageism is pernicious,” says Kaldes, “It’s everywhere.” But our own attitudes also pile on. Negative self-talk, calling ourselves “old,” or excusing references we make as “out of date” are common ways we contribute to the problem.
“The ultimate irony about ageism is you become the object of your discrimination,” says Mark Lachs, MD, Director of Geriatrics for the New York Presbyterian Health Care System.
What can we do to change ageism and ultimately our health outcomes? “First, we need to take back the word ‘old’,” says Kaldes, signifying that the meaning and power of language changes and can be changed too. Catching ourselves in ageist talk is a way to combat ageism. “It starts with us stopping all those little micro-aggressions toward ourselves, saying, ‘I’m too old for this or that.’ And we can stop buying all those horrible birthday cards that tear us down instead of celebrating us. We can become an aging activist in our own lives and embrace it instead of trying to run away from it.” And we’ll end up healthier physically and mentally if we do.
