What is ageism?
Ageism refers to stereotype, prejudice and discrimination against people based on their age. Unlike racial or sexual stereotypes that are typically frowned upon, ageism is socially condoned and institutionalized in the US and other countries. The combination of negative age-related stereotypes and discrimination can make ageism a chronic stressor for older people. People often have false ideas about aging. You can take the 25-question Aging Quiz (http://faculty.webster.edu/woolflm/myth.html0 to test your knowledge.
Ageism and health
A recent review evaluated the associations of ageism and health at both the institutional and individual person levels. A literature search found 422 studies that met the inclusion criteria. Ageism predicted significantly worse health outcomes in 96 percent of the studies and in 74 percent of the associations tested within those studies. Moreover, significant associations occurred for all 45 countries that the studies covered, in all 11 health domains, and over the 25-year period of the studies. Ageism occurs at both the institutional and individual levels. To top it off, the prevalence of significant findings increased over time.
Everyday ageism predicts poorer health of older Americans
Ageism includes prejudice, stereotypes, and discrimination related to old age, the aging process, and older adults. Do experiences of everyday ageism adversely affect older adults? Researchers at the University of Michigan studied this question using cross-sectional data collected in December 2019 from 2,035 adults of age 50-80 (average of 63 years) in the National Poll on Healthy Aging. Adverse health outcomes included 1) self-reported fair or poor physical health, 2) the number of diagnosed chronic health conditions (out of nine possible), 3) self-reported fair or poor mental health, and 4) two types of depressive symptoms. Experiences of ageism were measured with the 10-item Everyday Ageism scale according to three domains: ageist messages (two items), ageism in personal interactions (five items), and internalized ageism (two items). The composite everyday ageism scale of the three domains ran from 0-30 points, with higher scores showing stronger ageism.
Ninety-three percent of participants reported experiencing regularly one aspect of everyday ageism. Participants rated internalized ageism as the most commonly experienced (81 percent) followed by ageist messages (65 percent) and ageist personal interactions (45 percent). Higher scores on the Everyday Ageism scale predicted greater odds of participants reporting worse physical and mental health. Internalized ageism predicted the greatest risk for all four health outcomes. Ageism might contribute directly and indirectly to poorer physical and mental health by reducing access to medical care, embodying negative expectations of aging, and diminishing normative expectations for older person’s health. Pervasive ageism in the US may contribute to poorer health of older people.
Ageism predicts worse psychological well-being
Ageism appears to diminish the psychological health of older people. A recent systematic review supports this idea. All of the 13 included studies found a negative association between ageism and some aspect of psychological well-being. In addition, the review identified five factors that diminished the effects of ageism on psychological well-being. The factors included 1) pride in being a member of their age group, 2) lower prevalence of negative emotions (such as, feeling hurt or sad or frustrated), 3) a positive view of aging, 4) greater body esteem, and 5) greater ability to adjust personal goals.
Negative self-perceptions of aging predict worse health
Other researchers at the University of Michigan conducted a systematic review of observational studies that investigated associations between ageism and health. Sixty-seven studies met the inclusion criteria. Ageism included three categories: 1) age stereotypes (attitudes toward older adults as a group), 2) self-perceptions of aging (attitudes toward one’s own aging), and 3) age discrimination. Two-thirds of the included studies focused on self-perceptions of aging. Health included seven domains: 1) disease, 2) mortality, 3) physical/functional health, 4) mental health, 5) cognitive function, 6) quality of life, and 7) health behaviors. The 45 studies that focused on self-perceptions of aging had 57 significant associations with various health domains and only 6 non-significant associations. The 10 studies that focused on age discrimination had 12 significant associations with health domains and 2 non-significant associations. Interestingly, studies rated as good quality had 25 significant associations between dimensions of ageism and domains of health and only 2 non-significant associations. Overall, ageism predicts negative health outcomes, with the strongest findings arising from negative self-perceptions of health.
Financial costs of ageism
Ironically, despite the widespread prevalence of ageism and its associated adverse health outcomes, as of 2020, no published accounting of the cost of ageism existed. Researchers at Yale University rectified this situation using health data from Americans age 60 years or older in the nationally representative Health and Retirement Study. Health care cost data came from the Institute for Health Metrics Evaluation for year 2013. Researchers calculated effect sizes for three aspects of ageism (discrimination aimed at older persons, negative age stereotypes, and negative self-perceptions of aging) for 8 of the top 10 sources of health care spending in 2013. These sources included cardiovascular disease, chronic respiratory disease, musculoskeletal disorders, injuries, diabetes mellitus, treatment of smoking, mental disorders, and non-communicable diseases. Two of the top 10 sources of health care cost arose from pregnancy and births that were unrelated to ageism. The one-year costs related to age discrimination, negative age stereotypes and negative self-perceptions of aging were $11.1, $28.5, and $33.7 billion, respectively. The total cost of ageism in the US in 2013 (after eliminating overlapping costs) was estimated at $63.8 billion. In addition, ageism resulted in 17 million cases of the eight sources of health care costs. Aside from the human suffering, we Americans have financial reasons to phase out ageism in our country.
