The reality of ageism
 

As life expectancies lengthen and the world population of people aged over 65 booms, older people continue to face ageism – treated as invisible, stereotyped and discriminated against – which impacts on their health and quality of life and ignores their social and economic contribution, and the situation has worsened through the Covid-19 pandemic.

 

On the International Day of Older Persons (1 October 2021), Dr Sihle Nhlabathi, member of the South African Society of Psychiatry (SASOP) said that combatting ageism would result in healthier, more active ageing and enable society to benefit more from the economic participation and social value of the growing population of over-65s, expected to more than double by 2050.

 

Although they are often invisible in media and marketing, or portrayed in stereotypes, people over 65 already outnumber children under five, and projections are that by 2050 there will be twice as many over-65s as children under five, and they will also outnumber 15- to 24-year olds (1.5bn vs 1.3bn).[i]

“Life expectancy globally is currently about 73 years and is expected to reach 77 in 2050. Half of all children born in 2020 are now predicted to live beyond 100,[ii] meaning older people will no longer be invisible nor irrelevant.

 

“While there are negative perceptions of older people as weak, incompetent and a burden on society, the evidence points to the contrary. With increased longevity, many people work, earn an income and pay tax well over the age of 65, as well as playing an important role in childcare. In the UK, for example, it has been shown that the contribution of older people through taxation, consumer spending and other economically valuable activities outweighs the public expenditure on their pensions, welfare and health care,” she said.

 

Research had shown that the situation in Japan, where more than a third of the population is over 60, was similar, with a very limited effect of an ageing population on economic growth. Although there is less evidence available from low- and middle-income countries, one example is Kenya where the average of small-scale farmers is 60, making them critical to food security.[iii]

 

“Unlike racism and sexism, ageist attitudes are still seen as socially acceptable and largely go undetected or unchallenged, but research has shown that ageism has significant impact on older people’s mental and physical health, and their potential for active ageing. 

 

“Social exclusion due to ageism is a chronic stress factor for older people, while ageism also leads to fewer social and economic opportunities for older people, who still have great value to offer in the workplace and society,” she said.

 

Dr Nhlabathi said it was particularly concerning that ageist attitudes were prevalent amongst health care professionals,[iv] leading to discrimination and impacting on the quality of health care provided for older people.

 

“Ageism and false assumptions about older people’s mental ability and physical health, such as assuming the person is hard of hearing or that depressive symptoms are ‘normal at their age’, can place older people at risk through less screening and preventative care, less information provided to them about their conditions, and less access to needed care and treatments – placing their health at risk,” she said.

 

The concept of active ageing is promoted by the World Health Organisation (WHO) to prolong and improve health in later life, by encouraging older people’s continued participation in social, economic, cultural, spiritual and civic affairs, as well as continuing to be physically active.

 

“There is substantial research showing that job performance does not decrease with age, and also a rise in research that highlights benefits of ageing – older people have been shown to act more rationally in problem-solving and social conflicts, to retain their knowledge and experience, and are generally more emotionally healthy.[v]

 

“It makes sense then to promote active ageing, higher retirement ages and encouraging employers to adapt working practices to the age of employees,” Dr Nhlabathi said.

 

Dr Nhlabathi said that ageism in public discourse and policy decisions had come to the fore in the response to the Covid-19 pandemic, impacting on older people’s health, well-being and rights.

 

Initial perceptions of Covid-19 as affecting mainly older people led many to dismiss public health measures such as masks and physical distancing as irrelevant to them, in turn impacting on the risks to older people, while deaths of older people from the disease were seen as “inevitable” and of less consequence than the deaths of younger people.

 

Ageism and a perception of older lives as less valuable was also seen in discussions and policies on the allocation of scarce resources such as ventilators.[vi]

A blanket view of all older people as “high risk” and stricter restrictions imposed by governments on older people, such as visitors barred from care homes and retirement facilities, and orders for older people to self-isolate and stay home, worsened the isolation, anxiety and social disconnectedness already experienced by older people.

 

However, Dr Nhlabathi said greater intergenerational solidarity experienced during the pandemic – such as younger people delivering groceries and medicines for older neighbours, tending to their gardens and making sure they could stay connected with loved ones via smartphones, video calling and technology such as Zoom – was a positive sign.

 

“Intergenerational solidarity provided significant support and important social connections for older people during the pandemic.

 

“Intergenerational contact has been shown to be beneficial to both young and older people, and although little is known about how to combat ageism, this together with education and awareness raising amongst medical professionals, employers and the public, seems to hold some hope for encouraging more positive attitudes to older people,” she said.

 

Dr Nhlabathi said while ageist treatment impacted negatively on older people’s health, self-esteem and quality of life, there was also the risk to their mental health and well-being from internalizing negative stereotypes of age and ageing.

 

“On the one hand there is the risk that internalizing these stereotypes and prejudices leads to the older person seeing less opportunity, and more limitation, in their life with age. But working with older people to develop more positive self-perceptions and attitudes towards their own ageing process benefits their health, functioning and longevity.

 

“Older people can combat ageism if they are able to see these negative perceptions as false, inaccurate and off-base,” she said.

[i] All population statistics in this article are from - UN – World Population Prospects 2019 … 

[ii] North, Fiske. Inconvenienced Youth …

[iii] UK, Japan, Kenya examples all from Officer, A “valuing older people”

[iv] Burnes, Interventions to reduce ageism..

[v] Inconvenienced Youth

[vi] Fraser et al. Ageism and  Covid 19…