How Ageism Affects the Way We Age
“It was an invisible, underlying tension that I felt every day” says Camille Alexander, a communications executive based in Dallas, Texas, describing the age discrimination she experienced. At 53 years old, she was hired by one of the Big Four accounting firms known for their competitive work environment: “I was the oldest person in a team of 40 — most were in their 20s and 30s. Even though I held a very senior position, I was treated as if I was too old to keep up. My boss, who was 10 years younger and whose position I had taken over, became exasperated when I didn’t learn everything about the role in the first two or three months — even though she had had seven years to master it.”
Age discrimination is real and happens in all areas of life — from the workplace to social settings, and even within families. What’s surprising is that some of the stereotypes associated with ageism, such as slowness or the assumption of diminished mental capability, aren’t reserved only for people in their 80s and beyond, but can even be levied against those in their 50s. “We experience ageism anytime someone assumes we’re too old for something, instead of finding out who we are and what we’re capable of,” says 68-year-old Ashton Applewright, a self-described, pro-aging radical, in a 2017 TED® Talk about ending ageism that’s been viewed more than 1.5 million times.
“I felt isolated and excluded,” recalls Alexander. “The very experience they hired me for was never acknowledged or put to good use. And it wasn’t only that my ideas were not valued but, even when we would talk about their cute, young kids, they would never ask about mine, who were in college. I stuck it out for over a year, but it was stressful and demoralizing. Then I landed in a new job, again working with mostly younger people, but I felt welcomed and supported and realized that much of that toxic environment stemmed from ageism.”
WHAT IS AGEISM?
Ageism can even occur in unlikely places, such as the healthcare system. Healthcare workers might display a patronizing attitude, or might not administer or offer a full array of treatment options. Life-saving procedures may be denied to those past a certain age; younger lives are often deemed more worthy. “There have always been a limited supply of organs available for transplants, and they have always been reserved for younger patients,” says Teresa Barnes Tosi, a research and patient advocate for respiratory illnesses, including pulmonary fibrosis.
But as the population ages, some of these discriminatory practices may be changing. “When my father was transplanted in 1996, the oldest age to qualify for lung transplants was 60. Over the years that jumped to 65. Now, more surgeons will assess physiological age, rather than just chronological age. So, if an older patient seems fit and well enough to survive the surgery, they may be given an opportunity,” says Tosi. “But even still, there are centers with hard and fast cutoff points who will deny older patients.”
WHO IS AGEIST?
Ageism can be exhibited by individuals, companies, healthcare workers and even one’s own family. Ageism is a worldwide problem and can exist across all cultures, even in those with a reputation of respecting their elders. One cross-sectional study surveyed over 83,000 people in 57 countries and found that over one-third of the countries included in the research showed moderate or high levels of ageism.3 A systematic review by Yale University researchers analyzed over 400 studies that had investigated “ageism,” “age discrimination,” “age stereotypes” and/or “perceptions of aging.” Ageism — and adverse effects from it — were found in all 45 countries that had been included in the studies, and poor countries showed a higher prevalence.4
The problem is considered to be so widespread — and growing — that the World Health Organization issued a treatise, The World Report on Ageing and Health, in 2015. “The ageing of populations is rapidly accelerating worldwide,” the report notes. Acknowledging that this demographic trend will affect population health, health systems, the workforce and budgets, the report was commissioned to highlight the issues. The WHO report evaluates various aspects of aging, and provides recommendations to create a more age-friendly world where physical, social and workplace environments can extend a person’s functional ability, productivity, health and well-being.2
ARE YOU AGEIST?
One often unrecognized aspect of ageism is its internalization. Yes, a person may experience ageism on the job, from a physician, or even from members of one’s own family. But, what might be most harmful is that one can also absorb ageist attitudes and be ageist against oneself. Self-directed ageism that is characterized by negative attitudes can affect health in detrimental ways.
We learn at an early age what being “old” means. “Our culture somewhat brainwashes us to equate aging with decline on every front and we seldom challenge that underlying stereotype, even when experience tells us a different story,” says Applewright, also the author of This Chair Rocks: A Manifesto Against Ageism. For example, in health clubs around the country, one can find people in their 70s and 80s working out with those much younger. Yet, the societal — and, often, personal — expectation is that getting old means you wither.
Even if we don’t feel old, society starts giving indicators that we’ve reached a certain age: invitations to join AARP arrive in the mail at 50, senior discounts may be offered unprompted, people give up their seats on subways or may offer help at grocery stores. Someone who is constantly being treated as “old” may start assuming the role. If you accept that you are doomed to grow old and acquire age-associated behaviors and characteristics, it may as well be a fait accompli, according to research. Negative self-perceptions are associated with a reduced sense of self-efficacy, increased depression and worse physical health. On the other hand, people with positive attitudes about aging have been shown to have higher levels of well-being, better health and/or longevity.5
“Start with yourself first, then worry about addressing ageism in the culture or within individual silos like the workplace and healthcare systems,” says Applewright. In her 2017 TED® Talk about ending ageism, she admits that she was scared stiff about getting old: “I worried about ending up drooling in some grim institutional hallway.” But she points out that having fact-based, rather than fear-based attitudes about aging is one of the best things we can do to age better and more healthfully. “Our fears tend to be out of proportion to the reality, and that fear and anxiety makes us more vulnerable to the exact things we fear.”
For example, many people fear dementia. But only one in 10 people over the age of 65 has Alzheimer’s, according to the Alzheimer’s Association®.6 “Yes, 10 percent is a big number, but nine out of 10 us will never get Alzheimer’s and overall rates are declining,” says Applewright. “The reality is that the vast majority of us are fine till the end.”
Age discrimination is real and happens in all areas of life — from the workplace to social settings, and even within families.
Many common perceptions and assumptions about older people are based on outdated stereotypes, according to the World Health Organization. But some stereotypes about aging are positive — perhaps the most common is the idea that we grow older and, therefore, wiser. “That ‘wisdom’ trope is a stereotype, albeit a benevolent one,” says Applewright. “Some young people are old, and some older people don’t seem to have learned a lot along the way.” More often than not, aging stereotypes are negative. Older people are often perceived as frail, vulnerable and therefore, dependent, as well as out of touch or disengaged, if not cognitively challenged.
But research indicates that job performance does not necessarily decrease with age, even if the perception is that it does. Forced retirement is one practice the WHO report recommends abolishing: “Policies enforcing mandatory retirement ages do not help create jobs for youth, as was initially envisaged, but they do reduce older workers’ ability to contribute and also reduce an organization’s opportunities to benefit from the capabilities of older workers.”2
“The older a person is, the less their chronological age tells you about their cognitive function and their physical function because heterogeneity is the defining characteristic of old age,” says Ashton Applewright, a 68-year-old aging activist. “Seven year olds have a lot more in common with each other developmentally, socially and physically than 37 year olds, who are infinitely more homogenous than 67 year olds, and so on...” Research from the WHO report concurs: “As the evidence shows, the loss of ability typically associated with ageing is only loosely related to a person’s chronological age. There is no ‘typical’ older person. And while there is likely to be some age-related decline, it might not actually hamper a person’s work performance or other pursuits.”2
Internalizing aging stereotypes can hamper self-esteem. “The thing I see the most is that women think that they can’t try to look younger — with Botox, fillers, even hair color — and still be a feminist or be perceived as accepting their age. They think they need to look like ‘old’ looks,” says Cheryl Kramer Kaye, a former beauty editor and writer at top national magazines including Shape® and Redbook®, and currently the beauty director of Next Tribe™, a website targeted to “women aging boldly.” Kramer points out that beauty interventions are the last thing we should be judging each other — or ourselves — for doing. “Feminism is about supporting women in all the different choices we make,” she says. “I’ve always felt that the goal should be to look and feel fantastic for your age. Am I happy when colleagues think I look younger than I am? Of course. Our society prizes youth and that first impression of vitality is important. But I readily share how old I am, 51, because I want the people I work with to know that I speak from a position of experience and authority.”
Of course, removing the pressure to look artificially young is integral to perceiving aging in a positive way. “We need to embrace the idea that living is aging and aging is living,” says Applewright. “Health is a spectrum. Sh** will fall apart. It’s fantastic that there are some octogenarians doing pole dancing, but you shouldn’t hold yourself up to some standard that if you are not pole dancing that then means you are in any way lesser.”
HARMFUL EFFECTS OF AGEISM
While the body breakdown that can accompany aging can create aches and pains, there may be nothing as emotionally gut-wrenching as the social shunning that leaves one feeling like a cast-off past its prime.
While ageism can technically be applied to a person who is younger, in most cases, it’s experienced by people who are older and it may even be more pervasive than sexism and racism, according to the World Health Organization.2 Anyone of any gender or race or ethnicity can experience it, and a real concern is its negative effects on both physical and mental health.7 “Negative attitudes towards aging affect harm our health by affecting how our minds and bodies function,” says Applewright. Older people also are offered fewer social and economic opportunities.8
Studies have shown that people with negative attitudes towards aging die 7.5 years earlier, on average.9 “It’s not that the scary stuff isn’t real, it’s that our fears are out of proportion to the reality and fear and anxiety make us more vulnerable to exactly the things we fear,” says Applewright. Yale University researcher, Dr. Becca Levy PhD, has coined this phenomenon, “stereotype embodiment theory.” She proposes that stereotypes are assimilated from the surrounding culture, and their embodiment leads to self-definitions that influence functioning and health.10 Levy’s research has shown that self-directed ageism is associated with an increased risk for cardiovascular events such as angina, congestive heart failure, myocardial infarctions and strokes, as well as a higher presence of brain changes related to Alzheimer’s disease.11,12
As a larger percentage of the population ages, addressing ageism both at the individual and societal level will become a necessity. More educated people have been found to consider “old age” to start at later ages and often do not self-identify as “older” person and so may be buffered against some of the negative health effects of internalized ageism.3 Interventions to reduce ageism are being researched. Addressing bias at a young age is considered to be key. One study of over 1300 undergraduate college students found that increased education about aging and increasing positive contact with older adults resulted in lower levels of negative attitudes towards aging.13 Another study had 77 college students view a documentary addressing the pain and prejudice experienced by older adults. After viewing, there were significant improvements in measures of empathy towards older adults.14 Addressing our own perceptions and fears will help stop the internalization of negative attitudes on aging. “Keep in mind that aging is not just something that annoying old people do. Aging begins the day we are born,” says Applewright.