Age is one of the three characteristics we tend to notice first about other people, along with sex and race. Ageism is a multifaceted issue that includes stereotyping and discriminating against people of a particular age. It can look like a birthday card ridiculing older adults, or like telling someone they look good for their age. While the number of people aged 60 and older is expected to more than double worldwide by 2050, persistent ageism may impact these individuals’ experiences with receiving necessary services and remaining active in their communities.
Institutional ageism refers to policies, social norms, and laws that lead to unfair restrictions on opportunities for older adults, while interpersonal ageism occurs in the interaction between individuals. Self-directed ageism is when ageism is internalized and self-projected, impacting individuals’ perceptions of themselves.
Ageism may lead to barriers in access to health care services or treatments. Almost 20% of U.S. adults aged 50 and older attest to experiencing discrimination in a health care setting that leads to inappropriate or inadequate care. Negative perceptions of older adults by health care providers have been shown to result in delayed access to emergency care, contribute to mortality risk, and lead to slower illness recovery. The estimated medical cost of ageism in the U.S. is $63 billion annually.
Older adults are also regularly excluded from randomized clinical trials, even for drugs that are intended to treat conditions common to this population. A systemic review of clinical trials found that more than 30% included an age cap and more than 90% of those trials did not include a justification for the age limits.
Ageism can also manifest in restricted opportunities for employment for older adults. A 1967 law, the Age Discrimination in Employment Act, forbade discrimination against people who are more than 40 years old. However, in the almost 60 years since the bill’s passage, it has only been updated twice; the last time was in 1991. Employers with less than 20 employees are still exempt from the law.
The NCIOM Healthy Aging Task Force, convened beginning in June 2022, examines many of the barriers to well-being experienced by older adults in North Carolina. Several of these factors are impacted by the experience of ageism. The task force is examining incidence of falls and resulting injuries, some of which may be impacted by improper medication management. The task force is also discussing nutrition; older adults who experience ageism have been shown more likely to experience barriers to healthy eating. Social isolation is another key factor covered by the task force, including its impact on older adults’ mental health; poor self-perception of aging has been linked to mental health decline, worse outcomes in memory tests, as well as higher rates of depression. Lastly, the task force is discussing mobility within older adults’ communities, an issue that may be impacted by a lack of understanding or commitment to the needs of older adults, sometimes evident in unkempt sidewalks, inaccessible public transport, and the lack of mandatory aging-in-place accommodations in home design.
The task force has also discussed the ways in which older adults are perceived by their communities, and how our state’s changing demographics may require increasing awareness of the services and supports needed by older adults. In addition, there is evidence that intergenerational contact, such as younger people spending time with older adults, may increase awareness and reduce the likelihood of ageism and its negative effects.
On October 7, aging advocates observed Ageism Awareness Day; however, casual ageism portrayed on television and in anti-aging face cream ads will not be countered with one day. Anxiety about aging, driven by these cultural portrayals, can be countered, instead, with understanding and respect for the needs of older individuals, as well as by substantive policy change to support these needs.