Ageism is a global challenge: UN

Every second person in the world is believed to hold ageist attitudes – leading to poorer physical and mental health and reduced quality of life for older persons, costing societies billions of dollars each year, according to a new United Nations report on ageism.

The report released today by WHO, Office of the High Commissioner for Human Rights (OHCHR), United Nations Department of Economic and Social Affairs (UN DESA) and United Nations Population Fund (UNFPA), calls for urgent action to combat ageism and better measurement and reporting to expose ageism for what it is – an insidious scourge on society.

The response to control the COVID-19 pandemic has unveiled just how widespread ageism is – older and younger people have been stereotyped in public discourse and on social media. In some contexts, age has been used as the sole criterion for access to medical care, lifesaving therapies and for physical isolation.

“As countries seek to recover and rebuild from the pandemic, we cannot let age-based stereotypes, prejudice and discrimination limit opportunities to secure the health, well-being and dignity of people everywhere,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General. “This report outlines the nature and scale of the problem but also offers solutions in the form of evidence-based interventions to end ageism at all stages.”

 

FINDINGS FROM THE REPORT

Ageism seeps into many institutions and sectors of society including those providing health and social care, in the workplace, media and the legal system. Healthcare rationing based solely on age is widespread.  A systematic review in 2020 showed that in 85 per cent of 149 studies, age determined who received certain medical procedures or treatments.

Both older and younger adults are often disadvantaged in the workplace and access to specialized training and education decline significantly with age. Ageism against younger people manifests across many areas such as employment, health, housing and politics where younger people’s voices are often denied or dismissed.

“Ageism towards younger and older people is prevalent, unrecognized, unchallenged and has far-reaching consequences for our economies and societies,” said Maria-Francesca Spatolisano, Assistant Secretary-General for Policy Coordination and Inter-Agency Affairs in the Department of Economic and Social Affairs. “Together, we can prevent this. Join the movement and combat ageism.”

Ageism has serious and wide-ranging consequences for people’s health and well-being. Among older people, ageism is associated with poorer physical and mental health, increased social isolation and loneliness, greater financial insecurity, decreased quality of life and premature death. An estimated 6.3 million cases of depression globally are estimated to be attributable to ageism.  It intersects and exacerbates other forms of bias and disadvantage including those related to sex, race and disability leading to a negative impact on people’s health and well-being.

“The pandemic has put into stark relief the vulnerabilities of older people, especially those most marginalized, who often face overlapping discrimination and barriers – because they are poor, live with disabilities, are women living alone, or belong to minority groups,” said Natalia Kanem, Executive Director, United Nations Population Fund. “Let’s make this crisis a turning point in the way we see, treat and respond to older people, so that together we can build the world of health, well-being and dignity for all ages that we all want.”

Ageism costs our societies billions of dollars. In the United States of America (USA), a 2020 study showed ageism in the form of negative age stereotypes and self-perceptions led to excess annual costs of US$63 billion for the eight most expensive health conditions. This amounts to US$1 in every US$7 spent on these conditions for all Americans over the age of 60 for one year (see note to editors).

Estimates in Australia suggest that if 5 per cent more people aged 55 or older were employed, there would be a positive impact of AUD$48 billion on the national economy annually. There are currently limited data and information on the economic costs of ageism and more research is needed to better understand its economic impact, particularly in low- and middle-income countries.

“Ageism harms everyone – old and young. But often, it is so widespread and accepted – in our attitudes and in policies, laws and institutions – that we do not even recognize its detrimental effect on our dignity and rights said Michelle Bachelet, United Nations High Commissioner for Human Rights. “We need to fight ageism head-on, as a deep-rooted human rights violation.”

 

COMBATTING AGEISM

The report notes that policies and laws that address ageism, educational activities that enhance empathy and dispel misconceptions, and intergenerational activities that reduce prejudice all help decrease ageism.

All countries and stakeholders are encouraged to use evidence-based strategies, improve data collection and research and work together to build a movement to change how we think, feel and act towards age and ageing, and to advance progress on the UN Decade of Healthy Ageing.

The Global report on ageism compiles the best evidence on the scale, the impact and the determinants of ageism, effective strategies to tackle the problem and recommendations for action to create a world fit for all ages. The report is directed at policymakers, practitioners, researchers, development agencies and members of the private sector and civil society.

Ageism arises when age is used to categorize and divide people in ways that lead to harm, disadvantage, and injustice. It can take many forms including prejudicial attitudes, discriminatory acts, and institutional policies and practices that perpetuate stereotypical beliefs.

Prevalence figures based on a survey of 83 034 people in 57 countries found one in every two people held moderately or highly ageist attitudes (i.e. stereotypes and prejudice). More information: https://www.mdpi.com/1660-4601/17/9/3159.

Excess costs of health care: Ageism influences health through three pathways: psychological, behavioural and physiological. Psychologically, negative age stereotypes can exacerbate stress; behaviourally, negative self-perceptions of ageing predict worse health behaviour, such as noncompliance with prescribed medications; physiologically, negative age stereotypes predict detrimental brain changes decades later, including the accumulation of plaques and tangles and reduction in the size of the hippocampus.

In the USA, ageism led to excess costs of US$63 billion for a broad range of health conditions during one year. This amounts to US$1 of every US$7 spent on the eight most expensive health conditions for all Americans over the age of 60 during one year. The excess health care spending due to ageism was derived from the following: (a) number of Americans aged 60 years or older in 2013; (b) prevalence of interpersonal and self-directed ageism based on percentage of people that agree to the following statements: “You are treated with less courtesy or respect than other people”, “Forgetfulness is a natural occurrence just from growing old” and “The older I get the more useless I feel.” (c) evidence of the impact of such ageist statements on the eight health conditions; (d) prevalence of the eight health conditions in 2013, the most recent year for which health care spending was available; and (e) Institute for Health Metrics and Evaluation (IHME) costs per person of the eight health conditions in 2013.  More information: https://academic.oup.com/gerontologist/article/60/1/174/5166947.