#219 Structural Ageism can Kill You
Ageism
An analysis shows how dangerous ageism can be. It covered 422 different studies, involving 7m participants.
A Five-Minute Read.
A team trawled the academic literature on ageism. For all studies that showed a quantitative association between ageism and health. They have provided an updated summary. They show insights into the types of ageism and the mechanism of their action. They found 422 studies across 45 different countries. All demonstrated a powerful association between ageism and health. 95% of all the studies showed a negative effect. It held across sex, race, age and geography.
They looked at “structural” discrimination and “individual” ageism. The former looks at ageist attitudes within social institutions. How that causes them to deny older people access to key resources.
The studies that looked at “individual dimensions” focus on the impact on a person. The impact of ageism directly on their longevity. Whether ageism can impact perceived quality of life or social relationships. These studies also looked at how ageism has that impact. How it can induce poor health behaviours or depression. In this Newsletter I will focus on Structural Ageism. I will deal with the individual aspects next week.
How Ageism Impacts Health.
One’s attitude to life has a major impact on life and longevity. People with a positive attitude live longer and live healthier for longer. A threat to that positive self-image is thus a threat to health. Such threats can come from two places. A generalized negative belief of ageing in society is called ageism. It can have many impacts. It can permeate an individual’s life and influence the view they hold of their own ageing. It can also trigger “everyday ageism”. People act on the ageist stereotype. Sometimes these acts are well meant but carry a negative connotation. An offer of help can signal an underlying view of weakness.
Structural ageism is different. Denying someone medical treatment or access to a sports club, “because they are old” has two effects. It directly undermines someone’s health. It also sends a signal that their life is not as valuable as a younger person. That in turn undermines self-image, self-worth and view of ageing.
Structural Discrimination
149 of the studies looked at the impact of ageism on "health services and treatments". Discrimination negatively affected health in 85% of cases. There were two groups within that. The first related to differential treatment for the old versus the young. Treatments across a wide range of diseases were denied to older patients. There was a a direct impact on health but also on things such as depression. These studies spanned many countries and were not only in developed world. They included experiments, not just surveys. For example, in one study, young doctors were offered scenarios. Some described old, and other young, patients but the illness was the same. They specified more and better treatments for the young.
The other group of studies focused on drug trials. In other Newsletters I have discussed how and why older people are not included in such studies. 49 studies looked at this issue. All but one trial excluded older people. Many of these diseases are more common in older people. For example, one study showed looked at Parkinsons disease. 49% of drug studies did not include older people.
These studies try to prove efficacy. Older people with multiple diseases complicate that process, and make it more expensive. Unfortunately, these types of studies offer little insight into dosage for older people. Interactions with other drugs are not usually part of such trials. Many older people take multiple drugs. See Newsletter #122 How Many Drugs Do You take a Day?
There were then a group of studies that looked at the signaling of “an old life is worth less”. Actions by public or commercial organizations that send the wrong signal on the value of a life. Access to sports and health facilities denied. Because “obviously an older person would not get value”. 80% of these studies showed a direct relationship to a negative health outcome.
Discrimination in the workplace is well known. Some studies have looked at the later health of the individual. There was a total of 27 such studies. 91% demonstrated a link to health. The most common finding was a link with subsequent depression. Ongoing age discrimination led to individuals taking early retirement.
Structural discrimination is definitely bad for health.
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