#220 “Individual” Ageism and Health

How does ageism impact on an individual?

A Five-Minute Read

We return to the exhaustive collection of studies of ageism and health. In last week’s Newsletter we looked at studies of Structural Discrimination (Newsletter #219). This occurs when ageing stereotypes permeate a public or private institution. The institution then makes decisions and policies. These undermine the value of an older person’s life. My trainer gave me a perfect example. He described the recommended exercise program for “old” people that he was taught during his training (some years ago!). It did not allow for any variation across individuals. It assume a decrepit body!

This sequel focuses on a whole collection of studies. Each assesses the impact of ageism on different measures of health and intermediate negative states. They focus on the individual, not the institution. The structural and individual domains are obviously linked. Denying someone a job or a medical treatment will send a signal to the individual. So does assuming that they cannot exercise. It undermines their self-image and self-worth.

Life, Death and Ageism

There are ten studies that measure the impact on longevity. Put simply these studies suggest that if you experience ageism your life will be shorter. Your self-image and your view of ageing are crucial. Ageism attacks both. The 10 studies use longitudinal panels tracking individuals throughout their lifetime. There are studies from all over the world. For example, a US study of people suffering impairment with their everyday living. Those that attributed it to “ageing” had a shorter life.

There is a study of 10,000 Chinese over twenty years. Their sense of “perceived uselessness” was measured every five years. Increased levels of uselessness significantly increased the chance of dying. A study from 25 years ago found a long-lasting effect of positive perceptions of ageing. They lived for 7.5 years longer if they had been more positive 23 years earlier! This advantage remained after allowing for many other factors associated with health and death. This included age, gender, socioeconomic status. They also include loneliness, and measures of health, all 23 years earlier. Other studies have shown that the rate of change of positive and negative perceptions have an added effect.

Intermediate Measures

Other studies have looked at different measures. For example, at assessments of “quality of life” or “poor social relationships”. These variables can be associated with subsequent ill health. There are 44 studies related to the association between ageism and mental health. All but one shows a negative association. The other is inconclusive. Many relate to depression and increasing depressive symptoms over time. Experiences of ageism signal that an individual’s life is worth less. As we saw last week workplace discrimination leads to subsequent clinical depression.

Another 52 studies look at the relationship with physical health. Older people with a more negative attitude to ageing are 31% less likely to recover from a severe disability. At least according to one of the reviewed studies. The onset of chronic diseases seems to come more often and earlier. Across many countries hospitalization seems to be more common for those whose self-image has been damaged by ageism.

In general, all these findings appeared across 45 different countries. There is at least one study on each continent. They were not confined to the developed countries.

Pathways to Health

Many of the studies explored how ageism influenced health. How mental state could influence current and future health. The most obvious is behavioral. If ageing seems “negative and inevitable” people do take less care of themselves. There were 29 studies showing that they exercise less and are more likely to engage in behaviours that are a risk to health. In a study of over 9000 people in Ireland the pattern was clear. A poor self-image about ageing increased smoking and drinking.

Psychological pathway studies show a relationship between ageism and loss of agency and control. They are related to a loss of purpose in life. The need for control and agency is deep seated. There are many studies that show that loss of control is detrimental to health. How the decision to enter a care home is made influences subsequent life expectancy. If a individual decides for themselves, then they live longer than those who did not exercise such control.

There are a few experimental studies on ageism and cognitive ability. These manipulated attitude to ageing and took cognitive and behavioral measures. The most famous did this within a care home setting. The results were that residents became more active physically and mentally. They became more sociable.

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