Ageism

 The following is from the Lancet, published in March 2021.

On March 18, 2021, the Global Report on Ageism was launched by WHO, the Office of the UN High Commissioner for Human Rights, the UN Department of Economic and Social Affairs, and the UN Population Fund. Combating ageism is one of the four action areas of the Decade of Healthy Ageing (2021–2030). Changing how we think, feel, and act towards age and ageing is a prerequisite for successful action on healthy ageing and for progress on the three other action areas of the Decade of Healthy Ageing: developing communities that foster older people's abilities, delivering person-centred integrated care and primary health services responsive to older people's needs, and providing long-term care for older people who need it.

The COVID-19 pandemic has taken the lives of many older people, it has also exposed ageism in different settings—eg, discrimination in access to health care, inadequate protection of older people in care homes and of young people's mental health, and stereotypical media portrayals that pit generations against each other.

Consensus on the meaning of ageism has remained elusive and there is insufficient evidence on the topic. The Global Report on Ageism highlights that ageism can be institutional, interpersonal, or self-directed and summarises the best evidence on the scale, impacts, and determinants of ageism against both older and younger people and the most effective strategies to address ageism. Ageism is an important social determinant of health that has been largely neglected until now.

Like all forms of discrimination, ageism generates divisions and hierarchies in society and influences social position on the basis of age. Ageism results in various harms, disadvantages, and injustices, including age-based health inequities and poorer health outcomes.

Globally, ageism affects billions of people: at least one in two people hold ageist attitudes against older adults, with rates much higher in lower-income countries. In Europe, the only region for which data about ageism are available for all age groups, one in three people have experienced ageism.

Ageism impacts all aspects of older people's health. For instance, it shortens their lifespan, worsens their physical and mental health, hinders recovery from disability, and accelerates cognitive decline.1 Ageism also exacerbates social isolation and loneliness and reduces access to employment, education, and health care, all of which impact health.

As the Global Report on Ageism shows, ageism places a heavy economic burden on individuals and society, including in health-care costs. Annually, ageism accounts for US$1 in every $7—or $63 billion—spent in the USA on health care for the eight conditions with the highest health-care costs among people aged 60 years and older.12

The evidence reviewed in the report shows that three strategies are effective to reduce ageism: policy and law, education, and inter generational contact interventions. Policy and law can address discrimination and inequality on the basis of age and protect human rights. Educational interventions across all levels of education can correct misconceptions, provide accurate information, and counter stereotypes. Inter generational contact interventions are among the interventions that work best to reduce ageism against older people and could also have a role in combating ageism against younger people.

The Global Report on Ageism makes three recommendations for concrete actions that all stakeholders can take to combat ageism. First, invest in effective strategies to prevent and respond to ageism. Second, fund and improve data and research to better understand ageism and how to address it. Third, build a movement to change the narrative around age and ageing. The promise of the Decade of Healthy Ageing can only be fully realised if ageism is recognised as a social determinant of health and tackled.