An old woman goes to her doctor to complain about pain in her knee and he says, “Oh, you’re getting older so if your knee hurts, that’s just a part of aging.”  

“Well, my other knee is just as old and it doesn’t hurt,” replies the woman. This anecdote is not meant to be a joke but it is funny. And it shows an implicit ageist bias by the doctor.

Dr. Julie Allen surveyed 2,048 seniors, ages 50-80, and she found over 93% reported regularly experiencing one or more forms of ageism. Allen said that common everyday ageism stresses out seniors and her study found age discrimination was associated with four health indicators just as racism has been linked to poor health outcomes.

“Everyday ageism may serve as a chronic source of stress in the lives of older adults and this contributes to accelerated aging, increased risk for a broad range of health issues, as well as premature mortality,” Allen said.

She said ageism is embedded in our healthcare system. For example, health care professionals assume seniors will need certain types of care and they are less likely to give diagnostic tests. 

“So older adults who actually make the effort to seek care, leave not having received what they need and should have,” she said. Seniors are routinely excluded from clinical trials, she added.

“Studies have shown ….if older adults feel patronized or misunderstood or are actively discriminated against when they do seek care, they may be less likely to seek health care services in the future,” Allen said.

Julie Ober Allen, PhD, MPH, is an Assistant Professor of Health Promotion at the University of Oklahoma and an Adjunct Faculty Associate at the University of Michigan Research Center.

Examples of Garden Variety Ageism

Everyday ageism is defined as “brief verbal, nonverbal, and environmental indignities that convey hostility, a lack of value, or narrow stereotypes of older adults. Examples abound.

Seniors hear jokes about old age or having a “senior moment”; they see plenty of  anti-aging commercials. They might believe that having health problems is just part of getting older; they may believe, as many non-seniors do, that feeling depressed, sad, or worried is normal if you are older.

People assume seniors will have difficulty using cell phones or computers; they have trouble understanding or remembering things; younger people insist on helping when none is needed; they assume seniors do not do anything important or valuable. And seniors internalize negative messages and disparaging thoughts about themselves.

“Associating poor health with old age may be the most deeply rooted aging stereotype, despite evidence to the contrary (for example, 82.3% of participants in the current study rated their physical health as good or better),” wrote Allen.

But something else is going on, namely, that many seniors understand that managing chronic illnesses like diabetes will add years to their lives. Furthermore, as you age, eating less meat, and more fruits and vegetables, will do the same. And if you stay active, your life will be full and happy until very near the end when death will come quickly.  

The Impact of Ageism on Women

“It turns out women get older in larger numbers than men,” said Dr. Louise Aronson. She is a leading geriatrician, professor, and author of the bestseller, Elderhood: Redefining Aging, Transforming Medicine, and Reimagining Life.

Here are the facts:  for people 65 and up, there are 79 men for every 100 women; for people 65-74, there are 88 men for every 100 women: and for people 85 and older there are only 53 men for every 100 women. The gap between the sexes is getting smaller in the United States but for all the wrong reasons.

“It’s because women are dying more because there’s more obesity. There’s more women smoking and there’s more women drinking too much. So it would be better if the gap was getting smaller because we were helping men not to die but unfortunately that’s not what I can report,” Aronson said.

Gendered ageism is when sexism and ageism happen together. The effect is augmented partly because of money. Women make about 82 cents on the dollar for all ages. “If you are an older woman of color you have racism, sexism, ageism together,” she said.

Louise Aronson, MD MFA, is a leading geriatrician, writer, educator, professor of medicine at UCSF and the author of the New York Times bestseller and Pulitzer Prize finalist Elderhood: Redefining Aging, Transforming Medicine, and Reimagining Life.

Aronson said that women are evaluated as being less valuable, less competent, and are more likely to be fired with the same qualifications and performance reviews as men.

“Across all ages, Black and Latino women make only 65% of what a White man makes for doing the exact same work and having the exact same level of education. Even Black women with advanced degrees only make 70% of what White men make with advanced degrees.”

Aronson noted that because women have less income, their contributions to retirement funds are smaller. Women miss time on maternity leave, miss time on sick childcare or taking care of older relatives. All of these things add up to a double or triple financial jeopardy. Women enter old age with less money and fewer resources than men.

Aronson said women are more burdened than men as they age. “Women are much more likely to be informal caregivers, unpaid caregivers. Most caregiving in this country is done by women…In long term care, for instance, 90% of the poorly paid caregivers are women.

As they grow old women are more likely to be poor, more likely than men to have chronic diseases, to have more disabilities, more pain, and a lower sense of well-being.

“We know loneliness is really bad for the health but it’s often because they have outlived their husbands. As a result of caring for their husbands before their deaths women are more likely to be institutionalized in institutions that have a lower quality of care. We know women of color are more like to be in those lower quality institutions and we know people who are in low equality nursing homes are more like to die of everything,” Aronson said.

The Rethinking Aging Initiative is a long term social research project with the aim of shifting peoples’ understanding of aging and changing how people talk about it. The website is here: https://www.reframingaging.org

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