Introduction by Croakey: The first Ageism awareness day is being held in Australia today, October 1st, aligning with the UN’s International Day of Older Persons. It aims to draw attention to the existence of ageism in Australia, and globally.
Given the inequities exposed by the COVID-19 pandemic, there is no better time to recognise the discrimination faced by older people in society today. The UN’s theme for 2021 is ‘Digital Equity for All Ages,’ which again follows issues brought to light this past year when confidence and literacy in the use of technology was a requirement to be able to stay connected with loved ones, in turn leaving many older people feeling isolated.
Addressing ageism, and all its consequences, is a collective responsibility, writes Masters student Alison Ainsworth. Her article below won the Public Health Association of Australia’s (PHAA) National Student Think Tank Competition and is the first in a series of three articles from the competition.
Alison Ainsworth writes:
The COVID-19 pandemic has exposed and amplified existing health inequities among populations throughout Australia, and globally. Here, we examine how public health teams can respond to inequities affecting our older population, as recent studies show COVID-19 is widening the structural and social inequities that already exist for this population – whether they are in the community, residential care or hospital.
Amid the pandemic, it has become more evident that our health is socially determined. Investing in infrastructure to improve the circumstances in which people grow, live, work, and age, and the systems put in place to deal with illness is critical in supporting healthy ageing.
Discussed below are two issues affecting the health of older people and how public health policies can respond to the inequities they cause.
The first issue is ageism, defined by the World Health Organization (WHO) as the stereotypes, prejudice and discrimination towards others or oneself based on age, and the second issue is social isolation, defined by experts as an absence of social interaction or a lack of contact with others.
Ageism is the most socially normalised and tolerated form of discrimination, according to the WHO, which estimates that one in two people are ageist against older people.
Data released last week by the Australian Human Rights Commission also showed that 60 percent of Australians stereotype people and make assumptions because of their age and 63 percent have experienced ageism in some way.
Older people are commonly viewed as onlookers rather than active participants in society, with increasing frailty and ill health, and declining competence, according to the Commission’s report.
They are also portrayed as a passive, vulnerable and homogeneous group, when in fact they are extremely diverse, culturally and socially, in their health and how they age.
Such stereotypes can be harmful and perpetuate age discrimination and exclusion which affects intergenerational solidarity.
Physical, cognitive and mental impact
The COVID-19 pandemic has amplified harmful attitudes toward older people, that largely go unrecognised or unchallenged, and intensify intergenerational conflict.
As of 30 September, people over the age of 70 have accounted for 86 percent of COVID-related deaths, and research worldwide has shown a clear association between risk of severe disease and age, but the risks are not uniform.
Early in the pandemic, COVID-19 was portrayed as a disease affecting old people, and this belief led to older people being marginalised and positioned as more expendable than other age groups. It exposed disturbing public discourse that pitted the young against the old, demonstrated by the trending social media hashtag #boomerRemover, which calls for older people to sacrifice themselves for the benefit of society.
The impact of ageism on the physical, cognitive and mental health and wellbeing of older people is immense. Studies show ageism is associated with poorer health outcomes, decreased quality of life and increased risk of social isolation. The impact is greater for those who are also subject to discrimination based on other characteristics such as socio-economic status, disability, race, gender or sexual orientation.
Globally, there is a move to recognise the impact of ageism, led by the World Health Organization. This agency outlines that the issue requires a multisectoral and multifaceted approach through policy, education and intergenerational contact. The Human Rights Commission report stated that ageism has been so normalised in society that we often don’t even know it happens or recognise it.
The first step, therefore, is to raise awareness of what it is, who it affects and how it affects health and wellbeing, and how it intersects with other forms of discrimination.
Our political leaders and governments across all levels have a responsibility to drive change in the narrative from older people being a burden, to recognising their diversity and value to society. This is especially important in communication and decisions about the pandemic, where people of all ages are affected and at risk.
The diverse needs and perspectives of older people need to be central to informing and developing policy. In contrast to paternalistic and patronising approaches, it’s thought co-development of interventions will help to mitigate ageism and will also ensure they are inclusive and appropriate. It will also allow for policy to benefit from the experience and wisdom older people have to offer.
The media also play a significant role, both in how older people are framed and in raising public awareness to tackle ageism, and in promoting the social cohesion and cooperation that we need during a pandemic.
Advocacy coalitions, such as EveryAGE Counts in Australia, are working to bring about social change through political engagement and public campaigning.
Studies also show educational interventions, that are incorporated into formal education settings and workplaces are effective, especially when they promote intergenerational contact.
In emergency situations, such as the pandemic, intergenerational solidarity is a major asset and a time when we need it most.
The importance of social connection
Before COVID-19, social isolation was already a significant issue for our older population, affecting an estimated one in five people in Australia. COVID-19 restrictions on movement and social gatherings have increased the prevalence of social isolation and loneliness further in this group, especially for our culturally and linguistically diverse communities, as well as those living in long-term care facilities.
Ageism further increases the risk of social isolation, acting as a barrier to social participation or causing negative feelings that lead to social withdrawal. Social connection is a vital and much under-recognised determinant of health and research shows social isolation is a risk factor for a range of health conditions and premature death.
The increased attention on social isolation brought about by the pandemic provides us with an opportunity to address this persisting issue beyond COVID-19. At a local level, integrated support networks through charities, volunteers, and community health and social work services can provide meaningful social support to older people, especially those who are particularly vulnerable.
Creating safe ways for volunteering during COVID-19 can not only provide a support network to older people, but can be a critical means of social participation for volunteers themselves, as well as a mechanism for intergenerational contact.
Connecting virtually has become an important means for staying socially connected during physical distance measures, but data from before the pandemic showed 74 percent of Australians aged 70 and over are digitally disengaged – not because of the myth that they can’t learn new skills, but often because of a lack of opportunity to learn and engage with technology.
For example, the 2018 report on the digital behaviours of older Australians found that 62 percent of older Australians have never made a video call and 58 percent have never used social media message or chat functions, citing lack of trust and confidence.
We urgently need to improve access to the internet, provide computers or tablets and equip older people with digital skills through training and support. The Federal Government’s ‘Be Connected’ program is showing promise in improving digital inclusion for older people, but we need to ensure interventions target those most in need.
In conclusion, ageism and social isolation are significant public health issues for older people and have been further amplified by the COVID-19 pandemic. Addressing ageism is a collective responsibility to reframe the ageing narrative and promote intergenerational solidarity.
See here for Croakey’s archive of stories on aged care.
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