Q. What group endures widespread bias and negative stereotypes — yet is one we all want to join someday?
A. Older people. Also called seniors, elderly, geriatrics, blue hairs, codgers, over-the-hill crowd and a few other monikers inappropriate for publication.
The bias against older people is widespread throughout our culture and in healthcare. Ageism is our society’s accepted ideas about old age that portrays aging and older people in stereotypical, often negative, ways.
Healthcare marketers and communicators have a great opportunity to influence how we represent older adults in marketing, branding and media platforms. We can balance our need to target audiences that share characteristics while becoming aware of the harm ageism in healthcare can have on older adults.
The awareness and attitudes around sexism, racism, ableism and LGBTQIA discrimination have made tremendous progress in the last few years. Ageism, however, has become even more pervasive during the pandemic.
A 2019 Harvard study on attitude patterns revealed a dramatic drop in implicit bias toward gay people — 33% in one decade. If the trend this data indicates continues, anti-gay attitudes will be eliminated in the American mindset in nine years. But what about bias against the elderly? According to the study, it will take 138 years to reach that same neutral point for age bias.
What is ageism? Why is it a problem?
Ageism makes assumptions about someone based only on their age. Those assumptions often include an individual’s cognitive and physical abilities, interests, goals, tastes and preferences.
As with other prejudices, ageism overlooks the uniqueness of each person. By painting everyone with the same brush, ageism renders the members of this group invisible. And when a society accepts this bias, it unconsciously considers the group less human or less valuable than other groups. Disregard, oppression, isolation and abuse can follow.
The golden years don’t sound that golden for many older adults who experience ageist attitudes.
Ageism has negative consequences for all of society, not just older adults. By devaluing and making assumptions about older people, we block their contributions and participation in the workplace, the economy, the culture and relationships.
Embracing diversity of all types, including every age group, makes us better, smarter, stronger, more creative and richer in many ways.
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The consequences of ageism in healthcare
Healthcare is the arena where ageism may do the greatest harm. Overtreatment and undertreatment may sound like opposite ends of the spectrum, but they are both proven areas of concern when caring for older patients.
The research on ageism in healthcare is pretty grim. An international study shows doctors and other health professionals spend less time with older patients. Providers often dismiss symptoms such as fatigue and pain as unavoidable due to aging rather than look for underlying causes and provide treatment. Depression and anxiety are overlooked or ignored as just part of getting old. Physicians are less likely to involve older patients in medical decision-making since explaining the options can require more time.
The reverse, too much treatment, is also an issue. Older adults are often overtreated — enduring tests, undergoing surgeries and taking medications that do more harm than good without regard for the patient’s goals. Overtreatment involves a lot of factors, but better conversations between providers and patients are essential to solving them.
Self-ageism or internalized ageism also contributes to undertreatment, poor health and shorter lives. As we accept and believe ageist attitudes about ourselves, we are less likely to seek treatment as we grow older. Studies show that those who hold negative perceptions of growing old are less likely to pursue healthcare or adopt healthy habits such as quitting tobacco, exercising and healthy eating. Having negative views about growing older can be linked to an earlier death by 7.5 years.
Steps to avoid ageism in healthcare marketing
With ageism so entrenched in healthcare and the culture, it can seem overwhelming to advocate for change. But as healthcare marketers and content creators, we can bring age bias awareness to the forefront. We can make a difference. Here are some practical steps we can take to be part of the solution (and maybe add 7.5 quality years to our own lives).
Recognize implicit age bias
We all may be unaware of prejudices we hold about older people or aging. Implicit bias involves unconscious, automatic preferences for certain groups.
Laura Allen, published researcher and Ph.D. candidate in gerontology, explains, “Ageism is more invisible than other types of bias. All of us know older people, so we tend to be less aware of our prejudice. It feels more acceptable, less hostile or judgmental than other types of bias. But we know how harmful these stereotypes can be to older adults and our future selves.”
Awareness is a good first step. The Harvard Implicit Association Test (IAT) for age takes just a few minutes and can reveal attitudes and stereotypes we didn’t even think we held.
Watch our language
As healthcare communicators, what are we supposed to call older people? AARP has a great list of what’s cool, what’s not cool, and what’s just mean when referencing members of older generations. Semantics is as essential as accuracy. And the language we use can evolve, as it does for other groups that experience discrimination.
People are living longer than ever before. Yet that fact is often considered a problem or a burden rather than a triumph. Human life expectancy has doubled in a century. Author Steven Johnson (and others) regard that as humanity’s greatest accomplishment!
The Gerontological Society of America offers an excellent toolkit for their Reframing Aging initiative. Their Quick Start Guide is a handy reference to help healthcare communicators use terms that frame aging and older people as positive for our world. Pro tip: grey tsunami is not a preferred term. Talking positively about Americans living longer and healthier lives gets a thumbs up.
Distinguish between the realities of aging and ageism
As healthcare marketers, we need to convey information about health and healthcare services for older adults. The reality is that health challenges like hearing loss and memory issues may occur as we age. The risk for arthritis, heart disease, cancer and diabetes is higher in older adults. But those deficits and diseases don’t happen to everyone — and not at the same age. Make sure your content reflects that range of experience, being careful not to assume every 65 or 85-year-old is alike.
For instance, some, not all, people experience a loss of taste sensation in later years. Knowing that, content about eating a low-sodium diet should go beyond “cutting back on salt” and include information on adding flavor to food in other ways.
When covering senior housing options or memory loss topics, consider addressing the older adult directly in your content rather than a caregiver. For example, say, “if you experience problems such as…” instead of “if your loved one is experiencing…”
The Center for Medicare and Medicaid toolkit gives you more points to consider when preparing material directed to older adults. Fortunately, the techniques they suggest help everyone understand your content better since low health literacy crosses all generations.
Jenelen Dulemba has worked in aging for more than 30 years, directs a hospital older adult resource program and trains volunteers in aging sensitivity. She points out, “Humans are most alike at birth. We spend our lifetimes becoming less similar. That’s a lot of diversity.” The key to avoiding stereotypes comes from respecting people as individuals while understanding the changes affecting older adults.
Content that is positive, recognizes differences, doesn’t patronize and is easy to understand is just as important for an older audience as other generations.
Make your marketing inclusive and diverse
In her research, gerontology researcher Allen found that the media usually portrays older people in one of two extremes — the healthy and happy retiree or the frail and sick older person.
“One thing we can do in marketing materials is to be just as inclusive of older people and portray them in just as diverse a way as any other group you would be targeting,” she says.
Both healthcare marketers and journalists could benefit from training to avoid ageism. Allen co-authored an article in The Gerontologist about her study of newspaper coverage of COVID-19 in long-term care settings. She found that out of 54 articles published by major newspapers from January 21 to May 8, 2020, none (zero) directly quoted a long-term care resident. Instead, journalists substituted the voices of family members for resident voices, diminishing the experience of those most affected.
The lesson here is to choose our words, images, stories and sources to reflect the full spectrum of human experience. We need to challenge ourselves to think outside the box and be more diverse when we market to and about older adults. The result will be content that is fresher, more authentic and more likely to reach a new audience that previously felt excluded.
We’re passionate about eliminating ageism in healthcare. If you are too, here are some good resources to explore:
- Download The World Health Organization’s (WHO) publication, Campaigning to Tackle Ageism: current practices and suggestions for moving forward.
- Investigate The United Nations Decade of Healthy Ageing designated from 2021-2030. Their insightful articles and newsletter include the latest about COVID-19 and older adults.
- Read This Chair Rocks, A Manifesto Against Ageism. Author Ashton Applewhite’s website includes a TED talk, blog and clearinghouse of anti-ageism resources. Applewhite busts many myths about aging, helping us all feel more optimistic.
- Get to know Louise Aronson, author of Elderhood, a Pulitzer Prize finalist for her book about redefining aging, transforming medicine and reimaging life. She also makes appearances, so she might be a good choice for speaking to your organization.
Have you or your organization added age bias awareness to your diversity and inclusion initiatives? We’d love to hear from you! Tell us all about it by emailing firstname.lastname@example.org.
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