LeadingAge Magazine · July-August 2019 • Volume 09 • Number 04

If the world is a global village, this is perhaps no more evident than in the phenomenon of aging and ageism. In developing and developed countries alike, stereotypes, discrimination, and loss of civil rights for older persons are serious problems. Given increased longevity and lower fertility rates, older persons represent a significant part of every population and call for an energetic response.

From the UN and WHO to LeadingAge, a remarkably diverse number of organizations are working at many levels to combat ageism in most corners of the globe.

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Ageism Across the Globe

Alana Officer is a senior health adviser in the Department of Ageing and Life Course at the World Health Organization in Geneva. She said that it is a common mistake to think ageism is a challenge only in the developed world.

“Ageism is everywhere: health care provision, employment, education, the media. While cultures and contexts vary widely, attitudes toward older persons are predominantly negative, with older age all too commonly seen as a period of inevitable decline and frailty.”

Kate Bunting, executive director of HelpAge USA, says “There’s a myth that all older people are revered and cared for by their families in developing countries. The reality, though, is that traditional care and support structures have frayed due to a variety of social and economic factors, and older people cannot solely rely on their families to meet their needs. For example, the effects of globalization on migration patterns have left many grandparents as the primary caretakers for children. The widespread impact of HIV has also led to ‘skipped generation’ families with older people as the heads of households with children.”

“Cohesive family units are breaking apart,” says Katie Smith Sloan, president and CEO of LeadingAge. “Young people are moving to urban areas, while older people are left alone in rural areas, where it was always expected that children would care for parents. In Korea, for example, we see a high rate of suicide among older people with no support system.”

“There’s a myth that all older people are revered and cared for by their families in developing countries. The reality, though, is that traditional care and support structures have frayed due to a variety of social and economic factors, and older people cannot solely rely on their families to meet their needs.”

Officer cites a recent study of 57 developed and developing countries, which demonstrated that levels of respect for older people was low across all income groups. She quoted another study examining ageism over the last 200 years and found that it has increased in a relatively linear way, especially in terms of negative age stereotypes.

“We tend to see older age as a burden,” says Officer, “and then the tendency is cost containment, and not making the investments needed for people to age and live well. But there is no age limit to people’s human rights, and countries need to ensure that they provide the systems and services required to foster healthy aging.”

The Global Aging Phenomenon

How is it that ageism is now visible as a global problem? Two primary causes exist: medical advances have greatly reduced mortality rates across the world, and the number of children born to each woman is falling. In consequence, for the first time in history, there are more people over age 65 than under age 5. By 2050, according to the UN’s Office of the Commissioner of Human Rights, more than 1 in 5 of the world’s people will be 60 or older.

“This aging population is making us more aware of the prevalence of ageism,” says Sloan. “And it’s an opportunity to address ageism head-on, to recognize the value of older adults as contributing members of their societies.”

Meeting the Challenges of Demographic Change

Given these dramatic demographic changes, how can countries ensure that older persons, even as they become vulnerable, can remain productive members of their societies? A recent WHO report says, “There is mounting evidence from cross-national data that—with appropriate policies and programs—people can remain healthy and independent well into old age and can continue to contribute to their communities and families.”

There are an impressive number of national and international groups focused on the needs of older persons on every continent. Frequently taking the form of networks, they bring together communities and experts to identify and solve the global challenges of ageism.

Global Ageing Network

The Global Ageing Network (GAN) was founded in 1994 to connect and support care and service providers worldwide. LeadingAge is a founding member, and its Executive Director is LeadingAge’s President and CEO, Katie Smith Sloan. The Global Ageing Network encourages and shares innovations in aged care, services, supports, and housing. Members span the globe, from IAHSA-China to the South African Care Forum to the Malawi Network of Elderly Persons Organisations and many more. The Global Ageing Network will hold its Biennial Global Ageing Conference in Toronto this year, in partnership with another member organization, the Ontario Long Term Care Association.

(For more on the conference, see the article in this issue, “The 2019 Biennial Global Ageing Network Conference.”)

Leading Age Services Australia joined the Global Ageing Network in 2017. Tim Hicks, general manager for policy and advocacy, says “Like the rest of the world, Australia’s older population is in a state of transformation. Membership in the Global Ageing Network means that we are part of a network with rapid access to ideas and innovations across the country.”

HelpAge

HelpAge was established in 1983, and now has 130 network members and many more partners in 80 countries across the world. Each member has its own, on-the-ground focus.

“For example,” says HelpAge USA CEO Kate Bunting, “government pensions can help to cover basic health costs, to support other family members, and to send children to school. So, we are learning how to educate governments and help them set up these pensions.” In Thailand, HelpAge International helped expand the non-means-tested pension in 2009 and, today, 85% of the population aged 60 and above receive it.

“There is mounting evidence from cross-national data that—with appropriate policies and programs—people can remain healthy and independent well into old age and can continue to contribute to their communities and families.”

Bunting also described HelpAge’s work in Tanzania to end the persecution of older women as witches.

“Often, an accusation of witchcraft is a way to grab a woman’s land, sometimes by a relative,” Bunting says. “So, HelpAge works to help older women understand their rights and obtain the title to their land. HelpAge also works with the community to examine how such land grabs are happening.”

The International Longevity Centre (ILC) Global Alliance

Founded in 1979 in the United States and Japan, the ILC Global Alliance now has members across the globe. The Dominican Republic was the first developing country to join.

“Member organizations carry out the ILC mission through developing ideas, undertaking research and creating forums for debate and action in which older people are key stakeholders,” says Rosy Pereyra, MD, a geriatrician based in the Dominican Republic and head of the ILC there. “The ILC was created to study global aging and its implications, and to present these findings to the United Nations. One challenge is to present aging as an opportunity, not a problem.

“We think we are a young country, but we are aging and our society as a whole is only now waking up to this reality. We have to instruct the younger generations that all people have the same rights. Age discrimination is rampant in media, television, radio, comics, and education itself. Jobs listings often require candidates under the age of 35, even though this is against the law.”

Pereyra and the ILC are working with the Dominican Republic’s National Council for the Elderly, to shape supportive actions and policies for health, pensions, and housing. They are working with Santo Domingo’s mayor to promote the creation of an age-friendly city. And she emphasizes that while sustainable development goals are important, “The needs of older persons must be addressed in these goals. They cannot be left behind.”

The Centre for Dignified Ageing in Rwanda

The Centre for Dignified Ageing/Sazana is a small, local, faith-based organization addressing the rapidly changing needs of elders in the Muhanga district of Rwanda, according to Katharine Hobart, Ph.D., a member of Boston University’s School of Social Work faculty who provides the Centre with curriculum development and program evaluation assistance. Supported by private donors and church groups, the Centre targets many of the same challenges addressed by larger networks such as HelpAge and the ILC Global Alliance.

“Women outnumber men 2 to 1 among the very old, and elders are concentrated in rural areas where poverty is often accentuated and access to basic services is limited,” says Hobart. “And aging in Rwanda has been shaped by the 1994 genocide, which added stress to the already rapidly changing kinship patterns of care.

“The Centre’s projects include, for example, an elder's agricultural collective to generate income from growing cassava, mushrooms, and pineapples; community sensitization projects including celebrating worldwide Elder Day; rural preventive health screenings for elders for diabetes, high blood pressure and HIV; and the creation of elders credit and savings groups.”

The European Union’s Equinet for Employment Fairness

The European Network of Equality Bodies, or Equinet, serves the EU much like the U.S. Equal Employment Opportunity Commission (EEOC) does in the United States. Equinet represents 49 organizations in 36 European countries, according to Deputy Director Tamás Kádár, based in Brussels.

“While discrimination and stereotypes have always been present,” says Kádár, “older people are becoming more vocal in refusing such treatment.”

In Europe, according to Kádár, “there is a lack of comprehensive legal protection against age discrimination, and even where such protection is provided, age discrimination is considered less significant. Age seems so natural a distinction. We say that an older person should already be retired, should not have travel insurance, does not need a credit card.

“And we see ageism even in the courts. Judges seem ready to accept that worse health, or physical weakness, are natural conditions of aging. Technologies, while useful, can also be a problem. Age-based algorithms in the insurance and financial industries may limit access to products. Vendors will argue that such refusals are financially prudent, even though there are a variety of other ways to protect their business.”

The highest number of cases received by Equinet’s member national equality bodies are employment-related, involving dismissal or refusal to hire based on age. An employer may state a need for physical strength in a police department, for example, even though the job may be office-related. Or an applicant aged 40 may be refused for fear of early retirement.

“Age is easy to measure,” says Kádár, “but in general is not a good reason for refusing employment. People are realizing that age discrimination is a real issue, and this is a huge achievement given that age stereotypes are so widespread. Governments and companies are thinking more about age categories in legislation, and older persons are recognizing that they have rights to equal treatment.”

People are realizing that age discrimination is a real issue, and this is a huge achievement given that age stereotypes are so widespread.

Convention on the Rights of Older Persons

In 2010 the UN General Assembly established an Open-Ended Working Group on Ageing (OEWG) to address the situation regarding the human rights of older persons, and to consider the possibility of further measures. Its eleventh meeting will be held in 2020.

“Older people’s rights are mostly invisible,” according to one OEWG document. “Only one international human rights convention (concerning migrant’s rights) mandates against age discrimination.” Not surprisingly, there is growing interest in a United Nations Convention for the Rights of Older Persons.

Margaret Gillis, president of ILC Canada, says, “We know that United Nations Conventions work. For example, since the Convention on the Rights of the Child came into force in 1990, the number of child laborers has dropped by a third.

“A convention does many things. It allows advocates to track progress and hold governments accountable for transgressions and inaction. It clarifies the responsibilities of governments, establishes laws and policies, and calls for data collection and regular reporting. And a convention will encourage older persons themselves to speak openly.”

Jane Sherwin is a writer who lives in Belmont, MA.