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Diversity in Medicine: Age

Ashton Applewhite shares that we are happiest at the beginning and ends of our lives: The "U-curve of happiness," however there is a lack of knowledge about the happiness at the end of life. She pinpoints this lack of awareness on ageism, the discrimination and stereotyping on the basis of age. 

Takeaways: 

  • Ageism goes both ways; when someone assumes a person is too old to do something, or too young. 
  • All -isms are socially constructed ideas; rasism, sexism, homophobia. We make them up and they can change over time. 
  • Ageist behaviors: 
    • Heading to people your own age at parties. 
    • Grumbling about entitled millennials. 
    • Rejecting a haircut, a relationship, or an outing because it is not age-appropriate. 
  • Ageism starts in early childhood, around the same time as attitudes to race and gender start to form.
  • There is no line in the sand between young and old, one area this is detrimental to is the workforce where ageism cuts work lives short. Not one stereotype of older workers hold up under scrutiny. Diverse companies are not just better places to work, they work better, and just like race and sex, age is a criterion for diversity.  
  • Ageism disproportionally affects women through a double whammy of ageism and sexism. This is further compounded by race and by class and the poorest of the poor are old women of color. 
  • Ageism is a global human rights issue. Everyone-- all ages, all genders, all nationalities-- is old or future old. Unless we put an end to it, ageism will oppress us all. When we make the world a better place to grow old in, we make it a better place to be from somewhere else, to have a disability, to be queer, to be non-rich, to be non-white. 

Life has three major stages: Childhood, adulthood, elderhood. 

  • When aging adults are polled about their preferences among the words for old age (senior, old, elderly, geriatrics) results showed that no one liked any of them. 
  • The problem is not with the word old, it is how we think about old age
  • Elderhood has the challenge of being a stage which ends in death, but far more important than our deaths is the quality of the living that proceeds them.
    • We know we can influence the human quality of life & lifespans. In shaping our experience of elderhood, when we live matter as much as where. 
      • In the United States in the 1900 the average age of death was 49 and now it is 79. Today the wealthiest, higher income  Americans live 10-20 years longer than poor Americans. There is a 50 year difference in lifespan between the people of Botswana and those of Japan. 
  • Old age is generally viewed as beginning between ages 60 and 70. Living into elderhood gives us more years to enjoy life and to contribute to the world. 
  • Medicine is not objective or impartial, it is a microcosm of societal blind spots and biases. 
    • The CDC recommends 17 vaccine schedules for birth to age 18, and three or four adults between 19 and 64, but in 2020 still only recommends one schedule for all those over 65. 
    • Medical schools devote months to pediatrics, years to adult medicine, but at best just weeks to geriatrics. 
    • Medical research also displays disparities: in 1986 the NIH mandated studies include women and minorities, because when treated based off research that excluded them because they were different, they reacted differently to the treatment. In 1998 they mandated children be included for the same reasons. Inclusions of elders did not occur until 2019. 

Elderhood is different than childhood or adulthood. Often we blame old age for problems we have created or neglected but we need to apply to it the same care and creativity that we already apply to childhood and adulthood. When we are in elderhood we do not want to be met with self defeating stereotypes and needless limitations. We want what we have always wanted: opportunities, a society that recognizes our unique strengths and a culture that responds to our limitations with creativity and innovation. Like people of all backgrounds and ages, we want equity in language, healthcare, parks, home design and everything else. 

Last updated on Nov 30, 2022 4:12 PM