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David Oliver: What the pandemic measures reveal about ageism

BMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1545 (Published 22 April 2020) Cite this as: BMJ 2020;369:m1545

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Rapid Response:

Ageism in the UK: we need a fundamental shift in culture.

Dear Editor

We are perturbed that all over 70s are being advised to avoid unnecessary social contact and remain largely indoors.(1) In addition, if the lockdown is to be extended for this large group we feel it will be extremely bad for the health of individuals and for the country.

It is clear that ageism is becoming more prevalent during this pandemic.(2) A new report on attitudes to age highlight how widespread negative stereotypes are.(3) Negative stereotypes were found to be common in the media, in workplaces, and in health and social care settings. This is of concern as ageism itself can have a negative impact on physical and mental health.(4-6)

Restrictions instigated in order to protect people should be risk-related rather than purely age-related. Over 70s are 15% of the UK population and are the most diverse age group in our society.(7) A person’s age should not become the sole criterion for isolation or treatment. For example, a 55-year-old with asthma and is obese may be more vulnerable to the COVID-19 virus than a healthy 75-year-old who regularly takes part in energetic exercise.

We know very many fit and active 70+ people who eat healthily, swim, bike, run, weight train, use the gym who know their weight, BMI, blood pressure, have no underlying health conditions who refuse to be patronised and will vote with their feet if this ‘catch all/one size fits all’ discrimination continues beyond what is a reasonable time.

It is important to note that many people in this age group are still making a very active contribution to their communities, many work in a paid or voluntary capacity being vigorous and productive and include media personalities, business people, musicians, politicians and academics alongside those that manage charity shops, for example. There are also those who are active in fighting against COVID-19 by ensuring that vulnerable people are supported, helping with childcare and returning to the NHS and other organisations.

In order to challenge stereotypes about ageing Alex Rotas has been taking photographs of over 60s. Her excellent website has images of people from around the world taking part in a variety of sports and not letting age or societies image of age hold them back.(8) Public health professionals and policy makers who view these images may obtain a better understating about this heterogeneous group.

The World Health Organisation has developed a global strategy and action plan on ageing and health to try and ensure that everyone has the opportunity to experience both a long and healthy life.(9,10) It proposes that a fundamental step in fostering Healthy Ageing is to combat ageism. The strategy recommends that pervasive misconceptions, negative stereotypes and assumptions about ageing and older people need to be tackled by diverse actions including education, legislation, and other interventions to shift social norms.

Most people can now expect to live into their 60s and beyond; and longer lives can be a valuable resource for individuals and the country.(10) Rigid notions about the over 70s is most unhelpful. We urgently need a more nuanced approach for this significant group and need a change of policy, leadership and commitment from the government as we all tackle Covid 19.

References
1) Oliver D. Acute Perspective. David Oliver: What the pandemic measures reveal about ageism. BMJ 2020;369:m1545

2) Brooke, J. and Jackson, D. Older people and COVID‐19: Isolation, risk and ageism. J Clin Nurs. 2020. Accepted Author Manuscript. doi:10.1111/jocn.15274

3) Centre for Ageing Better. Doddery but dear? Examining age-related stereotypes. London: Centre for Ageing Better, 2020.

4) Levy B, Ashman O, Dror I. To be or not to be: the effects of aging stereotypes on the will to live. Omega (Westport). 1999-2000;40(3):409–20.

5) World Health Organization. World report on ageing and health. Geneva: World Health Organization, 2015

6) Chang, E., Kannoth, S., Levy, S., Wang, S., Lee, J.E., and Levy, B. Global reach of ageism on older persons’ health: A systematic review. PLoS ONE 2020, 15(1).

7) Agediscrimination.info. The current UK population. http://www.agediscrimination.info/current-uk-population (Accessed 25/04/20)

8) Rotas A. Alex Rotas Photography. https://alexrotasphotography.co.uk/ (Accessed 25/04/20)

9) Beard, J. R., Officer, A., de Carvalho, I. A., Sadana, R., Pot, A. M., Michel, J.-P., Chatterji, S. The World report on ageing and health: a policy framework for healthy ageing. The Lancet 2016, 387(10033), 2145–2154.

10) World Health Organization. Global strategy and action plan on ageing and health. Geneva: World Health Organization, 2017.

Competing interests: No competing interests

27 April 2020
Michael Craig Watson
Trustee, Institute of Health Promotion and Education.
Dr John Lloyd, Honorary Vice President, Institute of Health Promotion and Education.
Institute of Health Promotion and Education, PO Box 7409, Lichfield WS14 4LS, UK. http://ihpe.org.uk/