Abstract
Age discrimination (or ageism) is pervasive in society. Other forms of discrimination (such as racism) have been linked with adverse health outcomes, but age discrimination has not been well studied in public health. We aimed to examine associations between perceived age discrimination and health and wellbeing in England. We did a longitudinal observational population study with data from the English Longitudinal Study of Ageing, a nationally representative sample of older men and women. Participants were aged 50 years or older and reported experiences of age discrimination via a face-to-face computer-assisted personal interview and a self-completed questionnaire between July, 2010, and June, 2011. Self-rated health, chronic health conditions, and depressive symptoms were assessed between July, 2010, and June, 2011, and between May, 2016, and June, 2017. We used logistic regression to test cross-sectional associations between perceived age discrimination and baseline health status and prospective associations between perceived age discrimination and incident ill health over 6 years. Analyses were adjusted for age, sex, and wealth. Our sample for cross-sectional analyses of 2010-11 data comprised 7731 people who took part in the face-to-face interview, returned the self-completion questionnaire, and had available data for age discrimination. Perceived age discrimination was reported by 1943 (25·1%) participants. Patients who perceived age discrimination were more likely to self-report fair or poor health (odds ratio [OR] 1·32 [95% CI 1·17-1·48]) and to have coronary heart disease (1·33 [1·14-1·54]), chronic lung disease (1·37 [1·11-1·69]), arthritis (1·27 [1·14-1·41]), limiting long-standing illness (1·35 [1·21-1·51]), and depressive symptoms (1·81 [1·57-2·08]) than those who did not perceive age discrimination. Follow-up data collected 6 years after the baseline assessment were available for 5595 participants. Longitudinally, perceived age discrimination was associated with the deterioration of self-rated health (OR 1·32 [95% CI 1·10-1·58]) and incident coronary heart disease (1·66 [1·18-2·35]), stroke (1·48 [1·08-2·10]), diabetes (1·33 [1·01-1·75]), chronic lung disease (1·50 [1·10-2·04]), limiting long-standing illness (1·32 [1·10-1·57]), and depressive symptoms (1·47 [1·16-1·86]) over 6 years. Among older adults living in England, perceived age discrimination was associated with increased odds of poor self-rated health and risk of incident serious health problems over a 6-year period. These findings underscore the need for effective interventions at the population level to combat age stigma and discrimination. UK Economic and Social Research Council.
Highlights
Populations in England and other countries are growing older
Patients who perceived age discrimination were more likely to self-report fair or poor health and to have coronary heart disease (1·33 [1·14–1·54]), chronic lung disease (1·37 [1·11–1·69]), arthritis (1·27 [1·14–1·41]), limiting long-standing illness (1·35 [1·21–1·51]), and depressive symptoms (1·81 [1·57–2·08]) than those who did not perceive age discrimination
Perceived age discrimination was associated with the deterioration of self-rated health and incident coronary heart disease (1·66 [1·18–2·35]), stroke (1·48 [1·08–2·10]), diabetes (1·33 [1·01–1·75]), chronic lung disease (1·50 [1·10–2·04]), limiting long-standing illness (1·32 [1·10–1·57]), and depressive symptoms (1·47 [1·16–1·86]) over 6 years
Summary
Populations in England and other countries are growing older. Over recent decades there has been a marked increase in the number of older adults, because of increases both in the total size of the population and the proportion who survive into old age.[1] Ageism, which is defined as “systematic stereotyping of and discrimination against people because they are old”,2 is prevalent in society, and a substantial proportion of older adults report experiencing age-related discrimination in their everyday lives. In surveys of thousands of adults aged 52 years or older, 35% of those living in England and 29% of those in the USA experienced age-related discrimination a few times a year or more.[3] In another survey[4] of people aged 50 years or older in Canada and the USA, only 11% of participants reported never experiencing any form of ageism. Discrimination can promote intended and unintended unhealthy behaviours—either by acting as a barrier to healthy lifestyle (eg, people might avoid the gym for fear of discrimination) or by leading people to engage in such behaviours as a means of coping with or escaping the negative affect that discrimination can evoke.[7,8] www.thelancet.com/public-health Vol 4 April 2019
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