The biomedicalisation of ageing policies: a comparative analysis of public administration and expertise in Canada, the United States and Sweden

Abstract

This article explores how the biomedicalisation of ageing permeates the fields of public administration and public policy. We posit that the biomedicalisation of ageing policies depends strongly on: (1) the institutionalisation of ageing policy, both with regard to ministerial responsibility for programmes targeting older adults and the construction of ageing as a healthcare policy problem within the state apparatus; and (2) the dominant presence of health experts and professionals in the policy-making process in the field of ageing. We present a comparative analysis featuring three countries (Canada, Sweden and the US) with different administrative configurations and policy mixes in relation to older adults. We conclude that the biomedicalisation of ageing expertise is strongest in Canada and the US, and weakest in Sweden. The delegation of long-term care responsibility to municipalities and the strong commitment to develop and include social science expertise explains the Swedish outcome. The article provides illustrations as to why this distinction matters in policy making and in the day-to-day lives of older adults, and why it should be explored in other countries around the globe.