Experiences Of Ageism Research Articles

Age and expertise: The effects of ageism on professional recognition for senior nurses

This study explores the dual challenges of ageism and professional recognition faced by senior nurses in healthcare settings. Utilizing a phenomenological approach, we conducted semi-structured interviews with 20 registered nurses aged 50 and older in Abha City, Saudi Arabia. The analysis revealed four key themes: experiences of ageism, its impact on professional roles, discrimination and stigmatization, and the need for organizational support. Findings indicate that age-related biases lead to significant professional marginalization, reduced job satisfaction, and emotional distress among senior nurses. The study highlights the critical need for comprehensive policies, organizational support, and cultural changes to address ageism and recognize the valuable contributions of senior nurses. Promoting an inclusive work environment and equitable professional development opportunities can enhance the overall quality of care and job satisfaction for older nurses.

Personal Competence or Environmental Characteristics? Factors Influencing Happiness among Ageing Adults in Hong Kong Around the Period of COVID-19 Pandemic.

Drawing upon person-environment fit perspective, this study examines the joint and interactive influences of personal competence and environmental characteristics on the happiness of ageing adults around the period of COVID-19 pandemic. Data was collected in two rounds, before and during the pandemic, with 2,028 participants aged 55 years and older in Hong Kong. Personal competence encompassed financial status, physical health, and mental capital, while environmental characteristics included experiences of ageism, perceived social conditions, and age-friendly policies. Ordinary least squares regression was used to examine personal and environmental influences on happiness. Results indicated a significant decline in happiness following the onset of COVID-19 pandemic. Mental capital was found to have the strongest positive influence on happiness, followed by physical health, financial status, and social conditions. Mental capital mitigated the negative relationship between experiences of ageism and happiness. Practical interventions are informed to improve the well-being of ageing adults during pandemic.

Ageism from the perspective of older adults: A phenomenological study

ABSTRACT This study aims to determine what meaning older adults attribute to ageism and then to reach findings thereof in curriculum studies on the same topic. The study was conducted with phenomenological design. The researcher held face-to-face interviews with a total of 13 participants over the age of 65 using a semi-structured interview form and maximum variation sampling method. Inductive content analysis was used to analyze the data. The themes, sub-themes, and codes obtained as a result of the analysis were examined under four headings. These headings are discrimination as a concept, experiences of ageism, reactions expressed against ageism, and pattern of ageism. The results of the study showed that discriminatory attitudes and behaviors of other adults and social and biological/physiological conditions were among the factors that lead to ageism and behavioral, cognitive and emotional effects emerged when older adults were exposed to ageism. It was revealed that the older adults took measures against the effects of ageism by withdrawing from the social environment, ignoring, and being active. The results of the study were discussed in the context of disadvantaged groups, discrimination, ageism and culture literature, and inferences were made about the curriculum studies that can be carried out to raise awareness, knowledge, and skills by accepting that schools have an important role in combating ageism.

Voicing experiences of ageist nonrecognition in performance appraisal interaction: complexities in constructing stories that counteract organisational ignorance

ABSTRACT A growing line of research aims to give voice to employees’ experiences of ageism at work. This article complements this body of research by demonstrating how voicing experiences of ageism, and hence counteracting organisational ignorance towards ageism, can be a complex discursive endeavour. Ageist experiences can be based on subtle interactional exchanges at the workplace, including other workers’ nonrecognition (e.g. ostracism). We suggest that experiences of nonrecognition can be a source of what we call interactionally troublesome exchanges (ITEs), that is, instances of social interaction that a worker experiences as problematic, although the social violations of the interaction partner may be difficult to report to others (e.g. supervisors) who lack the same first-hand experience. We argue that the difficulties of reporting ageist nonrecognition are anchored in cultural and institutional expectations that undermine the organisational ‘tellability’ of stories that aim to describe colleagues’ subtle acts and omissions in daily workplace encounters.

HOW DO OLDER ADULTS COPE WITH INTERSECTIONAL EXPERIENCES OF AGEISM AND RACISM?

Abstract The World Health Organization recently launched a global campaign to end ageism due to its widespread, insidious negative health impacts on older adults. Similarly, racism is a key driver of health disparities and has been declared a public health crisis by jurisdictions around the United States. While a strong literature summarizes coping theory in general as well as beneficial and maladaptive coping mechanisms among older adults, limited research describes how older adults cope with experiences of ageism and racism, particularly through an intersectional lens. The aim of this qualitative, phenomenological study was to understand how older adults cope with intersectional experiences of ageism and racism. Twenty adults 60+ residing in the U.S. Mountain West who identified as Black, Hispanic/Latino(a), Asian-American/Pacific Islander, Indigenous, or White participated in a one-hour, semi-structured interview. A team of five coders engaged in an inductive coding process through independent coding followed by critical discussion. Peer debriefing, member checking, and an audit trail enhanced credibility. Nine themes were identified: 1) resistance, 2) exhaustion, 3) acceptance/‘let it go,’ 4) avoidance, 5) increased awareness through aging, 6) help others, 7) educate others, 8) self-determination/defy stereotypes, and 9) healthy lifestyle. These themes exemplify problem-focused and emotion-focused, as well as individual and collective coping strategies. Novel findings include how older adults may cope with ageism and racism through helping peer older adults and via increased awareness through aging. Practitioners should recommend coping strategies which combine collective and problem-focused responses to ageism and racism such as resistance, helping others, and educating others.

AGEISM EXPERIENCED AND EXPRESSED: MANIFESTATIONS ACROSS CONTEXTS AND TRANSGRESSORS

Abstract Ageism was first defined more than fifty years ago, yet its expressions and effects on society continue today. In this symposium, we examine manifestations of ageism across contexts and transgressors in order to determine the effects of ageism in light of a pandemic as well as a post-pandemic world. Important social contexts in which ageism plays a part are examined, such as the workplace and COVID-19 vaccination. As well, efforts to reduce ageism through confrontation are investigated, particularly with respect to reactions to ageist behavior. Providing a window into ageist communication during the pandemic, Bascu and colleagues detail how ageism was expressed in social media regarding policies for COVID-19 vaccination. Delving into the factors that drive older workers’ decisions to remain or to leave an organization, both Lagacé et al and Swift investigate the role that perceived ageism plays. Lagacé and colleagues assess how older workers’ perceptions of being the target of ageism impacts their well-being, their psychological disengagement, and their intentions to leave their organization. Swift considers how experiences of ageism in the workplace predict older workers’ retirement intentions through reduced job satisfaction and lowered intrinsic motivation to work. Chasteen et al. test the impact of confronting ageism on perceptions of transgressors as well as how perceivers use characteristics of an older adult target as a normative cue for determining their reactions to ageist behavior. Taken together, these presentations illustrate the influence of ageism on vital life domains such as healthcare and the labor force.

ESPO AND ACADEMY FOR GERONTOLOGY IN HIGHER EDUCATION SECTION SYMPOSIUM: UTILIZING TECHNOLOGY IN THE ADVANCEMENT OF OLDER ADULT EDUCATION

Abstract TThis symposium intends to echo one of the core values of the GSA 2023 Annual Scientific Meeting — empowering all ages. Online lifelong learning has become more common in the 21st century. The speed of technological development far exceeds people’s imagination. The speed at which technology develops is shown to create a widening gap between older and younger populations, known as the digital divide. Introducing technologies into intergenerational learning environments remains an important step to bridging the generational digital divide. In accordance with the AGHE gerontological education competencies, these authors will describe how older adults utilize technology. The first speaker will discuss the effectiveness of a virtual intergenerational program that addressed experiences of ageism for older and younger participants. The second speaker will introduce user-centered design principles and innovative tools that facilitate virtual Information Communications Technology (ICT) support and training for older people with limited abilities in using technology. The third speaker will illustrate concrete practice through international cases from different intergenerational technology integration projects. The fourth speaker will present key elements from the University of Rhode Island (URI) Engaging Generations Cyber-Seniors Program internship and describe student experiences enrolled in the program. The last speaker will discuss the benefits and challenges of technology use among older learners and state the experience of leading older learners using technology in Taiwan. This is a Geriatric Education Interest Group Sponsored Symposium.

Young adults’ experiences of ageism in the United Kingdom: Forms, sources, and associations with intergenerational attitudes

Although previous research suggests that a large proportion of young adults experience ageism, information is scarce regarding exactly how often they encounter different forms of age-based discrimination. To address this lacuna, we recruited young adults from the U.K. to complete four weekly surveys in which they reported the number of days during the preceding week on which they experienced various forms of ageism. More than three-quarters of our respondents experienced some form of ageism at least once during the reporting period, and more than one-quarter of respondents experienced ageism (on average) at least once per week during the reporting period. The most oft-encountered forms of ageism encountered by young adults involved being shown a lack of respect/being patronized and having other people make assumptions about their cognitive or social characteristics. Most commonly, the perpetrators of ageism were middle-aged and later middle-aged persons (rather than older people) encountered in the course of employment. The number of days on which young adults experienced ageism was inversely correlated with the degree to which they believed middle-aged and later-middle aged adults held positive stereotypes of young adults, and positively predicted the desire to avoid interaction with middle-aged, late middle-aged, and older adults.

A phenomenological, intersectional understanding of coping with ageism and racism among older adults

The aim of this qualitative, phenomenological study was to understand how older adults cope with experiences of ageism and racism through an intersectional lens. Twenty adults 60+ residing in the U.S. Mountain West who identified as Black, Hispanic/Latino(a), Asian-American/Pacific Islander, Indigenous, or White participated individually in a one-hour, semi-structured interview. A team of five coders engaged in an inductive coding process through independent coding followed by critical discussion. Peer debriefing enhanced credibility. Nine themes were organized by three umbrella categories: Coping with ageism: 1) distancing via self-determination/defying stereotypes, 2) distancing by helping others; Coping with racism: 3) resistance, 4) exhaustion; Coping with both ageism and racism: 5) increased awareness through aging, 6) healthy lifestyle, 7) education, 8) acceptance/ ‘let it go’, and 9) avoidance. Novel findings include how older adults may cope with ageism and racism via increased awareness through aging and with ageism specifically by helping peer older adults, although instances of internalized ageism were noted and discussed. The themes exemplify problem-focused (e.g., helping others) and emotion-focused (acceptance), as well as individual (e.g., self-determination) and collective (e.g., resistance) coping strategies. This study can serve as a resource for practitioners in applying a more nuanced understanding of the ways older adults cope with ageism and racism in later life.

COVID‐19 and K‐12 teachers: Associations between mental health, job satisfaction, perceived support, and experiences of ageism and sexism

AbstractK‐12 public school teachers faced unprecedented and novel disruptions in their workplace during the first entire school year of the COVID‐19 pandemic, leading to concerns about their treatment, mental health, and job satisfaction. Between April and June 2021, 341 public U.S. K‐12 school teachers from 12 states (covering Northeast, Southeast, Midwest, Southwest, West, and Pacific Northwest) completed online surveys regarding their perceived general support, experiences of ageism and sexism, job satisfaction, and mental health. Mental health symptoms mediated the relationships between sexism, ageism, and perceived support with job satisfaction (Model 1) and job satisfaction mediated the relationships between sexism, ageism, and perceived support with mental health symptoms (Model 2). Thus, the data supported two models pointing to dual co‐existing pathways from (a) general support and (b) experiences of discrimination to both job satisfaction and mental health. These results highlight the importance of developing and implementing policies and programs that can improve teachers’ general support from their community along with addressing job satisfaction.

“It’s the not being seen that is most tiresome”: Older women, invisibility and social (in)justice

Older women experience intersectional discrimination at the nexus of ageism and sexism. This is embodied, women’s aging bodies being culturally devalued within youth-privileging cultures and the hyper-sexualization of younger, able-bodied, women. Older women often face the dilemma of attempting to mask the signs of aging or aging “authentically” but encountering heightened stigma, prejudice, and discrimination. Very old women in the fourth age who “fail” to age “successfully” are subject to extreme social exclusion. Many older women speak of experiencing a loss of visibility as they age, however how this occurs, and what it means, has not yet been analyzed in depth. This is an important issue, as recognition—cultural status and visibility—is essential for social justice. This article reports on findings taken from a U.K. survey on experiences of ageism and sexism completed by 158 heterosexual, lesbian, and bisexual women aged 50 to 89. Their perceived invisibility took five forms: (a) being under-seen/mis-seen in the media; (b) being mis-seen as objects of sexual undesirability; (c) being “ignored” in consumer, social, and public spaces; (d) being “grandmotherized,” that is, seen only through the lens of (often incorrectly) presumed grandmotherhood; (e) being patronized and erroneously assumed to be incompetent. The findings are compared with Fraser’s social justice model. The argument presented is that older women’s experiences of nonrecognition and misrecognition are profound sources of social injustice. Both increased visibility and cultural worth are needed for older women to enjoy the benefits of social justice in later life.

Older adults’ perceptions of ageism before and during the COVID-19 pandemic

Objectives Studies assessing the effects of ageism on older adults during the COVID-19 pandemic suggest that perceiving ageism is associated with lower self-reported mental and physical health. Yet, it remains unknown whether these pandemic associations are distinct from pre-pandemic associations. The present study addressed this issue by controlling for pre-pandemic levels of ageism and mental and physical health in order to assess which pandemic-era experiences of ageism predict well-being in older people. Method Both prior to and during the pandemic, 117 older adults completed measures of perceived ageism, self-perceptions of aging, subjective age, subjective health, and life satisfaction. Results During the pandemic, perceived ageism predicted lower subjective health and life satisfaction. However, when controlling for pre-pandemic measures, perceived ageism during the pandemic predicted only subjective health but not life satisfaction. Perceptions of continued growth positively predicted both measures across most analyses. Conclusion The present findings suggest caution when interpreting the effects of ageism on well-being during the pandemic, as those associations may already have existed pre-pandemic. The finding that perceptions of continued growth positively predicted subjective health and life satisfaction suggests that promoting more positive self-perceptions of aging, along with combatting ageism in society, may represent important policy objectives.

OLDER ADULT PERSPECTIVES ON AGEISM DURING COVID-19: A QUALITATIVE STUDY

Abstract Since the COVID-19 pandemic began, there has been a reported surge of ageism toward older adults. Research demonstrates that events perpetuating negative attitudes towards older adults can increase ageism and associated negative outcomes. The purpose of this phenomenological qualitative study was to explore how older adults navigated experiences of ageism and their social relationships during the COVID-19 pandemic. Semi-structured interviews with adults ages 60 and older were conducted between February and April of 2021 over Zoom. Data were coded using an iterative, inductive approach and thematic analysis was performed to draw themes from the data. A total of 24 participants ages 61-80 (mean = 70.6) were interviewed. Most participants identified as white (n = 19) female (n = 14), retired (n = 21) and had at least a bachelor’s degree (n = 22). Findings showed that participants experienced ongoing ageism but did not report ageist experiences associated specifically with COVID-19. Ageist experiences, unrelated to COVID-19, as shared by participants included assumptions about older adults’ (in)ability to use technology, ageism in professional settings, and feelings that ageism is an inevitable part of growing older. Future research should examine the impact of intersectionality on this topic within more diverse populations and explore potential differences that may have occurred throughout different stages of the pandemic.

Ageism, an invisible social determinant of health for older Syrian refugees in Lebanon: a service providers’ perspective

BackgroundOlder refugees face particular challenges because their health and social needs are largely overlooked in humanitarian programmes, policies and research. The few studies available have shown that older refugees suffer from a high prevalence of non-communicable diseases, including mental health problems, increased social isolation and poverty, and difficulty accessing health and social services. This article aims to provide further in-depth understanding of how service providers perceive health and social challenges of older Syrian refugees living in Lebanon by focusing on (1) their health and social challenges; (2) the available and lacking services; (3) participation; and (4) policy recommendations to improve services.MethodsThis study is based on a qualitative research approach. Fifteen semi-structured interviews were conducted with health and social workers providing services to older Syrian refugees living in Lebanon. All interviews were digitally recorded, transcribed, coded and analysed using thematic analysis.ResultsStudy results clearly show that older refugees face increased marginalisation and neglect, mainly because of ageism. Ageism experienced at aid agency, family and individual levels, impacts negatively on older refugees. They have a sense of social isolation, neglect and feel they are a burden, consequently their social participation decreases, impacting negatively on their physical and mental health as well as their access to social and health care. Linked to experiences of ageism, study participants noted: (1) high prevalence rates of non-communicable diseases and mental health problems; (2) difficulties accessing care, with inadequate services to support the needs of older refugees; and (3) policy recommendations calling for an holistic approach to aid which takes into consideration the specific needs of older refugees as well as their capabilities.Concluding remarksAgeism is a key determinant of health which negatively impacts the physical, mental and social health, and wellbeing of older Syrian refugees. It pushes them to the margins of society where they are left behind by the humanitarian response, policy makers and researchers, as well as their communities and families. To mitigate this situation, this article calls for directly addressing ageism on social, service and policy levels.

Masquerading their way to authenticity: Does age stigma concealment benefit older women?

As women age they can be subject to both sexism and ageism, and consequently be stereotyped as low in competence and irrelevant despite having a relatively young subjective age. Drawing on theories of stigma, we conducted a survey study of older women (N = 184) with a strong interest in fashion and their visual image. We used template thematic analysis to understand their experiences in relation to their age-changed appearance. Two major themes were identified: unfavourable experiences of ageism and efforts to evade these experiences through attention to appearance. Our participants employed masquerade to conceal or reduce the visible evidence of their age—both to avoid ageism and to align their outward appearance more closely with their inner, felt, authentic selves. We interrogate the benefits and penalties of concealment for a group whose stigmatised condition is dynamic, changing as their appearance grows increasingly dissimilar to societally favoured youthfulness. Masquerade may for this group of women produce more positive than negative outcomes, via effects on felt authenticity.

Older adults' perceptions and experiences of ageism during the COVID-19 pandemic.

The current study investigates older adults’ perceptions of ageism in the United States during the COVID‐19 pandemic. Using tenets of Stereotype Embodiment Theory and the Behaviors from Intergroup Affect and Stereotypes Map framework, we sought to (a) examine whether older adults experienced ageism as self‐relevant during the pandemic and (b) understand whether older adults experienced certain media messages and interpersonal behaviors during the pandemic and interpreted them as being motivated by potentialpaternalistic age stereotypes. Older adults aged 65 and older recruited from the community (n = 73) participated in a semi‐structured interview about their perspectives on ageism toward older adults during the pandemic. Participants also completed an online survey about their experiences with a range of messages and interpersonal behaviors throughout the pandemic. We thematically analyzed interview data and identified three primary themes: self‐relevance of age stereotypes; awareness of negative, overgeneralized portrayals of older adults; and defenses against self‐relevance of age stereotypes. Survey responses were analyzed using descriptive statistics and frequency counts and suggest that participants attributed messages and behaviors potentially imbued with paternalistic ageism as motivated primarily by care and concern for older adults. The findings add to the field's understanding of older adults’ experiences and perceptions of ageism in the media and in interpersonal behaviors in the context of COVID‐19.

Ageism: the importance of the linguistic concept for the construction of the experience

AbstractThis study investigated if people are acquainted with the term ‘ageism’, and to what extent acquaintance with this term corresponds with reports of discrimination, due to age. The study included an online survey, answered by 1,025 Israeli respondents. The questionnaire began by asking the respondents to define ‘What is ageism?’ (gilanut in Hebrew) and then to mark ‘If and what types of discrimination they experienced in the last year’. Subsequently, we defined and demonstrated the term ageism and asked participants to share experiences of this phenomenon; 457 (45%) participants were not familiar with the term. In the group that was unfamiliar with the term, only 46 (10%) reported that they had such experiences. In the group that was acquainted with the term, 208 (30%) reported that they had experienced ageism. In contrast, once the term, ageism, was defined and demonstrated in the survey, 638 (62%) respondents shared experiences of ageism in their lives. Of those who shared their experiences of ageism, 202 (31%) were initially unfamiliar with the term. The study's results show that there is an association between the linguistic representation of the phenomenon of ageism and reports of ageism. In the wider sense, the study shows that language and words have the power to help people understand and interpret social and human experiences.

Experiences of Everyday Ageism and the Health of Older US Adults

Major incidents of ageism have been shown to be associated with poorer health and well-being among older adults. Less is known about routine types of age-based discrimination, prejudice, and stereotyping that older adults encounter in their day-to-day lives, known as everyday ageism. To examine the prevalence of everyday ageism, group differences and disparities, and associations of everyday ageism with indicators of poor physical and mental health. This cross-sectional study was conducted using survey data from the December 2019 National Poll on Healthy Aging among a nationally representative household sample of US adults ages 50 to 80 years. Data were analyzed from November 2021 through April 2022. Experiences of everyday ageism were measured using the newly developed multidimensional Everyday Ageism Scale. Fair or poor physical health, number of chronic health conditions, fair or poor mental health, and depressive symptoms. Among 2035 adults ages 50 to 80 years (1047 [54.2%] women; 192 Black [10.9%], 178 Hispanic [11.4%], and 1546 White [71.1%]; mean [SD] age, 62.6 [8.0] years [weighted statistics]), most participants (1915 adults [93.4%]) reported regularly experiencing 1 or more forms of everyday ageism. Internalized ageism was reported by 1664 adults (81.2%), ageist messages by 1394 adults (65.2%), and interpersonal ageism by 941 adults (44.9%). Mean Everyday Ageism Scale scores were higher for several sociodemographic groups, including adults ages 65 to 80 years vs those ages 50 to 64 years (11.23 [95% CI, 10.80-11.66] vs 9.55 [95% CI, 9.26-9.84]) and White (10.43 [95% CI, 10.20-10.67]; P < .001) and Hispanic (10.09 [95% CI, 9.31-10.86]; P = .04) adults vs Black adults (9.23 [95% CI, 8.42-10.03]). Higher levels of everyday ageism were associated with increased risk of all 4 negative physical and mental health outcomes examined in regression analyses (with odds ratios [ORs] per additional scale point as high as 1.20 [95% CI, 1.17-1.23] for depressive symptoms and b = 0.039 [95% CI, 0.029-0.048] for chronic health conditions; P values < .001). Internalized ageism was the category associated with the greatest increase in risk of poor outcomes for all health measures (with ORs per additional scale point as high as 1.62 [95% CI, 1.49-1.76] for depressive symptoms and b = 0.063 [95% CI, 0.034-0.092] for chronic health conditions; P values < .001). This study found everyday ageism to be prevalent among US adults ages 50 to 80 years. These findings suggest that commonplace ageist messages, interactions, and beliefs may be harmful to health and that multilevel and multisector efforts may be required to reduce everyday ageism and promote positive beliefs, practices, and policies related to aging and older adults.

Examining Attitudes and Experiences of Ageism During COVID-19: Are They on the Rise?

Gerontologists have warned of rising ageism amidst the COVID-19 pandemic. Older adults have been portrayed as a homogenous group given their health vulnerabilities and have been viewed with mixed perceptions. For instance, the pandemic has been viewed as an “old person’s” disease and older adults have been inherently linked to imposing health and safety lifestyle changes. Others have responded with acts of overaccommodative care that have minimized older adults’ autonomy. Taken together, there have been inferences of increased hostile and benevolent ageism. Currently, these claims lack empirical data, and the goal of this study was to examine if attitudes and experiences of ageism are on the rise. Across two studies, we examined young adults’ (N=268) attitudes of older adults and older adults’ (N=65) experiences of ageism before and after the start of the pandemic. In study 1, we examined ageist attitudes at 3 time points (2017, 2019, 2020) from separate, but equitable, college samples and found that hostile ageism was higher during the pandemic (F(2,265)=5.48, p<.001) and benevolent ageism demonstrated no differences. In study 2, we explored older adults’ experiences of ageism pre-and post-pandemic onset (2019, 2020) and, found that they reported experiencing less hostile ageism (t(64)=2.45, p<.05), with no differences in experienced benevolent ageism. Our findings suggest an increase in hostile ageist views, but a decrease in experiences, partially supporting the alleged claims of rising ageism. Nevertheless, the last year of the pandemic is dynamically contextualized and research should elaborate on the extent and consequences of this rise.

Age Equity: A Framework for Addressing Ageism, Stigma, and Bias

In the Covid-19 context, researchers and policy makers have turned their attention to long-standing disparities in health equity, including by race, ethnicity, poverty, sexuality, and gender. Yet, scholarship to date does not conceptualize age as a critical aspect of difference requiring an equity lens. In this presentation, we utilize an Age Equity Framework to investigate ageism based on research findings from the 2018 National Health, Aging and Sexuality/Gender Study (NHAS): Aging with Pride. Investigating ageism, stigma, and bias, we found nearly half of LGBTQ older adults feel invisible and disrespected. After adjusting for background characteristics, experiences of ageism were associated with higher rates of stigma, lifetime victimization, discrimination, lower support and community engagement, and adverse outcomes (lower mental and physical health and quality of life). The rapidly growing older adult population highlights the pressing need to consider age inequities and the importance of achieving age equity across the life course.