Nav: Home

The Lancet Public Health: Ageism linked to poorer health in older people in England

April 03, 2019

Ageism may be linked with poorer health in older people in England, according to an observational study of over 7,500 people aged over 50 published in The Lancet Public Health journal. Despite the known prevalence of age discrimination and existing evidence that other forms of discrimination, like racism, are linked to poorer health, this is the first study to examine the association between ageism and health and wellbeing.

Considering the demographic changes underway in high-income countries and the steadily increasing population of older people in the UK, these findings highlight the vital need to tackle ageism to improve the health and wellbeing of people as they age.

1,943 of 7,731 (25%) over 50-year olds surveyed experienced age discrimination. Those who reported age discrimination were more likely to rate their health as fair or poor compared to those who had not reported it (29% versus 24%).

Certain serious health problems were also more common among those who reported age discrimination compared to those who had not - including heart disease (17% versus 13%), chronic lung conditions (7% versus 5%), limiting longstanding illnesses (39% versus 33%), and depressive symptoms (19% versus 12%).

In addition to worse reports of their existing health, participants who reported age discrimination were more likely to develop a serious health problem during the study's six-year study period compared to those who did not report age discrimination - including higher rates of diabetes (6% versus 5%), heart disease (4% versus 3%), stroke (5% versus 3%), chronic lung disease (5% versus 3%), a limiting longstanding illness (26% versus 21%), or depressive symptoms (10% versus 7%).

The authors note that the follow-up data was only available for 5,595 of the 7,731 participants included in the original analyses. Participants who dropped out in the intervening six years tended to be older and less affluent, which may have led to conservative numbers of newly developed conditions.

Notably, 45% (883/1,943) of participants who reported age discrimination also reported discrimination based on other personal characteristics (eg. sex, physical disability) and the negative health effects were most pronounced in this group. The authors therefore stress that other factors, like socioeconomic status and disability, may intersect with and compound experiences of age discrimination.

Advocating for an approach that aims to tackle discriminatory behaviours in society and mitigate the effects of discrimination of older people, study author, Dr Sarah Jackson from University College London, UK, says: "As a society, we need to increase public awareness of what constitutes ageism and how it can affect health and wellbeing so we can build collective movements, like those that brought about legislative and social change for other forms of discrimination. On a clinical level, raising the issue of age discrimination with older patients could help to identify those at risk of future health problems." [1]

The research was conducted using data from the English Longitudinal Study of Ageing, a nationally representative sample of over 50-year olds. Participants reported experiences of age discrimination and rated their own health via self-completed questionnaires and face-to-face computer-assisted personal interviews in 2010-11. Follow-up questionnaires and interviews collected data on participants' health after a six-year period to record any health conditions they had developed since.

There are some limitations to the study. Age discrimination was self-reported so is subject to recall bias and reflects the participants own perceptions, rather than the act of discrimination itself. To minimise bias, participants were asked about a range of types of discrimination (not only age discrimination). Health conditions were also self-reported.

The authors discuss several possible ways that ageism could negatively impact health. Firstly, previous studies have shown that exposure to age discrimination can provoke stress responses harmful to both mental wellbeing and physical health. Secondly, people may use unhealthy behaviours, like smoking, drinking, poor diet or physical inactivity, to cope with experiences of age discrimination.

Thirdly, they suggest that age discrimination in healthcare could mean that older patients are not receiving the same standard of care as their younger counterparts. 41% (804/1,943) of those who reported experiencing age discrimination specified has said that they "receive poorer service or treatment than other people from doctors or hospitals" and the authors point out that age-related biases in recommended treatments are common. For example, older patients with cancer are less likely to receive treatments that aim to cure the disease and older people are rarely included in clinical trials for drugs to treat heart disease. [2, 3]

Finally, the authors highlight the lack of existing research into ageism and health, despite an established body of evidence that examines other forms of discrimination as social determinants of health and wellbeing. In light of this, they call for more research into how ageism operates to inform interventions and policies to tackle it.

Writing in a linked Comment, Professor Martin Gulliford, King's College London, UK, says: "The public health community has been slow to acknowledge the central role of discrimination in health inequality... Although the interrelationships between age, socioeconomic status, health status and experienced discrimination are complex, these findings suggest that not only does age discrimination cause short-term psychological distress to older people, but could also have an important effect on their long-term mental and physical health." [1]
-end-
Peer-reviewed / Observational study / People

NOTES TO EDITORS

This study was funded by the Economic and Social Research Council. It was conducted by researchers from University College London, UK., The funding for the English Longitudinal Study of Ageing is provided by the US National Institute on Aging (R01AG017644) and the UK Government.

The labels have been added to this press release as part of a project run by the Academy of Medical Sciences seeking to improve the communication of evidence. For more information, please see: http://www.sciencemediacentre.org/wp-content/uploads/2018/01/AMS-press-release-labelling-system-GUIDANCE.pdf if you have any questions or feedback, please contact The Lancet press office pressoffice@lancet.com

[1] Quotes direct from author and cannot be found in text of Article

[2] https://www.bmj.com/content/319/7205/309/rapid-responses

[3] https://onlinelibrary.wiley.com/doi/full/10.1111/j.1532-5415.1999.tb04571.x

IF YOU WISH TO PROVIDE A LINK FOR YOUR READERS, PLEASE USE THE FOLLOWING, WHICH WILL GO LIVE AT THE TIME THE EMBARGO LIFTS: http://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(19)30035-0/fulltext

The Lancet

Related Heart Disease Articles:

With a heavy heart: How men and women develop heart disease differently
A new study by researchers from McGill University has uncovered that minerals causing aortic heart valve blockage in men and women are different, a discovery that could change how heart disease is diagnosed and treated.
Heart-healthy diets are naturally low in dietary cholesterol and can help to reduce the risk of heart disease and stroke
Eating a heart-healthy dietary pattern rich in vegetables, fruits, whole grains, low-fat dairy products, poultry, fish, legumes, vegetable oils and nuts, which is also limits salt, red and processed meats, refined-carbohydrates and added sugars, is relatively low in dietary cholesterol and supports healthy levels of artery-clogging LDL cholesterol.
Pacemakers can improve heart function in patients with chemotherapy-induced heart disease
Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.
Arsenic in drinking water may change heart structure raising risk of heart disease
Drinking water that is contaminated with arsenic may lead to thickening of the heart's main pumping chamber in young adults, according to a new study by researchers at Columbia University Mailman School of Public Health.
New health calculator can help predict heart disease risk, estimate heart age
A new online health calculator can help people determine their risk of heart disease, as well as their heart age, accounting for sociodemographic factors such as ethnicity, sense of belonging and education, as well as health status and lifestyle behaviors.
Wide variation in rate of death between VA hospitals for patients with heart disease, heart failure
Death rates for veterans with ischemic heart disease and chronic heart failure varied widely across the Veterans Affairs (VA) health care system from 2010 to 2014, which could suggest differences in the quality of cardiovascular health care provided by VA medical centers.
Heart failure: The Alzheimer's disease of the heart?
Similar to how protein clumps build up in the brain in people with some neurodegenerative diseases such as Alzheimer's and Parkinson's diseases, protein clumps appear to accumulate in the diseased hearts of mice and people with heart failure, according to a team led by Johns Hopkins University researchers.
Women once considered low risk for heart disease show evidence of previous heart attack scars
Women who complain about chest pain often are reassured by their doctors that there is no reason to worry because their angiograms show that the women don't have blockages in the major heart arteries, a primary cause of heart attacks in men.
Where you live could determine risk of heart attack, stroke or dying of heart disease
People living in parts of Ontario with better access to preventive health care had lower rates of cardiac events compared to residents of regions with less access, found a new study published in CMAJ (Canadian Medical Association Journal).
Older adults with heart disease can become more independent and heart healthy with physical activity
Improving physical function among older adults with heart disease helps heart health and even the oldest have a better quality of life and greater independence.
More Heart Disease News and Heart Disease Current Events

Trending Science News

Current Coronavirus (COVID-19) News

Top Science Podcasts

We have hand picked the top science podcasts of 2020.
Now Playing: TED Radio Hour

Debbie Millman: Designing Our Lives
From prehistoric cave art to today's social media feeds, to design is to be human. This hour, designer Debbie Millman guides us through a world made and remade–and helps us design our own paths.
Now Playing: Science for the People

#574 State of the Heart
This week we focus on heart disease, heart failure, what blood pressure is and why it's bad when it's high. Host Rachelle Saunders talks with physician, clinical researcher, and writer Haider Warraich about his book "State of the Heart: Exploring the History, Science, and Future of Cardiac Disease" and the ails of our hearts.
Now Playing: Radiolab

Insomnia Line
Coronasomnia is a not-so-surprising side-effect of the global pandemic. More and more of us are having trouble falling asleep. We wanted to find a way to get inside that nighttime world, to see why people are awake and what they are thinking about. So what'd Radiolab decide to do?  Open up the phone lines and talk to you. We created an insomnia hotline and on this week's experimental episode, we stayed up all night, taking hundreds of calls, spilling secrets, and at long last, watching the sunrise peek through.   This episode was produced by Lulu Miller with Rachael Cusick, Tracie Hunte, Tobin Low, Sarah Qari, Molly Webster, Pat Walters, Shima Oliaee, and Jonny Moens. Want more Radiolab in your life? Sign up for our newsletter! We share our latest favorites: articles, tv shows, funny Youtube videos, chocolate chip cookie recipes, and more. Support Radiolab by becoming a member today at Radiolab.org/donate.