All around the world, people are living longer\u2014a basic hallmark of human progress and a triumph of public health. The World Health Organization (WHO) is in the public health business, and no organization has done more to raise awareness of ageism\u2014the biggest obstacle to meeting the challenges of population aging.<\/p>\n
Part of the WHO\u2019s global, anti-ageism campaign is a new list of 10 facts that correct common \u201cmisconceptions on ageing and health.\u201d<\/a> The global perspective is instructive, and it\u2019s making me rethink some things\u2014including the burning question of whether to start spelling \u201cageing\u201d the logical, British-and-Indian way. Here is the WHO\u2019s list, along with my comments.<\/p>\n 1. There is no typical older person<\/strong><\/p>\n That would top my list too. Stereotyping\u2014the assumption that all members of a group are the same\u2014<\/strong>underlies all prejudice. Of course, stereotypes are always a mistake, but especially when it comes to age, because we all age in different ways and at different rates. As geriatricians put it, \u201cHeterogeneity is the hallmark of ageing.\u201d Or, less formally, \u201cIf you\u2019ve seen one 80-year-old, you\u2019ve seen one<\/em> 80-year-old.\u201d<\/p>\n 2. Diversity in older age is not random<\/strong><\/p>\n Spoken like a tactful epidemiologist! WHO is pointing out that the playing field is far from level: \u201cThe physical and social environments in which we live are powerful influences on Healthy Ageing\u201d and are further shaped by \u201cour sex, our ethnicity, and financial resources.\u201d As I write in my book, This Chair Rocks: A Manifesto Against Ageism,<\/em> \u201cThe way we grow old is governed by a whole range of variables, including environment, personality, and genes, compounded by class, gender, race, luck, and the churnings of the global economy\u2014over which we have varying degrees of control.\u201d The effects compound each other and add up over time, which is why the poorest of the poor, all around the world, are old women of color.<\/p>\n 3. Only a small proportion of older people are care dependent<\/strong><\/p>\n \u201cCare dependent\u201d is a great way to put it. I tend to frame this in terms of the percentage of Americans over 85 who live in nursing homes (10 percent) and [the percentage] who can go about their everyday activities without any personal assistance (over half). The WHO frames this in economic terms as well, drawing on recent research showing that the contributions of olders in the UK \u201cwere worth nearly 40 billion more than expenditure on them through pensions, welfare and health care combined\u201d\u2014a figure set to nearly double by 2030.<\/p>\n 4. Population ageing will increase health-care costs but not by as much as expected<\/strong><\/p>\n The notion that older North Americans are an inevitable sink for health care dollars is incorrect<\/a>, and the WHO makes the international case. \u201cIn high-income countries, there is growing evidence that at around age 70, health-care expenditure per person falls significantly,\u201d the WHO observes, though [expenses for long term care] increase. So it makes sense to invest in long term care. Aging influences health care expenditures far less than other factors, especially expensive medical technologies. Related predictions that \u201ctoo many old people\u201d will tank the economy\u2014debunked here<\/a>\u2014are biased, outdated and just plain wrong.<\/p>\n 5. 70 is not yet the new 60<\/strong><\/p>\n I take issue with claims like \u201c60 is the new 40!\u201d because they\u2019re based in denial\u201460, no matter how active, is still 60\u2014but I\u2019ve been assuming that we\u2019re generally healthier and more vigorous than the generations that preceded us. Not so, says the WHO. Although severe disabilities may be less common, \u201cno significant change in less severe disability has been observed during the past 30 years.\u201d<\/p>\n 6. Good health in older age is not just the absence of disease<\/strong><\/p>\n \u201cThe combination of a person\u2019s physical and mental capacities (known as intrinsic capacity) is a better predictor of their health and well-being than the presence or absence of disease,\u201d notes the WHO, suggesting that we focus on improving intrinsic capacity rather than on specific ailments. As I write in my book, \u201cWhile physical decline is inevitable, poor health is not.\u201d People get chronic conditions but we learn to live with them. We find ways to keep doing the things we love\u2014versions of them, at least. No single, age-related condition affects most older people. Some of the oldest of the old live well, not by avoiding illness, but despite it.<\/p>\n 7. Families are important but alone cannot provide the care many older people need<\/strong><\/p>\n \u201cWhile families will always play a central role in long-term care, changing demography and social norms mean it is impossible for families alone to meet the needs of care dependent older people,\u201d the WHO points out, calling for training and supporting caregivers and for the government and other sectors to share responsibility. It\u2019s the absence of publicly funded support that turns caregiving into a burden\u2014one that falls largely on women. How about paid family leave and subsidizing care for people of all ages? How about a guaranteed, collective, universal right to long term care that gives women the same options that men\u2014white men with good jobs, at least\u2014have always enjoyed? How about providing decent wages, health and unemployment insurance, and a path to citizenship to those we pay to do this intimate and important work? Which would allow families to do what they do best: be family instead of nurses and administrators.<\/p>\n 8. Expenditure on older populations is an investment, not a cost<\/strong><\/p>\n Programs that help olders stay mobile and functional require funding, but what\u2019s often omitted from the accounting is the cost of not<\/em> making such investments. \u201cThese investments can yield significant dividends, both in the health and well-being of older people and for society as a whole through increased participation, consumption and social cohesion,\u201d says the WHO. Some of the return on investment is direct. For example, better health care leads to better health, which saves money, improves lives and allows people to contribute to what AARP calls the \u201clongevity economy.\u201d<\/a> Some is indirect, helping societies protect the human rights of their older members and enabling them to live with dignity.<\/p>\n 9. It\u2019s not all about genes<\/strong><\/p>\n \u201cWhile Healthy Ageing starts at birth with our genetic inheritance, only approximately 25 percent of the diversity in longevity is explained by genetic factors,\u201d according to the WHO. I remember how surprised I was to learn that, from none other than geriatrician Robert Butler, who coined the term \u201cageism\u201d and founded the National Institute on Aging. \u201cIt\u2019s really never too late to reinvent yourself and to invent different health habits. Only about 25 percent of our health appears to be due to genes. Seventy-five percent is environmental or behavior,\u201d Butler told me. That\u2019s why the WHO recommends that policies \u201caddress these person-environment interactions across the life course.\u201d<\/p>\n 10. Mandatory retirement ages do not help create jobs for youth<\/strong><\/p>\n \u201cPolicies enforcing mandatory retirement ages do not help create jobs for youth, but they reduce older workers\u2019 ability to contribute. They also reduce an organization\u2019s opportunities to benefit from the capabilities of older workers,\u201d writes the WHO. Indeed. The exchange of skills across generations is the natural order of things, but in much of the developed world, age discrimination in the workplace has subverted it. Another false dichotomy is that older workers take jobs away from younger ones. Economists call this the fallacy of the \u201clump of labor.\u201d When jobs are scarce, this is true in the narrowest sense, but that\u2019s a labor-market problem, not a too-many-old-people problem. A 2012 Pew Charitable Trusts study of employment rates<\/a> over the last 40 years found rates for younger and older workers to be positively correlated. In other words, as more older workers stayed on the job, the employment rate and number of hours worked also improved for younger people.<\/p>\n Want older people to be healthy? End ageism <\/strong><\/p>\n A growing body of evidence shows that attitudes toward aging have an actual, measurable, physical effect on how we age. People with more positive feelings about aging behave differently from those convinced that growing old means becoming irrelevant or pathetic. They do better on memory tests and are less likely to develop the symptoms of Alzheimer\u2019s disease. They can walk faster and are more likely to recover fully from severe disability. And they actually live longer\u2014an average of seven and a half years. Everyone agrees that health has the biggest effect on how we age\u2014and how much it costs. Think what a global anti-ageism campaign would do to extend not just lifespan but \u201chealthspan.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":" The World Health Organization (WHO) is in the public health business, and no organization has done more to raise awareness of ageism\u2014the biggest obstacle to meeting the challenges of population aging.<\/p>\n