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Beyond hearts and minds to anti-ageism actions in the Global South

To be anti-ageist is to be self-educating, calling out discrimination wherever we see it and being uncompromising in our demand for full dignity and citizenship for everyone at every stage of life, argues Dr Alexandre Kalache, president of the International Longevity Centre-Brazil.

Ageism as a term was first coined in 1969 by the founder of the International Longevity Centre, my much-admired friend and mentor Robert N. Butler. Also, as the founder and first director of the US National Institute of Aging, he was arguably the most influential gerontologist of the twentieth century.

Credit: Image courtesy of FolhaPress

Butler defined ageism as a combination of three interconnected elements: prejudicial attitudes toward older people and the aging process itself, discriminatory practices, and institutional policies and actions that perpetuate bias and stereotypes. To Butler’s definition can be added a fourth, and perhaps even more insidious, component: the negative thoughts and self-perceptions derived from deeply entrenched societal prejudices that are internalized by older persons themselves.

At the time Butler coined the term ageism, the proportion of older people was relatively small even in developed countries, and many older people continued to be integrated into family life. Since then, throughout the world, both the absolute and relative numbers of older persons have increased exponentially within a landscape of profound social change. Globally, the proportion of older adults aged 80 years and over has increased from 9% to 14% between 1980 and 2015 (https://bit.ly/3iLMa2a). These greater numbers of older people are also living longer, but not necessarily in good health. There is an increased need for care, and for longer periods of time, while the global pool of family carers is decreasing. In addition, fast-moving technological change has driven an underappreciation of many forms of traditional knowledge and has devalued much of the experience and contributions of older adults. The assets of learning assembled in youth and early adulthood no longer provide sufficient currency for longer lives, yet avenues for later-life educational and vocational renewal remain limited.

Both explicit and implicit ageism remains pervasive in all settings. At times it is almost wilfully unconsidered, and all too often it goes completely unchallenged. If we live long enough, we are all vulnerable to ageism. It may take some by surprise, but for a large number of others, it will simply build on the legacy of other forms of discrimination, arriving on top of a life history marked by social exclusion, precarious employment, low self-esteem and insecurity. The structural disadvantages that have framed our younger selves inevitably produce an amplified effect in later life — a cumulative inequality that makes the burden of ageism even more onerous.

Arguably, peoples’ relationship to older age is even more complex in the dynamic context of developing countries, where already almost 70% of the global older population resides. Developed countries first became rich and then aged, whereas developing countries are aging faster and in the context of prevailing poverty, if not misery. There are impressive instances, however, of older person’s empowerment in some developing countries, even if the progress is uneven. In Brazil, for example, the National Council on the Rights of Older People raised the voice of millions of older Brazilians from the local to the national stage through a country-wide process of peer selection until they were muted by political restructuring in 2019.

In addition to contributing the word ‘ageism’ to our dictionaries, Butler marked out a claim for hearts, minds and actions. One of his many enduring legacies has been to raise the awareness of aging issues among journalists and other opinion-makers. The Age Boom Academy he co-founded at New York’s Columbia University is now in its second decade, with alumni of nearly 200 members of the press. Following in these footsteps, the International Longevity Centre in Brazil (ILC-BR) has facilitated an all-medium award for best journalism on aging every year since 2010.

These initiatives serve to remind us that our human rights do not diminish with the accumulation of years, and that there is intrinsic value and experience at all stages of life. Capability at any age should not be contentious, yet ageism continues to fuel complacency and stigmatization across all societies. At the global level, it is reflected in the absence of any binding comprehensive international law to specifically protect the rights of older persons (the fastest-growing population sub-group in the world), and there is continued resistance toward the creation of a United Nations Convention for the rights of older people.

To achieve large-scale societal change, action is also required at the individual level. Just as the opposite of racist is not non-racist, it is anti-racist, the opposite of ageist is not non-ageist, it is anti-ageist. Claiming to be non-racist or non-ageist is simply a denial. Being anti-racist or anti-ageist is a commitment to actually doing something, which requires regular self-examination and purposeful action. At whatever age we are, to be anti-ageist is to be self-educating, willing to call out discrimination wherever we see it and to be uncompromising in our demand for full dignity and citizenship for everyone at every stage of life.

A new curiosity into the process of aging and older age itself in recent decades has prompted a re-examination of long-held existential notions about the human condition. The enormous heterogeneity of a much more expansive and complex older age is now more recognized, and, with it, the absurdity of ageism. The triumph of longer lives has brought about cultural and economic changes that are generating almost limitless potential for overall human development. It is high time we recognize this and take action to eradicate ageism once and for all.

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Correspondence to Alexandre Kalache.

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Kalache, A. Beyond hearts and minds to anti-ageism actions in the Global South. Nat Aging 1, 148–149 (2021). https://doi.org/10.1038/s43587-020-00026-y

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