Combating Ageism in Health Care

NP
By Nathan Paulus
Edited by Rae Osborn

Updated: November 1, 2024

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Ageism is a widespread but underestimated prejudice that considerably impacts health care delivery. Whether overt or implicit, age discrimination compromises health care by resulting in under or over-treatment. Furthermore, a 2020 study found that ageism against older individuals imposes a $63 billion annual burden on the health care system.

Fighting ageism is at the core of promoting an equitable, compassionate health care system. If you're an older adult experiencing ageism in health care, recognizing and knowing how to combat it can help you protect your rights.

What Is Ageism in Health Care?

Ageism encompasses stereotypes, prejudices and discriminatory actions based on an individual's age or the process of aging. In health care, this often manifests as discrimination against older adults, affecting both the overt and subtle aspects of care delivery.

These discriminatory practices can be overt — such as denying essential treatments because of a patient's age — or implicit — where age-related biases influence clinical decisions. For example, symptoms of a severe condition might be dismissed as "part of getting older," leading to delayed diagnosis and inappropriate treatment.

Federal law bans age discrimination in any program or activity that receives federal funds. This regulation includes health care programs funded by the Health Resources and Services Administration (HRSA), which cannot deny, restrict or limit services to someone because of their age. However, this rule does not apply to employment issues.

Signs of Ageism in Health Care

Whether ageism in health care is overt or subtle, it compromises patient care and reinforces harmful stereotypes about aging. Understanding these examples can help you recognize and address ageism effectively:

  1. 1

    Dismissal of Treatable Conditions

    Health care providers may dismiss treatable health issues as inevitable consequences of aging rather than conditions that can and should be addressed.

  2. 2

    Stereotypical Jokes

    Casual jokes in health care settings that reinforce ageist stereotypes contribute to a culture of disrespect and may make older patients feel undervalued and invisible.

  3. 3

    Pathologizing Aging

    Viewing natural aging processes as pathological conditions can lead to unnecessary medical interventions. This perspective skews the understanding of healthy aging and may lead to over-treatment.

  4. 4

    Communication Preferences

    Preferring to communicate with a younger companion rather than directly with the older patient undermines the autonomy and dignity of older adults. It assumes that they cannot make informed decisions about their health, which is often not the case.

When Is Age-Based Treatment Permissible?

There are specific contexts in which treating people differently based on age is justified and necessary. These situations are generally accepted when age serves as a proxy for another characteristic essential to the goals of the service or program. You can learn more about instances where differential treatment based on age is reasonable through the Health Resources and Services Administration's guidelines.

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    Using Age to Gauge Important Traits

    Age helps estimate vital characteristics for participating in certain activities or services.

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    Necessity of Age for Key Traits

    Certain essential traits for program goals are effectively assessed through age, making it a justified basis for differentiation.

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    Age as a Practical Indicator

    Age is a practical and straightforward indicator for determining whether individuals are ready for specific programs or activities.

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    Challenges of Direct Measurement

    Directly measuring every individual's specific traits or readiness without using age is often not feasible, making age a necessary and efficient proxy.

Consequences of Ageism on Health Care Outcomes

The consequences of ageism are severe and adversely affect patient outcomes. It can result in unmet health care needs, reduced quality of life and higher mortality rates among older adults. Furthermore, ageism can damage the patient-provider relationship, leading to miscommunication and distrust. The effects of ageism may include:

  1. 1

    Inadequate Pain Management

    Pain in older patients is often underestimated, resulting in insufficient treatment. This neglect highlights a critical area where ageist attitudes directly harm patient care.

  2. 2

    Unnecessary Medical Procedures

    Aggressive medical interventions, particularly near the end of life, showcase over-treatment driven by ageist perceptions.

  3. 3

    Exclusion From Preventive Care

    Older adults may unjustly be considered "too old" for preventive treatments, depriving them of the opportunity to maintain or improve their health status.

  4. 4

    Overmedication

    The practice of prescribing multiple medications can indicate over-treatment, posing risks such as adverse drug interactions and diminishing overall quality of life for older adults.

  5. 5

    Underdiagnosis of Mental Health Conditions

    There's a significant gap in diagnosing and treating mental health issues among older adults, often due to misconceptions about aging and mental health.

  6. 6

    Decreased Access to Rehabilitation Services

    There's a misconception that older adults benefit less from rehabilitation, leading to lower referral rates for potentially beneficial therapies.

  7. 7

    Limited Research and Clinical Trials Participation

    Older adults are often underrepresented in medical research and clinical trials, impacting the generalizability of findings and potentially excluding them from benefiting from cutting-edge treatments.

  8. 8

    Social Isolation

    Ageist attitudes in health care settings can contribute to a sense of isolation and worthlessness among older adults, exacerbating health problems and decreasing life satisfaction.

  9. 9

    Increased Health Care Costs

    Ageism can lead to unnecessary procedures and neglect of treatable conditions, unnecessarily driving up health care costs for individuals and the system.

How to Confront Age Bias in Health Care

Although systemic changes are necessary, individuals also hold significant power in addressing ageism. If you're experiencing age discrimination in health care, it's important to speak up. Ask for second opinions if you're uncomfortable with the care you're receiving. You can also contact your hospital or doctor's office to raise concerns. Here are actionable steps:

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    Speak Up

    If your concerns are being dismissed because of your age, assertively express your needs. It’s important to voice your expectations for your care and treatment.

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    Report Ageism

    Report ageism to the offending health care provider's office or hospital administration. Highlighting these issues can prompt health care facilities to review their practices and implement changes.

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    Seek Second Opinions

    Don't hesitate to seek a second opinion if unsure about a diagnosis or treatment plan. This can help ensure that your care is tailored to your needs rather than influenced by ageist assumptions.

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    Educate Yourself

    Gain knowledge about your health conditions and the treatments available. Understanding your health needs empowers you to engage more effectively in discussions about your care.

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    Build a Support Network

    Engage with peer groups or advocacy organizations focusing on elder rights and health care. These communities can offer support, advice and resources to combat ageism

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    Report Age Discrimination in Health Insurance

    If you face age discrimination in your health insurance coverage or services, consider reporting it to your insurance company's state insurance regulators or seek advice from legal experts or advocacy groups to address the issue.

Anti-Ageism Policies

Several policies aim to address ageism, focusing on health care inequity and support for older adults. By familiarizing yourself with these policies, you can better understand your rights and the efforts to ensure equitable care for people of all ages.

Age Discrimination Act of 1975

This act prohibits age-based discrimination in programs and activities receiving federal financial assistance, including health care services. It aims to ensure equal access to health care for individuals of all ages, fostering an environment of inclusivity.

Older Americans Act (OAA)

The OAA focuses on providing resources and support to older adults, ranging from nutrition programs to caregiver support. This act significantly improves health care accessibility and quality for older Americans, advocating for integrating these services into a holistic health care plan.

Additional Resources

We've compiled a list of reputable sources to support those looking to understand more about ageism and resources related to aging.

  • AARP: This is a nonprofit, nonpartisan organization that empowers people to choose how they live as they age, offering resources on health, employment, retirement planning and combating ageism.
  • Administration for Community Living: It provides information on services and programs designed to help older adults maintain their independence and thrive in their communities.
  • American Society on Aging: This society focuses on enhancing the knowledge and skills of those working with older adults and their families, offering educational resources and information on ageism.
  • Eldercare Locator: This public service connects older Americans and their caregivers with information on senior services.
  • National Institute on Aging (NIA): The NIA offers a wide range of information on healthy aging, research updates and tips for living a healthier life as you age.

About Nathan Paulus

Nathan Paulus headshot

Nathan Paulus is the Head of Content Marketing at MoneyGeek, with nearly 10 years of experience researching and creating content related to personal finance and financial literacy.

Paulus has a bachelor's degree in English from the University of St. Thomas, Houston. He enjoys helping people from all walks of life build stronger financial foundations.

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