Professional Documents
Culture Documents
Creating A More Active Society - Elderly - Obligatoriu
Creating A More Active Society - Elderly - Obligatoriu
The purpose of this article is to review what is known about: (1) the prevalence and nature
of ageist stereotypes; (2) the varied ways in which ageist stereotypes are harmful to health,
functioning, and well-being; and (3) strategies for effective communication with older
adults around lifestyle issues, with particular emphasis on physical activity.
Method:
This article reviews literature on current myths and reality of aging in the context of
designing health promotion programs for older adults. Strategies for combating ageist
stereotypes are based on a multilevel view of determinants of health and aging.
Conclusions: Ageist stereotypes are pervasive in U.S. society and harmful to older adults psychological
well-being, physical and cognitive functioning, and survival. Concrete strategies for
communicating with older adults can increase the effectiveness of health promotion
programs. Strategies for combating ageism and creating a healthier society must address all
segments of society, and include educational and media campaigns, an expansion of
current research foci, greater sensitivity from care providers, more opportunities for
intergenerational linkages, the design of productive roles for older adults, a retrofit of the
built environment, and intensified and collaborative action from both the public and
private sectors.
(Am J Prev Med 2003;25(3Sii):164 171) 2003 American Journal of Preventive Medicine
Introduction
he dramatic aging of the U.S. population underscores an urgent need for research to elucidate
steps that can be taken to enhance the health
and quality of life of Americans as they age. The
well-cited demographic facts reveal a generic picture of
our aging nation. One in eight Americans is now aged
65 years and many more people than ever before are
living into their 80s, 90s, or even 100s.1 Over the next
few decades, there will be a doubling of persons aged
65 from a current high of 35 million to an unprecedented 70 million older Americans.2 Since chronic
illness and disabilities and associated healthcare use
increase with aging, escalating healthcare costs and
164
other negative societal effects are often seen as inevitable consequences of the graying of America.3,4
Yet, this demographic revolution is not occurring in
a vacuum. Twenty-five years of gerontologic research
have generated a growing knowledge base about the
characteristics of the older population and the challenges facing older adults, their families, and society as
a whole.5 8 We are also learning that population aging
can signal an opportunity for increased attention to
health promotion and disease prevention interventions
for older adults.9,10 The extent to which such interventions will be promulgated, proven successful, and ultimately disseminated widely is dependent, in part, on
our views of the malleability of the older population
and the potential of health promotion activities for
improving the lives and functioning of older adults.
Set within the context of an ever-changing society,
this article explores the existence of ageist stereotypes,
including the manner in which they still exist at the
beginning of the twenty-first century; the varied ways in
which ageist stereotypes are harmful to health, functioning, and well-being; and strategies for effective
communication with older adults around lifestyle is-
165
Media
Ageism and negative stereotypes are pervasive in American society. The U.S. Senate Special Committee on
Aging recently held a hearing titled Image of Aging in
Media and Marketing.25 Expert witnesses testified
about the continued negative images of older persons
as feeble, ineffective, helpless, and irrelevant both in
print and on television.13 Despite an emphasis on
demographically based marketing principles, youth
dominate the advertising world. In their rush to target
younger audiences, advertisers totally neglect or fail to
recognize the variability in the 50 age group, a market
that is increasing in purchasing power and influence.26
There is a growing recognition that negative views of
older people might backfire on advertisers, with older
people refusing to buy products with age-biased ads.27
Snyder26 argues that values-based segmentation versus
current lifestyle or age-based segmentation will be more
effective in reaching older adults. An exception to the
under-representation of older people in ads can be
seen in the recent plethora of pharmaceutical ads that
have mushroomed since bans on direct advertising to
patients were lifted. Interestingly, these ads typically
portray older people as active and attractive.
167
169
Summary
The realities of aging are that older people are interested in their health and ways of enhancing the quality
of their lives through lifestyle changes. With bettertailored messages about the life-long benefits of health
promotion programs that resonate with life histories
and preferences, older adults can be successfully recruited into health promotion programs. Yet, ageist
stereotypes are pervasive in American society and harmful to older peoples health, functioning, and wellbeing.
The creation of a healthier society is dependent, in
part, on combating ageism, an insidious condition that
dilutes the potential for successful aging. This is not a
simple task, as it calls for strategies directed at all
segments of society, including older adults and their
caregivers, policymakers, and the population at large.
We recommend the adoption of educational and media
campaigns, an expansion of current research foci,
greater sensitivity from care providers, more opportunities for intergenerational linkages, the design of
productive roles for older adults, a retrofit of the built
environment, and intensified and collaborative action
from both the public and private sectors.
This article draws support and ideas from Active for Life, a
national program office supported by The Robert Wood
Johnson Foundation. Active for Life is part of the Active
Living Network supported by The Robert Wood Johnson
Foundation.
References
1. Federal Interagency Forum on Aging Related Statistics. Older Americans
2000: key indicators of well-being. Washington DC: U.S. Department of
Health and Human Services, 2000.
2. Administration on Aging. A profile of older Americans: 2002. Washington
DC: U.S. Department of Health and Human Services, 2002. Available at:
www.aoa.dhhs.gov/prof/statistics/profile/profiles2002.asp.
3. Binstock RH. Issues of resource allocation in an aging society. In: Hickey T,
Speers M, Prohaska T, eds. Public health and aging. Baltimore: Johns
Hopkins Press, 1997:5372.
4. Smeeding T, Butler RN, Schaber G, eds. The consequences of population
aging for society. Workshop report. New York: International Longevity
Center, 2000. Available at: www.ilcusa.org.
5. Hickey T, Speers M, Prohaska T, eds. Public health and aging. Baltimore:
Johns Hopkins Press, 1997.
6. Maddox G, ed. The encyclopedia of aging. Vols. 1 and 2. New York:
Springer Publishing Co., 2000.
7. National Center for Health Statistics. Health, United States, 1999. With
health and aging chart book. Hyattsville MD: U.S. Department of Health
and Human Services, 1999.
8. Ory MG, DeFriese GH, eds. Self care in later life. New York: Springer
Publishing Co., 1998.
9. National Research Council. Preparing for an aging world: the case for
cross-national research. Panel on a research agenda and new data for an
aging world, committee on population, committee on national statistics.
Washington DC: National Academy Press, 2001.
10. Maddox GL. The behavioral and social dynamics of aging well. In: Smedley
BD, Syme SL, eds. Promoting health: intervention strategies from social
and behavioral research. Washington DC: National Academy Press, 2000:
32236.
11. Butler RN. Ageism: another form of bigotry. Gerontologist 1969;9:2436.
12. Butler RN. Ageism. In: Maddox GL, ed. The encyclopedia of aging. Vol. 1:
AL. New York: Springer Publishing, 2000:38 9.
13. Butler RN. Written testimony for United States Senate special committee
on aging. Hearing on the image of aging in media and marketing,
September 2002. The Image of Aging in Media and Marketing. Hearing
before the special committee on aging United States Senate 107th Congress, 2nd Session, Washington DC, September 4, 2002. Serial no. 10735.
14. Riley MW, Foner A, Riley J. Aging and society pardigm. In: Bengston VL,
Scaie KW, eds. Handbook of theories of aging. New York: Springer
Publishing, 1999:327 43.
15. Cook FL. Age stereotype. In: Maddox GL, ed. The encyclopedia of aging.
Vol. 1: AL. New York: Springer Publishing, 2000:45 6.
16. Levy BR, Hausdorff, Hencke R, Wei JY. Reducing cardiovascular stress with
positive self-stereotypes of aging. J Gerontol 2000;55:20513.
17. Palmore EB. Ageism: negative and positive. 2nd ed. New York: Springer
Publishing, 1999.
18. Cutler NE, Whitelaw NW, Beattie BL. American perceptions of aging in the
21st century. Washington DC: National Council on the Aging, 2002.
19. Binstock RH. Changing criteria in old-age programs: the introduction of
economic status and need for services. Gerontologist 1994;34:726 30.
20. Kane RL. The public health paradigm. In: Hickey T, Speers M, Prohaska T,
eds. Public health and aging. Baltimore: Johns Hopkins Press, 1997:316.
21. National Center for Health Statistics. Early release of selected estimates
based on data from first quarter 2002. Hyattsville MD: U.S. Department of
Health and Human Services, 2002. Available at: www.cdc.gov/nchs.
22. Rowe JW, Kahn RL. Successful aging. New York: Pantheon Books, 1998.
23. Manton KG, Corder L, Stallard E. Chronic disability trends in elderly
United States populations: 19821994. Proc Natl Acad Sci U S A 1994;94:
25938.
24. Manton KG, XiLiang G. Changes in the prevalence of chronic disability in
the United States black and nonblack population above age 65 from 1982
to 1999. Proc Natl Acad Sci U S A 2001;98:6354 9.
25. The Image of Aging in Media and Marketing. Hearing before the special
committee on aging United States Senate 107th Congress, 2nd Session,
Washington DC, September 4, 2002. Serial no. 10735.
26. Snyder R. Ageism in advertisement. J Active Aging 2002;1:125.
27. Gardner M. This view of seniors just doesnt ad up. Christian Science
Monitor, January 15, 2003:14.
28. Guigliano RP, Camargo CA, Lloyd-Jones DM, Zagrodsky JD. Elderly patients receive less aggressive medical and invasive management of unstable
angina: potential impact of clinical guidelines. Arch Intern Med 1998;158:
111320.
29. Lewis JH, Kilgore ML, Goldman DP, et al. Participation of patients 65 years
of age or older in cancer clinical trials. J Clin Oncol 2003;21:13839.
30. Adelman RD, Greene MG, Ory MG. Communication between older
patients and their physicians. Clin Geriatr Med 2000;16:124.
31. Palmore EB. Ageism in Canada and the United States. Durham NC: Duke
University Center for the Study of Aging and Human Development, Fall
2002 (Vol. 22).
32. Smith M. Ageism widespread in Canada, U.S.? CARPnews, June 2002.
33. Levy BR. Improving memory in old age by implicit self-stereotyping. J
Personality Soc Psychol 1996;71:1092107.
34. Levy BR, Slade MD, Kasl SV. Longitudinal benefit of positive self-perceptions of aging on functional health. J Gerontol B Psychol Sci Soc Sci
2002;57:409 17.
35. Levy BR, Slade MD, Kunkel SR, Kasl SV. Longevity increased by positive
self-perceptions of aging. J Personality Soc Psychol 2002;83:26170.
36. Ory MG, Abeles RP, Lipman, eds. Aging, health and behavior. Newbury
Park CA: Sage, 1992.
37. Ory MG, Cox DM, Gift HC, Abeles RP. Aging and quality of life: celebrating
new research discoveries. In: Abeles RP, Gift HC, Ory MG, Cox D, eds.
Aging and quality of life: charting new territories in behavioral sciences
research. New York: Springer Publishing, 1994:118.
38. Ory MG, Cox DM. Forging ahead: linking health and behavior to improve
quality of life in older people. Soc Indicators Res 1994;33:89 120.
39. Kaplan GA, Strawbridge WJ. Behavioral and social factors in healthy aging.
In: Abeles RP, Gift HC, Ory MG, Cox D, eds. Aging and quality of life:
charting new territories in behavioral sciences research. New York:
Springer Publishing, 1994:5778.
40. King AC, Rejeski WJ, Buchner DM. Physical activity interventions targeting
older adults: a critical review. Am J Prev Med 1998;15:316 33.
41. Fiatrone MA, ONeill EF, Ryan ND, et al. Exercise training and nutritional
supplementation for physical frailty in very elderly patients. N Engl J Med
1990;330:1769 75.
42. Jette AM, Lachman M, Giorgetti MMC, et al. Exerciseits never too late:
the Strong-for-Life program. Am J Public Health 1999;89:66 72.
43. Anderson RT, Ory MG, Cohen S, McBride JS. Contexts of aging and issues
in older adults adherence to health interventions. Control Clin Trials
2000;21(suppl 5):17183.
44. Ory MG, Lipman PD, Karlen PL, et al. Recruitment of older participants in
frailty/injury prevention studies. Prevention Sci 2002;3:122.
45. International Longevity Center-USA, Ltd. A national crisis: the need for
geriatrics faculty training and development. Toward functional independence in old age. New York: International Longevity Center-USA, 2001.
Available at: www.ilcusa.org/_lib/pdf/health.pdf.
46. Barnes D. Experience corps lets senior volunteers give back. Washington
Times, February 28, 2002. Available at: www.experiencecorps.org/site/
stories/whats_new/news.html. Accessed December 1, 2002.
47. Partnership for Prevention. Creating communities for active aging. Washington DC, 2001. Available at: www.prevent.org.
48. Bush GW. Healthier US: the presidents health and fitness initiative.
Executive summary. Washington DC: USGPO, 2002. Available at: www.
whitehouse.gov/infocus/fitness/execsummary.html..
49. Agency for Healthcare Research and Quality, Centers for Disease Control
and Prevention. Physical activity and older Americans: benefits and strategies. June 2002. Available at: www.ahrq.gov/ppip/activity.htm. Accessed
December 1, 2002.
50. Crankshaw E, Rabiner D, OKeeffe J. An overview of programs and
initiatives sponsored by DHHS to promote healthy aging: a background
paper for the blueprint on aging for the 21st century technical advisory
group meeting. Washington DC: U.S. Department of Health and Human
Services, January 29, 2003.
51. Administration on Aging. USA on the move: steps to healthy aging.
Available at: www.aoa.gov/otm/index.asp. Accessed December 1, 2002.
52. Robert Wood Johnson Foundation. National blueprint for increasing
physical activity among adults 50 and older: creating a strategic framework
and enhancing organizational capacity for change. J Aging Physical Activity
2000;9(suppl):528.
53. The Robert Wood Johnson Foundation. Call for proposal. Active for Life:
increasing physical activity in adults age 50 and older, 2001. Available at:
www.Activeforlife.info. Accessed January 1, 2003.
54. Butler RN, Nyberg JP. The need for greater representation of older adults
in clinical trials. New York: International Longevity Center-USA, 2001.
Available at: http://www.ilcusa.org/_lib/pdf/clinicaltrialsib.pdf.
55. Jette AM. Assessing disability in studies on physical activity. Am J Prev Med
2003;25(suppl):122 8.
56. Guralnik JM, Ferrucci L. Assessing the building blocks of function: utilizing
measures of functional limitation. Am J Prev Med 2003;25(suppl):11221.
171