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10 | Fall 2015 • Vol. 39 .No. 3

G E N E R AT IO N S – Journal of the American Society on Aging

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The term “ageism” was coined in 1969 by Robert N. Butler, M.D., then a 42-year-old psychiatrist who (among his other civic and age-focused advocacy responsibilities) headed the District of Columbia Advisory Committee on Aging. In partnership with the National Capital Housing Authority (NCHA), Butler used the term “age-ism” during a Washington Post interview conducted by then cub reporter Carl Bernstein. The Post story, “Age and race fears seen in housing opposition,” described the apprehension of homeowners in Chevy Chase, Maryland, an affluent Washington, D.C., suburb, who were distressed by the NCHA’s decision to turn an apartment complex into public housing (Bernstein, 1969). The project was intended to offer residences for the elderly poor—includ- ing African Americans—and was opposed by residents who feared Chevy Chase would never be the same.

“People talk about aging gracefully, which is what they want to do of course. So, naturally, they don’t want to look at people who may be palsied, can’t eat well . . . who may sit on the curb and clutter up the neighborhood with canes,” Butler told Bernstein. “Until our society builds [a] more balanced perspective about age groups, this lends to embittered withdrawal by old people” (Bernstein, 1969).

Ageism: The Greater Prejudice? In Butler’s opinion, long-standing racial preju- dices and palpable class biases fueled an animus

against age, a stigma that few Americans at the time acknowledged. “In the course of a Wash- ington Post interview, I was asked if this negativ- ism was a function of racism,” Butler recalled (Butler, 1989). “In this instance, I thought it more a function of ageism.”

Anger about age-driven injustices impelled Butler to engage in political activism on behalf of the old (and the young). As a delegate to the 1968 Democratic National Convention, Butler had witnessed clashes on the Chicago streets be- tween age groups. This mayhem, to his mind, underscored a generation gap fomenting “in the political year 1968 [with] the elements of a counterrevolution by the middle-aged against both the young and the old” (Butler, 1969).

Elaborating upon his insights into ageism in The Gerontologist, he predicted that age bigotry would not soon fade. “Aging is the great sleep- er in American life,” he declared, noting that age- ism permeated programs and resources meant to serve older Americans, such as Medicare, Social Security, and public housing, marginalizing older adults. “Age-ism might parallel (it might be wishful thinking to say replace) racism as the great issue of the next 20 to 30 years,” he wrote (Butler, 1969).

Contempt, down through the ages Butler was not the first to identify a seemingly universal, widespread contempt for old people. Negative attitudes toward age and aging have been, and remain, deeply rooted in global

W. Andrew Achenbaum

Ageism predated Robert Butler, and remains in effect to this day.

A History of Ageism Since 1969

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history. Men and women who no longer could contribute to communal survival in Neolithic cultures were cast aside, often left to die. “Senec- tus morbidus est” (“Old age is a disease”), the philosopher Seneca (4 BC−AD 65) said.

By associating late life with disease and death, generations down the ages have justified the futility of granting the aged access to care (Achenbaum, 1978; Haber, 1983; Cole, 1992). Ageism is ubiquitous—evident in places as far-flung and with differing cultures as Japan (Gerlock, 2005) and east Africa (Ogonda, 2006)—and embedded in Western culture. The Roman poet Juvenal’s Satires mock impotent and priapic septuagenarian satyrs alike; other classical authors disparaged mature women’s disfigured grace and beauty. Unflattering imagery, like that in Keats’ poem, “Ode to a Nightingale,” permeates more modern works (de Beauvoir, 1971; Wyatt-Brown and Rossen, 1993). It is no wonder that post–World War II researchers, sampling respondents’ attitudes about old people, reported stereotypically negative responses to age and aging (Barron, 1953; Rosow, 1962; Tuckman and Lorge, 1953).

Robert Butler’s achievement was to give meaning to ageism as an affliction. (In 1969, “ageism” appeared in the Oxford English Dic- tionary; in 2003,“new ageism” showed up in the dictionary’s electronic version.) For the rest of his career, Butler’s critiques of ageism repeated themes enunciated when he had first introduced the subject:

Ageism can be seen as a systematic stereotyping of and discrimination against people because they are old, just as racism and sexism accomplish this with skin color and gender . . . I see ageism manifested in a wide range of phenomena, on both individual and institutional levels—stereotypes and

myths, outright disdain and dislike, simple subtle avoidance of contact, and discrimi- natory practices in housing, employment, and services of all kinds (Butler, 1989; Butler, 2005).

Whether working with the Veterans Admin- istration, serving as founding director of the National Institute on Aging, and, subsequently, as the (first U.S.) chair of geriatrics at New York’s Mount Sinai Hospital and Medical School, Butler constantly sought ways to rid eldercare of ageism. A top priority was training healthcare profes- sionals to treat older patients with dignity and compassion (Butler, 1980; Achenbaum, 2013).

Combating ageism was the frequent goal of the publications and workshops of the New York-based International Longevity Center (ILC), which Butler founded and led during his last two decades of life. Media Takes: On Aging, an influential ILC report (Dahmen and Cozma, 2009), documented that much remained to be done to counter the insidious effects of age- based prejudice. The report claimed that 80 per- cent of Americans were subjected to ageism. A year before his death in 2010, Butler wrote:

The advent of possible means to delay aging and extend longevity is a great intel- lectual and social as well as medical achieve- ment . . . The very words we use to describe people are undergoing greater scrutiny. It is ironic, then, that at the same time Ameri- cans are beginning to see an unfolding of the entire life cycle for a majority, we continue to have embedded in our culture a fear of growing old, manifest by negative stereo- types and language that belittles the very nature of growing old, its complexities and tremendous variability (Butler, 2008).

Efforts to Define and Measure Ageism The United States has always been an age- graded society. Its segmented age groups do not necessarily unify the populace, although most citizens claim to agree with Robert Wohl (1979) when he says, “the truest community to which

Robert Butler declared that ‘aging is the great sleeper in American life.’

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one can belong is that defined by age and experience.”

Intergenerational tensions flamed ageist rhetoric in the 1980s and 1990s, however. The New Republic depicted older people as “greedy geezers” who squandered their life savings and depleted Social Security funds (Fairlie, 1988). Younger Americans, struggling to obtain an education, a home, or a decent job blamed older Americans.

Debates over generational equity abated over time, without uprooting the perception that different age groups compete for diminishing resources in a zero-sum world. “Age-based social divisions, particularly in the current economic environment of budget deficits and fiscal tight- ening, threaten the sustainability of the Amer- ican social compact” (Network on an Aging Society, 2012).

Scores of researchers have since followed Butler’s lead in defining and measuring ageism. And scholars have deployed knowledge-building and consciousness-raising to mitigate, if not erad- icate, the stigma. A fair number of investigators merit attention here.

The researchers go to work Donald McTavish (1971) prepared an exhaustive review of research methodologies and cumu- lative findings concerning perceptions of old people; he found the literature at hand mixed in terms of validity and usefulness.

Ageism became the cornerstone of Erdman Palmore’s research while he was a graduate student in the 1950s. With Kenneth Manton, Palmore published the first systematic compari- son of age-based inequality to racism (the pair reported small but significant gains at the time) and sexism (they claimed that women’s inferior status was barely maintained). “Few people recognize the magnitude of age inequality in our society,” they reported (Palmore and Manton, 1973).

In 1976, Palmore developed, and subsequently maintained, a twenty-five-point “Facts on Aging”

quiz to help the public recognize the extent of their misinformation about older people’s qualities—a bias that contributed to age discrim- ination (Bennett, 2004). In a guest editorial, Palmore (2000) offered usage guidelines for avoiding ageism in gerontological language. At age 82, he co-edited the Encyclopedia of Ageism (2005), wherein sixty authors reviewed 125 aspects of ageism, ranging from mapping elder abuse to assessing ageism among children.

Emerging scholars take their turn A rising generation of scholars contributed to fresh understandings of ageism. Some validated insights by Butler and Palmore, while present- ing novel approaches (McGuire, Klein, and Chen, 2008). Becca Levy (2001), for example, demonstrated how implicit ageism generated adverse health effects. Stereotypes previously aimed at African Americans or women were internalized by aging Americans, eliciting self-inflicted prejudice.

Todd Nelson, in a collection of essays on ageism (2002) and a handbook on The Psychology of Prejudice (2005), sought to contextualize the syndrome by documenting the extent to which Americans’ derogation of aging clashed with their views concerning youth, mobility, change, and fear of death. In Agewise, Margaret Morganroth Gullette (2010), in her analysis of the Fourth Age, provided a devastating critique of the “culture of decline” and the “systems of decline” (including those fostered by healthcare professionals and pharmaceutical firms) that distort how we view passages through the life course.

Other investigators tracked policies under- mining ageism, such as changes in employment discrimination legislation, noting limitations in our country’s landmark Age Discrimination in

‘Class still matters: Disenfranchised older people have less access to power, prestige, or property.’

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Employment Act of 1967, which abolished mandatory retirement (Pampel and Williamson, 1992; Burchett, 2005).

International researchers—especially those in the United Kingdom—enriched the literature on ageism. Bill Bytheway (1995) surveyed the settings in which age biases compromised med- ical care, among other senior services. John Macnicol, who published a historical and contemporary analysis of age discrimination (2006) and also presented a think piece to the ILC (2010), argued that the British government took steps (not replicated in the United States) to encourage—even to force—older workers back into paid employment. Robin Blackburn claimed that poor public responses to older adults’ vulner- abilities posed a societal risk (2006).

Exploring the nature of spirituality in the Fourth Age, Malcolm Johnson and Keith Albans (2013) recounted and interpreted stories of people’s anxieties over declining capacities and fears of dying. Their treatment of ageism in late, late life recalled efforts by Nobel Laureate Elie Metchnikoff (1908) and psychologist G. Stanley Hall (1922), who linked gerontology and thanatol- ogy—a connection rarely pursued by investigators that is dedicated to probing “successful aging.”

Parsing the Evolution (or Devolution) of Ageism As ageism studies progressed, unresolved debates over definitional matters gave rise to measurement issues about ageism. Palmore acknowledged that his pioneering Equality Index was a useful but insufficient basis for such comparisons (Palmore, 1999). Synthesis is difficult (Aosved, Long, and Voller, 2009; Dittmann, 2003) because few researchers investigate intolerant beliefs simultaneously. Furthermore, as much survey data on ageism are self-reported; the negativity is likely to be implicit or unnoticed (as Becca Levy has shown). Ageism, after all, takes on various and nuanced forms, each with unique impacts: Making jokes at an older person’s expense is vastly different

from hitting one’s grandparents or stealing their assets and resources.

And, times change: “Racism, sexism, homo- phobia, and other forms of discrimination don’t look the way they used to” (Covert, 2014). Jim Crow laws may be history, but entrenched signs of disenfranchisement in African American communities remain—poverty, homelessness, incarceration, and violence. The status of women has improved due to greater opportunities in higher education and professional advancement, yet women are expected to interrupt their careers to be caregivers; and income disparities have not dissipated much since the passage of the Equal Pay Act of 1963, or with its amendment in 1974.

Though few Americans gave much thought to the presence of Spanish-speaking immigrants in America in the late 1960s, this now burgeon- ing, diverse segment of our society has become a potent force in contemporary life and culture. The same might be said of immigrants from Asia and the subcontinent. And, since the Stonewall Riots of 1969, there has been a radical transfor- mation of attitudes and public policies that sup- port and affirm the rights of gays, lesbians, bisex- uals, transgender individuals, and self-identified queers to participate in everyday affairs.

Much since 1969 remains the same about ageism. Then, as now, older Americans were a variegated group; their circumstances remain divergent in terms of financial resources and employment opportunities, mental and physical health, educational attainments, cultural diver- sity, marital status, religion, and region. Class still matters: Disenfranchised older people have less access to power, prestige, or property.

Ageism continues to bedevil segments of the older population in distressing ways. Most older African American women still embody a triple jeopardy (being female, African American, and

‘We no longer limit comparisons of ageism to racism and sexism.’

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old), which public agencies cannot fully amelio- rate. Older Americans remain under-represented in the media. And gerontology’s great irony per- sists—whereas most of us now live long enough to become old, ageism is the only prejudice that can diminish everyone’s quality of life.

That said, ageism itself has taken on four new forms since Butler identified the prejudice: • Older Americans benefit from age-based

discounts and entitlements, which is a positive development, but the benefits still convey a scent of ageism. Many of these perquisites originated in the pervasive notion that older people, uniformly, were poor. That is no longer the case. As a group, the old, on average, have more income at their disposal than younger cohorts.

• The Baby Boom Generation has seen both sides of ageism. In their youth, they mocked people older than age 30. Now, they face job discrimi- nation and competition from younger genera- tions. And, they are taunted for their obesity and improvidence. Their very numbers fan worries that they might bankrupt Social Security and Medicare.

• We no longer limit comparisons of ageism to racism and sexism. New dyads have emerged, notably ones associated with the disabled and with lesbian, gay, bisexual, transgender, and queer (LGBTQ) individuals. Conjoining age with Alzheimer’s Disease and related disor- ders, or recognizing the risk of HIV infections after age 60 arouses fears of loss of control and independence in late life and despair over pros- pects for a meaningful existence. Rates of dementia, sexually transmitted diseases, and

drug use and abuse underscore the need to invest more in mental health and to provide greater access to older Americans to public health education and interventions.

• Elderly men and women who are feverishly committed to extending careers well into what had been considered retirement years rarely notice how ageism cripples peers. This is one reason Americans can postpone the 1960s version of age 65.

Ageism preys on vulnerability—fragility, frailty, and dependency at advancing ages—espe- cially as dread of dying and death mounts.

Conclusion Two ironies frame the history of ageism, both before and after 1969. First, ageism predates Butler’s naming of a syndrome endemic over time and across space. Vulnerable elders feared physical and psychological abuse, regardless of their cohort’s proportionate numbers in a given population. Second, ageism remains virulent amidst “the longevity revolution” (Butler, 2008).

The gift of extra years should afford time and opportunities to grow, to cherish bonds, to review life’s meaning. Instead, older people often find themselves marginalized, which di- minishes their capacities to contribute—and to matter.

W. Andrew Achenbaum, Ph.D., holds the Gerson and Sabina David Professorship of Global Aging in the Graduate College of Social Work at the University of Houston, Texas. His most recent book is Robert N. Butler, MD: Visionary of Healthy Aging (New York: Columbia University Press, 2013).

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Achenbaum, W. A. 2013. Robert N. Butler, MD: Visionary of Healthy Aging. New York: Columbia University Press.

Aosved, A. C., Long, P. J., and Voller, E. K. 2009. “Measuring Sexism, Racism, Sexual Prejudice, Ageism, Classism and Religious Intolerance.” Journal of Applied Social Psychology 39(10): 2321−54.

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Barron, M. L. 1953. “Minority Group Characteristics of the Aged in American Society.”Journal of Gerontology 8(4): 477−82.

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Blackburn, R. 2006. Age Shock: How Finance Is Failing Us. London, UK: Verso.

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C O M I N G U P I N

Winter 2015-16

Family Caregiving

Kathleen Kelly and Jennifer Wolff, Guest Editors

The average family caregiver is a 49-year-old woman, caregiving for her aging mother who does not live with her. She is married and employed. Although men also provide assistance, female caregivers may spend as much as 50 percent more time providing care than male caregivers.

Caregiving for others affects all facets of life, from income to future earn- ings, savings, and health. What is the best way to support family caregivers throughout mainstream healthcare and long-term services and supports? This issue of Generations will give an overview of the current status of family caregiving, and include more than a dozen articles covering current federal and state policy efforts to address caregiving, including legal and workplace initiatives, existing legislation and its efficacy, as well as many smaller unique, replicable models for supporting caregivers in a diverse array of situations and cultures.

Generations

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