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Ageism and Discrimination

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Ageism and Discrimination Powered By Docstoc
					        Gerontology

Prof.Dr.Veronika Ospina-Kammerer



             Prof . Dr. VOK        1
Vulnerability and a Lack of Empathy
     or Compassion add up to


                               AGEISM
              Prof . Dr. VOK            2
Keine Sorge – keine Angst



Wir sprechen Deutsch!




                 Prof . Dr. VOK   3
Are you prejudiced?
 Do you say “aaawww, isn’t
  she cute?” when you see an
  older woman doing
  something a younger
  person might do (e.g.,
  having fun, kissing a man)?
 Do you think older people
  aren’t appealing because of
  their physical appearance
  (e.g., loose skin, wrinkles,
  gray hair, weight around the
  middle)?
                          Prof . Dr. VOK   4
Are you prejudiced?
 Do you think all old
  people are wise?
 Are you uncomfortable
  talking to elders?
 When you talk to older
  people do you look
  them in the eye?
 Are elders all “old
  people” to you or can
  you see each as an
  individual?         Prof . Dr. VOK   5
 Beliefs about Aging and Older People
The Social Construction of Aging
  Youth, speed, production ($) are American
   ideals
  Physical and mental weakness are stigmatized
    feel ashamed or embarrassed when weak, ill, or need
     help
  You have done something WRONG if you
   become ill or old or poor
     Blame the Victim


                         Prof . Dr. VOK               6
 Beliefs about Aging and Older People
The Social Construction of Aging
  Values underlie attitudes and stigma
     Survivor of the fittest
       • (I [behavior or attitude] and am alive/well and Mr. X didn’t so
         he became old/ ill/died
        • Control, control, control
             Do not believe that uncontrollable forces or chance has
               anything to do with becoming old or ill
     Belief in simple cause and effect relationships
       • e.g., She got cancer because she did/did not [behavior or
          attitude]


                                  Prof . Dr. VOK                      7
          Robert Butler on Ageism
In the 1960s, Robert Butler coined the phrase ageism,
which he defined as:

"A process of systematic stereotyping of and
discrimination against people because they are old, just
as racism and sexism accomplish this with skin color and
gender. Old people are categorized as senile, rigid in
thought and manner, old-fashioned in morality and skills
. . . . Ageism allows the younger generations to see older
people as different from themselves; thus they subtly
cease to identify with their elders as human beings . . . ."
(See R. Butler, Why Survive? Being Old in America, 1975 - item no. 71 of
this bibliography.)


                               Prof . Dr. VOK                              8
Ageism

Ageism can be coupled with
 other forms of oppression
      sexism, racism, beautyism…
      a powerful combination
  It all adds up to the beliefs that –
     AGING is bad
     AGING is ugly
     AGING is to be avoided
     AGING is a social and economic crisis
     We need to FIGHT AGING
                          Prof . Dr. VOK      9
Ageism

“A man's face is his autobiography. A
 woman's face is her work of fiction.”

          Oscar Wilde




                         Prof . Dr. VOK   10
                               AGEISM & SEXISM
                               The Double Standard
The men shown here are the plastic surgeons – note they haven’t been
touched up.




                               Prof . Dr. VOK                          11
What? We’re Prejudiced? Are you?
 Lots and lots and lots of examples in daily life…

  Conversations
  Jokes
  Television
  Birthday cards
  Newspaper
  Magazines
  Music lyrics


                       Prof . Dr. VOK                 12
 Ageism and the Media
 Subtle? NOT!
 Music http://music.msn.com/music/features/bandsofthelivingdead
   Is music only for the young?
   Rockers and rappers who are in their
    40s, 50s, and 60s are referred to as
    “living dead” -- Writer states they
    “refuse to die”
   Old men rockers are one thing but old
    women?
                              Prof . Dr. VOK                       13
Ageism and the Media
Subtle? NOT!

Prejudice and discrimination on TV
  Less than 2% of prime time television characters are
   65%
  Majority of film and TV writers are white men under 40
  Only 1/3 of older characters on prime time TV are
   women
  70% of older men and 80%+ of older women on TV are
   portrayed disrespectfully, treated with little if any
   courtesy, and looked at as “bad”
      Examples from Ageism in America: Status Reports of Ageism in America by The Anti-
      Ageism Taskforce at The International Longevity
                                     Prof . Dr. VOK                                       14
 The Truth About Aging
 The truth is that most older people are more
  vulnerable due to losses
   Physical losses
      May not be able to walk, drive, grocery shop, clean house, talk on
       telephone, see instructions or watch television, etc.
   Social losses
      Loss of parents, spouse, siblings, friends
      Coupled with physical, income, and cognitive, may lose ability to get to
       and enjoy social activities
   Income losses
      Retirement
   Cognitive losses
      Some processing changes and memory loss are normal
 And sadly enough, some people prey on older
  people’s vulnerability
                                 Prof . Dr. VOK                             15
    Age Discrimination & Health Care
 60% of adults aged 65+ do not receive
  recommended preventive services
  40% do not receive flu and pneumonia vaccines
 Only 10% of elders receive screening tests
  for
  Bone density
  Colorectal and prostate cancer
  Glaucoma
    Despite the fact that the average age of colorectal cancer
    patients is 70, more than 70% of prostate cancer is
    diagnosed in men 65+, and people over 60 are 6 times
    more likely to have glaucoma
                              Prof . Dr. VOK                     16
     Age Discrimination & Health Care
 Chemotherapy is underused in the treatment of
  breast cancer patients aged 65+ even though
  survival could improve with many
 Older patients are significantly underrepresented in
  clinical trials for all types of cancer but notably in
  trials for breast cancer
 Older persons are the biggest users of prescription
  drugs, yet 40% of clinical trials between 1991 and
  2000 excluded older persons



                            Prof . Dr. VOK                 17
Race and Gender Discrimination in
Health Care
                 The Effect of Race and Sex on
                   Physicians’ Recommendations
                   for Cardiac Catheterization

                 Article in The New England Journal
                   of Medicine, 2/25/99

                 By Schulman, Berlin, Harless,
                   Kerner, Sistrunk, Gersh, Dube,
                   Taleghani, Burke, Williams,
                   Eisenberg, & Escarce


              Prof . Dr. VOK                        18
Background
 There are sex and race differences in terms of
  the prevalence of heart disease, heart attack,
  and death from heart attack in mid and later life
  in particular.
   African Americans and women are more likely to
    die from heart disease and heart attack and also
    have higher rates of hypertension.
 Women and African Americans tend to have
  greater functional disability due to angina
  before myocardial infarction as well.
 Cardiovascular tests and procedures can help
  with quality of life and the extension of life.
                        Prof . Dr. VOK                 19
Research Question & Methods

 Research Question
  Does the race and sex of a patient independently
   influence how physicians manage chest pain?

 Methods
  Actors portrayed male/female white/black older patients
   (age 55 and 70) with particular characteristics in scripted
   interviews about their symptoms
  Identical data given to physicians about patients
   (medical history, results of tests, etc.)
  Sample of 720 physicians derived from attendees at two
   national medical conventions
  Computerized survey asked physicians to make
   recommendations for managing the patient’s chest pain
                           Prof . Dr. VOK                    20
Results
 Physicians’ mean estimates of the probability of coronary artery
  disease were lower for women
 A sophisticated logistic regression analysis indicated that the odds
  of women and African American patients being referred for cardiac
  catheterization was lower than for men or whites
    Looking at the effect of the double whammy (sexism and
      racism), it was found that Black women were significantly less
      likely to be referred for cardiac catheterization than white men
 Some believe that people are most sympathetic to people like
  themselves; hence, the finding (white male doctors tended to favor
  or refer white men)
    Along these lines, one could ask -- Were the female and Black
      cardiologists more likely to refer women and African Americans
      for cardiac catheterization?

                                Prof . Dr. VOK                           21
You might ask – but aren’t college-educated
 younger adults less likely to be prejudiced
 than others?

And finally, you might ask – aren’t nursing
 students less likely to be prejudiced?


                    Prof . Dr. VOK            22
Study of Standardized Patients

Nursing students
Which patient was ascribed the most
 negative characteristics?
Which patient was least preferred to work
 with?
Why?



                   Prof . Dr. VOK            23
Your Beliefs and How They Affect You
and Your Treatment of Others

  How much control over things do you feel
   you need to have to be okay, live life as
   you’d like, and avoid anxiety?
  How much control do you think you have
   over aging and disease?
  What impact do you think your notions have
   on your behavior?
  What impact do you think your notions have
   on the way you view others’ behavior?
  What impact to you think your notions have
   on the way you will treat others who are
   aging, dealing with health decline, disability,
   disease, pain and suffering, dying?


                               Prof . Dr. VOK        24
More Examples of Age-Related
Vulnerability in Today’s World
                  Out of sight, out of mind?
                          14,802 persons, mostly
                           elderly, died in France
                           during a 2003 heat wave
                          20% of health care
                           providers were gone,
                           most French families
                           were on vacation
                          Should government have
                           provided? Should people
                           have not vacationed?
                  Prof . Dr. VOK                     25
What is Resilience?
The Resilience of Elders of Color
The Resilience of Older Women



              Prof. Dr. VOK         26
 Ethnic Minority Distribution of Older Population
84.3% of total population 65+ is White and 15.7%
are ethnic minorities (8.1% African American, 5.6% Latinos,
      2.4% Asian/Pacific Islanders, 0.4% American Indians)




                            Prof. Dr. VOK                    27
            Ethnicity and Culture
   Know definitions of ethnicity and culture
   What is “resiliency?”
   Why do we even talk about the resiliency
    of particular groups?
   What social forces impact minority elders’
    lives? women’s lives?
       What interactions does the book say begin to
        add up and cause stress?
       Know what the double jeopardy hypothesis is

                         Prof. Dr. VOK                 28
           Issues Common Across
               Elders of Color
   Cumulative structural disadvantages
       Low paying jobs, higher poverty rates, more
        single women
       Lower rates of insurance coverage
       Sociocultural (structural and family-related)
        barriers to health care and social service use
   Centrality of family/kin
   Chronic illness patterns

                          Prof. Dr. VOK                  29
              Social Forces
   How do minority and women elders
    become “resilient?”
   Is the answer to force individuals to
    become resilient or should we change
    society?




                     Prof. Dr. VOK          30

				
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