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Getting Senior Issues on the Policy Agenda

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By Thomas Gresham

Is ageism the reason it’s so tough to get policy and legislation for older people onto the political agenda? Do politicians understand what matters to older adults?
If you want to understand why progress on crucial issues related to aging seems slow and elusive in today’s policy climate, you may have to travel back more than 50 years to when a series of milestone pieces of legislation radically improved conditions for many older adults.

That’s where Brian Kaskie’s thoughts go. Kaskie, an associate professor of health management and policy at the University of Iowa, points to the 1960s, when the United States expanded the Social Security System, passed the Older Americans Act, and created Medicare and Medicaid.

At the time, Kaskie says, the problems faced by an aging population were pervasive and relatively uniform, such as insufficient retirement savings and poor health care coverage.

Those transformative federal legislative efforts proved to be sustainable in later decades, and Kaskie says their enduring success raising the quality of life for older adults helps explain the inadequate attention paid to aging in policymaking today.

“It seems what’s happened is that we put all this on autopilot,” says Kaskie, editor-in-chief of Public Policy & Aging Report.

“And any political activity that has to do with the financing of older persons or the health care of older persons really is left to the halls of bureaucracy. It’s just not part of any national agenda that Congress or the president really spends a lot of time on.”

Ageism a “major barrier”

In March 2021, the World Health Organization released its Global Report on Ageism, which highlighted worldwide challenges associated with ageism and the way that the issue touches on all aspects of society. Ageism, the report says, “is a major barrier to enacting effective policies and taking action on healthy aging.”

Ageism’s impact can be difficult to nail down in a concrete way, but experts agree that ageism undoubtedly has an influence on the way that policies related to aging issues are treated by both policymakers and the public, among an array of challenges.

Ageism in action

Janine Vanderburg, director of Changing the Narrative, a strategic communications and awareness campaign aimed at ageism, says ageism simply is “rampant,” pointing to an AARP study indicating that 78 percent of people age 45 and older experienced or witnessed workplace age discrimination; and a University of Michigan study that found that 82 percent of people age 50 to 80 in the United States had experienced everyday ageism.

The largest obstacle to overcoming ageism in the public policy realm is how pervasive and accepted it is, even among well-meaning individuals, Vanderburg says.

“Researchers talk about unconscious or implicit bias: Because of messages we’ve received from childhood on, we subconsciously form negative judgments about people based on their age,” Vanderburg says.

Patricia D’Antonio, vice president of policy and professional affairs for the Gerontological Society of America, says everyone is susceptible to being ageist in some way.

“There’s that explicit ageism that we hear sometimes, but then there’s also this implicit bias that people have that they don’t even realize they have,” D’Antonio says. “Even as we age, we have that, so older people themselves may have some of that implicit bias—that internalized bias—about aging. That does impact public policy.”

Dearth of diversity

Older adults represent a broad swath of people, but D’Antonio says popular culture tends to focus on two visions of older adults—frail and bedridden or carefree and active.

“I don’t think that we recognize how diverse we become as we age,” D’Antonio says. “I think that affects policy because when we choose certain messages about aging it affects how people think about aging.”

As Jan Mutchler, director of the Gerontology Institute at the University of Massachusetts Boston, says, “There’s a kind of shorthand that we do all the time, particularly in the media, to reduce complicated stories to simplistic things. That’s a place where ageism is really reinforced.”

Similarly, Kate de Medeiros, a research associate at the Scripps Gerontology Center and a professor of gerontology at Miami University, says a common stereotype she sees applied to older adults are that they are “weak and dependent.”

That creates a skewed perspective that hovers over policy discussions and infuses the policies that result.

“On one hand, it’s sometimes done to help encourage policies to take care of these people, but what it also does is it works in the opposite way and reinforces these negative stereotypes,” de Medeiros says.

“That, in turn, can hurt older workers, older people in general, because they’re portrayed as weak, less than competent and in need of protection.”

A lack of attention

Kaskie says there “absolutely” has been a lack of attention given to aging and public policy.

Kaskie says the aging population has become more diverse not only in terms of racial and ethnic composition but in terms of financial stability, health status and education background. For a population defined by their age, they even differ widely by age, especially as Americans’ lifespans have grown.

As Frank Newport, a Gallup senior scientist, noted in an essay, “The 65 and older ‘senior’ category is large and includes people whose ages can differ by more than 30 years. This makes the seniors category bigger than any of the three other commonly used age groups, and one that includes people who were born at quite different times in our nation’s history and thus with different life experiences.”

“It is good to be aware that ‘seniors’ as a group today are hardly monolithic, particularly in terms of their approach to politics,” Newport wrote.

Not a monolith

Still, even as the demographic of older adults has become less uniform, they still frequently are viewed as a singular voting block, ignoring the complex intergenerational dynamic that exists. Consequently, the major challenges that loom for subgroups within the older adult demographic, such as those who are not financially prepared for retirement or those with major health problems, can still get overshadowed and lost in the public debate.

In that vein, Vanderburg says public policy addressing aging issues is incomplete, emphasizing certain issues while ignoring other important ones.

“The public policy focus around aging issues too often reflects ageist stereotypes that are prevalent in society—for example, that aging is all a time of decline, deterioration, dependence, depression,” Vanderburg says.

“So policy discussions tend to focus exclusively on things like long-term care, financial fraud, and more. These are really important issues, but other really important issues that also impact quality of life are being ignored. What we don’t do is include older adults in policy discussions around broader issues like workforce development. We know that older adults both want and need to work. But rarely does workforce development policy include discussions of how we can ensure that people have access to training and upskilling across their life spans.”

In addition, Vanderburg believes ageism is reflected in the fact that Medicare does not cover vision, dental and hearing (though she notes hearing’s prospects are improving), and “attempts to get those covered in recent proposed federal legislation have for the most part been dismissed.”

Also, she says, “across the country, and in most places, workplace age discrimination is treated less seriously in the legal system than other forms of discrimination.”

Vanderburg says ageism arrives in policy discussions in a variety of forms. For instance, Vanderburg says a colleague shared with her that a policymaker had expressed a reluctance to support legislation that would increase home sharing among older and younger adults because older people “might be taken advantage of.”

“Just like the rest of us, policymakers aren’t immune from having stereotypes that can inadvertently affect their decisions,” Vanderburg says.

No sound bite issues

Part of the challenge with confronting ageism in public policy discussions, Kaskie says, is that it often is difficult to pinpoint how much of an impact ageism has on those debates, just as it can be complicated to prove someone is the victim of an individual case of age discrimination.

In general, Kaskie says the policy issues specific to aging adults are not polarizing enough to draw the spotlight, and that can keep them from being more of a priority for either party.

“Our issues aren’t made for TV,” says Kaskie, who has served as a congressional fellow working with the Senate Committee on Aging. “When you think of the two tails of both parties, the most vocal persons who get on TV the most spend more time talking about issues that are fairly divisive—issues that really separate the two political parties. You don’t hear about how these two very distinct parties are finding common ground and working to solve problems that would benefit a lot of older persons because they don’t rise to the level of being featured on MSNBC or Fox. So then it just doesn’t rise to the top of the agenda. And so that’s keeping us from moving forward.”

D’Antonio says one place where ageism can be most apparent in the spotlight of public policy debates is in the ways that older policymakers themselves become the target of hostile age-related remarks.

“There are people who simply think that they can talk about older people in a certain way, and we hear that when people talk about policymakers sometimes,” D’Antonio says. “It’s a very distressing part of the discourse. Calling that out is really important.”

Kaskie notes that the rise of the diversity, equity and inclusion movement largely has bypassed the consideration of ageism and its impact, including in the workplace, and De Medeiros says that the increasing care taken to use preferred terms for groups of people has yet to extend to older people. That exclusion has made it more difficult to gain a foothold in policy discussions related to diversity efforts.

De Medeiros says policymakers are insulted because of their age for evidently problematic reasons.

“Age is often viewed as a negative, especially when people aren’t happy with a certain policymaker,” de Medeiros says.

“We can think about the accusations of Biden having cognitive deficits or we saw this when John McCain ran as well.

It’s something we see time and time again. They get demonized for their age.

“Then, on the other hand, we haven’t heard Anthony Fauci called out for his age. So, it can depend on the particular individuals whether age is villainized or not. It’s unfortunately a fallback when people blame things on age when they’re not happy with other things, and it’s a huge obstacle. It’s this socially acceptable way of criticizing people that nobody seems to be that bothered by.”

The pandemic’s impact

Vanderburg believes there are signs that the pandemic both made ageism worse and exposed existing ageism.

For instance, she noted that two viral hashtags on social media referred to the coronavirus pandemic as #BoomerRemover and #GrandmaKiller.

“This sort of thing exposed the ageism that has always been there,” Vanderburg says.

De Medeiros believes COVID-19 exacerbated ageist behaviors in the workplace, too, pointing to reporting that older workers may have missed out on professional opportunities due to employers taking “protectionist” stances that keep them home.

Among the policy issues that Vanderburg says stood out during the pandemic were that nursing homes and skilled nursing facilities were not prioritized for personal protective equipment, and “presumably well-meaning policymakers were issuing stay-at-home orders that targeted older people, while suggesting that younger people could carry on.”

In addition, a political figure suggested that grandparents should sacrifice themselves for the economy and “within a few months that same idea was emerging in economic policy reports,” Vanderburg says.

“Older people were disproportionately moved out of the workforce, and because of the current weak state of age discrimination laws and the lack of public interest in devoting workforce development efforts at older people, they continue to remain unemployed,” she says.

Awareness, then action

Mutchler believes increased awareness of ageism is cause for optimism, even if formidable challenges remain.

“I think we’ve made progress and awareness, and that I think is at least a positive,” Mutchler says.

“People are talking about it more, acknowledging it more, and obviously that kind of thing has to happen in order for progress to really be made. But there still are a lot of barriers to figure out before we can implement real change.”

Changing demographics including the aging of the baby boomer generation (those born between 1946 and 1964) could bring attention to aging issues and ageism in the policy realm with newly sharp focus.

“We’ve been talking for a long time about boomers eventually coming into old age, and here they are, and they’re as activist as ever, they are healthier than their older cohorts, they want to be involved, and they don’t want to be talked down to,” Mutchler says.

“I think that when you have a large cohort, even though it is a very diverse cohort, in terms of politics, cultural background, and all those kinds of things, it does sort of demand attention in a way that smaller ones did not.”

See yourself in policy

However, a crucial obstacle that limits the discussion of aging in public policy is that “when we talk about older people, we don’t recognize that we’re talking about ourselves,” de Medeiros says.

“It’s important to know that aging isn’t about someone else,” de Medeiros says. “It’s about all of us. We’re all aging. And, ironically, we all want to live as long as we can, but when people do, they’re penalized for it by being devalued.”

As an example of how a lack of awareness of aging issues’ universality can impact policy, Kaskie points to the abundance of resources available for the child-related needs of parents in the workforce but the relative dearth of resources for those same workers tied to helping to care for their own parents.

“There’s a lot of employers who just aren’t even aware of that, nor do their employees think about asking for it,” Kaskie says. “We need to be more focused on that and elevating those parts of the conversation to improve policies.”

Ultimately, D’Antonio says, the more people see themselves in policy issues tied to aging, the more progress can be made.

“It’s not only an impact for people over the age of 60, or over the age of 65, but as we look at policies in family caregiving, as we look at policies in nursing homes, as we look at policies in services provided, we can see that they actually benefit us all across generations,” D’Antonio says.

“I don’t think it’s really understood how these policies benefit all of us. It’s not an us versus them thing. It’s not about supporting one generational group versus another. It’s about benefiting all of us.”