Just as there is racism and sexism, there is ageism. For those who have not yet come across this new term, the Accademia della Crusca defines it as “discrimination, prejudice or marginalization of a person in relation to age; in particular discrimination against older adults”. A form of exclusion, therefore, yet considered acceptable and not as reprehensible as the others: suffice it to say that, according to the World Health Organization (WHO), one person in two displays ageist behavior.

This word became established in Italy from 2020, but the English equivalent from which it derives, ageism, dates back to 1969, introduced by the US psychiatrist and geriatrician Robert Butler. The reason it is important to know and recognize ageism is that it has profound implications for both society and the health system of a country. In particular of a country like Italy, where population aging is a significant issue.

We discuss it with Eleonora Selvi, President of the Longevitas Foundation.

Eleonora Selvi, why is it important to bring this term into our everyday language?

“We need to start from the fact that language makes a difference, because it is able to generate or slow down change. Think, for example, of the implications of using words such as racism, sexism or femicide. The word ageism began to gain ground when Covid confronted us with an ethical choice — which people to admit to hospital in a situation of limited beds and resources — and with strongly discriminatory communication: that ‘only older people die anyway’. Hence the question: what value do we give to different ages? And ageism does not only concern older people: it concerns young people when they are not valued at work, with a resulting waste of energy and resources, for example, or women who have a child when they are no longer very young. That is why it is very important for everyone to make this term commonly used”.

So is it first and foremost a cultural issue?

“Certainly. We must change the narrative about longevity, so that it is no longer perceived negatively, as a great tsunami. And we must create the conditions to avoid a ‘war between generations’ when resources are scarce. Around this motto, ‘changing the narrative’, a great many people and, in some cases, companies are coming together worldwide. Italy, which is the second longest-lived country in the world, should be a beacon and lead this change. Instead, I do not see great movements on the part of the institutions: we communicate little and badly on this topic. Ageism is still a taboo, to go back to the question of words: people prefer to talk about active aging instead. And yet the WHO gives clear indications to counter it, also providing toolkits for correct communication. What I see are above all grassroots movements”.

How do you think longevity should be considered?

“As an opportunity for everyone and for the country as a system, provided, however, that we manage to create the conditions for this to really be so. I am referring to the silver economy, to consumption linked to lifestyles, but also to the creation of networks for social inclusion, to countering isolation, to active prevention and health education, aspects we work on a great deal at the Longevitas Foundation, collaborating with universities and local authorities. We must remember that ageism toward older people is a negative view that leads us to associate age with frailty: when it is internalized, it worsens quality of life. An example? If I am 80 and everyone tells me that my life no longer has any value, then there is no point in my doing prevention. This has enormous social and economic repercussions. A study published in Gerontologist on people over 65 showed that the probability of dying within 9 years is 45% in older people who have a negative self-perception of aging, compared with 10% in those without negative stereotypes”.

How can change be achieved?

“We have identified three key actions. First: promoting both awareness and education campaigns to recognize and counter age-based discrimination, and lifelong learning programs. Second: fostering intergenerational relationships, through the creation of inclusive environments and meeting places. This means rethinking urban environments in a new way: we do not want cities designed for older people, but for everyone. Otherwise we will have ghettos. A good example is the neighborhood social spaces in Rome: former senior centers that have now become centers where many kinds of activities are held for all ages, with cultural offerings at better prices than the market. The third point is work: an increasingly dynamic dimension, which changes quickly and in which we will have to stay longer and longer. Companies risk, on the one hand, finding themselves with a great many mature employees, experiencing them as a burden because they lack the managerial culture to use them in the right way; on the other, under-using young people. We must promote all those forms of mentoring aimed at improving the relationship between generations in the world of work”.

Let’s now talk about ageism in healthcare. What exactly is it?

“The age-related discrimination, prejudice and stereotypes in healthcare. Suffice it to say that 40% of people over 85 with heart problems are undertreated. We do not want to be utopian, because we know that the national health system is on the verge of default, but there must be an overall vision that, in our opinion, is lacking today. This is the aim of the Florence Charter, the first manifesto against ageism in healthcare, drawn up by an international panel of experts in which we took part, led by the president of the Italian Society of Gerontology and Geriatrics, Andrea Ungar (the manifesto is published in European Geriatric Medicine and Journals of Gerontology, ed.). The document lists 12 concrete actions to minimize the negative impact of ageism in healthcare. First of all, it is necessary to educate healthcare workers. In addition, June 17 has been established as the World Day against Elder Abuse. We ask the European Union to do its part and to push all governments to make countering ageism in healthcare mainstream.

Is there gender ageism? Are women more discriminated against?

“For women, ageism adds to gender discrimination and the result is, in my opinion, among the most devastating. We are talking about widely tolerated discrimination: women lose social value when they are no longer sexually attractive, and this shifts attention toward a form of self-care that is not healthy: a process of body transformation that drains women’s economic resources, and psychological resources too. The bar is moving lower and lower: look, for example, at Sweden, which had to outlaw the consumption of anti-age products for under-16s. The explosion of cosmetic products aimed at teenage girls is also a form of marketing-driven ageism: it has been decided to lower the age of consumption of certain products at the expense of people’s safety: it is essential that parents are aware of this and act as a barrier, but also that institutions take on the task of countering this phenomenon. I believe that a code of ethics on these issues, which will become increasingly disruptive, is urgently needed. Without an awakening of awareness, there will be no going back”.