Guest Column: Kate De Medeiros
For the first time in human history, more people in the world are aged 60 and over than under age 5. Although this shift in age structure is a direct credit to the success of public health efforts — clean water, vaccinations, reproduction education — it has been met with alarmism and misunderstanding. Phrases like “gray tsunami,” which link aging populations to devastating outcomes; zombie metaphors that characterize older persons as endless consumers of scarce resources such as health care; or works such as Zeke Emanuel’s controversial 2014 essay in The Atlantic titled “Why I Want to Die at 75” unfairly and inaccurately misrepresent both the great heterogeneity in older persons and the potential benefits or demographic dividends in aging societies. In reflecting upon Week Four’s lecture series exploring longer, fulsome lives, I therefore raise some points to consider on how social contexts shape how we think about later life.
In social gerontology (a social science discipline that explores structures and policies affecting the experience of growing old), we describe aging as a social construction of a biological phenomenon. Social rules (for example, at what age is a person entitled to certain rights and privileges?) and values imbue physical change and the passage of time with meaning. German Chancellor Otto von Bismarck, for example, originally established age 70 as the official retirement age in his newly created welfare state in the 19th century, eventually lowering it later to age 65. Why 65? It was simply an age where he saw a sharp decline in the number of citizens making his program more affordable to administer. Even though researchers know that chronological age is a poor predictor of many things, and that nothing magically changes in people when they turn 65, 65 still stands out as the marker of “old age” in many countries. In countries like Thailand, where the mandatory retirement age is lower, age 60 is considered “old,” even though people there can expect to live 25 more years than that on average — or more. That leads to my first point to consider: What determines when a person becomes “old” and why?
Additionally, ageism, or the devaluation of people because of their perceived age, is another important consideration. Ageist practices — toward others or ourselves — emphasize the idea that aging is bad. Examples of ageist practices include phrases such as “young lady” to a person that is clearly not young, which actually emphasizes the point that the speaker thinks the person is old; self-deprecating humor such as “I’m having a senior moment,” that serves as a type of apology for aging; birthday cards meant to shame a person for getting older; or even using the term “elderly” to categorize a large group of people as frail and/or helpless based on chronological age. Aging activists such as Ashton Applewhite have called ageism the last socially accepted form of discrimination today, actively calling out ageist practices in media and on social platforms. Points here to think about include: Do ageist practices and attitudes cloud our views on what it means to grow old? Are there social risks in claiming old age as an identity?
Finally, there are misconceptions regarding life expectancy and lifespan, which present a skewed picture of what the shift in age structure means. Life expectancy at birth describes the average number of years that a person born in a given year and given place could expect to live. Lifespan is the theoretical maximum number of years that a given species can live. In the United States, life expectancy at birth changed from around 50 years in the 1900s to around 78 years in 2019. Lifespan has remained the same — 120 years. As an average, life expectancy at birth was low at the turn of the 20th century due to high mortality rates (only 1 in 5 children on average survived past age 5). A life expectancy at birth of age 50 didn’t mean that few people lived to be older than 50, but rather fewer people survived childhood to reach old age. Recently, the United States has seen a decline in life expectancy at birth because of the opioid epidemic. In addition to declining infant mortality, fertility rates have also declined. In many countries such as Germany, birth rates are well below population replacement rates, leading to overall population decline and aging. Understanding the differences between life expectancy and lifespan is important in dispelling the myth that people are surviving longer due to extreme measures in health care or technologies that push human life past its “natural” limits. There are not large groups of older persons living on life support or living in nursing homes (fewer than 4% of people age 65 and over in the United States are nursing home residents). Instead, breakthroughs in cancer treatments, for example, have allowed people who may have died at a younger age to live longer. For some, added years mean added risk for other chronic conditions such as Alzheimer’s disease, or for a fall that might cause a hip fracture. Given the full picture of life expectancy and lifespan, some points to consider include: How is older age being portrayed regarding health care and health care expenditures? Are there key aspects that are being overlooked or under-emphasized?
As the Week Four lectures present a variety of perspectives on longevity — including talks centered on policies and aging, health disparities, frailty, technology and spiritual aspects of later life, I encourage everyone to think deeply on what shapes their own attitudes toward aging and later life, to challenge stereotypes they may have about what it means to grow old, and to consider what they can do to positively change the social contexts that frame old age.
Kate de Medeiros is the O’Toole Family Professor of Gerontology at Miami University of Ohio, where her research interests are concerned with cultural structures affecting the experience of aging and the construction of self, such as autobiographical writing, as well as personhood in people with dementia. She is one of three Miami faculty on the grounds during the 2019 season as part of a Faculty Fellow program made possible by a philanthropic gift aiming to expand dialogue beyond the confines of Chautauqua in the tradition of the Chautauqua movement, as envisioned by its founders. She will lead post-10:45 a.m. lecture conversations at 12:30 p.m. today in Smith Wilkes Hall and Thursday in the Hall of Christ.