“And these are the first signs:/Not knowing how, not hearing who, the power/Of choosing gone.” Poet Philip Larkin describes our growing sense of powerlessness as we age. Everyone grows old. Our energy wanes, our joints creak, our hair grays, and we require more medical care and support. Senile, archaic, useless. These are three of the pejoratives society uses to describe older adults. Such stereotypes (how we think), prejudice (how we feel), and discrimination (how we act) towards others or ourselves, based on age, are ageism. Alarmingly, ageism is so widespread that one in two people globally holds negative views toward the elderly. It seeps into institutions, media portrayals, and medical care itself (WHO, 2025). While prejudice or discrimination of any sort is harmful, ageism is especially destructive—mentally and physically—towards the most vulnerable. For many in the USA, ageism seems to be an ‘othering’ that is still ‘socially acceptable’ in many ways (Weir, 2023). Yet such discrimination based on age steers clinicians to choose fewer effective treatments for older adults. And it debilitates older individuals’ self-worth and well-being in all aspects. Because they are rooted in prevalent social preconceptions, the health disparities caused by ageism can only be alleviated through comprehensive action plans. All of us—the government, doctors, NGOs—are called to enhance medical service access, to educate society about ageism, and to improve health and wellbeing among older adults.
The current reality is grim. In the United States, 20% of adults over 50 report discrimination when seeking healthcare, often leading to poorer physical and mental health outcomes (Pelham, 2023). Ageism in healthcare denies treatment, delays prevention, and, in the most insidious form, shortens lives. For instance, older cancer patients (>65 years old) are often “excluded from clinical trials” and denied aggressive treatment from health professionals deeming them “too physiologically old” (Schroyen et al, 2014). They also tend to be excluded from drug trials, such as new cancer therapies in oncological studies (The Lancet, 2023). This age-driven discrimination widens public health disparities severely but remains overlooked. So far, no oncology intervention on ageism has been implemented (Hasse et al, 2023). In general, with ageist beliefs, “clinicians’ biases can result in unequal treatment, fewer referrals, or misdiagnoses” (Time, 2020). Ageism also exacerbates other social inequities, amplifying disparate outcomes due to race and gender, which compound the harms of ageism. For example, compared to white men, Black women over 65 are significantly less likely to be recommended life-saving procedures such as joint replacement surgery, showing how ageism intersects with racial and gender biases to intensify inequality (King’s Fund, 2023).
More insidiously, age discrimination heavily influences how people see themselves and thus undermines their agency and how they advocate for themselves. Typical examples of such scenarios are avoiding yearly health inspections or a passive-aggressive attitude towards treatment. In fact, research shows that older adults who internalize negative age stereotypes increase their risk of cardiovascular disease, worsening health outcomes in the future (Laber-Warren, 2023). When older adults internalize ageism, they are less likely to seek preventive care, adhere to treatment, and even have shorter lifespans—up to 7.5 years less—than those with more positive self-perceptions (Levy et al., 2002). More recent research further supports the view that such age prejudice erodes mental health, increases rates of depression, anxiety, and avoidance of preventive checkups (Frontiers in Medicine, 2021). Delays in treatment may seem to be a trivial matter, but they often worsen chronic conditions and raise mortality risks—making the fact that 85% of studies found such delays particularly alarming (Time, 2020).
The consequences of ageist prejudice also structure daily interactions at clinics and hospitals. Consider the patient Joanne Whitney, for example. An 84-year-old retired clinical professor of pharmacy, Whitney, described her feeling of being “devalued” and treated as “muddle-headed” while interacting with healthcare personnel and professionals (Graham, 2021). Such an experience denies her lifetime expertise in the clinical field. Whitney is not alone. Her experience illustrates systemic ageism, where older adults are consistently underrepresented in clinical trials, dismissed in medical decision-making, and deprioritized in resource allocation, reflecting not isolated incidents but ingrained structural bias. Excluding older patients in clinical trials can be lethal, as the comorbidities that older people tend to have are not considered in the trials—they can enlarge current health disparities to an alarming degree.
Although ageism is sometimes overlooked in favor of gender or ethnicity, it is key to understanding the reasons for treatment disparities in our elder population. Why does ageism occur? We will have to look beyond the healthcare system. Cultural preconceptions, in combination with other types of injustice, perpetuate it across society.
Cultural stereotype shapes how one may act in a certain environment. This applies to older adults, too. Under ageism, our elders suffer from negative self-perceptions, such as the belief that older adults like them are inherently fragile or cognitively incapable of action. This discourages preventive care and strong advocacy when seeking treatment. And thanks to social media and a lack of awareness compared to race and gender, stereotypes of ageism may spread more rapidly. Media portrayals that depict older adults as burdens will further strengthen people’s attitudes toward the older population. Older adults rarely make appearances on social media, and if they do, they can be either stereotyped into a despondent curmudgeon or perfect grandparents (Weintrob,2022). However, aging adults are a heterogeneous population and often demonstrate more resilience and more mature coping ability than younger adults. In fact, Japanese centenarian cancer survivors showed “greater well-being” than their younger counterparts (Shikimoto et al, 2025). People aged 50 and over are also found to display strong resilience amidst challenges (Carey, 2021). Therefore, to limit treatment, care, and support options simply based on age bias constitutes cruel injustice for older patients and their loved ones.
Even though ageism may be consequential in many areas, it is preventable. Along with both cultural perception and structural change, ageism can be transformed and decreased. On the cultural side, public health programs and communities that promote “successful aging” can reshape the entire system: how older adults view themselves in terms of biases, and how they perceive others view them. This action will finally encourage preventive health behaviors, boosting both mental and physical well-being (Frontiers in Medicine, 2021). Clinicians should be trained to learn and understand the elderly patients, as well as their own values, ensuring equitable treatment and respect for older patients. Structurally, institutions must incorporate age into broader health equity frameworks, just as they do with race, gender, and disability (WHO, 2025). In addition to addressing salary disparities and guaranteeing older workers have access to healthcare benefits, policy measures can enforce rights against employment discrimination. The inclusion of older populations in research and data collection is equally vital because their exclusion produces harmful blind spots, as was the case with early HIV reporting that overlooked those over 50 (Lloyd-Sherlock et al., 2020). Fighting ageism involves more than just prolonging life; it also entails enhancing its quality, maintaining dignity, and reestablishing equity.
Ageism is reversible, even if the flow of time may not be. In addition to improving the health of the elderly, treating them fairly and with dignity makes our healthcare system more humane for everyone.
References
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