COVID-19 Reporting Makes Ageism Acceptable
Last weekend, in their June 13–14 issue, the Wall Street Journal titled their leading editorial — the one in the upper left, with extra-large type — “The Covid Age Penalty.” The article begins, “By now it’s clear that people older than 65 are the most vulnerable to the novel coronavirus.”
There’s just one problem. There’s no published evidence that age alone makes people more susceptible to getting the virus or a more severe illness.
In fact, this article goes on to say, “The good news is that most people over 65 who are in generally good health are unlikely to die or get severely ill from COVID-19.”
So…why doesn’t the influential WSJ title their lead editorial, “The Comorbidity Penalty?”
Evidence from Outside the US: It’s not about age.
Shortly afterward, the same WSJ published a knowledgeable, credible article: Virus Hits Younger People More In Poor Places. In Mexico, just 17% of Covid deaths occur in people over 75; that number is 12% in India. The article says:
“Doctors say the virus isn’t behaving differently outside the US and Europe. It still causes far more complications for the elderly than the young. The reasons more middle-aged people are dying in poorer countries include demographics, a greater prevalence of underlying diseases, and weaker health care systems…”
“Another reason fewer older people are dying in poorer nations is the lack of institutionalized care for the elderly. An estimated one-third or more of deaths in the US have taken place in nursing homes…”
Like most media sources, the article provides facts but refuses to draw the obvious conclusion. Age isn’t the culprit. Comorbidities and crowded living situations contribute strongly to susceptibility to COVID-19 and to severity of cases among those afflicted.
“Everybody knows” means, “This is a lie.”
Amidst the furor of COVID-19, news stories continue to demonize, patronize, and insult older people. I’m working on a book (When I Get Old I Want To Be A Bitch) that challenges the stereotypes. And I’m infuriated to see COVID-19 giving ageism a big boost, all in the name of science.
The implications are terrifying. That WSJ article even says, “This is a tragedy in lives cut short, but it also means that states and cities should be able to lift their lockdowns safely if they focus on protecting vulnerable Americans.”
What’s next: protective concentration camps?
Even the most reputable news sources reinforce the stereotype.
These ageist statements are so commonplace that people nod along (“Everybody knows it”) without questioning theory truth. Here are some examples from some of the most trusted mainstream media:
(1) “Let’s say they are older…”
“I think that, if a person is really trying to minimize their risk — like, let’s say they are older, or have a respiratory or cardiovascular condition…” That’s Asaf Bitton, a primary-care physician and public-health researcher associated with Harvard and Brigham and Women’s Hospital, interviewed by Isaac Chotiner for the New Yorker.
(2) “Seniors are the most vulnerable…”
A Time Magazine article: “The virus doesn’t hit all demographics equally hard — and seniors are the most vulnerable.”
(3) Stay home, seniors!
A Florida news site, The Apopka Voice, added a rather patronizing headline: “Stay home, seniors: COVID-19 recommendations for Florida’s older population.”
“Given that the state’s death toll has now surpassed 1,100 and there are at least 32,138 confirmed cases of the novel coronavirus in Florida alone, it might be high time for seniors in the Sunshine State to start taking the pandemic seriously. And that means staying at home.” [emphasis added]
In a truly bizarre twist, many of these articles go on to a more accurate position, just as the WSJ did:
“Older adults may be particularly susceptible…”
AARP’s website began an article with, “…researchers have learned that older adults may be particularly susceptible to the respiratory illness…” but then quotes immunologist, Vineet Menachery: “Age and your condition in life will really drive your susceptibility.” [Italics added.
“With underlying illnesses…”
“For most of [endangered American adults], their age puts them in danger: More than 76 million Americans are 60 or older…Age and underlying health issues go hand in hand: COVID-19 has so far been most menacing to older people with underlying illnesses.” — PublicIntegrity.org
“Especially those …”
NPR Podcast Host Scott Simon: “Of course, the highest rate of fatalities from the coronavirus has been among older people, especially those with underlying medical conditions.” [emphasis added]
Simon’s podcast guest Melissa Batchelor, Director of the Center for Aging, Health and Humanities at George Washington University in Washington, D.C., accurately says:
“So I think a lot of people think about older adults as one group — that they’re all the same, that they’re all very frail, disabled people. …Every older adult ages differently.”
But then she suggests people use tact when “checking up on” older neighbors.
“83% of deaths are people 65 and older, BUT…”
And (what’s up with Florida news?) the Tampa Bay Times for May 18 wrote: “In Florida, 83 percent of coronavirus deaths are people 65 and older.”
Sounds damning, right? But if you read further in the same article, “The percentage of deaths tied to care centers has been steadily increasing over the past several weeks. Now, at least 43 percent of deaths statewide can be attributed to long-term care facilities — the equivalent of 875 lives lost.”
What happens to the “over-65” death numbers when we remove the 43% associated with care centers? We don’t know. Nobody wants to tell us.
In fact, in the same article, Alberto Moscoso, a spokesman for the Florida Health Department, admits that citizens who test positive for COVID-19 is counted as a COVID-19 death … even if they die of something totally unrelated to COVID-19, such as a car accident.
So the whole headline turns out to be questionable at best. Yet that big number — 83% of deaths occur in the over-65 demographic — is what readers will take away.
News stories create false images of helpless seniors.
Writing in the New England Journal of Medicine, distinguished gerontologist Louise Aronson says [emphasis added]:
“The Wall Street Journal quoted a pulmonologist as saying that the patients on the Princess Cruise ship were not like the average septuagenarian because ‘They are not bedridden.’
“The average 70-something is not bedridden. People in their 70s run two of the three branches of our government and represent the most rapidly growing segment of the U.S. labor force.”
Paul Westhead was 68 years old when he coached the WNBA’s Phoenix Mercury to a league championship in 2007. Mary Nell Meadors coached the Atlanta Dream to the finals in 2010 at age 67. The 2017 New York City Marathon featured 88 runners over 75.
And in Philadelphia, Natalie Levant became a stand-up comedian at 81; eight years later, she’s still performing and her lines aren’t exactly G-rated.
Go ahead: tell them they’re helpless.
Bias can influence the presentation of accurate data.
Writing for the New York Times, Paula Span suggested that older Americans are particularly vulnerable to loneliness because they can’t take advantage of technology to connect. In fact, the article says, “about a third of Americans over 65 told Pew Research they weren’t confident about using digital technology.”
Why not say instead, “About two-thirds of Americans over 65 are comfortable with technology.” And why not add that tech-savvy represents a cohort effect, not an aging effect. Today’s 45-year-olds won’t forget their tech twenty years from now.
The impact can be almost comical.
The Time COVID-19 guide for seniors quotes a study in the Journal of the American Medical Association “showing that children 10 and under accounted for just 1% of all COVID-19 cases, for example, while adults in the 30–79 age groups represented a whopping 87%.”
Even if the disease were distributed evenly among age groups, you’d expected a smaller percentage in a 10-year age range compared to a 49-year age range. Someone’s desperate to exaggerate the impact of age on susceptibility.
Pointing fingers at “older people” has devastating consequences in these 3 ways:
(1) Reinforcing the stereotype of older people as frail and weak, which justifies treating them as second class citizens and denying them opportunities for meaningful employment. This stereotype gets reinforced when research reports fail to
(a) separate effects of chronological age from the effects of underlying conditions; and
(b) recognize the extremely large variation among “older” people, including variations in immunosenescence — the impact of aging on the immune system.
(2) Ignoring the real villain in the COVID-19 statistics: nursing homes, care homes, Native American reservations, and prisons
(3) Recommending protective measures for “older” people, which could actually cause them harm. Remaining at home, inactive, or in a subpar care home, will impair anyone’s immune system. It’s especially cruel to active
Reinforcing the Stereotype
The age stereotype assumes that (a) older people have weaker immune systems and (b) older people come with comorbidities. But published research and anecdotal evidence show that these reasons do not hold for all — perhaps even the majority — of older people.
Immune System Decline Is Not Inevitable Or Universal
Time Magazine, presenting a COVID-19 guide for seniors, quotes Dr. Steven Gambert, professor of medicine and director of geriatrics at the University of Maryland School of Medicine: “their [older people’s] immune systems, even if not significantly compromised, simply do not have the same “ability to fight viruses and bacteria.” As always, we don’t know if Dr. Gambert was accurately and completely quoted, but the message is clear: “When you get old, your immune system gets weaker. Deal with it.”
An abundance of anecdotal evidence shows a wide variance in elderly immune systems. For example:
On May 4, the AARP published an article, questioning the role age plays in surviving COVID-19, with an emphasis on “keeping the immune system strong.” This article begins by comparing the swift recovery of a 104-year-old with the death of a 52-year-old — anecdotal evidence.
The publication also quotes Atul Butte, a researcher in pediatrics and biostatistics at UCSF: “Some healthy older people had little or no decline in T cells. Some had as many as younger people, and women seemed to have higher amounts in general as they aged.”
The book What Makes Olga Run describes Olga Kotelko, a track star who began competing at age 77 and continued till her death in her mid-nineties. No one claims that Olga is typical, but she’s hardly the only person to remain fit and athletic well past her eightieth birthday.
A Guardian article interviewed five top athletes, aged 73–108.
And finally, you may have read the story of the 82-year-old powerlifter: she tackled a burglar who made the mistake of breaking into her home. He was relieved when the police came to take him away.
Research show Immunosenescence varies widely and can be modified.
Writing in AgingCell, a peer-reviewed journal (impact factor = 1), Niharika Arora Duggal et. al. compared immune profiles of 125 adults aged 55–79 with 75 younger but more sedentary adults. The active “older” group, who had engaged in cycling over a period of years
“had significantly higher serum levels of the thymoprotective cytokine IL‐7 and lower IL‐6, which promotes thymic atrophy. Cyclists also showed additional evidence of reduced immunosenescence, namely lower Th17 polarization and higher B regulatory cell frequency than inactive elders..”
Obviously these results should be understood within the limitations of a small cross-sectional study. Then again, it would be impossible to assign people randomly to regular exercise over a period of years. You’d have to order an equal number to remain sedentary, which would be cruel and possibly life-threatening.
A review study in 2018, published in Frontiers in Immunology (impact factor = 6.4), asks the question directly: Can physical activity counteract the effects of aging? These authors cautiously noted that the benefits of chronic exercise may be greater compared to the benefits from acute exercise, i.e., short-term training initiated at the beginning of an experiment.
However, the authors noted:
“Despite the immune system’s vulnerability to prodigious exercise training, the overall anti-inflammatory effect of exercise may reduce the risk of age-related chronic disease characterized by chronic low-grade inflammation (e.g., cancer, type 2 diabetes, heart, and Alzheimer’s disease).”
They conclude that “Many studies show the positive effect of exercise on the immune system such as elevation in T-cell proliferative capacity, increased neutrophil function, and NK cell cytotoxic activity.”
Generally, an article in the Handbook of Immunosenescence concluded, long-term exercise has been associated with positive outcomes, such as “increased responsiveness to vaccines, greater NK-cell function, reduced proportions of exhausted/senescent T cells in the periphery, lower frequency of pro-inflammatory monocytes, enhanced function and number of anti-inflammatory Tregs, and longer leukocyte telomere lengths.”
Therefore, breezy references to “weakened immune systems” need to be regarded with suspicion.
Although the jury seems to be out on the long-term benefits of short-term training, older people who have been exercising for a long time, in the absence of hereditary or environmentally induced changes, will most likely have “younger” immune systems, compared to the sedentary couch potatoes.
Forcing the elderly to lock down tighter than their younger counterparts would likely weaken their immune systems even further. If doctors really want to help older people, they might advise more fifty-somethings to get a gym membership instead of a colonoscopy.
Underlying Medical Conditions (Comorbidities)
Many publications have reported the story of Washington state choir members who were victims of a “superspreader.” According to the CDC version, 61 choir members attended a rehearsal on March 10. One member attended with what appeared to be symptoms of a cold.
Within days, 52 choir members came down with COVID-19: 32 confirmed and 20 “probable.” Of the “probable” cases, one later agreed to be tested, with test results negative. Therefore, the CDC article points out, it is possible that at least some of the 20 unconfirmed cases were caused by something other than COVID-19; the graphic showing 87% infection rate might not hold up if everyone were tested.
The median age of choir members: 69.
In other words, one half ranged from 69–83 and the other half from 31–68. All but three recovered without hospitalization; the three members who were hospitalized had more than two underlying medical conditions. This anecdotal evidence suggests that the underlying medical conditions — not the members’ age — influenced the severity of the infection.
Reinforcement comes from geriatrician and gerontologist George Kuchel of the University of Connecticut.
“It is not chronological age alone that determines how one does in the face of a life-threatening infection such as COVID-19,” he cautions in StatNews. “Having multiple chronic diseases and frailty is in many ways as or more important than chronological age.”
“An 80-year-old who is otherwise healthy and not frail might be more resilient in fighting off infection than a 60-year-old with many chronic conditions.” — Geriatrician George Kuchel
Science journalist Brian Resnick reports in Vox: “a March 4 analysis by the national health institute found that of the 105 patients who died from the virus, the average age was 81. This put a 20-year gap between the average age of people who tested positive for the virus and the deceased, the institute said.
As a side note, the average age isn’t meaningful in this case because outliers can bias the number; it would have been more helpful to report the median and range.
However, in the same article, Resnick reports, “Among the 105 patients who had died in Italy as of March 4, two-thirds had three or more preexisting conditions.” [Emphasis in the original.]
When you separate out pre-existing conditions, age disappears.
I’ve only found one source that differentiates causal factors of age and pre-existing conditions. The website Worldometers reported the percentage of COVID-19 patients who died, by age and by underlying conditions.
As of April 14 — Share of death WITHOUT underlying conditions (when it was known that the individual had no underlying conditions):
45–64: 59% [Note this is a 19-year range; the others are much shorter]
Obviously, it’s hard to gauge how accurate or universal these numbers are. But we just don’t have any others. And frankly, nobody’s looking.
Why mess with a perfectly good stereotype?
Finally, Time Magazine headlines an article: “Almost Every Hospitalized Coronavirus Patient Has Another Underlying Health Issue, According to a Study of New York Patients.”
The next step would seem to be an analysis: comorbidities by age. Instead, it’s all too easy to dismiss “older” people as inevitably coming with comorbid baggage.
Do older people really have all those underlying conditions?
Stereotype-lovers will be tempted to argue, “Older people and underlying conditions go together inevitably.” But is that true?
In their article Diagnostic Errors In Older Patients, published in the International Journal of General Medicine (impact factor not yet available), three co-authors found significant examples of both underdiagnosis and overdiagnosis among patients 65 and older. The authors noted that this article, published in 2016, was believed to be the first to explore this critical topic among elderly patients.
Anecdotal evidence agrees. In her book, Goddesses Never Age, Christiane Northrup (a board-certified OB-GYN) writes that older people are taking multiple medications, saying flatly that most are unnecessary.
And an article in Aging Care says, “Polypharmacy may be the biggest threat to seniors’ health, quality of life and longevity.” The article rather patronizingly targets caregivers and “loved ones.” But they do include a recommendation to review medications for side effects as well as for necessity.
“Protective” Policies Can Harm Older Citizens
Misconceptions and stereotypes lead to policies that are not just useless but also cruel. Some countries have put in place special restrictions for “older” people, such as denying them access to the outdoors except for short grocery trips. Yet we have seen that activity strengthens immune systems, meaning that enforced idleness and isolation might actually make older people more vulnerable when they do get the virus.
American politicians have talked about isolating this group when the country re-opens.
Speaking on the Hugh Hewitt Show, Vice President Pence reported that college athletic associations might “request” that “elderly alumni” skip sporting events.
An anonymous comment to Alex Stone’s New York Times article makes a particularly poignant case against those blanket rules:
My father who is in his late 80’s fears the virus but perhaps almost as much he fears the future. He is worried about a future where vulnerable people have to remain quarantined to protect their health even though the rest of the world returns to some semblance of normalcy. He is a computer literate, intellectually sharp man who pre Coronavirus played tennis 2 x weekly, worked with a trainer 2 x weekly, and lunched with friends regularly.
The Real Villain: Nursing Homes
In one of the most ludicrous attempts to associate” aging” with severe illness, an article in Time Magazine reports:
What’s more, seniors’ risk of exposure to any pathogen is often higher than that of other adults. There are 48 million seniors overall in the U.S., and while only about 3% of them reside in assisted living facilities, that still factors out to more than 1.4 million already at-risk people living in communal environments in which disease can spread quickly.
This statement has cause and effect backward. “Risk of exposure” isn’t due to age; it’s due to problems in nursing homes that have been well-documented and ignored for many years.
“They [nursing homes] are death pits,” said Betsy McCaughey, as quoted in a New York Times article. McCaughey, a former lieutenant governor of New York, founded the Committee to Reduce Infection Deaths, an education campaign aimed at stopping hospital-acquired infections.
“These nursing homes are already overwhelmed,” McCaughey says. “They’re crowded and they’re understaffed. One Covid-positive patient in a nursing home produces carnage.”
A number of policymakers in New York have alleged that nursing home facilities in that state have been underreporting their COVID-19 fatality figures, possibly because “New York State counts as hospital deaths those of nursing home residents who die in a hospital. It could also be that the high number of non-long-term care deaths in New York explains the lower percentage (i.e., a much larger denominator).”
What SHOULD Be Shocking Us Into Action
From the CDC website: One to three million serious infections occur in long term care facilities each year and an estimated 380,000 people die. That means 38% (if 1 million) or 12.7% (if 3 million) of seniors picking up infectious diseases will die, each and every year.
When we assume“the elderly” are weak and frail, we accept these deaths as inevitable. Writing for the WSJ, Betsy McCaughey points out that as many as 77% of COVID-19 deaths are associated with nursing homes. But she goes on to excuse the numbers: “Not all deaths are preventable; the elderly are vulnerable to infectious diseases.”
Out of 383,000? With proper infection control, the residents wouldn’t have as much opportunity to be vulnerable; and with adequate staffing and care, not to mention immune-boosting activity, the numbers could go down drastically.
In other words, the entire country has been placed on lockdown, and we’re doomed to be wearing masks for months to come, when 150–200,000 people die of coronavirus. We don’t have clear evidence of why these people die; and we’re not sure that these protective measures will make a difference.
But when larger numbers of elderly people die, every single year, from a clearly identifiable cause, we as a society offer a collective shrug.
There’s no market mechanism to motivate nursing homes to behave responsibly and shockingly little government oversight. In fact, Governor Andrew Cuomo said bluntly, “It’s not our job” to provide PPE to nursing homes. The state doesn’t run nursing homes, he said; if nursing homes don’t do their job, they will lose their licenses. That’s all, said Cuomo, that can be done.
Given the limited resources available to police nursing homes, not to mention the threat of retaliation to residents when family members complain, the nursing homes most likely aren’t afraid of losing their licenses. Nursing homes were never particularly well-policed; the Trump administration, responding to powerful lobbyists for nursing homes, has weakened controls even further.
Apart from infection control, nursing home residents experience a great deal of stress, from loss of control over their lives as well as outright abuse. Estimates of abuse range from 15–24%; one survey found that 24.5% of people with relatives in nursing homes reported physical abuse.
And it’s likely that understaffed nursing homes, even with the best intentions, will contribute to compromised immune systems among residents: questionable food quality, limited access to fresh air and exercises, limited mental stimulation, loneliness, and more.
Nursing Homes as Ground Zero
In a widely quoted statement, CMS Administrator Seema Verma wrote, “Nursing homes have been ground zero for COVID-19. Nursing home reporting to the [Centers for Disease Control and Prevention] is a critical component of the go-forward national COVID-19 surveillance system and to efforts to reopen America.”
The truth is, every report of COVID-19 deaths shows a large percentage attributable to nursing homes. The Foundation For Research On Equal Opportunity states baldly that, “Nursing homes and assisted living facilities account for 42% of all Corona deaths.” The AARP reports Kaiser Foundation estimates of 43,000 or about one-third of all COVID-19 deaths, with the same data reported by the New York Times. The Times article goes on to say, “The share of deaths tied to long-term care facilities for older adults is even starker at the state level. In 14 states, the number of residents and workers who have died accounts for more than half of all deaths from the virus.
Yet when reporting COVID-19 cases and death rates, new media rarely run a cross-tab analysis of age x nursing home residence or age x comorbidities. These statistics all get reported separately. An ordinary reader will be encouraged to see each quality as an independent factor: you’re more likely to die if you’re old OR have underlying conditions OR come from a nursing home.
Even worse, we’re not seeing a commensurate proportion of resources and attention dedicated to addressing disease-causing factors in nursing homes. Instead, we’re seeing hundreds of articles urging everyone to wear masks and maintain social distance. It’s like calling the fire department when a building catches fire; with flames leaping to the top floor, the fire department searches the perimeter for sparks and stamps them out.
Other demographic populations at high risk get taken more seriously.
It’s very common for new media to say and write things like, “Elderly people and those with underlying conditions should be especially careful.” As we’ve seen, numerous articles direct us to care for “seniors” and wrap them in metaphorical cotton wool.
But other demographic groups also remain susceptible.
One undisputed fact about COVID-19 is that men die at much higher rates than women. The facts are widely reported. Brookings Institute, for instance, says “the COVID-19 gap is so stark that it justifies further investigation, and there are some nascent, if modest, efforts to do so.”
Brookings summarizes reports: “To date [May 15], around 5,000 more men than women have died from the virus in the U.S. Across all age ranges, the gender gap in death rates is high — and seems particularly wide for those in middle age. For those aged 45 and 54, there are five men dying for every two women.
Even more convincingly, NYC data shows that men die far more than women, even when controlling for pre-existing conditions.
A Time Magazine article asks, “Why Is COVID-19 Striking Men Harder Than Women?”
The article quotes several sources, including a JAMA article, showing indisputably that men die at much higher rates than women. More women than men are alive at ages 75 and up; when researchers adjust for population size, the disparity seems even greater.
Yet we are not seeing articles titled, “Why Is COVID-19 Striking Older People More Than Younger?” The WSJ headlines the “Age Penalty,” but what about the “Gender Penalty?”
No one has urged that men take extra precautions. I suspect few women turn to their husbands, brothers, fathers, and boyfriends to say, “Be extra careful! Maybe I should do the shopping for you.”
Moreover, when we ask, “Why men?” the answer involves unchangeable biological facts, such as the number of X chromosomes. As reported in StatNews, older men averaged more cytokine-producing cells than older women; older women had more and better B cells and T cells.
In contrast, the risk for older people is explained by comorbidities and weakened immune systems, which are far from universal, hard-wired or inevitable.
Race and Ethnicity
African-Americans and Latinos are dying at a much higher rate than whites. It’s generally recognized that these differences are due to environmental conditions rather than physiological differences. In fact, you’ll find striking similarities when you compare race effects with age effects. Instead of simply assuming these populations are inevitably weaker, we are seeing stories that — correctly — dig for deeper causes. Just two examples:
From the New York Times: “The alarming number of African-Americans across many states being killed by COVID-19, health experts said, is likely to be related to higher rates of health conditions, rooted in longstanding economic and health care inequalities, that make it harder for them to survive the infection.”
And another New York Times article: “Public health experts say Latinos may be more vulnerable to the virus as a result of the same factors that have put minorities at risk across the country.” These factors include lower wages, jobs requiring them to be present every day rather than being able to work from home, and “long-standing social and health inequities.”
In a particularly eloquent NYT article, sociology professor Dr. Sabrina Strings argues that the cause of racial inequities for COVID-19 can be traced back to slavery. We can learn from this history lesson: health problems among the elderly often can be traced back to dismissive medical professionals and lack of research attention, also going back a long, long time.
The Big Take-Away: Look at Causal Factors, Not Demographics
From Myth To Mainstream
In a New York Times op-ed piece, Alex Stone attacked the myth that “boomers” were taking COVID-19 precautions too lightly. He refers to countless columns where children of the boomers complain, “My parents won’t stay home and mask up when they go out.”
“The evolution of this myth from online anecdote to mainstream news is a tale of how misinformation can proliferate today, even in the absence of intent to deceive.”
Ironically, the problem of “myth to mainstream” is far more serious when it comes to myths about the health and susceptibility of “older” people, not their beliefs.
Most commonly, news reporters simply assume “Old = Vulnerable,” even when they associate vulnerability with weaker immune systems and comorbidities.
it’s not clear why we can’t just look directly at immune systems and comorbidities. Why bring age into it?
It’s not an age: it’s a mindset.
Researchers have suggested that we’re looking at the whole concept of “age” through the wrong lens, particularly in the light of a famous study by the psychological researcher Ellen Langer.
Langer created a large-scale experiment, where 8 men in their seventies were taken to a converted monastery and told, “Try to be the person you were 22 years ago.” The environment was re-created to resemble the world these men had known when they were younger. Staff told them to speak of culture and news events from 22 years ago — but in the present tense.
By the end of the study, tests revealed that the men had gained in manual dexterity, looked younger (based on observer reports) and even had improved their eyesight.
Knowing traditional journals would dismiss her methodology and question the results. Langer never submitted the study for publication.
Yet in 2010, BBC created a reality show, inviting aging former celebrities to a “country house meticulously retrofitted to 1975, right down to the kitschy wall art.” Once again, after just a few days, the participants emerged physically as well as mentally stronger; someone arriving in a wheelchair walked out on their own power with just a cane.
These examples show how malleable the characteristics associated with aging can be. Reminding people they’re old and weak can act as a prime, leading them to feel even more helpless and more vulnerable to illness.
In the first part of her book, Women Rowing North (p. 28), Mary Pipher writes:
“Explanations for the behavior of the old tend to be markedly different from what they are for the behavior of younger people.”
If an older woman gets a speeding ticket — “she’s old.” Overdraft on a checkbook? Getting lost? Leaving the stove on? These things could happen to a person of any age. But when they happen to an older person, it’s “because you’re old.”
We know that dismissing issues with the elderly with, “Because you’re old” has devastating economic and social consequences for older people.
Yet we also know that it’s easier to say “because you’re old” than “because you’re male.” It’s getting easier (hopefully even more after the current initiatives and demonstrations) to say “because you’re old” than “because you’re black” or “because you’re Latino.” We need to remember there were times when that wasn’t true. Vernon Jordan writes movingly about assumptions that black people were inferior intellectually; his mother’s client was astonished that a black male child could read. Today we’re astonished to learn that an 81-year-old female could be a powerlifter who drives away burglars.
And not so long ago women were considered inherently frail. Until the sixties and seventies, women played half-court basketball: their bodies were considered too delicate for running up and down the whole court.
With objective, agenda-free research, and more attention to the research outcomes, we might find that a lot of assumptions about “the elderly” disappear quickly into the same kind of myths.
Reporting data by age, without considering mediators and moderators, does a disservice to the so-called elderly, to medicine and to society.
When we claim “older people” or “elders” are considered inherently vulnerable because of their age, we give employers a reason to support age discrimination. Who wants a vulnerable, weak person handling an important job? Who takes a vulnerable person seriously? Why not relegate elders — especially women — to being sweet little grandmas who give much and expect little in return?
When doctors believe people over 65 are uniformly weak, they make recommendations that actually endanger their health. They prescribe unnecessary tests and drugs. They dismiss complaints. Most importantly, they ignore the variance among individuals that grows wider, not narrower, as people age. Experienced geriatricians say, “If you’ve seen one 80-year-old, you’ve seen one 80-year-old.”
If we’re being fed half-truths, exaggerations, and outright lies about one aspect of the COVID-19 crisis, we’re more likely to question everything else. Do we really need to wear masks? Do we really need to carry out social distancing indefinitely?
Worst of all, do we blame the elderly? When COVID-19 is considered a disease of the elderly, the elderly are blamed for economic consequences. Texas Lt Governor Dan Patrick encourage them to die for the economy. It’s a lot easier than cleaning up the nursing home mess.
Replace the Stereotype
I propose 3 action steps that any of us can take to change the stereotype, without leaving home. Just use your computer.
(1) Next time you see an article about COVID-19 referring to “the elderly” or “the seniors,” ask if you could substitute a term like “persons with comorbidities.”
If the article has a comment section, write a comment. If comments aren’t open, write a letter to the editor. (Just google “letter to the editor + publication name”, e.g., “letter to the editor NY Times”). Don’t be awed by the reputation of the news outlet or the author. They’ve all made horrible mistakes and they know it.
(2) Write your legislators — state and federal — about the condition of nursing homes.
Google “nursing home abuse” and get the facts. Tell them you’re tired of paying taxes to protect nursing home shareholders from compliance with regulations. Remind them that the statistics on COVID-19 deaths would be lower for everyone if nursing homes were properly regulated. Ask them why we accept 380,000 deaths a year from nursing homes (while slashing the economy for COVID-19 deaths).
(3) Become sensitive to stereotyping and insults about aging.
We’re all realizing we need to be more sensitive to insults against the black community. We know the impact of naming public places after Confederate generals and calling a restaurant “Sambo.” We see corporations voluntarily replacing insulting brands like “Aunt Jemima” and “Uncle Ben.”
A lot of older people aren’t crazy about being called “Grandma” either…as in an actual ad from the past year, “So simple even Grandma could do it.”
You’re being equally insensitive when you support statements that old people are sick, afraid of technology, weaker or slower.
You’re not complimenting an entire generation when you label them as uniformly wise sages or doting grandmas. Some 70-year-olds see themselves as students, learning a new field or embarking on a new career. Some never had children. Some (like me) are simply not good with children and found other ways to leave a legacy.
Go to any all-purpose gym. You’ll see older people walking slowly in a circle in time to music. Meanwhile, in the next room, people the same age will be training intensively to run marathons.
Apart from heredity and accidents, you have a lot of opportunities to influence which room you’ll occupy when you turn sixty. That’s the lesson to take from all this — not blaming ‘the elderly” for the spread of coronavirus.
Cathy Goodwin helps business owners develop a strong message, a compelling online presence, and a story that sells. She’s the author of several books on Amazon, a professional speaker, and a sometime standup comedian. She lives in Philadelphia with two cats.
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