Ageism: A Public Health Issue

Smoking cigarettes causes cancer. Secondhand smoke does too. Most people read this and think, “Duh. Everybody knows that.”

It wasn’t that long ago when people smoked cigarettes on airplanes. Do you remember when the people sitting at the table next to you in a restaurant lit up cigarettes at the end of their meal? Our older neighbors remember. It was a long, hard, often emotional fight to ban smoking cigarettes in public places. In the end, it became a public health issue. In the end, science-informed policy won out.

Twenty years ago, what today is understood as accepted fact was a raging, divisive, community controversy. Yes, people can still poison themselves and their own health privately if they so choose, but 15 years ago, my community decided in favor of public health. Secondhand smoke was prohibited in public places. The town where I live acted on the principle that what affects one of us affects all of us.

In her recent book Breaking the Age Code: How Your Beliefs About Aging Determine How Long & Well You Live (2022), Becca Levy, PhD, outlines her 20-plus years of scientific research and experiment at Harvard and Yale universities. You may ask, how can my beliefs about aging determine how long and well I live? Here are two of Levy’s evidence-based examples: 

  1. People with pro-aging beliefs live an average of 7.5 years longer than people who fear or deny getting older.
  2. Pro-aging beliefs reduce the incidence of Alzheimer’s disease among people who have the APOE4 gene that predisposes them to Alzheimer’s.

Levy has quantified how ageism—a widespread form of prejudice that is directed at older persons—leads to excess costs of over $63 billion a year for a broad range of health conditions in this country. Her research also found that, in one year, ageism was responsible for 17.04 million cases of the eight most expensive health conditions among those 60 and older.

Levy’s findings make a strong case for reducing the epidemic of ageism, which produces not only a financial cost for society but also a human cost for the well-being of not just older persons but of our whole community.

Here’s an image: a visible but not-too-thick, low-hanging cloud of blue cigarette smoke covering your entire town, seeping everywhere, touching everything and everyone— small babies and children breathing in the smoke. Smoke so ubiquitous it is normalized. People coughing every day but nobody noticing it.

Now think of that cloud of smoke as being unconscious bias or any form of othering. Think of that smoke as being ageism—touching everything and everyone. Systemic and internalized ageism, covering the entire town, seeping everywhere. Normalized. 

We don’t see ads for cigarettes anymore in our local newspapers, but we do see ads claiming wrinkles are bad, claiming gray hair is bad, claiming old is bad and young is good. 

One of the first steps in banning smoking cigarettes in public places was to understand the science behind this public health issue. Becca Levy has contributed a large, early step in understanding the science behind the public health issue of ageism. Pro-aging beliefs are good for all of us, no matter how long we’ve been alive.