AGEISM DURING THE COVID-19 PANDEMIC

Abstract

In 2021, five decades after it was first defined, ageism was declared by World Health Organization to be a global challenge that needs to be addressed. This article reviews the potential ageist elements in social media, the mass media, and healthcare practices directed towards older adults during a recent global context, the COVID-19 pandemic. Evidence indicates that some presentations relating to older adults in the mass media and in social media contained ageist elements ranging from the more subtle forms of ageism to more explicit forms, such as nicknames given to the COVID-19 pandemic in the social media (e.g. 'Senior Deleter'). Evidence also reveals that during the pandemic some medical practices were ageist.

Headnote

Abstract: In 2021, five decades after it was first defined, ageism was declared by World Health Organization to be a global challenge that needs to be addressed. This article reviews the potential ageist elements in social media, the mass media, and healthcare practices directed towards older adults during a recent global context, the COVID-19 pandemic. Evidence indicates that some presentations relating to older adults in the mass media and in social media contained ageist elements ranging from the more subtle forms of ageism to more explicit forms, such as nicknames given to the COVID-19 pandemic in the social media (e.g. 'Senior Deleter'). Evidence also reveals that during the pandemic some medical practices were ageist.

Key words: ageism, pandemic, older adults, social media.

1. Introduction

The term ageism was coined by Butler (1969) to refer to the feelings, beliefs, and behaviors directed towards people based solely on chronological age. These relates especially to feelings, beliefs, and behaviors directed towards older age groups, with a special highlight on discrimination, negative beliefs (stereotypes) and negative feelings (prejudice) (Ayalon & Tesch-Römer, 2018; Nelson 2005). According to a recent study that took into consideration the content of magazines, newspapers and literature over the last 210 years, ageism directed towards older adults has increased since the 19th century. The analysis reports that the general description of older adults in today's society is more negative than that which existed in the 19th century (Ng & Chow, 2021). According to the World Health Organization, one in two people have feelings, beliefs, or behaviors toward older adults that can be framed as ageist (Word Health Organization, 2021a). This is a worrying aspect since ageism is associated with many negative outcomes. For instance, ageism is related to decreased older adults' emotional wellbeing (Kang & Kim, 2022), worse physical health (Chang et al., 2020; Levy et al., 2014; Meisner, et al., 2013, Wurm et al., 2017), older adults' decreased speed (Ginsberg et al., 2014), decreased longevity (Levy et al, 2002), increased loneliness (Ribeiro-Gonçalves et al., 2023) and so on. Another important aspect is that negative beliefs (negative stereotypes) exert an effect three times larger than positive beliefs (Meisner, 2012) on older adults' performance.

Studies related to a recent context, namely the COVID-19 pandemic, revealed that there were visible signs of increased ageism in many areas of society (Ayalon et al., 2021; Lichtenstein 2021). This article reviews the literature concerning the attitudes and behaviors directed toward older adults that may be considered markers of ageism.

2. Method

This article is structured as an overview review according to the typology of Grant and Booth (2009). According to the previously mentioned authors, this type of review may not include a comprehensive searching method, or a quality assessment of the literature.

3. Ageism on social media during the COVID-19 pandemic

During 2020, since the early stages of the pandemic, older adults as a group were placed by medical authorities in the high-risk category (Onder et al., 2020; Yanez et al., 2020; Zhou et al., 2020). This depiction of older adults as a group of risk elicited reactions on online social media. Social media incorporates widely-used platforms on which to share content, beliefs, feelings, and information. In 2019 in the European Union, 54% of persons between 16-74 years of age used social media platforms (Eurostat, 2020), so it has become an important source of information about social perception. Consequently, it is an important source of information for investigating beliefs and feelings with regard to older adults.

Some of the early reactions that emerged on social media during the COVID-19 pandemic can easily be considered ageist, due to the offensive, ridiculing and humiliating descriptions of older adults. One study (Jimenez-Sotomayor et al., 2020) took into account the content of tweets in the first ten days of the pandemic, when, as was mentioned, older adults were presented as the risk group among adults, and revealed that a high proportion of tweets were offensive towards older adults in many ways. For instance, one tweet stated "Calling #Covidl9 the Boomer remover should not make me giggle, but it does" (Jimenez-Sotomayor et al., 2020, p. 1662). The tweets were also ageist because in the content the lives of older adults were considered not as valuable as those of younger ones. Up to 21% of the tweets may be in this situation (Jimenez-Sotomayor et al., 2020). Reducing the importance of the lives of older adults, considering them expendable, or considering that death and illness are natural for older adults, is a disturbing and an alarming aspect (Fraser et al., 2020). There were voices on social media that even called for generational sacrifice. For instance, the Texas governor, Dan Patrick, suggested that older adults should sacrifice their lives in the pandemic for the younger generation's benefit. It is interesting that the reactions to this call on Twitter also express support for this position (5% of the tweets expressed support) whereas 90% expressed opposition (Barrett et al., 2021).

In another study it was found that an average of 18% of daily tweets that referenced older adults in the first months of the pandemic incorporated ageist elements (Xiang et al., 2021). However, cultural differences may exist. An analysis of Weibo, a Chinese social media platform, revealed less ageist content during COVID-19 pandemic, with less than 10% of the content analyzed having ageist elements. Weibo had a more positive characterization of older adults then Tweeter (Xi et al., 2021).

Other ageist examples are the trending hashtag on Twitter and TikTok - #OK, Boomer or the tiBoomer Remover (Meisne, 2020; Ng & Indran, 2022; Sipocz et al., 2021). These two hashtags were offensive towards older adults and ridiculed them. It is worth mentioning also the ageist nicknames introduced by younger adults for the COVID-19 virus on Tweeter. Among the nicknames were: Boomer Doomer, Senior Deleter or Elder Repeller (Meisne, 2020). These nicknames reflect some of the younger generations' negative beliefs, feelings, and behaviors directed toward older adults.

An analysis performed in 20 countries comparing the characterization of older adults before and during the pandemic found that the ageist elements increased during the pandemic, not only on social media, but also in online newspapers and magazines (Ng et al., 2021). Mass media analyses during the COVID-19 pandemic also revealed ageist tendencies such as infantilized depictions of older adults (Lichtenstein, 2021) or extensive presentation of older adults as a group of vulnerable adults. In a way, media extended the medical authorities' depiction of older adults as being vulnerable (Zhang & Liu, 2022).

4. Ageism during the covid-19 pandemic in healthcare practice

Healthcare practitioners were on the front line during the COVID-19 pandemic, and many actions were coordinated by them. Consequently, it is also necessary to assess if the interventions of the health practitioners present any signs of ageism.

Scholars argue that the way medical authorities handled the pandemic indicated that they engaged in some ageist behaviors that raised some ethical concerns (Jecker, 2022; Martínez-Sellés et al., 2020; Pawlikowski, 2020; Sahebi et al., 2020; Satomi et al., 2020). For instance, one act of discrimination was the prioritization of medical resources based on chronological age criteria as happened in Italy in the early stages of pandemic (Rosenbaum, 2020; Vergano et al., 2020). This decision was based on the incorrect assumption that all adults who have the same chronological age also have the same biological resources and limitations, and that they are a homogenous group of adults (Farrell e al., 2020; Martínez-Sellés et al., 2020). Older adults also reported that they felt that their individuality was diminished by the medical measures during the COVID-19 pandemic (Derrer-Merk et al., 2022). This homogenization of older adults reinforces the negative stereotype found in society prior to the pandemic, namely that old age is implicitly linked to illness or fragility (Bai, 2014; Hummert; 1990; Hummert, Garstka, Shaner & Strahm 1994; Nelson, 2005 ).

Other ageist attitudes may be related to insufficient attention being paid to prevention and care in living facilities (Monahan et al., 2020 ), reduced attention to medical problems not related to COVID-19 (Pujolar et al., 2022; Zhu et al., 2022 ), or stricter quarantine measures based on age criteria (Barth et al., 2021). However, healthcare practitioners had been no strangers to ageism before the COVID-19 pandemic. Studies reveal different discrimnation behaviors toward cancer patients based on the patient's chronological age (Derbey, 1991), while the same can be said with regard to stroke intervention (Hadbavna & O'Neill, 2013 ) or cardiology (Bowling, 1999). Studies also revealed that ageism prior to the pandemic was predictive of the behavior of nurses during the pandemic. Ageist attitudes were associated with less willingness to help older patients (Lytle et al., 2022).

5. Discussions

The results reveal that during the COVID-19 pandemic were multiple markers of ageism on social media and healthcare practice. The results are in line with other studies that revealed ageist attitudes in mass media (Ayalon et ak, 2021; Bravo-Segal & Villar, 2020), in governmental statements (Naughton et ak, 2023), and in public policies to approach COVID-19 pandemic (Vergano et ak, 2020). The ageist manifestations during the pandemic may be considered a big setback in the effort to reduce age discrimination and age stereotypes (Morrow-Howell & Gonzales, 2020) to such extent that in 2021 the World Health Organization (World Health Organization, 2021 b) called ageism a global problem and a challenge, expressing concern relating to its frequency and costs for both older adults and society. This call from the World Health Organization also comes after mass media and social media representation of older adults during the early stages of the COVID-19 pandemic, but also after the attitudes of medical authorities during the early stage of the pandemic, when older adults were homogenized as a vulnerable age group and medical decisions started to be taken using cut-off points based on chronological age. Due to the many implications of ageism related to older adults' emotional well-being (Kang & Kim, 2022), physical health (Chang et ak, 2020; Meisner, et ak, 2013), longevity (Levy et al, 2002), or loneliness (Ribeiro-Gonçalves et al., 2023), more efforts are needed to reduce it.

As compared to other forms of discrimination, ageism directed towards older adults is unique because it also has the chance to affect those adults who have an ageist attitude as he/she progresses through age. Consequently, if the negative depiction of older adults in social and mass media is not a problem for younger adults that use these outlets, or who create the content on mass media, the answer may be that while this is not yet a problem for them, it may become as they get older. This makes ageist attitudes with regard to older adults a potential problem for all, since the chances of reaching older adulthood are higher than in the previous centuries (Dobriansky et ak, 2007).

6. Conclusions

This article reveals that during the COVID-19 pandemic, social media posts were to some extent ageist. Healthcare professionals exhibited also behaviors that can be considered ageist. The approach of the COVID-19 pandemic may be considered a setback in the effort to combat discrimination and negative stereotypes related to old age and older adults.

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