Age

Ageism can be very subtle but is common throughout society; it can affect wellbeing, damage confidence and create exclusion. Individuals can be subject to assumptions and different treatment based on their age or perceived age, no matter how old or young they are.

Older people in particular, are subject to stigma, prejudice and social isolation. Older people are often also the poorest in society, and some are vulnerable to abuse. 

Children and young people can also be discriminated against and are viewed with suspicion by society. Their lack of power means that their views are often ignored and they are also vulnerable to abuse.

Discrimination arises either because difference is ignored and therefore people’s needs are not met or difference is recognised but forms the basis of unfavourable treatment or stereotyping.

Age equality means that age should not be used to define or presume anything about the role, value or potential of an individual.

The following video is a short film by the Equality & Human Rights Commission titled ‘What is Age Discrimination’.

Age and Other Protected Characteristics

Age discrimination links to other forms of discrimination- 

• Older people, especially older women are often on low incomes. This is caused by a combination of factors including the state pension not being linked to earnings and women being less likely to have occupational pensions of sufficient level.
• Disability increases with age, especially visual impairment and blindness. 74.25% of those registered blind or partially sighted in Scotland are aged 65 or over.
• Young people may be discriminated from exploring their sexuality and their gender identity by their family, at school or in hospital. LGBTQ+ young people may be less likely to express their sexuality or their gender identity due to fear of discrimination from family, friends and other young people. This can lead to low self-esteem and serious long-term negative health effects e.g. anxiety, depression and feeling suicidal.
• Peer pressure can pressure young people into concealing their religious beliefs or practices, while overt symbols of faith make young people more likely to be victims of religious provocation.
• Ageing may further reduce the ability to communicate for those for whom English is not their first language.
• Teenage women living in areas of highest deprivation are four times more likely to become pregnant than those in the least deprived areas. ; Teenage women from the most deprived areas are more likely to deliver than to terminate their pregnancy. In contrast, those from the least deprived areas are more likely to terminate than to deliver their pregnancy.
• The health of older people in Scotland varies according to social circumstances. The gap in life expectancy between the most affluent and deprived communities has widened significantly in the last 40 years, particularly among males. Life expectancy has either stopped increasing or has decreased in almost all council areas since 2012-2014.
• Emergency hospital admissions as a result of unintentional injury are over 40% higher for children living in the most deprived areas.

Older People

Long life is a sign of good health, and the ageing of the world’s population is an indicator of improving health worldwide. Although there are no specific conditions or illnesses associated with ‘being old’, the older people get the more likely they may be to experience a range of different conditions such as chronic disease, cancer and disability and to experience more than one of these together.

Increased protection for adults at risk of harm or neglect is in place through the Adult Support and Protection (Scotland) Act 2007. While the Act defines adults at risk as those aged 16 years and over, it provides protection to many older people with cognitive impairments such as dementia.

Young People

Healthcare, lifestyle and experience in childhood and adolescence have a significant impact on physical and mental health in later life. Certain conditions particularly affect young people, such as some inherited problems, accidents and injury and sexual and mental health issues, or they may have different experiences of conditions which affect all ages.

The United Nations Convention on the Rights of the Child (UNCRC) is the base standard for children’s rights and sets out the fundamental rights of all children. On 16 March 2021, the Scottish Parliament unanimously passed the United Nations Convention on the Rights of the Child (Incorporation) (Scotland) Bill (‘the UNCRC Bill’). The UNCRC Bill is a landmark piece of legislation that aims to incorporate the UNCRC into Scots law to the maximum extent of the Scottish Parliament’s powers. We already use the UNCRC as a framework to ensure that we consider children’s rights whenever we take decisions, and to help provide every child with a good start in life and a safe, healthy and happy childhood. It forms the basis of our national approach for supporting children, called Getting it right for every child (GIRFEC). Fulfilling children’s rights is also critical to our commitment to #KeepThePromise that all care experienced children and young people will grow up loved, safe and respected.

All Ages

Traditional assumptions about age related conditions are increasingly being challenged. People with conditions previously associated with childhood, e.g. cystic fibrosis, severe physical disability, are increasingly surviving into adulthood. Similarly, younger people may suffer from conditions previously associated with ‘old age’ such as dementia or the need for social care and support.

Age Discrimination and Health

Age discrimination in health can lead to inappropriate treatment, misdiagnosis or reluctance from patients to get involved with health services. It may take some of the following forms:

• Stereotyping of old age as being automatically linked to ill-health
• Low expectations of older people’s mental capacity, leading to inappropriate behaviour or symptoms not being believed.
• Health or social care support or treatments having upper or lower age limits.
• Lack of support or time for meals, resulting in undernourishment
• Young people being placed in adult wards
• Information not produced with age group in mind
• Judgemental attitudes
• Confidentiality and anonymity not respected
• Abuse or neglect or older or young people, in hospitals, care settings or at home
• Denial of the right to make choices about health and personal affairs

How we are addressing age issues

NHSGGC is working to ensure no-one using our services is discriminated against on grounds of age or any other protected characteristic.

We are also working to raise awareness of the nature of direct and indirect age discrimination and our responsibilities under equalities legislation. We will do this by improving education and training of healthcare professionals on the effects of ageism in clinical care and care settings and by improving patient and carer experience of discharge planning.

Patients aged 81 and older are less likely than younger patients to feel they have been given adequate information about their discharge and what to do about their health if they are worried after leaving hospital. A Fairer NHSGGC 2024-25 highlights our plans to ensure that older people and their carers are routinely involved in discharge planning and decisions as part of person centred care.

This will be supported by the application of the Frontline Equality Assessment Tool (FEAT) which has been designed to assess inequalities sensitive practice within frontline services. This involves checking the patient information collected, how communication support is assessed and knowledge of protected characteristic related issues as well as the impact on discharge planning. Within NHSGGC’s frontline services the use of FEAT will contribute to the recognition and sharing of good practice as well as highlighting where improvements in services can be made.

Overall service planning is increasingly taking account of the changing age profile of the population and the impact this will have on demand for services. Awareness of the need to ensure age equality within our services informs this planning process. However, there are circumstances where a targeted approach to specific age groups is appropriate both when providing services and when consulting and involving individuals. For example, Sandyford sexual health services have been designed to ensure that they are accessible to young people and have the confidence of young people.

Publications

• Age discrimination: key points for the workplace
• Fairer Scotland Older People Framework
• Ethnic Health Inequalities in Later Life
• Later Life UK Factsheet
• That Age Old Question
• UN Convention on Rights of the Child

Websites

• Age Scotland
• Public Health Scotland 
• NHSGGC Public Protection Team
• UNICEF –  Convention on the Rights of the Child
• Research Institute for the Care of Older People (RICE)
• Scottish Public Health Observatory