Reuben Ng1,2, Jeremy W Lim-Soh1. 1. Lee Kuan Yew School of Public Policy, National University of Singapore. 2. Lloyds Register Foundation Institute for the Public Understanding of Risk, National University of Singapore.
Abstract
OBJECTIVES: Ageism has increased over 200 years and costs the U.S. health care system $63 billion a year. While scholars agree on the consequences of ageism, there are disagreements on whether it is related to the demographics of aging, or society's cultural values. We test both hypotheses across 20 countries. METHOD: To circumvent the sampling limitations of survey studies, we used an 8-billion-word corpus, identified 3 synonyms with the highest prevalence-aged, elderly, old people-and compiled the top 300 words (collocates) that were used most frequently with these synonyms for each of the 20 countries. The resulting 6,000 collocates were rated on an ageism scale by 2 raters to create an ageism score per country. Cultural dimension scores-Power Distance, Individualism, Masculinity, Uncertainty Avoidance, and Long-term Orientation-were taken from Hofstede, and demographics-size and speed of population aging-came from the World Development Indicators. RESULTS: Of the 20 countries, UK topped the ageism table, while Sri Lanka had the lowest ageism score. Multiple regression models showed that higher levels of masculinity and long-term orientation are associated with ageism, controlling for other cultural dimensions, demographics (size and speed of aging), and economics (GDP-per-capita). DISCUSSION: Our findings blunt the deterministic nature of ageism at the societal level. Demographics is only one side of the ageism coin, and the cultural side is equally, if not more important. This study lays the groundwork to tackle societal ageism-one of our generation's most pernicious threats.
OBJECTIVES: Ageism has increased over 200 years and costs the U.S. health care system $63 billion a year. While scholars agree on the consequences of ageism, there are disagreements on whether it is related to the demographics of aging, or society's cultural values. We test both hypotheses across 20 countries. METHOD: To circumvent the sampling limitations of survey studies, we used an 8-billion-word corpus, identified 3 synonyms with the highest prevalence-aged, elderly, old people-and compiled the top 300 words (collocates) that were used most frequently with these synonyms for each of the 20 countries. The resulting 6,000 collocates were rated on an ageism scale by 2 raters to create an ageism score per country. Cultural dimension scores-Power Distance, Individualism, Masculinity, Uncertainty Avoidance, and Long-term Orientation-were taken from Hofstede, and demographics-size and speed of population aging-came from the World Development Indicators. RESULTS: Of the 20 countries, UK topped the ageism table, while Sri Lanka had the lowest ageism score. Multiple regression models showed that higher levels of masculinity and long-term orientation are associated with ageism, controlling for other cultural dimensions, demographics (size and speed of aging), and economics (GDP-per-capita). DISCUSSION: Our findings blunt the deterministic nature of ageism at the societal level. Demographics is only one side of the ageism coin, and the cultural side is equally, if not more important. This study lays the groundwork to tackle societal ageism-one of our generation's most pernicious threats.
The negative impact of ageism on health and well-being is well established, but there are
disagreements on the factors that promote ageism. There are two competing hypotheses. First,
the demographic argument linked ageism to the size of the aging population, as posited by
Löckenhoff et al. (2009), as well as the speed of
aging (North & Fiske, 2015). Second, the
cultural argument linked ageism to one’s “social environment” (Hofstede, 2001, p. 6), albeit with mixed results across life domains
and age groups (North & Fiske, 2015; Voss et al., 2018). Though many studies have advanced
the competing hypotheses in a mutually exclusive way, few have tested both demographic and
cultural hypotheses in the same study. A systematic review of ageism across 199 papers found
that only eight studies considered institutional or cultural determinants (Marques et al., 2020).We aim to test the competing hypotheses across 20 countries through a computational
linguistics approach that measures societal ageism in a cross-cultural corpus of 8 billion
words. According to Cultivation Theory (Gerbner et al.,
1994), the large representation of online media within the corpus reflects societal
perceptions of respective countries and provide an extraordinary platform to study ageism. An
example of such an approach is Ng et al.’s (2015)
study of how age stereotypes have changed over time in a historical corpus of 400 million
words that spans 200 years. They found that age stereotypes became more negative over time,
and switched from positive to negative after 1880.This study is significant in three ways: (a) Conceptually, the cultural antecedents of ageism
cannot be studied independently of the demographic and economic realities that differentiate
countries. Our study provides a nuanced view of the cultural predictors of ageism, after
adjusting for demographic and economic covariates. (b) The innovative use of our country-level
corpus to measure ageism circumvents the sampling limitations of survey studies (Hofstede, 2001, p. 4). (c) Practically, understanding
the cultural underpinnings of ageism lays the groundwork for designing interventions to reduce
it, as studies shows the malleability of cultural frames (e.g., Dweck et al., 1995).
Cultural Dimensions
Hofstede (1984, 2001) conceptualized one of the most comprehensive and widely used
dimensions of national culture through surveys of IBM employees in 72 countries and
validated his work with subsequent surveys. Though Hofstede’s dimensions have been
criticized (as much as they have been cited; Minkov,
2018), they remain useful for this study. First, the multiple dimensions provide a
comprehensive coverage of cultural differences, as compared to any single dimension. Second,
they are widely recognized and understood, demonstrating this study’s comparability and
contribution to prior literature. Third, the Hofstede dimensions are intended as a
national-level (between-system) measurement of culture as opposed to other individual-level
(within-system) cultural variables (Hofstede,
2001; Zhang et al., 2016). Since our
platform measures age stereotypes at the national level, we found Hofstede’s dimensions to
be compatible as they conceptualize culture at the national level.The framework started with four dimensions—Power Distance, Individualism, Masculinity, and
Uncertainty Avoidance. Subsequently, Long-term Orientation was added to accommodate the new
findings from the Chinese Values Survey of Asian cultures (Hofstede, 2001). Power Distance is “the extent to
which the less powerful members of organizations and institutions accept and expect that
power is distributed unequally. The basic problem involved is the degree of human inequality
that underlies the functioning of each particular society.” Individualism
is “the degree to which individuals are supposed to look after themselves or remain
integrated into groups, usually around the family. Positioning itself between these poles is
a very basic problem all societies face.” Masculinity is “the distribution
of emotional roles between the genders, which is another fundamental problem for any society
to which a range of solutions are found; it opposes ‘tough’ masculine to ‘tender’ feminine
societies.” Uncertainty Avoidance is “the extent to which a culture
programs its members to feel either uncomfortable or comfortable in unstructured situations.
Unstructured situations are novel, unknown, surprising, different from usual. The basic
problem involved is the degree to which a society tries to control the uncontrollable.”
Long-term Orientation is “the extent to which a culture programs its
members to accept delayed gratification of their material, social, and emotional needs.”
(Hofstede, 2001, p. xix).
Masculinity, Long-term Orientation, Individualism, and Ageism
There are no known studies on the associations between Masculinity, Long-term Orientation,
and age stereotypes at the national level, though current studies point to potential links.
Existing qualitative studies found a link between Masculinity and ageism in the IT industry,
which is dominated by men, with a sizable proportion who are reaching older age. Interviews
revealed that older IT workers are perceived negatively due to their age and decreased
Masculinity since they are perceived to be trailing their younger male colleagues (Comeau & Kemp, 2007). Another qualitative study
in older men with chronic conditions also found that illness brought about a perception of
deceased Masculinity and increased ageism (Separavich
& Oliveira, 2020). In contrast, a survey study of undergraduates found that
stereotypes of older men are positive, and increasingly so with perceptions of Masculinity
(Thompson, 2006). Building on these qualitative
and survey studies, we hypothesize that countries with higher reported Masculinity will be
associated with more negative age stereotypes (Hypothesis 1).Increased Long-term Orientation has been linked to more proactive security actions (Aurigemma & Mattson, 2019), innovation (Bukowski & Rudnicki, 2019), and resilience (Sulphey, 2020). These studies show that Long-term
Orientation involves the delay of current gratification for a future benefit such as
increased security and innovation. However, this delayed approach is unrealistic for aging
societies that have to deal proactively with the needs of the elderly population
immediately or risk spending more for acute care later. Against this
background, we hypothesize that higher Long-term Orientation will be associated with
negative age stereotypes (Hypothesis 2).With regard to Collectivism and age stereotypes, North
and Fiske (2015) found that collectivism is associated with more negative age
stereotypes, as it could spur resentment toward older adults for demanding support and
enjoying benefits without contributing to society. In line with these findings, we
hypothesize that increased Collectivism will be associated with more negative age
stereotypes (Hypothesis 3).
Demographics and Ageism
North and Fiske (2012, p. 987) suggested that one
cause of ageism could be the “resource threat” posed by the elderly who form an increasingly
large proportion of the population, and may be seen to contribute to the fiscal burden
(Ng, Lim, et al., 2020; Tepe & Vanhuysse, 2009; Walker, 1990). Löckenhoff et al.
(2009), in survey of college students across 26 countries, found that the size of the
above-65 population was related to ageism, while North
and Fiske (2015) in a meta-analysis of 37 East-West comparisons found that the
speed of aging—rate of growth in the population above 65 years—was related to ageism. The
implications of the demographic thesis are very different from those of the cultural thesis
(Hypotheses 1, 2, and 3). As population aging is an inevitable demographic reality in most
developed countries, a validation of the demographic thesis would suggest that we should be
resigned to the growth of ageism at the societal level. On the other hand, culture has
proven to be surprisingly malleable in priming studies (Dweck et al., 1995), including experiments that increased the physical performance
of older adults (Levy et al., 2014), and
decreased interpersonal ageism between undergraduate students and older adults (Lytle et al., 2020). We sought to test both theses in
the same model.
Method
Dataset
The News on the Web Corpus (Davies, 2017) is
the largest cross-cultural corpus that consists of web-based newspapers and magazines from
7,000 websites across 20 countries with over 28 million articles. This dataset—created
with funding from the National Science Foundation (NSF) and the National Endowment for the
Humanities (NEH) to study contemporary language usage in countries where English is widely
used—is appropriate as Cultivation Theory (Gerbner et
al., 1994) suggests that the large representation of online media reflects the
societal perceptions of respective countries and provides an extraordinary platform to
study societal ageism. For this study, we used a full year’s dataset (2017) with 1.75
billion words. The geographical makeup of the corpus spans six regions: North America
(America and Canada); the British Isles (Ireland and United Kingdom); Oceania (Australia
and New Zealand); Asia (Bangladesh, Hong Kong, India, Malaysia, Pakistan, Philippines,
Singapore, and Sri Lanka); Africa (Ghana, Kenya, Nigeria, South Africa, and Tanzania); the
Caribbean (Jamaica).
Measurement of Ageism
We used three synonyms that were consistent with Ng
et al., (2015) study, and evidenced the highest normalized frequencies in the
dataset: “aged” (41.5 per million), “elderly” (22.2 per million), and “old people” (1.3
per million). For each synonym, we compiled the top 300 words that co-occurred most
frequently, known as collocates, for each of the 20 countries with the following inclusion
criteria: (a) Lexical Proximity: collocate present within four words prior or after the
respective synonym; (b) Relevant context: collocate referred to specifically to an old
person (checked by two raters); and (c) Mutual Information Score of 3 and above: collocate
had a stronger association with the respective synonym than other words in the corpus for
that country indicating semantic bonding (Church &
Hanks, 1990). This is an innovative application of concordance analysis, used in
computational linguistics to study language shifts and to identify stereotypes in other
studies (Ng et al., 2015). The rigorous process
generated 6,000 (300*20) collocates. Thereafter, each collocate that met the study
criteria was rated on a scale from 1 (very positive) to 5 (very negative), a method found
to be valid and reliable to measure age-stereotype associated words (Levy & Langer, 1994). For example, ‘frail’ will be rated as
very negative while ‘wise’ would be rated as very positive. The inter-rater reliability
using Cronbach’s alpha was .991 (95% CI: 0.987, 0.994) for the scoring method. Age
stereotypes (ageism scores) for each country were created by calculating the mean of all
300 collocate scores for that country.
Hofstede’s Five Cultural Dimensions
Calculations of the country dimension scores are found in Hofstede (2001) and Hofstede
and Minkov (2013) that were based on the original IBM surveys, and subsequent
studies (e.g., Hofstede Insights, 2020). The
country score for each dimension is calculated as follows. First, the individual survey
responses to each question are summed up at the national level. For a question requiring a
5-point Likert scale, this is done by assigning 1–5 points for each answer and then taking
the national mean of the answers. For a question requiring a Yes/No or multiple-choice
answer, this is done by taking the national percentage who gave a specific answer or set
of answers, such “Option A OR Option C.” Second, these national-level question scores are
combined according to a weighted formula to yield a country dimension score that is based
on three to eight survey questions. The weights are used to balance the importance of each
survey question as well as generate final scores that range from 0 to 100. For the present
analysis, the scores were divided by 100 to match our other variables, such that they
range from 0 to 1.
Demographic Variable: Aging
To test the demographic hypothesis that ageism is related to the size of the elderly
population, we included the size of the above-65 population as a proportion of the total
population, following previous studies (e.g., Löckenhoff et al., 2009). Rather than the percentage above 65 years, North and Fiske (2015) argued that ageism is
associated with a country’s speed of aging as a faster decline in the old age support
ratio—or the average number of working adults who are supporting a retiree—will generate
more intense fiscal pressures that pay out pensions at the expense of young taxpayers. We
found this argument to be valid and included both the proportion above 65 years and the
speed of aging for the respective country. The latter is calculated by subtracting the
2007 statistic for the size of the above-65 population from the 2017 statistic in the
World Development Indicators (World Bank,
2020), which is a cross-country panel dataset that covers developmental
statistics.
Controls: GDP per capita
Prior studies (Löckenhoff et al., 2009; North & Fiske, 2015) controlled for GDP per
capita to test the possible influence of level of development or modernization on ageism.
Similarly, we used a measure of logged GDP per capita from the World Development
Indicators (World Bank, 2020) as
covariates.
Analytic Strategy
To test the competing hypotheses of culture and demographics, we ran a series of OLS
regressions with the cultural and demographic variables as predictors and age stereotypes
as the outcome. We ran four models to establish robustness. Model 1 included the
percentage above 65 years, and controlled for GDP per capita. Model 2 used the speed of
aging in the past decade as the demographic predictor, and controlled for GDP per capita.
Model 3 included only the cultural variables, controlling for GDP per capita, and Model 4
is the full model that included all demographic and cultural variables, controlling for
GDP per capita. As Long-term Orientation scores were unavailable for Jamaica and Kenya,
complete-case analysis was applied for Models 3 and 4. We tested for heteroskedasticity
using visual confirmation of the residual-versus-fitted plot of the main model as well as
White’s and Breusch–Pagan / Cook–Weisberg tests. All statistical analyses were conducted
in SPSS 25.
Results
Descriptive Statistics: Ageism and Cultural Dimensions
The descriptive statistics for all variables are as follows. The dependent variable, age
stereotypes, had a theoretical range of 1 (most positive) to 5 (most negative). However,
the values in the sample ranged from 2.79 to 3.37. Of the 20 countries/territories, 17
evidenced negative age stereotypes, with the UK as the most negative. Age stereotypes are
positive in three countries, Ghana, Tanzania, and Sri Lanka, with the latter being the
most positive. This corroborates the literature on the ubiquity of ageism around the world
(Ayalon & Tesch-Romer, 2018).The five cultural dimensions had a theoretical range from 0 to 1, with means ranging from
0.44 to 0.61, and standard deviations ranging from 0.13 to 0.28. The territory with the
lowest Power Distance was New Zealand, while the highest was Malaysia. The territory with
the lowest Collectivism was the United States, while the highest was Pakistan. The
territory with the lowest Masculinity was Sri Lanka, while the highest was a tie between
Jamaica and Ireland. The territory with the lowest Uncertainty Avoidance was Singapore,
while the highest was Pakistan. Singapore evidenced the highest scores in Long-term
Orientation while Ghana scored the lowest. Scatter plots for the relationships between age
stereotypes, Masculinity, and Long-term Orientation, that relate to our hypotheses, are
presented in Figures 1 and 2.
Figure 1.
Scatterplot of ageism and masculinity across 20 countries.
Figure 2.
Scatterplot of ageism and long-term orientation across 20 countries.
Scatterplot of ageism and masculinity across 20 countries.Scatterplot of ageism and long-term orientation across 20 countries.The mean population above 65 years was 9%, which is approximately the global average. The
territory with the largest population above 65 was the United Kingdom (18%), and the one
with the smallest was Kenya (2%). Meanwhile, the mean change in population above 65 years
over 10 years was 2%, with the fastest aging in Hong Kong (4%), and no aging trend in
Nigeria (0%). This shows that our sample covers a good range of values for the demographic
hypotheses.
Multivariable Regression
We tested the hypotheses progressively across four models. Models 1 and 2 tested the
demographic hypothesis that aging societies are associated with increased ageism. Neither
“percentage of elders above 65 years” (Model 1) nor speed of aging measured by “change of
population above 65 years” reached significance, controlling for GDP per capita.
Therefore, we did not find evidence in support of Hypotheses 4 and 5.Through Model 4, we found support for Hypotheses 1 and 2. Masculinity was significantly
associated with ageism (β = .85, p < .01), and Long-term Orientation
was associated with ageism (β = .65, p < .05) controlling for other
cultural dimensions (Power Distance, Collectivism, Uncertainty Avoidance), demographics
(proportion of population above 65 years), and development (GDP per capita). Unlike in
other studies, Collectivism was not significantly associated with ageism, controlling for
covariates. Table 1 presents the results.
Table 1.
Regressions of Ageism With Cultural Dimensions, Demographics, and Economics as
Predictors and Covariates
(1)
(2)
(3)
(4)
Log (GDP per capita)
−0.021
0.113
−0.015
−0.004
(0.065)
(0.070)
(0.044)
(0.066)
Population above 65
1.230
−0.289
(1.381)
(1.262)
Change in population above 65
−8.234
(speed of aging)
(6.151)
Power distance
0.014
0.010
(0.199)
(0.209)
Collectivism
−0.240
−0.261
(0.159)
(0.190)
Masculinity
0.865***
0.851***
(0.196)
(0.214)
Uncertainty avoidance
0.387
0.417
(0.346)
(0.385)
Long-term orientation
0.628***
0.651**
(0.189)
(0.221)
N
20
20
18
18
R2
0.088
0.136
0.792
0.793
Adjusted R2
−0.020
0.035
0.678
0.648
Notes: Standard errors in parentheses. Constant not shown.
*p < .1. **p < .05. ***p
< .01.
Regressions of Ageism With Cultural Dimensions, Demographics, and Economics as
Predictors and CovariatesNotes: Standard errors in parentheses. Constant not shown.*p < .1. **p < .05. ***p
< .01.A visual inspection of the residuals-versus-fitted plot for Model 4 did not suggest any
heteroskedasticity. Similarly, White’s test (p > χ 2 =
0.389) and the Breusch–Pagan / Cook–Weisberg test (p > χ 2
= 0.326), also for Model 4, did not indicate any heteroskedasticity.
Discussion
This is one of the first known studies to report associations between Masculinity,
Long-term Orientation, and ageism across 20 countries. Higher levels of Masculinity and
Long-term Orientation are associated with ageism, controlling for other cultural dimensions
(Power Distance, Collectivism, Uncertainty Avoidance), demographics (percentage of elders
above 65 years), and GDP per capita.Highly masculine societies that emphasize competition and favor the strong and successful
may systematically frame elders as weak, leading to the development of ageism at the
societal level. This societal-level finding corroborates with qualitative research at the
individual level that alluded to this link among older IT professionals (Comeau & Kemp, 2007) and older men with chronic
conditions (Separavich & Oliveira, 2020). Our
finding is consistent with studies that draw a link between ageism and ableism—defined as “a
network of beliefs, processes and practices that produce a particular kind of self and body
(the corporeal standard) that is projected as the perfect, species-typical and therefore
essential and fully human” (Campbell, 2001, p.
44; Chivers, 2018; Overall, 2006; Sutter et al.,
2017). The glorification of the capable and the degradation of the incapable are
two sides of the same coin, therefore it is plausible that masculinity is linked to
ageism.On the other hand, societies with higher Long-term Orientation tend to be highly rational
in an economic sense and may prefer to invest in the young with greater potential, instead
of older persons who would be net consumers in the future. Our findings extend theoretical
work on the societal trajectory of Long-term Orientation. While Long-term Orientation may be
linked to innovation (Aurigemma & Mattson,
2019) and better cyber hygiene (Bukowski &
Rudnicki, 2019), the (unintended) downside could be the systematic diminishment of
groups with low future potential, such as older adults.The lack of a statistically significant link between collectivism and ageism is
inconsistent with the conclusion from North and Fiske’s
(2015) meta-analysis. Our finding could be explained by Zhang and colleagues’ (2016) distinction between individualism at the
personal and societal/cultural levels. Juxtaposing the World Values Survey data with priming
experiments, they found that individual-level individualism was linked to ageism, but
cultural-level individualism was not. Our findings are aligned as Hofstede’s (2001) measure of Collectivism is conceptualized at the
societal/cultural level.The lack of statistical significance for our control variable, GDP per capita, appear to
support the inclusion of older workers in today’s labor markets as compared to the earlier
industrialization period (Tavernier et al.,
2019). Nevertheless, there is strong evidence to suggest that the substance of
exclusion has not changed, though the form may have: ageism in the workplace is manifested
consistently in hiring, promotion, and other human resource (HR) practices.Of broader significance, our findings blunt the deterministic nature of ageism at the
societal level. While countries with a faster aging population and higher percentage of
older adults (Löckenhoff et al., 2009; North & Fiske, 2015) are more ageist, that is
only one side of the ageism coin. Our study provides evidence that the cultural side is
equally important—as shown in numerous studies from cognition (Dweck et al., 1995) to beauty perceptions (Broer et al., 2015; Heidekrueger,
Sinno et al., 2017; Heidekrueger, Szpalski et
al., 2017). The train has left the station on the demographic reality: Little can
be done about slowing the pace of population aging or increasing the fertility rate that
remains stubbornly low in many developed countries. Instead, cultural mindsets are more
malleable, as priming studies have shown, and individual-level interventions to decrease
interpersonal ageism have achieved considerable success (Lytle et al., 2020; Turner et al.,
2018). Additionally, priming with implicit age stereotypes has been shown to
effectively increase the physical performance of older adults (Levy et al., 2014). These individual-level efficacy trials need to be
scaled up at the societal level, and our study provides the cultural considerations to do
this effectively.Drilling down to societal interventions that decrease ageism, future studies could focus on
factors that mediate the culture–ageism relationship. In addition, societal-level
interventions could be amplified by prioritizing countries high in Long-term Orientation and
Masculinity. We hypothesize that countries high in Long-term Orientation and Masculinity are
associated with more ageist health policies. Against this background, interventions could
target policymakers in these societies to increase their awareness of ageism in health
policies and public communications especially during the Covid-19 pandemic where elders are
incessantly described as vulnerable. These research ideas will extend important studies
showing institutional ageism in health policies formulated by governments and international
organizations (Lloyd-Sherlock et al., 2016).
Future studies should test the mediation hypothesis (e.g., Ng, Allore, et al., 2020) and design interventions targeted at
policymakers to create a multiplier effect for their respective countries.While this study circumvents the limitations of most survey studies that “provoke”
responses rather than studying “naturally” occurring behavior (Hofstede, 2001, p. 4)—our study is not without limitations. The
corpus compiled English sources, and did not include advanced aging countries like Japan.
This is a significant limitation that will be addressed in future studies when we expand the
corpus to other languages.In conclusion, ageism has increased over 200 years (Ng
et al., 2015) with a staggering 1-year price tag of $63 billion on the U.S. health
care system (Levy et al., 2020). At this critical
juncture, we need societal-level studies to distill the underpinnings of ageism. Across 20
countries, we show that cultural factors—Masculinity and Long-term Orientation—are linked to
ageism, after adjusting for a country’s economic development and demographic trajectory.
This important study lays the groundwork to design societal interventions to tackle our
generation’s most insidious threats.
Authors: Peter Niclas Broer; Sabrina Juran; Marc E Walker; Reuben Ng; Katie Weichman; Neil Tanna; Yuen-Jong Liu; Ajul Shah; Anup Patel; John A Persing; James Grant Thomson Journal: Ann Plast Surg Date: 2015-06 Impact factor: 1.539
Authors: Sibila Marques; João Mariano; Joana Mendonça; Wouter De Tavernier; Moritz Hess; Laura Naegele; Filomena Peixeiro; Daniel Martins Journal: Int J Environ Res Public Health Date: 2020-04-08 Impact factor: 3.390