Intended for healthcare professionals


Institutional ageism in global health policy

BMJ 2016; 354 doi: (Published 31 August 2016) Cite this as: BMJ 2016;354:i4514
  1. Peter G Lloyd-Sherlock, professor1,
  2. Shah Ebrahim, professor2,
  3. Martin McKee, professor3,
  4. Martin James Prince, professor4
  1. 1School of Development Studies, University of East Anglia, Norwich NR4 7TJ, UK
  2. 2Department of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
  3. 3ECOHOST, London School of Hygiene and Tropical Medicine
  4. 4Institute of Psychiatry, King’s College London, UK
  1. Correspondence to: P G Lloyd-Sherlock p.lloyd-sherlock{at}

Peter G Lloyd-Sherlock and colleagues argue that a focus on premature mortality is discriminating against the needs of a growing older population

The sustainable development goals agreed in March 2016 by the United Nations General Assembly set the global development agenda for the next 15 years. They include an ambitious target to reduce premature mortality from non-communicable diseases by a third by 2030. Premature mortality, defined by the World Health Organization as deaths occurring between the ages of 15 and 70, has gained broad acceptance in health research and policy over the past decade. We argue that it is explicitly ageist, reflecting institutional ageism in global health policy. Its inclusion in the sustainable development goals sends a strong signal in favour of discriminating against older people in the allocation of health resources and the collection of data. We consider the emergence of ageist approaches in global health policy and the potential effects of ageism in the sustainable development goals. We propose a less discriminatory approach.

Institutional ageism

Ageism is defined as: “a process of systematic stereotyping and discrimination against people because they are old.”1 Institutional ageism differs from, but is related to, interpersonal ageism. It involves the inclusion of ageist principles in formal rules and procedures and in wider institutional cultures. It is characterised by language consistently depicting older people in negative terms.2

Less research has been done on ageism than on other forms of discrimination, such as racism and sexism. Studies of institutional ageism have mainly explored discrimination in employment and the workplace,3 and few studies explicitly examine its role in health. Most of the health studies focus on specific groups, such as older people who are lesbian, gay, or bisexual or racial minorities.4

Several arguments have been used to justify age discrimination in health policy. The …

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