Ageism and the Older Worker: A Scoping Review

Blaming the young is always more accessible rather than accusing the older employees: an experimental view over age and health in organizations

Introduction

The stereotype content model postulates that different groups evoke different emotions and reactions based on two dimensions: intention toward others (warmth) and competence.

Methods

In this study, we used an experimental design and a qualitative approach to investigate how managerial strategies are selected and motivated when a subordinate makes a work task related error but belongs to a group that is stereotypical perceived differently in terms of warmth and competence (age groups with or without a medical condition). Thus 75 employees analyzed one of the five hypothetical cases and described the managerial strategy and motivation for usage.

Results

Data revealed that managerial strategies incorporate more active harm elements for younger employees in contrast with vulnerable groups (older employees with unspecified medical conditions, younger or older employees with a medical condition), who benefit from more active facilitation strategies. The strategy usage motivation is also different in the case of younger employees, the control group and the vulnerable groups.

Discussion

The study outcomes bring additional evidence to support the stereotype content model theory and the socioemotional selectivity theory, enriching applicability on organizational practice and human resources management.

Trends in Incidence of Hip Fracture and Hip Replacement in Denmark, 1996 to 2018

Importance

The past several decades have witnessed substantial changes in treatments that are particularly relevant for older patients.

Objectives

To assess changes in national-level incidence rates of fracture- and musculoskeletal-related (ie, arthritis-related) hip replacement procedures for individuals aged 40 to 104 years over a 23-year period in Denmark.

Design, Setting, and Participants

This cohort study used national Danish health registers to include the Danish population aged 40 to 104 years from January 1, 1996, to December 31, 2018. Data were analyzed from May 31, 2022, to February 14, 2024.

Main Outcomes and Measures

Age- and period-specific incidence rates of hip fracture and hip replacement stratified on fracture-related vs arthritis-related indication.

Results

From 1996 to 2018, a total of 3 664 979 individuals were followed up for a mean (SD) of 14.6 (7.7) years, resulting in a follow-up time of 53 517 861 person-years and 158 982 (first) hip fractures, of which 42 825 involved fracture-related hip replacement procedures. A further 104 422 individuals underwent arthritis-related hip replacement. During the first 2 decades of the 21st century, hip fracture rates declined by 35% to 40% for individuals aged 70 to 104 years, and the proportion of the population undergoing fracture-related hip replacement increased by 50% to 70%, with modest variation across those aged 75 to 99 years. Rates of arthritis-related hip replacements peaked for individuals aged 75 to 79 years, but with the largest relative rate increase (75%-100%) occurring for those aged 80 to 94 years, primarily from 2001 to 2015, whereafter it remained nearly unchanged. The decline in rates of arthritis-related hip replacement after 75 to 79 years of age was gradual and did not suggest an upper age limit for access to arthritis-related hip replacement.

Conclusions and Relevance

The findings of this cohort study suggest that during the past several decades in Denmark, the incidence of hip fractures declined by 35% to 40% among patients aged 80 to 104 years, while the proportion receiving fracture-related hip replacement remained relatively constant after 75 years of age. During the first decades of the 21st century, arthritis-related hip replacement incidence increased by 50% to 100% among older patients and stabilized hereafter, with no apparent cutoff age for this type of procedure. These patterns indicate a positive overall trend with declining hip fracture incidence over the last decades in Denmark, and the observed hip replacement incidence suggests that age is currently not a major determining factor guiding this type of surgery.

Age Differences in Unemployment Risk and Reemployment Outcomes in Late Working Life in Sweden

Participation of older workers in the labor market depends, among other things, on older workers employment chances. This study examines age differences regarding risk of unemployment and reemployment outcomes in late working life in Sweden. Using Swedish registry data, we analyzed the probability of unemployment as well as work-related activity following unemployment (wage- or self-employment; exit; downward mobility) of all people born between 1954 and 1968 (aged 49-63) and registered in Sweden between the years 2012 and 2018. Results show that although risk of unemployment does not differ significantly across age groups, younger age groups are more likely to be reemployed as wage-employed while older age groups are more likely to be reemployed as self-employed or exit working life. After an unemployment period, older employees are more likely to have a lower wage than during their previous employment or become part-time unemployed. We conclude that different age groups have unequal chances in late working life in terms of reemployment, risk of exit, and risk of downward mobility following unemployment. Policies for extending working life and promoting inequality should include measures for increasing employability of older workers such as anti-discriminatory laws and dealing with skills mismatch.

When there is no justice, we need an old HERO. The trickle-down effect of psychological capital: the moderating role of organizational justice and leaders' age

The objective of the study was to explore the impact of leaders' ages and followers' perceptions of organizational justice (POJ) on the transfer of psychological capital (PsyCap) from leaders to followers, particularly examining how employees' resilience is influenced by leaders' PsyCap. While some evidence exists regarding PsyCap's trickle-down effect, the specific circumstances triggering this phenomenon remain unclear. This study investigates the relationship between followers' and leaders' PsyCap, employing the Social Cognitive Theory and considering the moderating effects of leaders' age and POJ. The study focused on leader-follower dyads within a randomly selected sample of 406 businesses, encompassing 812 respondents. The survey investigation utilized the CAPI approach. The hypothesized model underwent testing through multilevel dyadic regression analysis, employing an actor-partner interdependence model. The findings support two moderators -employees' POJ and managers' age - and highlight the cross-over effect of PsyCap. Specifically, a stronger trickle-down link is observed when a leader is older and operating within a low POJ environment. Additionally, the study revealed a positive correlation between employees' PsyCap and POJ. The development of POJ enhances employees' PsyCap and resilience, while leaders' PsyCap may compensate for organizational POJ deficiencies. This study is among the first to explore PsyCap's moderators, specifically analyzing leaders' ages and POJ as factors influencing the cross-over effect of PsyCap. By identifying previously unrecognized moderators affecting the cross-over PsyCap effect, this research contributes significantly to the PsyCap literature.

Managers' perception of older nurses and midwives and their contribution to the workplace-A qualitative descriptive study

AIMS AND OBJECTIVES

The aim of this study was to explore healthcare managers' perceptions about older nurses' and midwives' and their contribution to the workplace.

DESIGN

A qualitative descriptive methodology.

METHOD

Twenty healthcare managers working in Australia participated in semi-structured interviews. Data were collected between April 2019 and April 2021. Interviews were recorded, transcribed and then analysed using thematic analysis.

RESULTS

All healthcare managers said older nurses and midwives contributed to the workplace through their experience and knowledge. Managers viewed them as a different type of worker and while there were some positive aspects to this, it was mostly negative. Although managers identified a broad age range for the older nurses or midwives, there was a common perception that if they were no longer able to perform their duties, they should leave the workforce.

CONCLUSION

Healthcare managers' perceptions towards older nurses and midwives are mostly negative, and their understanding of older workers' contribution is contradictory and poor. These negative views co-exist with the lack of agreement on who is the older worker, which explain the reluctance of healthcare organizations to invest in their older workforce. Future research is needed to better understand the unique contribution of older nurses and midwives in healthcare and how they can be supported at work.

IMPACT

The global ageing population will result in a rise in complex age-related health issues and will require an experienced and knowledgeable workforce. Given the greater experience of older nurses and midwives they are an important part of the health workforce. Yet managers' perception of the contribution by older nurses and midwives were often negative. The findings of this study highlight the need for organizational change so that the contribution of older nurses and midwives is recognized and supported by managers.

Gender differences in the determinants of mature entrepreneurship? The case of Germany

Mature female entrepreneurs represent a non-traditional model of self-employed workers in both ways: in terms of gender and age. The transition into self-employment for women aged 45 years and older represents a topic of aging research that still tends to be overlooked. Previous studies found ambivalent results for the issue regarding motives and entrepreneurial pathways between former employmen or unemployment-and starting one's own business and the ways in which these entrepreneurial activities are shaped by social differences (such as gender) and biographically accumulated resources and restrictions. This article studies biographical-related factors and motivations that determine what is variously referred to as mature entrepreneurship for men and women aged 45 and above. Using data from the German Socio-Economic Panel (SOEP), the descriptive analysis explains the main gender differences among people within the target age group who have taken the step into self-employment. The multivariate analysis interrogates the main determinants that govern any increase in the probability of becoming self-employed after the age of 45 and seeks to identify the main differences between women and men in relation to such determinants. The results show substantial gender-based occupational segregation in entrepreneurship patterns in this age group, with men working longer hours on average than women and enjoying higher average earnings. However, the multivariate analysis shows that the main drivers for mature entrepreneurship are similar for both men and women and that necessity represents an important factor for everyone for starting a business.

AI ageism: a critical roadmap for studying age discrimination and exclusion in digitalized societies

In the last few years, we have witnessed a surge in scholarly interest and scientific evidence of how algorithms can produce discriminatory outcomes, especially with regard to gender and race. However, the analysis of fairness and bias in AI, important for the debate of AI for social good, has paid insufficient attention to the category of age and older people. Ageing populations have been largely neglected during the turn to digitality and AI. In this article, the concept of AI ageism is presented to make a theoretical contribution to how the understanding of inclusion and exclusion within the field of AI can be expanded to include the category of age. AI ageism can be defined as practices and ideologies operating within the field of AI, which exclude, discriminate, or neglect the interests, experiences, and needs of older population and can be manifested in five interconnected forms: (1) age biases in algorithms and datasets (technical level), (2) age stereotypes, prejudices and ideologies of actors in AI (individual level), (3) invisibility of old age in discourses on AI (discourse level), (4) discriminatory effects of use of AI technology on different age groups (group level), (5) exclusion as users of AI technology, services and products (user level). Additionally, the paper provides empirical illustrations of the way ageism operates in these five forms.

Employee perception of managers' attitudes towards older workers is associated with risk of loss of paid work before state pension age: prospective cohort study with register follow-up

It is increasingly urgent to retain older workers in the workforce. In the present study, we analysed the prospective associations between employees' perceptions of their managers' attitudes towards older workers, and of having experienced age discrimination in the labour market with the risk of loss of paid work before the state pension age. Questionnaire data from 10,320 currently employed workers aged 50 + on perceptions of managers' attitudes towards older workers and perceived age discrimination were collected at baseline in the SeniorWorkingLife study. Data on labour market affiliation were obtained from national registers at baseline and two-year follow-up. Results show that the perception of negative attitudes was prospectively associated with an increased risk of loss of paid work for three of the five negative attitudes "older workers create conflicts, their qualifications are outdated, and they cannot keep up with the pace and development". Perception of positive attitudes was prospectively associated with a reduced risk of loss of paid work. The perception of age discrimination was prospectively associated with an increased risk of loss of paid work. The results strengthen existing evidence on associations between ageism and labour market attachment, by applying a longitudinal design and including actual change in labour market participation. However, some negative attitudes may be more detrimental to the older workers' labour market participation. Employees' positive perceptions of managers' attitudes reduced the risk. Good relations between employees and managers appear to be important for retaining older workers in the labour market.

Ageism, Job Engagement, Negative Stereotypes, Intergenerational Climate, and Life Satisfaction among Middle-Aged and Older Employees in a University Setting

This study examined whether age-related discrimination, negative age-related stereotypes about declining abilities due to age, job engagement (cognitive, physical, and emotional), and workplace intergenerational climate in terms of positive intergenerational affect (PIA) and workplace intergenerational inclusiveness (WIG) correlated with life satisfaction in a university setting. The analysis was based on 115–117 faculty and staff, 50 years or older. A Principal Axis factor analysis with Promax rotation on the job-related variable revealed three factors: Experiencing Ageism (discrimination and negative stereotypes), Work Climate (PIA and WIG), and Job Engagement (physical, emotional, and cognitive). The factor-based regression scores on the three-factor-based scores were correlated with life satisfaction and also subjected to hierarchical regression analyses with age, sex, and education entered on the first step and the three factors on the second step. The results of both the correlational and hierarchical regression analysis indicated that experiencing ageism was significantly predictive of life satisfaction, and that ageism may play a more primary role than job engagement and work climate-related variables in accounting for life satisfaction.

Testing the Shielding Effect of Intergenerational Contact against Ageism in the Workplace: A Canadian Study

Negative outcomes of ageism in the context of the Canadian labor market are well documented. Older workers remain the target of age-based stereotypes and attitudes on the part of employers. This study aims at assessing (1) the extent to which quality and quantity intergroup contacts between younger and older workers as well as knowledge-sharing practices reduce ageist attitudes, in turn (2) how a decrease in ageist attitudes increase the level of workers’ engagement and intentions to remain in the organization. Data were collected from 603 Canadian workers (aged 18 to 68 years old) from private and public organizations using an online survey measuring concepts under study. Results of a path analysis suggest that intergroup contacts and knowledge-sharing practices are associated with positive attitudes about older workers. More so, positive attitudes about older workers generate higher levels of work engagement, which in turn are associated with stronger intentions to remain with the organization. However, positive attitudes about older workers had no effect on intentions to remain in the workplace. Results are discussed in light of the intergroup contact theory.

The meaning of nursing practice for nurses who are retired yet continue to work in a rural or remote community

BACKGROUND

Although much research has focused on nurses' retirement intentions, little is known about nurses who formally retire yet continue to practice, particularly in rural and remote settings where mobilization of all nurses is needed to assure essential health services. To optimize practice and sustain the workforce stretched thin by the COVID-19 pandemic, it is necessary to understand what it means for retired registered nurses (RNs) and licensed practical nurses (LPNs) to work after retirement. This study explored what nursing practice means for RNs and LPNs who have formally retired but continue to practice in rural and remote communities.

METHODS

A pan-Canadian cross-sectional survey conducted in 2014-2015 of nurses in rural and remote Canada provided data for analysis. Textual responses from 82 RNs and 19 LPNs who indicated they had retired but were occasionally employed in nursing were interpreted hermeneutically.

RESULTS

Retired nurses who continued to practice took on new challenges as well as sought opportunities to continue to learn, grow, and give back. Worklife flexibility was important, including having control over working hours. Nurses' everyday practice was inextricably tied up with their lives in rural and remote communities, with RNs emphasizing serving their communities and LPNs appreciating community recognition and the family-like character of their work settings.

CONCLUSIONS

Retired nurses who continue to work in nursing see retirement as the next phase in their profession and a vital way of engaging with their rural and remote communities. This study counters the conventional view of retaining retired nurses only to combat nursing shortages and alleviate a knowledge drain from the workplace. Rural and remote nurses who retire and continue working contribute to their workplaces and communities in important and innovative ways. They can be characterized as dedicated, independent, and resilient. Transitioning to retirement in rural and remote practice can be re-imagined in ways that involve both the community and the workplace. Supporting work flexibility for retired nurses while facilitating their practice, technological acumen, and professional development, can allow retired nurses to contribute their joy of being a nurse along with their extensive knowledge and in-depth experience of nursing and the community.

Further examination of knowledge and interactions in ageism among college students: Value for promoting university activities

Ageism is recognized as a reason that few students pursue careers in aging. While widely studied, the findings regarding factors that contribute to ageism are mixed. The findings from previous studies are also tempered by methodological issues. To better understand the factors that contribute to ageism among students and guide the development of programming and activities to reduce ageism, a survey study was conducted. The study explores associations between frequency of interactions with older adults, quality of the interactions, and ageism. Students' knowledge of aging is also examined. Using refined measures to assess knowledge of aging and interactions with older adults, the study includes data from 1,040 college students, most of whom are traditional age students (i.e., under the age of 25). Findings from multiple regression analyses document the interplay between frequency and quality of interactions and the role of knowledge on multiple dimensions of ageism. Frequency of interactions with older adults is significantly associated with lower levels of ageism only when the interactions are perceived as favorable. Knowledge of aging is significantly associated with lower levels of ageism. The findings provide valuable information for developing activities to reduce ageism. A new ageism reduction program, which was guided by the study findings and age-friendly university framework, is described. Implications for gerontological education are also discussed.

The Impact of Age Stereotypes and Age Norms on Employees' Retirement Choices: A Neglected Aspect of Research on Extended Working Lives

This article examines how older workers employ internalized age norms and perceptions when thinking about extending their working lives or retirement timing. It draws on semi-structured interviews with employees (n = 104) and line managers, human resource managers and occupational health specialists (n = 52) from four organisations in the United Kingdom. Previous research has demonstrated discrimination against older workers but this is a limiting view of the impact that ageism may have in the work setting. Individuals are likely to internalize age norms as older people have lived in social contexts in which negative images of what it means to be "old" are prevalent. These age perceptions are frequently normalized (taken for granted) in organisations and condition how people are managed and crucially how they manage themselves. How older workers and managers think and talk about age is another dynamic feature of decision making about retirement with implications for extending working lives. Amongst our respondents it was widely assumed that older age would come with worse health-what is more generally called the decline narrative - which served both as a motivation for individuals to leave employment to maximize enjoyment of their remaining years in good health as well as a motivation for some other individuals to stay employed in order to prevent health problems that might occur from an inactive retirement. Age norms also told some employees they were now "too old" for their job, to change job, for training and/or promotion and that they should leave that "to the younger ones"-what we call a sense of intergenerational disentitlement. The implications of these processes for the extending working lives agenda are discussed.

What Do the Managers Think of Us? The Older-Worker-Perspective of Managers' Attitudes

Background: Due to demographic changes, the need to prolong working life has become increasingly salient. Paradoxically, stereotyping and discrimination against workers based on their age can limit possibilities for a long working life. A large body of research has investigated attitudes towards older workers; however, less is known about differences across occupational groups as well gender differences. Aim: To compare perceptions of the managers’ perceptions of older workers between employees from mainly seated work and mainly physical work as well as men and women. Method: Data from 11,444 workers aged 50+ from the baseline questionnaire survey in the SeniorWorkingLife study were analyzed. Results: Across all groups, a larger proportion of the respondents indicated that their managers had more positive than negative perceptions of older workers. Respondents from the International Standard Classification of Occupations (ISCO) group 5–9 (mainly physical work) and women were less likely to point at both positive and negative perceptions than the ISCO group 14 (mainly seated work) and men, respectively. Conclusions: The results indicate that there are differences between those with mainly physical and mainly seated work as well as gender differences. More research is warranted to explore the nature of these differences and, in particular, attitudes towards older female and male workers, respectively.

Producing precarity: The individualization of later life unemployment within employment support provision

There have been marked policy shifts within many nations towards 'extended work lives', with such shifts often underpinned by an assumption that individual aging citizens can make the responsible choice to prolong work and thereby avoid dependency on the state. However, possibilities for extended work lives are inequitably distributed, and older workers who become unemployed often face prolonged unemployment and barriers to obtaining sustainable employment. Drawing on findings from an ethnographic study addressing the negotiation of long-term unemployment in two North American cities, this article attends to how jobseekers aged 50 and older, employment support service providers, and organizational stakeholders understood and attempted to manage later life unemployment. Employing a critical discourse analysis approach informed by a governmentality perspective, the findings illustrate how possibilities for framing the problems faced by older jobseekers and for managing later life unemployment were constrained by broader individualizing neoliberal mandates. Despite recognition of systemic barriers tied to ageism and its intersection with other axes of disadvantage, stakeholders and service providers enacted a narrow individualized approach to manage ageism. This individualized approach, in turn, produced tensions within service provision and shaped precarity for older jobseekers through encouraging them to be 'realistic' regarding the types of work and wages available to them as older workers. If the extended work life agenda continues to be politically promoted as a key solution in the management of population aging, it is imperative to re-configure policy and service approaches to avoid the downloading of insurmountable barriers onto older jobseekers in ways that increasingly produce precarious lives marked by uncertainty, instability, and vulnerability.

Insights into the Sustainable Return to Work of Aging Workers with a Work Disability: An Interpretative Description Study

Purpose A sustainable return to work (S-RTW) following prolonged work disability poses particular challenges as workers age. This article provides a synthesis of the factors and issues involved in a S-RTW process for aging workers following such a disability. Methods Using interpretive description methods, a critical review was conducted of the literature specifying return-to-work factors and issues for aging workers with regard to four major causes of work disability (musculoskeletal disorders, common mental disorders, cancer or other chronic diseases). The initial review concerned the 2000-2016 literature, and was subsequently updated for November 2016-December 2018. To further explore and contextualise the results of this literature review, four focus groups were held with stakeholders, representing the workplace, insurance, and healthcare systems and workers. Qualitative thematic analysis was performed. Results Fifty-five articles were reviewed and 35 stakeholders participated in the focus groups. Returning to work and staying at work appear to be particularly challenging for aging workers, who face notable issues and stigma concerning their ability to meet work demands, as well as their mobilisation and engagement in these processes. Such findings echo in many ways the main assertions of the literature on aging at work, except those regarding the transformation of capacities with aging, which is not mentioned in relation to workers with a work disability. The influence of healthcare and compensation systems on the S-RTW of aging work-disabled workers has also received little attention to date. Conclusions The results underscore that aging workers with a disability are frequently vulnerable in terms of their health or their jobs. Intersectoral efforts are needed to remedy this situation to keep them at work.

Ageism Amplifies Cost and Prevalence of Health Conditions

Background and Objectives

The persistent status of ageism as one of the least acknowledged forms of prejudice may be due in part to an absence of quantifying its costs in economic terms. In this study, we calculated the costs of ageism on health conditions for all persons aged 60 years or older in the United States during 1 year.

Research Design and Materials

The ageism predictors were discrimination aimed at older persons, negative age stereotypes, and negative self-perceptions of aging. Health care costs of ageism were computed by combining analyses of the impact of the predictors with comprehensive health care spending data in 1 year for the eight most-expensive health conditions, among all Americans aged 60 years or older. As a secondary analysis, we computed the number of these health conditions experienced due to ageism.

Results

It was found that the 1-year cost of ageism was $63 billion, or one of every seven dollars spent on the 8 health conditions (15.4%), after adjusting for age and sex as well as removing overlapping costs from the three predictors. Also according to our model, ageism resulted in 17.04 million cases of these health conditions.

Discussion and Implications

This is the first study to identify the economic cost that ageism imposes on health. The findings suggest that a reduction of ageism would not only have a monetary benefit for society, but also have a health benefit for older persons.

Digital Health Coaching Programs Among Older Employees in Transition to Retirement: Systematic Literature Review

Background

The rapid increase of the aging population is pushing many national governments to reshape retirement legislation in order to extend older adults’ working life. Once retired, older adults can be invaluable resources for the community as family carers, as volunteers, or by returning to work. Healthy aging is one of the main conditions for being able to work longer and being active after retirement. The latter, indeed, represents a very sensitive life transition, which can entail psychological and social difficulties. Interventions for promoting older workers’ health and well-being and supporting the transition to retirement are on the top of the policy agenda of most European countries. Recently, computer-based and digital health interventions have been seen as promising means to reach this purpose.

Objective

This systematic literature review aimed to explore studies on digital health coaching programs for older workers that followed a user-centered design approach and evaluated their effectiveness in providing older adults with guidance for adopting a healthy lifestyle and being active in the community.

Methods

The search identified 1931 papers, and 2 relevant articles were selected by applying specific eligibility criteria.

Results

To our knowledge, only few digital health coaching programs have targeted the population of older workers to date; there is an insufficient number of studies on the efficacy of such programs. The results show the difficulties of assessing the efficacy of digital coaching itself and with respect to older employees. The 2 studies suggest that digital health programs for workplaces can improve various aspects of older employees’ well-being; however, they considered health mainly from a physical perspective and neglected contextual, social, psychological, and cultural factors that can influence older workers’ health and general well-being. Future digital health coaching programs should adopt the healthy aging paradigm as a multidimensional lens for interpreting the impact of eHealth technology on aging and retirement. The literature around this issue remains at an embryonic state, and this gap needs to be filled by further investigations that apply a user-centered approach for designing the technology, test innovative research methodologies, and adopt new technical solutions for high-quality interaction design.

Conclusions

Further digital health coaching programs aimed at supporting healthy and active living for older workers and retirees are necessary. The user-centered design approach is recommended in order to fully address the users’ health needs and the technological requirements throughout development. Moreover, the healthy aging perspective allows inclusion of physical, social, and psychological factors influencing the transition from work to retirement, as well as the experiences and interactions of individuals with the technology.

Development and Validation of a Workplace Age-Friendliness Measure

BACKGROUND AND OBJECTIVES

Measuring the extent to which the culture of organizations can be considered age-friendly is a significant anchor in the constructive inclusion process of older workers in workplaces, given the consistent aging of the workforce. Hence, the purpose of this research was to develop a novel, comprehensive, and theoretically driven measure of workplace age-friendliness.

RESEARCH DESIGN AND METHODS

Three multiphased, multisourced studies were conducted: a qualitative assessment procedure and 2 separate quantitative field surveys of individual-level perceptions.

RESULTS

A 24-item scale of workplace age-friendliness was developed, consisting of 4 dimensions that represent the different ways in which organizational culture aligns with an aging and older workforce: age-friendly core culture, development, wellness, and flexibility. Confirmatory factor analysis verified that a 4-factor structure is the most appropriate solution, with all dimensions having acceptable internal consistency. Preliminary evidence of construct validity is also presented.

DISCUSSION AND IMPLICATIONS

The measure developed in this study may serve researchers as well as practitioners in the field of aging and work. Further implications and limitations of using this instrument in future empirical study on workplace age-friendliness are discussed.

Institutional and Individual Factors Affecting Health and Employment for Low-Income Women With Chronic Health Conditions

OBJECTIVES

This qualitative study explored risk and protective factors affecting employment and health among low-income older women with chronic health conditions or physical disabilities.

METHODS

The authors conducted a secondary data analysis of 14 intensive interviews with low-income older women with chronic health conditions who had participated in a federally funded training and employment program for workers aged 55 and older. Qualitative data were analyzed using thematic analysis.

RESULTS

The physical nature of the work and discrimination were risk factors, with unaccommodating work environments, ageism, and/or ableism, and internalized ageism identified as subthemes of discrimination. Protective factors, namely institutional supports (e.g., access to retraining, time management flexibility) enhanced health and self-confidence. Occupational demands matched with the capacity of the individual resulted in continued employment and improved health.

DISCUSSION

Working conditions can degrade health through exposure to mental and physical health risks, or support health through access to financial and interpersonal resources. Institutional supports such as workplace flexibility and retraining are crucial to obtaining a good fit between occupational demands and the capacity of individuals, enabling a positive relationship between employment and health. Legislation designed to prevent discrimination, enhance opportunities for lifelong learning, and encourage flexible work arrangements among low-income women with chronic health conditions may facilitate healthier working lives.

Global reach of ageism on older persons' health: A systematic review

OBJECTIVE

Although there is anecdotal evidence of ageism occurring at both the structural level (in which societal institutions reinforce systematic bias against older persons) and individual level (in which older persons take in the negative views of aging of their culture), previous systematic reviews have not examined how both levels simultaneously influence health. Thus, the impact of ageism may be underestimated. We hypothesized that a comprehensive systematic review would reveal that these ageism levels adversely impact the health of older persons across geography, health outcomes, and time.

METHOD

A literature search was performed using 14 databases with no restrictions on region, language, and publication type. The systematic search yielded 13,691 papers for screening, 638 for full review, and 422 studies for analyses. Sensitivity analyses that adjusted for sample size and study quality were conducted using standardized tools. The study protocol is registered (PROSPERO CRD42018090857).

RESULTS

Ageism led to significantly worse health outcomes in 95.5% of the studies and 74.0% of the 1,159 ageism-health associations examined. The studies reported ageism effects in all 45 countries, 11 health domains, and 25 years studied, with the prevalence of significant findings increasing over time (p < .0001). A greater prevalence of significant ageism-health findings was found in less-developed countries than more-developed countries (p = .0002). Older persons who were less educated were particularly likely to experience adverse health effects of ageism. Evidence of ageism was found across the age, sex, and race/ethnicity of the targeters (i.e., persons perpetrating ageism).

CONCLUSION

The current analysis which included over 7 million participants is the most comprehensive review of health consequences of ageism to date. Considering that the analysis revealed that the detrimental impact of ageism on older persons' health has been occurring simultaneously at the structural and individual level in five continents, our systematic review demonstrates the pernicious reach of ageism.

Reducing Ageism: Education About Aging and Extended Contact With Older Adults

BACKGROUND AND OBJECTIVES

Ageism is of increasing concern due to the growing older population worldwide and youth-centered focus of many societies.

RESEARCH DESIGN AND METHODS

The current investigation tested the PEACE (Positive Education about Aging and Contact Experiences) model for the first time. Two online experimental studies examined 2 key factors for reducing ageism: education about aging (providing accurate information about aging) and extended contact (knowledge of positive intergenerational contact) as well as their potential combined effect (education plus extended contact).

RESULTS AND DISCUSSION

In Study 1, 354 undergraduates in all 3 experimental conditions (vs. control participants) reported less negative attitudes toward older adults (delayed post-test) and greater aging knowledge (immediate and delayed post-tests), when controlling for pre-study attitudes. In Study 2, 505 national community participants (ages 18-59) in all experimental conditions (vs. control participants) reported less negative attitudes toward older adults (immediate post-test) and greater aging knowledge (immediate and delayed post-tests). In summary, across 2 online studies, education about aging and knowledge of intergenerational extended contact improved attitudes toward older adults and aging knowledge.

IMPLICATIONS

Thus, brief, online ageism-reduction strategies can be an effective way to combat ageism. These strategies hold promise to be tested in other settings, with other samples, and to be elaborated into more in-depth interventions that aim to reduce ageism in everyday culture.

JD-R model on psychological well-being and the moderating effect of job discrimination in the model

Purpose

The purpose of this study was to investigate the moderating effect of chronic job discrimination on the relationships among job demands, job resources, personal resources and psychological well-being among aged workers.

Design/methodology/approach

This study used “National Survey of Midlife Development in the United States (MIDUS Refresher)” data collected from 862 aged workers in the United States from 2011-2014. A moderated multiple regression analysis was adopted.

Findings

The results of the multiple regression analysis show that skill discretion, self-esteem, optimism and active coping had positive effects on psychological well-being, while chronic job discrimination had a negative effect on psychological well-being. Co-worker support, supervisor support, job demands and decision-making authority were not significant. Among the interaction terms, the moderating effect between optimism and chronic job discrimination was significant.

Originality/value

Based on the results, this study offers implications for understanding the effects of job discrimination in the workplace among aged workers and their perceived psychological well-being, in the context of job demands and resources (JD-R) model.

Measuring Age Discrimination at Work: Spanish Adaptation and Preliminary Validation of the Nordic Age Discrimination Scale (NADS)

Negative stereotypes about older workers can result in ageism and age discrimination in the workplace. The aim of this study is to carry out an adaptation to Spanish and a preliminary validation of the Nordic Age Discrimination Scale (NADS) in a sample of Spanish workers over 55 years of age. The study involved 209 employees aged between 55 and 67 years old (155 women (74.2%) and 54 men (25.8%)) working in the health sector with different professional categories (nurses, doctors, nursing assistants, ancillaries and health technicians). The reliability index of the six dimensions of the NADS (promotion, training, development, development appraisals, wage increase and change processes) measured by Cronbach's alpha was α = 0.83. The exploratory and confirmatory factor analyses, with the goodness-of-fit indexes used, reflect an acceptable adjustment of the single-factor structure of the NADS. Regarding criterion and construct validity, the NADS correlated positively and negatively with the respective variables in the expected directions, except in one case. These results indicate that the Spanish version of the NADS shows adequate levels of internal consistency and criterion validity, and this instrument meets standard psychometric properties in its Spanish version.

Retirement Sequences of Older Americans: Moderately Destandardized and Highly Stratified Across Gender, Class, and Race

Purpose of the Study

A destandardization of labor-force patterns revolving around retirement has been observed in recent literature. It is unclear, however, to which degree and of which kind. This study looked at sequences rather than individual statuses or transitions and argued that differentiating older Americans' retirement sequences by type, order, and timing and considering gender, class, and race differences yields a less destandardized picture.

Design and Methods

Sequence analysis was employed to analyze panel data from the Health and Retirement Study (HRS) for 7,881 individuals observed 6 consecutive times between ages 60-61 and 70-71.

Results

As expected, types of retirement sequences were identified that cannot be subsumed under the conventional model of complete retirement from full-time employment around age 65. However, these retirement sequences were not entirely destandardized, as some irreversibility and age-grading persisted. Further, the degree of destandardization varied along gender, class, and race. Unconventional sequences were archetypal for middle-level educated individuals and Blacks. Also, sequences for women and individuals with lower education showed more unemployment and part-time jobs, and less age-grading.

Implications

A sequence-analytic approach that models group differences uncovers misjudgments about the degree of destandardization of retirement sequences. When a continuous process is represented as individual transitions, the overall pattern of retirement sequences gets lost and appears destandardized. These patterns get further complicated by differences in social structures by gender, class, and race in ways that seem to reproduce advantages that men, more highly educated individuals, and Whites enjoy in numerous areas over the life course.

How does returning to work after retirement influence older workers' health? A scoping review protocol

INTRODUCTION

The return to the labour market after retirement is an increasing phenomenon in the North American population. It is the subject of a growing number of studies, whose conclusions seem inconsistent. As returning to working life after retirement is not neutral for individuals, the aim of this article is to present the protocol of a scoping review about its effects on older workers' health.

METHODS AND ANALYSIS

The methodology of Arksey and O'Malley, including the recommendations of Levac et al and Daudt et al will be used. The process is composed of seven steps, from the identification of the research question, to the planning of knowledge transfer activities. Documents dealing with retirees returning to work in connection with health will be explored and analysed using the International Classification of Functioning, Disability and Health.

ETHICS AND DISSEMINATION

Approval has been obtained for the consultation step of the protocol (ethics board of the Centre intégré universitaire en santé et services sociaux de la Capitale Nationale, project #2019-1753). The Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols checklist will be used to support transparency and guide translation of findings. Findings will be shared with various stakeholders involved in older workers' health. Findings will also be disseminated in workshops, peer-reviewed journals and conferences.

Aging and Cardiometabolic Risk in European HEMS Pilots: An Assessment of Occupational Old-Age Limits as a Regulatory Risk Management Strategy

Old-age limits are imposed in some occupations in an effort to ensure public safety. In aviation, the "Age 60 Rule" limits permissible flight operations conducted by pilots aged 60 and over. Using a retrospective cohort design, we assessed this rule's validity by comparing age-related change rates of cardiometabolic incapacitation risk markers in European helicopter emergency medical service (HEMS) pilots near age 60 with those in younger pilots. Specifically, individual clinical, laboratory, and electrocardiogram (ECG)-based risk markers and an overall cardiovascular event risk score were determined from aeromedical examination records of 66 German, Austrian, Polish, and Czech HEMS pilots (average follow-up 8.52 years). Risk marker change rates were assessed using linear mixed models and generalized additive models. Body mass index increases over time were slower in pilots near age 60 compared to younger pilots, and fasting glucose levels increased only in the latter. Whereas the lipid profile remained unchanged in the latter, it improved in the former. An ECG-based arrhythmia risk marker increased in younger pilots, which persisted in the older pilots. Six-month risk of a fatal cardiovascular event (in or out of cockpit) was estimated between 0% and 0.3%. Between 41% and 95% of risk marker variability was due to unexplained time-stable between-person differences. To conclude, the cardiometabolic risk marker profile of HEMS pilots appears to improve over time in pilots near age 60, compared to younger pilots. Given large stable interindividual differences, we recommend individualized risk assessment of HEMS pilots near age 60 instead of general grounding.

Do people who experience incarceration age more quickly? Exploratory analyses using retrospective cohort data on mortality from Ontario, Canada

Objectives

We aimed to explore whether mortality data are consistent with the view that aging is accelerated for people with a history of incarceration compared to the general population, using data on mortality rates and life expectancy for persons in Ontario, Canada.

Methods

We obtained data from the Ontario Ministry of Community Safety and Correctional Services on all adults admitted to provincial correctional facilities in Ontario in 2000, and linked these data with death records from provincial vital statistics between January 1, 2000 and December 31, 2012. We used life table methods to calculate mortality rates and life expectancies for this cohort by sex and 5-year age group. We similarly generated population comparison rates using publicly available data for the general population of Ontario in 2006 as the midpoint of the follow up period. We compared these mortality indices between the 2000 Ontario prison cohort and the general population by age group and sex.

Results

The difference in all-cause mortality rates between the 2000 Ontario prison cohort and the general population was greatest for younger adults, with the prison cohort experiencing rates of death that would be expected for persons at least 15 years older at ages 20 to 44 for men and ages 20 to 59 for women. Life expectancy in the 2000 Ontario prison cohort was most similar to life expectancy of persons five years older in the general population at age intervals 20 to 45 in men and 20 to 30 in women.

Conclusions

For most of adulthood, life expectancy and mortality rates are worse for adults with a history of incarceration than for the general population in Ontario, Canada. However, the association between mortality and incarceration status is modified by age, with the greatest relative burden of mortality experienced by younger persons with a history of incarceration and modified by sex, with worse relative mortality in women. Future research should explore the association between incarceration status and markers of aging including mortality, morbidity and physical appearance.