1 Age discrimination: The last socially acceptable discrimination? Jorge Plano (Argentina) Coordinación de Organismos de la Sociedad Civil de América Latina y el Caribe sobre Envejecimiento y Vejez CORV Social Forum. Geneva, 1-3 de april 2014 Los derechos de las personas de edad

2 Concepts Cases Proposals

3 ageism “process of systematic stereotyping or discrimination against people because they are old, just as racism and sexism accomplish with skin colour and gender. Ageism allows the younger generations to see older people as different than themselves; thus they subtly cease to identify with their elders as human beings.” Robert Butler, 1969

4 Two faces of discrimination Exclusion Segregation Contempt Elimination Patronizing Clientelism Pity Overprotection vs. a human rights perspective

5 Prejudices and stereotypes Mental impairment Disease Low productivity at work Only leisure A burden on the family and the State Asexual Antitechnological Death waiting room Childlish Passive Lack of flexibility Sometimes these are self-fulfilling prophecies

6 CASES

7 European Union Eurobarometer Survey

8

9 Discrimination: by type

10 Age discrimination: by country

11 (Quality-Adjusted Life Year / Disability-Adjusted Life Year) Related to the "global burden of disease" QALY / DALY concepts

12 QALY / DALY and age Also relative weights < 1 are assigned to different types of disabilities World Bank, 1993 (Global burden of disease)

13 QALY / DALY usage QALY and DALY concepts were developed for the macro evaluation of health budgets but are being used as a policy rule to define actions like research resources allocation and even increasingly as a managerial tool to decide personal medical interventions. The Convention on the Rights of Persons with Disabilities put disability issues in the framework of human rights, QALY/DALY returns it to a medicalized view.

14 QALY / DALY: reflections All human beings are born free and equal in dignity and rights How many steps to return to eugenesia, to “lives unworthy to be lived” and to recreate Aktion T4?

15 Older women in Tanzania

16 Witchcraft in Tanzania Older women are targeted because of red eyes which are associated with a witch but are in fact the result of a lifetime of cooking in unventilated kitchens Disputes over property ownership and inheritance have often led to accusations of witchcraft which in turn result in violence, abuse and killings of older women. According to the Legal and Human Rights Centre report (2009) there was a total of 2,585 killings of older women for the period

17 That is: 517 older women killed per year in Tanzania under accusation of witchcraft

18 Ageism and age discrimination in primary and community health care in the United Kingdom Centre for Policy on Ageing, 2009

Evidence of discrimination in policies and practice Older age is a factor in deciding to refer for specialist treatment with low referral rates for older people for cholesterol testing, angiography and revascularisation; Parkinson’s disease; chronic kidney disease; and cancer Evidence of discrimination in systems and structures Older people, many with multiple conditions that can be effectively managed, now constitute the main users of the NHS, but there remains a general absence of a multidisciplinary approach to care of older people with complex needs. … There is evidence that multidisciplinary teams achieve better outcomes for people with multiple pathologies and functional problems. Older people are moved into care homes without a comprehensive assessment and opportunity for rehabilitation, compared to younger people requiring support. There is evidence that the 400,000 older people living in care homes have difficulty accessing the services of a GP and other primary care services.

Evidence of discrimination in resources Discrimination is implicit in a general lack of priority for services that benefit older people, such as chiropody, integrated falls services, continence services and audiology services. Older people have difficulty accessing rehabilitation services and dental services; older people have hearing and vision conditions that are not identified but could be treated; and there can be long waiting times to access aids which would significantly improve quality of life. ATTITUDES/PRACTICE Covert discrimination that is difficult to challenge arises from attitudes, custom and practice that practitioners may not recognise as being ageist.

21 Discrimination is the fundamental obstacle that must be attacked to achieve a change in the situation of older people, because it is based on ancient prejudice and stereotypes and is the ideological basis of behaviours and even have an influence on policies.

22 By taking discrimination as the basis we are situating the older people question as a human rights issue. Therefore is not enough with goodwill, education and campaigns.

23 We need to generate a specific binding international instrument referred to older people, that clearly states the equalization of their rights and opportunities establishing a universal and mandatory framework

24 Many thanks for your attention Jorge Plano