FST BLOG

Changing how we think about ageing: Joining up medical sciences, social sciences and the humanities

• 23 October 2024
• General
• Martina Zimmermann

Achieving attitudinal change to ageing would have far-reaching implications for how we retire, treat and care for older people, fund research and care, and understand intergenerational relations. It would break down barriers to opportunity across the age spectrum and contribute to healthier ageing for all.

Ageing evokes anxieties about vulnerability and dependence. It comes with concerns about decline and loss, and it is aligned with ill health and disease. This narrative is only partly informed by the biological reality of bodily change across the life span. It is also directed by cultural and wider societal perceptions of what ageing means.

The Sciences of Ageing and the Culture of Youth (SAACY) is invested in achieving attitudinal change to ageing. Funded by a UK Research and Innovation Future Leaders Fellowship, SAACY looks at how we talk and think about ageing, in scientific research, medical practice and wider culture, and it explores how the way we do so can affect our own experiences of ageing, our attitudes to getting older and the decisions we make about older people, in families and communities as much as at the level of policy.

Long-term changes in discourse rely on a maximal number of coalition partners across disciplines and sectors. Alongside academic researchers, stakeholders include national and local charities and other third-sector organisations invested in quality of life in older age and across generations; education and information providers alongside health and care practitioners; older people, local organisations and community bodies; the creative industries; funding bodies; policymakers and the Government.

As part of SAACY, literature-based research closely attends to the dialogue between cultural discourses and scientific models of ageing. A sociological study explores meanings and anticipations of ageing, also in collaboration with project partners in the charity sector. Together with local charities as well as major national charities we seek out opportunities for engaging with different people to challenge pessimism about ageing. And bringing the perspectives and convictions of older people into policy labs, about ‘Shifting How We View the Ageing Process’ (2023), and, this autumn, on ‘Shifting Representations of Ageing in Advertising, the Media and the Creative Industries’ (report in preparation), we aim to develop policy change for the ageing population.

In this blog, I explore what joined-up expertise from life and medical sciences, social sciences and the humanities might look like in the service of an ageing population. I offer snapshots of synergies between large-scale, predictive qualitative and quantitative research, and studies that describe and contextualise.

Important to all these research endeavours are the stories about ageing we listen to. These stories interlock biological, psychological and social aspects of ageing. In other words, culture influences health in older age by way of bio-psycho-social connections. Take two examples: self-directed pessimism about ageing and cumulative effects of lifetime inequalities. Both have cellular and molecular substrates.

Epidemiologist Becca Levy has done important work in the area of self-directed ageism. For example, individuals who hold more negative views about their own ageing are less likely to engage in health behaviours like exercise and diet; and these behaviours potentially result in worse mobility and physical functioning and an increased risk of cardiovascular events.

Evidence regarding stereotype embodiment is also relevant for experiences in a global economy. In prosperous societies, where older people hold low social status, considering oneself as old comes with subjective ill health (Marques et al., 2015). In collectivistic, less affluent cultures, by comparison, age bias is much less common, with consequences for subjective health and wellbeing in older age (Ackerman and Chopik, 2021).

In multi-cultural contexts like the UK, collectivistic perspectives are alive in marginalised communities (Zimmermann et al., 2023). Yet exactly these marginalised communities continue to incur the greatest inequalities in health and wellbeing in older age. Social determinants of health, including money, knowledge and beneficial social connections have been proposed as protecting health since the 1990s (Link and Phelan, 1995), and biological correlates range from the neuroendocrine and immune systems to cardiovascular health and sleep quality (Ryff, Singer and Love, 2004; Robinson et al., 2021).

In reverse, knowing about biological realities as one ages, and integrating this knowledge into social scientific and humanities research endeavours that focus on human dimensions of healthcare, means that arguments for changes in policy and practice can be made more forcefully.

Consider the fact that older people cope less well with stress (Whalley, 2001). The human stress response is controlled by the brain and delivered by cortisol; a finely tuned negative feedback loop restricts long-term negative effects of cortisol. Ageing disrupts this negative feedback. Cortisol background levels are higher, and, following activation, return to baseline takes longer. Across the life span, factors like diet and lifestyle support stress management. The older we get the more social and psychological factors complicate the control of cortisol levels (think of ageism in the job market and the growing likelihood of stressful life events like the death of a spouse or a health diagnosis).

A greater emphasis on the biological realities of ageing can shift focus onto health humanities and health sciences research with a view to directing attention to social and psychological factors, both of which can be modified through shifts in policy and practice, at individual, community and population levels.

What to take from all this? Stories we listen to influence how we age. Filling a narrative gap about biology at the receiving end of culture has huge implications for how we approach care, do research, and plan our lives on a changing planet.

Contextualized research brings together biological, psychological and social dimensions. Medico-scientific interventions provide large sets of quantitative data like clinical trials; this kind of knowledge is particularly meaningful as and when designed with appreciation of specific values and belief systems, and with respect to the context of individual human conditions, knowledge of which derives from the humanities and qualitative research.

Differences in temporality and scale make it difficult for individuals to see the connection between the general and the particular (Dillon and Craig, 2021), between their own ageing (and their attitudes to getting older) and the challenges arising from population ageing. The humanities can address this narrative gap while concurrently sharing in the research that explores how stories age us, culturally, psychologically and biologically.

Expectations of health (or not) in older age determine how we think about our own future selves. Contextualised research will achieve healthier ageing for all, and this will generate new thinking about ageing, which, in turn, will come with downstream effects for more optimistic perceptions of growing older in the future.

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