Ageism Is Pervasive In Health Care?

Ageism is pervasive in health care, with older people excluded from tests for drugs, less likely to receive preventive care, and deprived of professionals trained in their needs, according to a report presented to a Senate committee Monday.

"Ageism is a deep and often-unconscious prejudice against the old, an attitude that permeates American culture," said Daniel Perry, executive director of the not-for-profit Alliance for Aging Research, which prepared the report.

Among the shortcomings: only about 10 percent of American medical schools require course work or rotations in geriatric medicine, and fewer than 3 percent of medical school graduates take elective courses in geriatrics.

Only five out of 145 medical colleges have full geriatric medicine departments, Perry told the Senate Special Committee on Aging.

Sen. John Breaux of Louisiana, the top Democrat on the committee, said there are some 42,000 pediatricians in the country compared to 9,000 specialists in geriatric medicine, a number that is far too small as the nation girds for 77 million aging baby boomers.

The report, citing various studies, said only 10 percent of people aged 65 and above receive the appropriate screenings in such areas as bone mass, colorectal and prostate cancer and glaucoma. Breaux compared that to the 95 percent of five-year-olds who are up-to-date on their immunizations.

It also related that while older Americans are the biggest users of prescription drugs, 40 percent of clinical studies between 1991 and 2000 excluded people over 75 from participating.

Dr. Robert Butler, head of the International Longevity Center and the man who coined the term "ageism" in the 1960s, cited studies concluding that medication problems may be responsible for as many as 17 percent of hospitalizations of older Americans and that drug misuse by older people costs some $20 billion a year in hospital stays.

Dr. Joel Streim, head of the American Association for Geriatric Psychiatry, said that while 20 percent of those above 65 have a mental illness, mental health care and alcohol and substance abuse treatments focus mainly on young people.

"Ageist attitudes and health care policies that discriminate against older adults prevent them from getting the treatment they need and deserve. This is a shameful tragedy," he said.

Sen. Ron Wyden, D-Ore., said he was raising the same problems more than 20 years ago when he was executive director of the Oregon chapter of the Gray Panthers. "Nothing short of a revolution" in the country's medical education system is needed, he said.

The report also recommended increased training and education of health care providers, more research into aging, the inclusion of older patients in clinical drug trials, and education for both patients and physicians in proper screening and prevention methods.

By Jim Abrams