(2-15) Global Report On Ageism-Eng

C HA PT E R 01
GLOBAL REPORT ON
1
GLOB A L R E P ORT ON AGE I SM
2
GLOBAL REPORT ON
Global report on ageism
ISBN 978-92-4-001686-6 (electronic version)

ISBN 978-92-4-001687-3 (print version)
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C HA PT E R 01
CONTENTS
MESSAGE BY THE UNITED NATIONS SECRETARY-GENERAL VII

PREFACE IX
ACKNOWLEDGEMENTS XI
ABBREVIATIONS XIII
EXECUTIVE SUMMARY XV
INTRODUCTION XIX
01. THE NATURE OF AGEISM 1

1.1 Defining ageism 2
1.2 How ageism works and how it arises 8
1.3 Ageism and other "-isms" 9
1.4 Conclusions and future directions 12
02. THE SCALE OF AGEISM AGAINST OLDER PEOPLE 21
2.1 Institutional ageism 22
2.2 Interpersonal ageism 31
2.3 Self-directed ageism 36
03. THE IMPACT OF AGEISM AGAINST OLDER PEOPLE 47
3.1 The impact of ageism on health 48
3.2 The economic impact of ageism 54
04. THE DETERMINANTS OF AGEISM AGAINST OLDER PEOPLE 65
4.1 Determinants of interpersonal ageism 67
4.2 Determinants of self-directed ageism 72
05. THE SCALE, IMPACT AND DETERMINANTS OF AGEISM
AGAINST YOUNGER PEOPLE 81
5.1 The scale of ageism against younger people 82
5.2 The impact of ageism against younger people 84
5.3 The determinants of ageism against younger people 86
V
06. STRATEGY 1: POLICY AND LAW 93

6.1 What they are and how they work 94
6.2 How well they work 96
6.3 Examples 97
6.4 Key characteristics and costs 101
07. STRATEGY 2: EDUCATIONAL INTERVENTIONS 113
7.3 Examples 116
08. STRATEGY 3: INTERGENERATIONAL CONTACT
INTERVENTIONS 125
8.3 Examples 128
09. PROMISING STRATEGIES 139
9.1 Campaigns 140
9.2 Potential strategies for mitigating the impact of ageism 145
10. THE WAY FORWARD 153
10.1 Recommendation 1: invest in evidence-based
strategies to prevent and respond to ageism 154
10.2 Recommendation 2: improve data and research to gain
a better understanding of ageism and how to reduce it 157
10.3 Recommendation 3: build a movement to change the narrative
around age and ageing 159
10.4 Conclusions 161
GLOSSARY 163
INDEX 169
VI
MESSAGE BY THE UNITED
NATIONS SECRETARY-GENERAL
年齡歧視在世界各地的機構、法律和政策中普遍存在。它損害個⼈健康和尊嚴以及經
Ageism is widespread in institutions, laws and policies across the world. It damages individual
濟和社會。它剝奪了⼈們的⼈權和充分發揮其潛⼒的能⼒。
health and dignity as well as economies and societies writ large. It denies people their
human rights and their ability to reach their full potential.
儘管具有普遍性和有害影響，年齡歧視仍然缺乏專⾨研究、信息、分類數據和系統趨
勢分析的堅實知識基礎。這份關於年齡歧視的新全球報告填補了這⼀空⽩，並強調需
Despite its pervasive nature and harmful impacts, ageism still lacks a solid knowledge base
要採⽤前瞻性思維、基於權利的⽅法，解決⽀持整個⽣命歷程中“年齡”長期假設的基
of dedicated research, information, disaggregated data and systematic trends analysis. This
本社會、立法和政策結構。
new Global report on ageism fills this gap and underscores the need to adopt a forward-
COVID-19rights-based
thinking, approach that addresses the underlying societal, legislative and
⼤流⾏對老年⼈產⽣了毀滅性的影響。代際團結必須成為我們努⼒恢復的
policy structures that support long-standing assumptions about ‘age’ across the life course.
試⾦⽯。作為衛⽣⼯作者和護理⼈員，老年⼈也為危機應對做出了重要貢獻。例如，
在老年⼈以及照顧她們的有償和無償護理⼈員中，婦女的比例過⾼。
The COVID-19 pandemic has had a devastating impact on older persons. Intergenerational
我於 2020must
solidarity 年 5 be⽉發布的關於老年⼈和 COVID-19
a touchstone in our efforts 的政策簡報強調需要認識到老年
to recover. Older persons have also made
important contributions to the crisis response, as health workers and caregivers. Women,
⼈在社會中的多重⾓⾊——作為照顧者、志願者和社區領袖——並強調傾聽⼈們聲⾳
for instance, are over-represented among both older persons and among the paid and
的重要性所有年齡段的⼈，重視他們的貢獻並確保他們有意義地參與決策。
unpaid care workers who look after them.
解決年齡歧視問題對於創造⼀個更加平等的世界⾄關重要，在這個世界中，每個⼈的
尊嚴和權利都得到尊重和保護。這是 2030 年可持續發展議程的核⼼，該議程是世界
My policy brief on older persons and COVID-19, released in May 2020, highlights the need
公認的藍圖，旨在為所有⼈在⼀個健康的星球上建設⼀個和平與繁榮的未來。本著這
to recognize the multiple roles that older persons have in society – as caregivers, volunteers
and community leaders – and underscores the importance of listening to the voices of
種精神，我向全球廣⼤受眾推薦這份報告，並期待與所有合作夥伴共同努⼒，恪守不
people of all ages, valuing their contributions and ensuring their meaningful participation
讓任何⼈掉隊的承諾。
in decision-making.
Addressing ageism is critical for creating a more equal world in which the dignity and
rights of every human being are respected and protected. This is at the heart of the 2030
Agenda for Sustainable Development, the world’s agreed blueprint for building a future of
peace and prosperity for all on a healthy planet. In that spirit, I commend this report to a
wide global audience and look forward to working with all partners to uphold the promise
to leave no one behind.
VII
VIII
PREFACE
COVID-19 has
COVID-19 affected people of all ages, in different ways. But beyond the impacts of the
以不同的⽅式影響了所有年齡段的⼈。但除了病毒本⾝的影響之外，⼀些
virus itself, some of the narratives about different age groups have exposed a deep and
關於不同年齡組的敘述暴露了⼀個深刻⽽古老的弊病：年齡歧視。老年⼈通常被視為
older malady: ageism. Older people have been often seen as uniformly frail and vulnerable,
⾝體虛弱和脆弱，⽽年輕⼈則被描繪成無敵的，或者魯莽和不負責任的。基於年齡的
while younger people have been portrayed as invincible, or as reckless and irresponsible.
成⾒（我們的想法）、偏⾒（我們的感受）和歧視（我們的⾏為⽅式）並不新鮮。
Stereotyping (how we think), prejudice (how we feel) and discrimination (how we act) based
on age, are放⼤了這些有害的態度。
COVID-19 not new; COVID-19 has amplified these harmful attitudes.
這份關於年齡歧視的全球報告再及時不過了。它的主要信息是，我們可以⽽且必須防
This global report on ageism could not be timelier. Its main message is that we can and
⽌年齡歧視，即使我們對年齡和衰老的思考、感受和⾏為⽅式的微⼩轉變也會為個⼈
must prevent ageism and that even small shifts in how we think, feel and act towards age
和社會帶來好處。
and ageing will reap benefits for individuals and societies.
這份報告表明，年齡歧視是普遍存在的、無處不在的和陰險的，因為它在很⼤程度上
This report shows that ageism is prevalent, ubiquitous and insidious because it goes largely
未被認識和挑戰。年齡歧視對⼈們的健康、福祉和⼈權造成嚴重⽽深遠的影響，並給
unrecognised and unchallenged. Ageism has serious and far-reaching consequences for
社會造成數⼗億美元的損失。在老年⼈中，年齡歧視與⾝⼼健康狀況較差、社會孤立
people’s health, well-being and human rights and costs society billions of dollars. Among
和孤獨感增加、經濟不安全感加劇以及⽣活質量下降和過早死亡有關。⽂獻中對年輕
older people, ageism is associated with poorer physical and mental health, increased
⼈年齡歧視的探討較少，但年輕⼈在就業、健康和住房等⼀系列領域都有報導。在整
social isolation and loneliness, greater financial insecurity and decreased quality of life and
premature death. Ageism, in younger people has been less well explored in the literature but
個⽣命過程中，年齡歧視與能⼒歧視、性別歧視和種族主義相互作⽤，使不利因素更
reported by younger people in a range of areas including employment, health and housing.
加複雜。
Across the life course, ageism interacts with ableism, sexism and racism compounding
為了實現作為可持續發展⽬標核⼼的持久、更加美好的發展前景，我們必須改變圍繞
disadvantage.
年齡和老齡化的敘述。我們必須提⾼對年齡歧視態度和⾏為的關注度並密切關注，採
To achieve the long-lasting, vastly better development prospects that lie at the heart of
取應對策略，制定⽀持⼈⽣各個階段的綜合政策應對措施。
the Sustainable
2016 Development Goals, we must change the narrative around age and ageing.
年，世界衛⽣⼤會呼籲世界衛⽣組織與合作夥伴合作，領導⼀場打擊年齡歧視的
We must raise visibility of and pay closer attention to ageist attitudes and behaviors, adopt
全球運動。世衛組織與⼈權事務⾼級專員辦事處、聯合國經濟和社會事務部和聯合國
strategies to counter them, and create comprehensive policy responses that support every
⼈⼝基⾦合作編寫的《全球年齡歧視報告》，通過提供證據說明什麼有助於預防並回
stage of life.
應年齡歧視。
In 2016, the World Health Assembly called on the World Health Organization to lead a
我們都可以在預防和應對年齡歧視⽅⾯發揮作⽤。該報告建議所有利益相關者（包括
global campaign to combat ageism in collaboration with partners. The Global Report on
政府、⺠間社會組織、學術和研究機構以及企業）採取措施執⾏新的和現有的政策和
Ageism, developed by WHO in collaboration with the Office of the High Commissioner
立法，提供教育並促進代際接觸，以造福所有年齡段的⼈。
for Human Rights, the United Nations Department of Economic and Social Affairs and the
隨著各國尋求從⼤流⾏中恢復過來，所有年齡段的⼈都將繼續⾯臨不同形式的年齡歧
United Nations Population Fund, informs the campaign by providing the evidence on what
works to prevent and respond to ageism.
視。年輕的⼯⼈可能更不可能找到⼯作。老年⼯⼈可能成為裁員的⽬標。僅基於年齡
的醫療保健分類將限制老年⼈的健康權。如果我們要確保世界各地⼈們的健康、福祉
We all have a role to play in preventing and responding to ageism. The report suggests
和尊嚴，我們就必須在這場危機中和之後解決年齡歧視問題。隨著各國更好地從⼤流
steps for all stakeholders – including governments, civil society organizations, academic and
⾏中恢復過來並加快實現可持續發展⽬標的進程，所有國家都必須採取措施打擊年齡
research institutions and business – to enforce new and existing policies and legislation,
provide education and foster intergenerational contact for the benefits of people of all ages.
歧視。我們的願景是⼀個不分年齡⼈⼈共享的世界，在這個世界中，基於年齡的刻板
印象、偏⾒和歧視不會限制我們的機會、健康、福祉和尊嚴。我們邀請您使⽤本報告
As countries seek to recover from the pandemic, people of all ages will continue to face
中的證據來幫助實現這⼀願景。
different forms of ageism. Younger workers may be even less likely to get jobs. Older workers
may become a target for workforce reduction. Triage in health care based solely on age
will limit older people’s right to health. We will have to tackle ageism in and after this crisis
if we are to secure the health, wellbeing and dignity of people everywhere. As countries
IX
build back better from the pandemic and to accelerate progress towards the Sustainable
Development Goals, all must adopt measures that combat ageism. Our driving vision is a
world for all ages, one in which age-based stereotypes, prejudice and discrimination do not
limit our opportunities, health, wellbeing and dignity. We invite you to use the evidence in
this report to help this vision become a reality.
Tedros Adhanom Ghebreyesus Liu Zhenmin

Director-General Under-Secretary-General
World Health Organization United Nations Department of
Economic and Social Affairs
Michelle Bachelet Natalia Kanem

United Nations Executive Director, United Nations
High Commissioner Population Fund
for Human Rights
X
ACKNOWLEDGEMENTS
The development of this report has been led by an Editorial Committee at the World Health
由 Alana 官員、Vânia
Organization de la Fuente-Núñez
(WHO) comprising 和 Christopher
Alana Officer, Vânia Mikton and
de la Fuente-Núñez 組成的組織 Christopher
Mikton under the overall guidance of Etienne Krug,
（世衛組織），在健康問題社會決定因素主任 Director,
Etienne Social
Krug Determinants of Health,
和全⺠健康覆蓋/更健康
and Naoko Yamamoto, Assistant Director-General, Universal Health Coverage/Healthier
⼈⼝助理總幹事 Naoko Yamamoto 的全⾯指導下；並與老齡化項⽬主管 Amal
Populations; and in collaboration with Amal Abou Rafeh, Chief, Programme on Ageing Unit; Rio
Abou RafehLeader,
Hada, Team 合作；Human Rio Hada，聯合國⼈權事務⾼級專員辦事處⼈權和經濟及社會
Rights and Economic and Social Issues Section, in the Office of
問題科組長；和聯合國⼈⼝基⾦⼈⼝與發展處處長雷切爾·斯諾。許多其他全球和區域
the United Nations High Commissioner for Human Rights; and Rachel Snow, Chief, Population
and Development Branch, United Nations Population Fund. Many other global and regional
世衛組織和聯合國⼯作⼈員提供了與其⼯作領域相關的投入。沒有他們的奉獻、⽀持
WHO and United Nations staff provided inputs relevant to their areas of work. Without their
和專業知識，這份報告是不可能完成的。
dedication, support and expertise this report would not have been possible.
負責制定報告中使⽤的年齡歧視概念框架的核⼼⼩組包括 Sophie Amos、Louise
Ansari、Liat Ayalon、Jane
A core group responsible Barratt、Necodimus
for developing the conceptual Chipfupa、Patricia
framework of ageism that Conboy、
was used
in the reportCostello、Vânia
Mary-Kate included Sophie Amos,de la Louise Ansari, Liat Ayalon, JaneKendall
Fuente-Núñez、Nathaniel Barratt,-Necodimus
Taylor、
Chipfupa,
Angga Patricia Conboy,Oﬃcer、Bhanu
Martha、Alana Mary-Kate Costello, Vânia de la Fuente-Núñez,
Pratap、Jelena SofranacNathaniel
和 Jemma Kendall-
Taylor, Angga Martha, Alana Officer, Bhanu Pratap, Jelena Sofranac and Jemma Stovell.
Stovell。
該報告的主要作者是
The lead authors on theVânia
reportde la Fuente-Núñez（第
were Vânia de la Fuente-Núñez 1、2、4、5、6、10
(Chapters 1, 2, 4, 5,章）和
6, 10) and
Christopher Mikton（第
Christopher Mikton 2、3、5、7、8、9、10
(Chapters 章）。該報告得益於眾多專家和學
2, 3, 5, 7, 8, 9, 10). The report benefited from the rich inputs
of many experts and academics. It was also informed by a series of systematic and scoping
者的豐富投入。它還從與世衛組織合作進⾏的⼀系列系統性和範圍界定審查和定性研
reviews and qualitative research conducted in collaboration with WHO. The names of the
究中獲得了信息。專家和作者的姓名列在貢獻者下。
experts and authors are listed under Contributors.
該報告還得益於其他幾個⼈的努⼒，特別是 Miriam Pinchuk，他編輯了報告的最終
⽂本；盛開媒體、平⾯設計和傳播；
The report also benefited from the effortsJudi Curryother
of several 校對； Christine
people, Boylan
in particular ⽤於索
Miriam Pinchuk,
who edited
引； the final設計⼈物；以及
Sue Hobbs text of the report;Alexia
Blossom for media,
Sapin graphic design
和 Florence Taylor and communication;
的⾏政⽀持。還
Judi Curry
要感謝 for proofreading;
Alison Christine Boylan
Brunier、Christopher for indexing;Russell、Sari
Black、Sarah Sue Hobbs for Setiogi
the design
和 of the
figures; and Alexia Sapin and Florence Taylor for their administrative support. Thanks are also
Kazuki Yamada
due to Alison 的媒體和交流。
Brunier, Christopher Black, Sarah Russell, Sari Setiogi and Kazuki Yamada for
世衛組織還要感謝⽇本政府為本報告的編寫、翻譯和出版提供的慷慨財政⽀持。報告
media and communication.
的編寫也得到了對世衛組織的核⼼⾃願捐款的⽀持。
WHO also wishes to thank the Government of Japan for its generous financial support for
the development, translation and publication of this report. The development of the report
was also supported through core voluntary contributions to WHO.
CONTRIBUTORS
Authors of background research papers
• A systematic review of existing ageism scales – Liat Ayalon, Pnina Dolberg, Sarmitė
Mikulionienė, Jolanta Perek-Białas, Gražina Rapolienė, Justyna Stypinska, Monika
Willińska and Vânia de la Fuente-Núñez.
• Ageism, healthy life expectancy and population ageing: how are they related? Alana
Officer, Jotheeswaran Amuthavalli Thiyagarajan, Mira Leonie Schneiders, Paul Nash
and Vânia de la Fuente-Núñez.
XI
• Campaigning to tackle ageism? Move with the evidence tide – Cassandra Phoenix
and Vânia de la Fuente-Núñez.
• Determinants of ageism against older adults: a systematic review – Sibila Marques,

João Mariano, Joana Mendonça, Wouter De Tavernier, Moritz Hess, Laura Naegele,
Filomena Peixeiro and Daniel Martins.
• Global reach of ageism on older persons’ health: a systematic review – E-Shien

Chang, Sneha Kannoth, Samantha Levy, Shi-Yi Wang, John E. Lee and Becca R. Levy.
• Interventions to reduce ageism against older adults: a systematic review and meta-
analysis – David Burnes, Christine Sheppard, Charles R. Henderson, Monica Wassel,
Richenda Cope, Chantal Barber and Karl Pillemer.
• Scoping review on ageism towards younger populations – Vânia de la Fuente-Núñez,

Ella Cohn-Schwartz, Senjooti Roy and Liat Ayalon.
Additional contributors
Rapid reviews and general research support were provided by Gesa Sophia Borgeest on the
intersections between ageism and other “-isms”, and by Laura Campo Tena on campaigns
to reduce ageism against younger people, COVID-19 and ageism, the impact of ageism on
the well-being of older people and strategies to mitigate the impact of ageism. Liat Ayalon,
Jane Barratt, Nena Georgantzi, Estelle Huchet and Karl Pillemer drafted Box 2.1 on Ageism
and COVID-19. Data analysis on the prevalence of interpersonal ageism against older adults
was provided by Jotheeswaran Amuthavalli Thiyagarajan. A review of ageism and statistics
was provided by Michael Herrmann. Information and resources on law, policies and related
processes were provided by Julia Ferre and Nena Georgantzi. Photos and testimonials were
provided by HelpAge International and the United Nations Major Group for Children and
Youth, coordinated by Jemma Stovell, and Aashish Khullar and Lucy Fagan, respectively.
Peer reviewers
The peer reviewers for the report were Amal Abou Rafeh, Jotheeswaran Amuthavalli Thiyagarajan,
Louise Ansari, Ashton Applewhite, Alanna Armitage, Liat Ayalon, Anshu Banerjee, Jane Barratt,
Françoise Bigirimana, David Burnes, George-Konstantinos Charonis, Harsh Chauhan, Silvia
Gascon, Vitalija Gaucaite Wittich, Nena Georgantzi, Regina Guthold, Rio Hada, Manfred Huber,
Alex Kalache, Nancy Kidula, Marlene Krasovitsky, April Siwon Lee, Becca R. Levy, Ramez Khairi
Mahaini, Mary Manandhar, Sibila Marques, Patricia Morsch, Innocent Bright Nuwagira, Hiromasa
Okayasu, Martha Pelaez, Silvia Perel Levin, Cassandra Phoenix, Karl Pillemer, Ritu Sadana, Saliyou
Sanni, Dorothea Schmidt, Yi Wen Shao, Elisha Sibale, Briget Sleap, Jemma Sovell, Julie Steffler,
Yuka Sumi, Tran Bich Thuy, Enrique Vega and Kazuki Yamada.
Conflicts of interest
None of the experts involved in the development of this report declared any conflicts of
interest.
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ABBREVIATIONS
COVID-19 Novel coronavirus 2019 (also known as SARS-CoV-2)
GRADE Grading of Recommendations Assessment, Development and Evaluation
MIPA A Madrid International Plan of Action on Ageing
PEACE Positive Education about Ageing and Contact Experiences
PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses
STDs Sexually transmitted diseases
UN United Nations
WHO World Health Organization
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EXECUTIVE SUMMARY
Age is one of the first things we notice about other people. Ageism arises when age
年齡是我們注意到其他⼈的第⼀件事。當年齡被⽤來以導致傷害、劣勢和不公正並削
is used to categorize and divide people in ways that lead to harm, disadvantage and
弱代際團結的⽅式對⼈們進⾏分類和劃分時，就會出現年齡歧視。年齡歧視在整個⽣
injustice and erode solidarity across generations. Ageism takes on different forms
命過程中呈現出不同的形式。例如，青少年可能因發起政治運動⽽受到嘲笑；老年⼈
across the life course. A teenager might, for instance, be ridiculed for starting a
political movement; both older and younger people might be denied a job because
和年輕⼈都可能因為年齡⽽被拒絕⼯作；或者老年⼈可能會被指控使⽤巫術並被趕出
of their
他們的家鄉和村莊。 age; or an older person might be accused of witchcraft and driven out of
their home and village.
年齡歧視損害我們的健康和福祉，是製定有效政策和採取健康老齡化⾏動的主要障
礙，正如世界衛⽣組織
Ageism damages our health (WHO) 會員國在老齡化與健康全球戰略和⾏動計劃中以及整
and well-being and is a major barrier to enacting
個⼗年所承認的那樣健康老齡化：2021-2030。作為回應，世衛組織被要求與合作夥
effective policies and taking action on healthy ageing, as recognized by World Health
Organization (WHO) Member States in the Global strategy and action plan on ageing
伴⼀起發起⼀場打擊年齡歧視的全球運動。
and health and through the Decade of Healthy Ageing: 2021–2030. In response, WHO
關於年齡歧視的全球報告是由世衛組織、⼈權事務⾼級專員辦事處、聯合國（UN）經
was asked to start, with partners, a global campaign to combat ageism.
濟和社會事務部和聯合國⼈⼝基⾦為該運動編寫的。它針對決策者、從業者、研究⼈
員、發展機構以及私營部⾨和⺠間社會的成員。本報告在界定了年齡歧視的性質之
The Global report on ageism was developed for the campaign by WHO, Office of
the High Commissioner for Human Rights, the United Nations (UN) Department of
後，總結了關於年齡歧視的規模、影響和決定因素的最佳證據以及減少年齡歧視的最
Economic and Social Affairs and the United Nations Population Fund. It is directed
有效策略。最後提出了三項⾏動建議，以證據為依據，為所有年齡段的⼈創造⼀個世
at policy-makers, practitioners, researchers, development agencies and members of
界。private sector and civil society. This report, after defining the nature of ageism,
the
summarizes the best evidence about the scale, the impacts and the determinants
of ageism and the most effective strategies to reduce it. It concludes with three
recommendations for action, informed by the evidence, to create a world for all ages.
The nature of ageism

年齡歧視的本質
Ageism refers to the stereotypes (how we think), prejudice (how we feel) and
discrimination (how we act) directed towards people on the basis of their age. It can be
年齡歧視是指基於年齡對⼈們的刻板印象（我們的想法）、偏⾒（我們的感受）和歧
institutional, interpersonal or self-directed. Institutional ageism refers to the laws, rules,
視（我們的⾏為⽅式）。它可以是製度性的、⼈際關係的或⾃我指導的。制度性年齡
social norms, policies and practices of institutions that unfairly restrict opportunities
歧視是指機構的法律、規則、社會規範、政策和做法不公平地限制機會並系統地使個
and systematically disadvantage individuals because of their age. Interpersonal ageism
⼈因其年齡⽽處於不利地位。⼈際年齡歧視產⽣於兩個或兩個以上個體之間的互動，
arises in interactions between two or more individuals, while self-directed ageism occurs
when ageism is internalized and turned against oneself.
⽽⾃我導向的年齡歧視發⽣在年齡歧視被內化並反對⾃⼰時。
年齡歧視始於童年，並隨著時間的推移⽽加劇。從很⼩的時候開始，孩⼦們就會從周
Ageism starts in childhood and is reinforced over time. From an early age, children pick
圍的⼈那裡得到關於他們⽂化的刻板印象和偏⾒的線索，這些線索很快就會被內化。
up cues from those around them about their culture’s stereotypes and prejudices, which
然後，⼈們使⽤這些刻板印象進⾏推論，並引導他們對不同年齡段的⼈和他們⾃⼰的
are soon internalized. People then use these stereotypes to make inferences and to guide
感受和⾏為。
their feelings and behaviour towards people of different ages and towards themselves.
年齡歧視經常與其他形式的刻板印象、偏⾒和歧視交叉並相互作⽤，包括能⼒歧視、
Ageism often intersects and interacts with other forms of stereotypes, prejudice and
性別歧視和種族主義。多種交叉形式的偏⾒加劇了不利條件，並使年齡歧視對個⼈健
discrimination, including ableism, sexism and racism. Multiple intersecting forms of
康和福祉的影響更加嚴重。
bias compound disadvantage and make the effects of ageism on individuals’ health
and well-being even worse.
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The scale
年齡歧視的規模 of ageism
Ageism pervades many institutions and sectors of society, including those providing health
年齡歧視遍及社會的許多機構和部⾨，包括提供健康和社會保健、⼯作場所、媒體和
and social care, the workplace, the media and the legal system. Health-care rationing on
法律系統的機構和部⾨。基於年齡的衛⽣保健配給很普遍，老年⼈往往被排除在研究
the basis of age is widespread, and older adults tend to be excluded from research and
和數據收集⼯作之外。老年⼈和年輕⼈在⼯作場所往往處於不利地位。
data collection efforts. Older ⼈們對年輕
and younger adults are often disadvantaged in the workplace.
People get angrier about crimes committed
犯罪者⽽不是年長者犯下的罪⾏更加憤怒，並將這些犯罪視為更嚴重的違法⾏為。 by younger offenders, rather than older, and
年
see these crimes as more serious transgressions. Ageism also shapes how statistics and
齡歧視還影響了政策所依據的統計數據和數據的收集⽅式。
data, on which policies are based, are collected.
在全球範圍內，有⼆分之⼀的⼈反對老年⼈。
Globally, one in two people are ageist against 在我們擁有數據的唯⼀地區歐洲，三分
older people. In Europe, the only region
for which we have data, one in three
之⼀的⼈報告稱其成為年齡歧視的⽬標，⽽年輕⼈報告的年齡歧視比其他年齡組更嚴 report having been a target of ageism, and younger
people report more perceived age discrimination than other age groups.
重。
The impact of ageism

Ageism has serious and far-reaching consequences for people’s
年齡歧視對⼈們的健康、福祉和⼈權具有嚴重⽽深遠的影響。 health, well-being
對於老年⼈來說，年齡
and human rights. For older people,
歧視與更短的壽命、更差的⾝⼼健康、更慢的殘疾恢復和認知能⼒下降有關。 ageism is associated with a shorter lifespan,
年齡歧
poorer physical and mental health, slower recovery from disability and cognitive
視會降低老年⼈的⽣活質量，增加他們的社會孤立感和孤獨感（兩者都與嚴重的健康
decline. Ageism reduces older people’s quality of life, increases their social isolation
問題有關），限制他們表達性慾的能⼒，並可能增加老年⼈遭受暴⼒和虐待的風險。
and loneliness (both of which are associated with serious health problems), restricts
their ability to express their sexuality and may increase the risk of violence and
年齡歧視還會減少年輕⼈對他們⼯作的組織的承諾。
abuse against older people. Ageism can also reduce younger people’s commitment
對於個⼈⽽⾔，年齡歧視會導致老年貧困和經濟不安全，最近的⼀項估計表明，年齡
to the organization they work for.
歧視會使社會損失數⼗億美元。
For individuals, ageism contributes to poverty and financial insecurity in older age,
and one recent estimate shows that ageism costs society billions of dollars.
The determinants of ageism

Factors that increase the risk of perpetrating ageism against older people are being
增加對老年⼈實施年齡歧視風險的因素是更年輕、男性、對死亡感到焦慮和受教育程
younger, male, anxious about death and less educated. Factors that reduce the risk
度較低。降低對年輕⼈和老年⼈實施年齡歧視風險的因素是具有某些個性特徵和更多
of perpetrating ageism against both younger and older people are having certain
的代際接觸。
personality traits and more intergenerational contact.
增加成為年齡歧視⽬標的風險的因素是年齡較⼤、依賴護理、在該國的健康預期壽命
Factors that increase the risk of being a target of ageism 成為針對年輕⼈的年齡
較低以及在某些專業或職業部⾨⼯作，例如⾼科技或酒店業。 are being older, being
care-dependent, having a lower healthy life expectancy in the country and working in
歧視⽬標的⼀個風險因素是女性。
certain professions or occupational sectors, such as high-tech or the hospitality sector.
A risk factor for being a target of ageism against younger people is being female.
Three strategies to reduce ageism

Three strategies to reduce ageism have been shown to work: policy and law,
educational activities and intergenerational contact interventions.
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• Strategy
策略 1: Policy and law – Policies and laws can be used to reduce ageism
1：政策和法律——政策和法律可⽤於減少對任何年齡組的年齡歧視。例如，它
towards any age group. They can include, for example, policies and legislation that
們可以包括解決年齡歧視和不平等問題的政策和立法以及⼈權法。可以通過採⽤新的
address age discrimination and inequality and human rights laws. Strengthening
⼿段來加強反對年齡歧視的政策和法律
policies and laws against ageism can be achieved by adopting new instruments
在地⽅、國家或國際層⾯，並通過修改允許年齡歧視的現有⽂書。該戰略要求國家和
at the local, national or international level and by modifying existing instruments
that permit age discrimination. This strategy requires enforcement mechanisms
國際層⾯的執法機制和監督機構確保有效實施解決歧視、不平等和⼈權問題的政策和
and monitoring bodies at the national and international levels to ensure effective
法律。
implementation of the policies and laws addressing discrimination, inequality and
human rights.
‧ 策略 2：教育⼲預——減少年齡歧視的教育⼲預應包括在所有級別和類型的教育
• Strategy 2: Educational interventions – Educational interventions to reduce
中，從⼩學到⼤學，以及正規和非正規教育環境。教育活動通過提供準確的信息和反
ageism should be included across all levels and types of education, from
陳規定型的例⼦，有助於增強同理⼼，消除對不同年齡組的誤解，減少偏⾒和歧視。
primary school to university, and in formal and non-formal educational contexts.
Educational activities help enhance empathy, dispel misconceptions about
‧different
策略3：代際接觸⼲預——還應投資於代際接觸⼲預，旨在促進不同代⼈之間的互
age groups and reduce prejudice and discrimination by providing accurate
動。這種接觸可以減少群體間的偏⾒和刻板印象。代際接觸⼲預是減少針對老年⼈的
information and counter-stereotypical examples.
年齡歧視最有效的⼲預措施之⼀，它們也顯⽰出減少針對年輕⼈的年齡歧視的希望。
• Strategy 3: Intergenerational contact interventions – Investments should also
be made in intergenerational contact interventions, which aim to foster interaction
這些建議旨在幫助利益相關者減少年齡歧視。實施它們需要政治承諾、不同部⾨和⾏
between people of different generations. Such contact can reduce intergroup
為者的參與以及針對具體情況的適應。在可能的情況下，它們應該⼀起實施，以最⼤
prejudice and stereotypes. Intergenerational contact interventions are among the
most effective interventions to reduce ageism against older people, and they also
限度地減少對年齡歧視的影響。
show promise for reducing ageism against younger people.
‧ 建議1：投資於預防和解決年齡歧視的循證戰略。應優先考慮⽀持的三項戰略
Three recommendations for action
最好的證據：制定政策和法律，實施教育
和代際接觸⼲預。為了在⼈⼝⽔平上產⽣影響，必須擴⼤這些戰略。在以前沒有實施
These過此類⼲預措施的情況下，應對它們進⾏調整和測試，然後在證明它們在新環境中起
recommendations aim to help stakeholders reduce ageism. Implementing them
requires political commitment, the engagement of different sectors and actors and context-
作⽤後擴⼤規模。
specific adaptations. When possible, they should be implemented together to maximize
their impact on ageism.
‧ 建議2：改進數據和研究，以更好地了解年齡歧視以及如何減少它。提⾼我們對各個
• Recommendation 1: Invest in evidence-based strategies to prevent and
⽅⾯的理解
tackle ageism. Priority should be given to the three strategies supported by
年齡歧視——其規模、影響和決定因素——是減少針對年輕⼈和老年⼈的年齡歧視的
the best evidence: enacting policies and laws, and implementing educational
先決條件。應使⽤有效和可靠的年齡歧視衡量尺度在各國收集數據，特別是在低收入
and intergenerational contact interventions. To make a difference at the level of
和中等收入國家。但當務之急應該是製定減少年齡歧視的策略。戰略有效性的證據基
populations, these strategies must be scaled up. Where such interventions have
not been implemented before, they should be adapted and tested, and then scaled
礎正在發展，但仍達不到所需的⽔平。應優化現有戰略，估計其成本和成本效益，然
up once they have been shown to work in the new context.
後擴⼤規模。需要進⼀步製定和評估有希望的戰略，例如減少年齡歧視的運動。
• Recommendation 2: Improve data and research to gain a better understanding
‧of建議3：發起⼀場運動，改變圍繞年齡和老齡化的敘述。我們都可以在挑戰和消除年
ageism and how to reduce it. Improving our understanding of all aspects
of ageism – its scale, impacts and determinants – is a prerequisite for reducing
齡歧視⽅⾯發揮作⽤。政府、⺠間社會組織、聯合國機構、發展組織、學術和研究機
ageism against both younger and older people. Data should be collected across
構、企業和各個年齡段的⼈都可以加入
countries, particularly in low- and middle- income countries, using valid and reliable
減少年齡歧視的運動。通過作為⼀個廣泛的聯盟走到⼀起，我們可以改善參與打擊年
measurement scales of ageism. But the top-most priority should be developing
齡歧視的不同利益相關者之間的合作和溝通。
strategies to reduce ageism. The evidence base for the effectiveness of strategies
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is developing, but it still falls short of what is needed. Existing strategies should
be optimized, their cost and cost–effectiveness estimated and then they should be
scaled up. Promising strategies, such as campaigns to reduce ageism, need to be
further developed and evaluated.
• Recommendation 3: Build a movement to change the narrative around age

and ageing. We all have a role to play in challenging and eliminating ageism.
Governments, civil society organizations, UN agencies, development organizations,
academic and research institutions, businesses and people of all ages can join
the movement to reduce ageism. By coming together as a broad coalition, we can
improve collaboration and communication between the different stakeholders
engaged in combating ageism.
CONCLUSIONS
現在是對年齡歧視說不的時候了。
It is time to say no to ageism. This 這份關於年齡歧視的全球報告概述瞭如何打擊年齡
Global report on ageism outlines how to combat
ageism and, hence, contribute to improving
歧視，從⽽為改善健康、增加機會、降低成本和使⼈們在任何年齡都能茁壯成長做出 health, increasing opportunities, reducing costs
and enabling people to flourish at any age. If governments, UN agencies, development
貢獻。如果政府、聯合國機構、發展組織、⺠間社會組織以及學術和研究機構實施有
organizations, civil society organizations and academic and research institutions implement
效的戰略並投資於進⼀步的研究，如果個⼈和社區加入運動並挑戰每⼀個年齡歧視的
strategies that are effective and invest in further research, and if individuals and communities
例⼦，那麼我們將共同創造⼀個世界
join the movement and challenge every 老少皆宜。
instance of ageism, then together we will create
a world for all ages.
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INTRODUCTION
介紹
Ageing is a natural and lifelong process that, while universal, is not uniform. How we age
衰老是⼀個⾃然⽽終⽣的過程，雖然普遍，但並不統⼀。我們如何變老是由我們與我
is shaped by the relationships we have with the social and physical environments we have
們⼀⽣所⽣活的社會和物理環境的關係所決定的。我們的年齡也因個⼈特徵⽽異，包
lived in throughout our lives. How we age also varies according to personal characteristics
括我們出⽣的家庭、我們的性別和我們的種族
including the family we were born into, our sex(1)。我們活得越久，彼此之間的差異就
and our ethnicity (1). The longer we live,
the more different from each other we become, making diversity a hallmark of older age.
越⼤，這使得多樣性成為老年的標誌。
我們的年齡反映了我們還活著的年數。但什麼被認為是年輕或年老部分取決於背景、
Our age reflects the number of years we have been alive. But what is considered young
⽬的和⽂化。在 18 歲時，您可能被認為太老⽽無法學習成為⼀名競技體操運動員，
or old partly depends on context, purpose and culture. At age 18 you may be considered
但⼜太年輕⽽無法競選⾼級政治職務。在什麼構成老年、中年和青年⽅⾯，⽂化也各
too old to learn to be a competitive gymnast, but too young to run for high political office.
不相同。⼀個世紀前，在⻄歐和北美，老年開始的時間比今天要早得多。
Cultures also vary as to what constitutes older age, middle age and youth. A century ago
in western Europe and North America, old age started much earlier than it does today.
我們每個⼈對年齡和衰老的思考、感受和⾏動⽅式——我們⾃⼰的和他⼈的——可以
幫助我們茁壯成長，也可以限制我們的⽣活和我們享受的⾃由。當基於年齡的偏⾒滲
How we each think, feel and act towards age and ageing – our own and that of others
透到我們的機構中時（例如法律、健康、教育），它們會造成並延續群體之間的差
– can either help us thrive or limit the lives we lead and the freedoms we enjoy. When
異，從⽽使個⼈層⾯的變化無法單獨解決年齡歧視問題，正如對性別歧視 (2)can
age-based biases permeate our institutions (e.g. legal, health, educational), they 和種族create
and perpetuate
主義 (3) 的研究所表明的.disparities between groups so that individual-level change alone cannot
address ageism, as research on sexism (2) and racism (3) has shown.
Box 0.1
The word ageism
年齡歧視這個詞
The term ageism was coined in 1969 by Robert Butler, an American gerontologist
年齡歧視這個詞是由羅伯特巴特勒於 1969
and the first director of the National 年創造的，他是⼀位美國老年學家，也是
Institute on Aging in the United States. While
美國國家老齡化研究所的第⼀任主任。雖然年齡歧視在多個世紀、國家、背景和⽂化
ageism has existed across centuries, countries, contexts and cultures, the concept
is relatively new and does not – yet – exist in every language. This can make it
中都存在，但這個概念相對較新，並且並非——還——存在於每種語⾔中。這使得提
challenging to raise awareness about this social phenomenon and to advocate for
⾼對這種社會現象的認識和倡導變⾰變得具有挑戰性。那些缺乏年齡歧視特定術語的
change. Those languages that lack a specific term for ageism tend to use a proxy,
語⾔傾向於使⽤代理，例如德語中的 Altersdiskriminierung，它只包含歧視的維度。
such as Altersdiskriminierung in German, which captures only the dimension of dis-
其他具有特定術語的語⾔，例如⻄班牙語（edadismo
crimination. Other languages that have a specific term,或 such
edaismo）和法語
as Spanish (edadismo
（âgisme），現在才開始更廣泛地使⽤它。在每⼀種語⾔中找出⼀個表⽰年齡歧視的
or edaismo) and French (âgisme), are only now starting to use it more widely. Iden-
tifying a word for ageism in every language would be one way to start generating
詞將是開始在各國之間產⽣意識和改變的⼀種⽅式。儘管年齡歧視涵蓋任何基於年齡
awareness and change across countries. Although ageism covers any stereotypes,
的刻板印象、偏⾒和歧視，但其他術語也被⽤來指代針對兒童和青年的年齡歧視，包
prejudice and discrimination based on age, other terms have also been used to
括成⼈主義
refer to (4-6)
ageism和兒童主義 (7, 8) 的概念。年齡歧視將是本報告中⽤於指代基於年
directed against children and youth, including the concepts of
齡的刻板印象、偏⾒和歧視的唯⼀術語。
adultism (4-6) and childism (7, 8). Ageism will be the only term used in this report
to refer to age-based stereotyping, prejudice and discrimination.
Ageism refers to the stereotypes, prejudice and discrimination directed

年齡歧視是指基於年齡對他⼈或⾃⼰的刻板印象、偏⾒和歧視。 towards others or
年齡歧視影響所有年
oneself based on age. Ageism affects people of all ages and will be the only term used in
齡段的⼈，並且將是本報告中唯⼀⽤來指代基於年齡的刻板印象、偏⾒和歧視的術語
this report to refer to age-based stereotypes, prejudice and discrimination (see Box 0.1).
（⾒框 0.1）。
XIX
Ageism is prevalent, deeply ingrained and more socially accepted than other
年齡歧視普遍存在，根深蒂固，比其他形式的偏⾒更能被社會接受。 forms of bias.
與年齡相關的偏
Age-related bias is often seen as humorous or at the least harmless. People fail to see that
⾒通常被視為幽默或⾄少是無害的。
how ⼈們沒有看到年齡和老齡化是如何構成的（例
age and ageing are framed (e.g. having a senior moment, grey tsunami, the problem of
如，老年時刻、灰⾊海嘯、⼈⼝老齡化問題、“年輕⼈認為他們無所不知”）和使⽤的
ageing populations, “young people think they know everything”) and the language that is
語⾔（⾒框
used (see Box0.2）使誤解和
0.2) perpetuate影響我們制定的政策和我們創造的機會——或者不影響。
misconceptions and influence the policies we develop and the
opportunities we create – or don’t. Ageism, as shown in this report, can change how we view
如本報告所⽰，年齡歧視可以改變我們看待⾃⼰的⽅式，可以讓⼀代⼈與另⼀代⼈競
ourselves, can pit one generation against another, can devalue or limit our ability to benefit
爭，可以貶低或限制我們從年輕⼈和老年⼈⼝可以做出的貢獻中受益的能⼒，並可以
from what younger and older populations can contribute and can reduce opportunities for
減少健康、長壽和福祉的機會
health, longevity and well-being 同時也產⽣了深遠的經濟後果。
while also having far-reaching economic consequences.
Box 0.2
Language
Language conveys meaning and can fuel misconceptions that can lead to ageism.
語⾔傳達意義，並可能助長可能導致年齡歧視的誤解。老年⼈、老年或老年⼈等詞會
Words such as elderly, old or senior elicit stereotypes of older people as universally
引起⼈們對老年⼈普遍虛弱和依賴的刻板印象，並且經常被⽤作貶義。同樣，少年這
frail and dependent, and they are frequently used in a pejorative sense. Similarly, the
個詞引起了年輕⼈不成熟的刻板印象。本報告在提及個⼈和群體時使⽤中性語⾔，包
word juvenile elicits a stereotype of younger people as immature. This report uses
neutral language when
括老年⼈、年輕⼈或老年⼈、老年⼈⼝和年輕⼈等術語。referring to individuals and groups, including the terms older
person, younger person or older people, older populations and younger people.
Why a global report on ageism?

為什麼要發布⼀份關於年齡歧視的全球報告？
老齡化與健康全球戰略和⾏動計劃（2016-2030 年）(9) 以及相關的世界衛⽣⼤會
The Global strategy and action plan on ageing and health (2016–2030) (9) and the related
WHA69.3(10)
World 號決議將打擊年齡歧視確定為製定關於健康老齡化的良好公共政策和改
Health Assembly resolution WHA69.3 (10) identified combating ageism as a prerequisite
善⽇常⽣活的先決條件
to developing good public——老年⼈的⽇常⽣活。作為回應，世界衛⽣組織（世衛組
policy on healthy ageing and to improving the day-to-day lives of
older people. In response, the World Health Organization (WHO) was called
織）被要求與其他夥伴合作，開展⼀項打擊年齡歧視的全球運動。 on to develop,
在製定全球打擊年
in cooperation with other partners,
齡歧視運動的願景和原則時，很明顯，為了防⽌傷害、減少不公正和促進代際團結，a global campaign to combat ageism. While developing
the vision and principles of the Global campaign to combat ageism, it became evident that
我們需要減少針對所有年齡段的⼈的年齡歧視。
to prevent harm, reduce injustice and foster intergenerational solidarity we need to reduce
ageism against people of all ages.
To prevent harm, reduce injustice and foster

intergenerational solidarity we need to
reduce ageism against people of all ages.
健康老齡化⼗年：2021-2030 是老齡化與健康全球戰略和⾏動計劃以及 2030 年可

The Decade of Healthy Ageing: 2021–2030, an action plan for the last 10 years of both the
持續發展議程過去
Global strategy and 10 年的⾏動計劃，已於
action plan on ageing and2020
health年 8 the
and ⽉獲得世界衛⽣⼤會和 2020
2030 Agenda for Sustainable
年 12 ⽉聯合國⼤會
Development, (11, 12,in13)。
was endorsed August與年齡歧視作⾾爭——即改變我們對年齡和老齡化
2020 by the World Health Assembly and in December
2020 by the United Nations General
的思考、感受和⾏為⽅式，是我們⾃⼰和他⼈的，是健康老齡化⼗年優先考慮的四個 Assembly (11, 12, 13). Combating ageism – that is,
changing how we think, feel and act towards age and ageing, our own and that of others, is
⾏動領域之⼀。打擊年齡歧視對於在其他三個⾏動領域取得進展也是不可或缺的：以
one of the four action areas prioritized by the Decade of Healthy Ageing. Combating ageism
培養老年⼈能⼒的⽅式發展社區，提供以⼈為本的綜合護理和初級衛⽣服務，以響應
老年⼈的需求並為老年⼈提供誰需要它並獲得長期護理。
XX
is also integral to achieving progress in the other three actions areas: developing communities
in ways that foster the abilities of older people, delivering person-centred integrated care
and primary health services that are responsive to the needs of older people and providing
older people who need it with access to long-term care.
Ageism, as shown in this report, can

change how we view ourselves, can pit
one generation against another, can
如本報告所⽰，年齡歧視可以改變我們看待⾃⼰的⽅式，可以讓⼀代⼈與另⼀代⼈競
devalue or limit our ability to benefit from
爭，可以貶低或限制我們從年輕⼈和老年⼈⼝可以做出的貢獻中受益的能⼒，並可以
what younger and older populations can
減少健康、長壽和福祉的機會同時也產⽣了深遠的經濟後果。
contribute and can reduce opportunities for
health, longevity and well-being while also
having far-reaching economic consequences.
雖然年齡歧視已被確定為⼀個重要問題，但缺乏關於年齡歧視的科學信息。在定義上
While ageism has been identified as an important problem, scientific information on ageism
達成的共識有限，關於問題規模的國際可比信息很少，⽽且關於減少問題的戰略的證
is lacking. There is limited agreement on definitions and little internationally comparable
據也很少。on the scale of the problem and a paucity of evidence on the strategies that
information
這份針對政策制定者、從業者、研究⼈員、發展機構、私營部⾨和⺠間社會的報告彙
work to reduce it.
編了關於年齡歧視的最佳證據。
This report, directed at policy-makers, practitioners, researchers, development agencies, the
private
宗旨 sector and civil society, compiles the best evidence on ageism.
本報告的中⼼主題是年齡歧視給個⼈和社會帶來的沉重負擔，以及各國政府、⺠間社
會、私營部⾨和各個年齡段的個⼈迫切需要採取⾏動。
Aims
報告的⽬標是：
The central themes of this report are the heavy burden that ageism places on individuals
• 提⾼對針對年輕⼈和老年⼈的年齡歧視的全球性質、規模、影響和決定因素的認
and society and the urgent need for action from governments, civil society, the private
識；
sector and individuals of all ages.
• 提請注意防⽌年齡歧視、促進和保護所有⼈實現和享受所有⼈權以及提出有效⼲預
戰略的必要性；
The goals of the report are to:
• 呼籲跨部⾨和利益相關者採取⾏動。
• raise awareness about the global 10
報告的範圍⽀持這些⽬標，報告分為 nature, scale, impact and determinants of ageism
章。第⼀個解釋了什麼是年齡歧視以及它如
directed against both younger and older people;
何對年輕⼈和老年⼈起作⽤。與針對老年⼈的年齡歧視相比，針對年輕⼈的年齡歧視
的證據要少得多，⽽且質量較差。因此，該報告分別提供了關於針對年輕⼈和老年⼈
• draw attention to the need to prevent ageism, to promote and protect the
realization and enjoyment
的年齡歧視的證據。第 of all human rights for all persons and to present
2-4 章僅涉及老年⼈，並詳細說明問題的規模（第 2 章）、
effective intervention strategies;
其影響（第 3 章）和年齡歧視的決定因素（第 4 章）。第五章匯集了關於針對年輕⼈
的年齡歧視的規模、影響和決定因素的所有證據。隨後的三章（第 6-8 章）側重於減
• call for action across sectors and stakeholders.
少針對老年⼈和年輕⼈的年齡歧視的策略，包括政策和法律，以及教育和代際活動。
第 9scope
The 章重點介紹了有希望但有效性尚未得到證實的策略。每章都解釋了相關的策略及
of the report supports these goals, and the report is divided into 10 chapters. The first
explains what ageism is and how it operates towards both younger and older people. There is
其⼯作原理；概述有效性的證據；在存在此類證據的情況下，確定可能使策略更有效
much less evidence on ageism against younger people than on ageism against older people, and
的成本和因素；並提供⽰例。與年輕⼈相關的證據包含在⽅框中。
it is of poorer quality. As a result, the report presents evidence separately about ageism towards
由於進⾏研究的⽅式很重要（⾒框 0.3），每章都有⼀個框來評估可⽤證據並建議未
來研究的機會。每章還提供了未來⽅向的結論和建議，第 10 章將這些結論和建議匯
XXI
總在⼀起，為政策和實踐提供廣泛的建議。
younger and older people. Chapters 2–4 relate only to older people and detail the scale of the
problem (Chapter 2), its impact (Chapter 3) and the determinants of ageism (Chapter 4). The
fifth chapter compiles all of the evidence about the scale, impact, and determinants of ageism
against younger people. The three subsequent chapters (Chapters 6–8) focus on strategies
that work to reduce ageism against older and younger people, including policies and laws, and
educational and intergenerational activities. Chapter 9 highlights strategies that are promising,
but whose effectiveness is not yet proven. Each chapter explains the relevant strategy and
how it works; provides an overview of the evidence on effectiveness; identifies the costs and
factors that can potentially make the strategy more effective, where such evidence exists; and
provides examples. Evidence relevant to younger people is included in boxes.
Because the way that research is conducted is important (see Box 0.3), each chapter has a box
evaluating available evidence and suggesting opportunities for future research. Each chapter also
offers conclusions and suggestions for future directions, which are drawn together in Chapter
10 to provide broad recommendations for policy and practice.
Box 0.3
How research is conducted on ageism matters
如何對年齡歧視問題進⾏研究
我們對年齡歧視的理解程度取決於對年齡歧視的研究是如何進⾏的，以及如何衡量年
How well we understand ageism depends on how the research on ageism was
齡歧視的。如果我們的定義和措施不准確，如果我們的研究產⽣的關於年齡歧視的規
conducted and how ageism was measured. If our definitions and measures are
inaccurate, if the picture that our research produces of its scale and distribution
模和分佈以及驅動因素和影響的圖片不准確，我們減少年齡歧視的努⼒將不會那麼有
and of the drivers and the impacts of ageism are inaccurate, our efforts to reduce
效。我們更有可能浪費時間和⾦錢。本可以避免的年齡歧視將持續存在，並會產⽣本
ageism will be less effective. We are more likely to waste time and money. And
報告中概述的嚴重後果。
ageism that could have been averted will persist, with the serious consequences
每⼀章對研究的討論在某種程度上都是建立在前⼀章的基礎上的。如果年齡歧視的定
outlined in this report.
義（第 1 章）不明確，就無法準確衡量年齡歧視，也無法⾃信地確定其規模和分佈
The2discussion
（第 of research in each chapter builds, to an extent, on the previ-
章和第 5 章）。如果不能準確衡量年齡歧視，就更難確定年齡歧視的影響（第
ous one. If definitions of ageism (Chapter 1) are not clear, ageism cannot be
3 章和第 5 章）。如果年齡歧視的決定因素（第 4 章和第 5 章）沒有正確識別，減
measured accurately and its scale and distribution (Chapters 2 and 5) cannot
少年齡歧視的策略（第 6-9 章）就不太可能有效，因為這些策略旨在針對這些決定因
be established with confidence. If ageism cannot be measured accurately, it
素。此外，如果沒有對年齡歧視的準確測量，這些策略對年齡歧視的影響就無法確
will be more difficult to ascertain the impact of ageism (Chapters 3 and 5).
If the determinants of ageism (Chapters 4 and 5) are not identified correctly,
定。
strategies to reduce ageism (Chapter 6–9) are unlikely to be effective because
⼆⼗⼆
the strategies are designed to target these determinants. In addition, without
精確評估。
accurate measures of ageism, the effect of the strategies on ageism cannot be
evaluated precisely.
XXII
Process
The conceptual framework for ageism was developed in collaboration with the core group
working on the Global campaign to combat ageism. In alignment with that framework,
several steps were taken to compile or collect evidence to inform this report including:
• a review of the global prevalence of ageism towards older people, broadly

understood as people aged 50 and older;
• a series of systematic reviews of research about ageism against older people

in English, French and Spanish that was carried out by experts that assessed
determinants, health impacts, intervention strategies and measurement;
• a scoping review on ageism directed towards younger people, which included

evidence on people younger than 50, from peer-reviewed literature in English,
Spanish and French;
• targeted searches to identify other forms of published quantitative and qualitative

evidence that were conducted in response to gaps identified in the research,
including ageism in low- and middle-income countries, ageism towards younger
people and the intersections between ageism and other ”-isms”;
• a review of global, national and local campaigns to tackle ageism; and
• personal testimonies from younger and older people.
This Global report on ageism charts the

steps that are required to combat ageism
and, hence, contribute to improving health,
increasing opportunities, reducing costs and
enabling people to flourish at any age.
While there are many perceptions and opinions about the scale, impact and determinants of
ageism and the most effective strategies to reduce it, this report has made every effort to
base its findings on solid evidence. When deciding on what evidence to report, findings from
systematic reviews – which aim to rigorously identify, evaluate and summarize the findings of
all relevant individual studies on a topic – have been prioritized over single studies. When no
evidence was available, the report points this out and calls for the gap to be filled. Ageism
research, like about 90% of the research on psychology and health, is predominantly carried
out in high-income countries, which account for some 15% of the global population.
It is anticipated that the policy and practice considerations outlined in this report will be
periodically reviewed and revised by the Department of Social Determinants of Health at
WHO, in collaboration with partners.
XXIII
Moving forward
This Global report on ageism charts the steps that are required to combat ageism and,
hence, contribute to improving health, increasing opportunities, reducing costs and enabling
people to flourish at any age. The aspiration of those who contributed to this report is
that it results in concrete actions that will be taken by all stakeholders, at all levels and
across all sectors, and that these actions promote social and economic development, the
achievement of human rights across the world and the development of a world for all ages.
XXIV
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XXV
FERNANDO, 64,
PLURINATIONAL
STATE OF BOLIVIA
SAUMYA , 24 ,
INDIA
XXVI
XXVI
C HA PT E R 01
01
“ Discrimination a gainst older people is a serious

issue. I was widowed seven m onths a go an d
sin ce my wife died, th e people, my own family
has discriminated a gainst m e for bein g older an d
widowed. My broth ers, my fath er-in-law n o lon ger
listen to m e. Th ey don’ t take any n otice of what I
say an d I feel hur t . Som e of my children suppor t m e,
“
th ey tell m e to take n o n otice but it is sa d that your
own family discriminates a gainst you.
Fernan do, 64 , Th e Plurinational State of Bolivia

©Sebastian Orma ch ea / HelpAge International
“ Youn g people based on th eir a ge are discriminated

an d often n ot in cluded in th e decision-makin g
spa ces. Th eir presen ce an d voices are often h eard o r
in cluded just to tick mark th e box of youth in clusion
but th eir recomm en dations are n ot in cluded.
Youn g people of a ge group 18-29 years are eith er
considered perpetrators of violen ce wh om we n eed
to stop or vic tims wh o n eed to be suppor ted but
“
youn g people are pea cebuilders an d a gents to build
positive pea ce within th eir communities.
Saumya, 24 , In dia
©Saumya Aggar wal / UN Major Group
for Children an d Youth
1
Ageism refers to the stereotypes (how we think),

prejudice (how we feel) and discrimination (how
we act) directed towards others or oneself based
on age.
Ageism can manifest at the institutional or the
interpersonal level or it can be self-directed.
Ageism can be implicit or explicit depending on
our level of awareness of being ageist.
01
Ageism starts in childhood and is reinforced over
Chapter time.
Ageism intersects with other “-isms” and can
result in compounded disadvantage.
1.1
DEFINING AGEISM
Age is one of the first characteristics – along with sex
與性別和種族⼀樣，年齡是我們在與他⼈互動時注意到他
and race – that we notice about other people when
⼈的⾸要特徵之⼀（⾒框 1.1）（3）。當年齡被⽤來以導
we interact with them (see Box 1.1) (3). Ageism arises
致傷害、劣勢和不公正並削弱代際團結的⽅式對⼈們進⾏
when age is used to categorize and divide people in
ways that lead to harm, disadvantage and injustice
分類和劃分時，就會出現年齡歧視。
and erode solidarity across generations.
年齡歧視在我們的⼀⽣中有多種形式。想像⼀下在⼯作場
Ageism takes many forms throughout our lifetime.
所被同事和主管系統地忽視，在家裡被家⼈光顧，在銀⾏
Imagine being systematically ignored by colleagues
and supervisors in the workplace, patronized by your
拒絕貸款，在街上被侮辱或迴避，被指控為巫術，被拒絕
family at home, denied a loan at the bank, insulted or
進入你的財產或⼟地，或者沒有得到治療在診所，這⼀切
Section 1.1 of this chapter defines avoided in the street, accused of witchcraft, denied
都只是因為您的年齡。這些都是年齡歧視如何滲透到我們
ageism and its three main access to your property or land, or not being offered
dimensions: stereotypes, prejudice ⽣活中的例⼦，從年輕到年老。
treatment at a clinic, all simply because of your age.
and discrimination. A clear and These are all examples of how ageism penetrates our
common understanding of ageism lives, from younger age into older age.
年齡歧視是⼀種多⽅⾯的社會現象，世界衛⽣組織 (WHO)
is crucial to raise awareness and
將其定義為基於年齡對他⼈或⾃⼰的刻板印象、偏⾒和歧
ensure consistency in research, policy Ageism is a multifaceted social phenomenon that
and practice (1-2). The definitions 視 (9)。年齡歧視有幾個相互關聯的⽅⾯：
the World Health Organization (WHO) defines as the
presented here underpin the rest ‧ 三個維度——刻板印象（思想）、偏⾒（感覺）和歧視
stereotypes, prejudice and discrimination directed
of the report. Section 1.2 describes towards others or1.1.1
（⾏動或⾏為）（第 oneself
節）； based on age (9). Ageism
how ageism works and how it arises. has several interrelated
‧ 表現的三個層次——制度的、⼈際的和⾃我導向的（第 aspects:
Section 1.3 describes intersections
between ageism and other “-isms”, 1.1.2• 節）；
three dimensions – stereotypes (thoughts),
su ch as sexism a n d ableism, ‧ 兩種表達形式——顯性（有意識）和隱性（無意識）
prejudice (feelings) and discrimination (actions
illustrating their cumulative impacts. （第 1.1.3or節）。
behaviour) (Section 1.1.1);
2
C HA PT E R 01
Age and stage of life are partly socially determined

Box 1.1
Age, although correlated with biological processes, is also socially shaped. Who
is considered young or old partly depends on context, purpose and culture (4-6).
At age 18 you may be viewed as too old to become a competitive pianist, but too
young to coach a professional soccer team. Cultures vary in how they demarcate
old age, middle age and youth and in the norms and expectations they have for
each of these life stages, which can change over time (7).
Environments also shape how we age. Inequalities linked, for instance, to sex, eth-
nicity and income determine our access to health care and education across the
life course, and they influence how we are at age 50, 60, 70 or 80. A large part of
the diversity we see in older age results from the cumulative impact of these health
inequities across the life course (8).
• three levels of manifestation – their age, including their physical and mental
institutional, interpersonal and self- capacities, social competencies and political
directed (Section 1.1.2); and religious beliefs. These inferences can
lead to overgeneralizations that consider
• two forms of expression – explicit every person within a given age group
(conscious) and implicit (unconscious) to be the same. For example, a common
(Section 1.1.3). overgeneralization is that older people are
年齡歧視的三個維度——刻板印象、偏⾒ frail, incompetent and friendly (15) or that
younger adults are materialistic, lazy and
和歧視——每個都與⼀種獨特的⼼理能⼒
1.1.1 Ageism as stereotypes, impatient (16).
有關：思想（刻板印象）、感覺（偏⾒）
prejudice and discrimination 年齡刻板印象的範圍可以從正⾯到負⾯
和⾏動或⾏為（歧視）。（17-19
Age 歲），但是，根據定義過度概
stereotypes can range from positive
The three dimensions of ageism – stereotypes, to negative (17-19), but, being by definition
括，所謂的正⾯和負⾯刻板印像都是不准
prejudice and discrimination – each relate to overgeneralizations,
確的，並且可能有害。 both⼀些年齡刻板印象
so-called positive
刻板印像是存儲我們對社會群體成員特徵
a distinct psychological faculty: thoughts and negative stereotypes are inaccurate and
的信念和期望的認知結構，⽽刻板印像是
(stereotypes), feelings (prejudices) and 跨越地區和⽂化
potentially (20,
harmful. 21)。
Some age例如，在歐
stereotypes
應⽤刻板印象信息的過程 (10)。刻板印象
actions or behaviours (discrimination). 洲、亞洲和南北美洲的不同國家，老年⼈
cut across regions and cultures (20, 21). For
指導我們的社會⾏為，並經常⽀配我們尋往往被刻板印象為溫暖（積極）和無能
example, older adults tend to be stereotyped
Stereotypes are (11-14)。
求和記住的信息 cognitive structures that as a mixture of warmth (positive) and
（消極）的混合體，⽽年輕⼈則被刻板印
store our beliefs and expectations about incompetence (negative) across different
在年齡歧視中，⼈們對年齡的刻板印象可象為⾼度能幹（積極）但溫暖度低（否
the characteristics of members of social countries in Europe, Asia and North and
以指導他們根據年齡對他⼈做出的推斷，
groups, and stereotyping is the process 定）（20,
South 22-24）。
America, while younger adults are
of applying stereotypic information (10).
包括他們的⾝⼼能⼒、社會能⼒以及政治 stereotyped as highly competent (positive)
Stereotypes guide our social behaviour and
和宗教信仰。這些推論可能導致過度概 but low in warmth (negative) (20, 22-24).
often govern what information we seek and
括，認為給定年齡組內的每個⼈都是相同
remember (11-14). Other age stereotypes tend to differ by
的。例如，⼀個常⾒的過度概括是老年⼈ contexts and culture (17, 21, 25-28). Table
虛弱、無能和友好 (15) 或者年輕⼈物質主
In ageism, the stereotypes that people hold 1.1 provides a catalogue of stereotypes
about age can guide
義、懶惰和不耐煩 the inferences that
(16)。 identified in different institutional settings
they make about other people based on across the world. Which stereotypes
3
Table 1.1. A catalogue of stereotypes identified in different institutional settings and countries
STEREOTYPES
INSTITUTION OR SECTOR
YOUNGER PEOPLE ARE… OLDER PEOPLE ARE…
Health and social care a
POSITIVE Healthy Warm

Physically active Likeable
Strong and energetic
NEGATIVE Risk-takers Rigid

Drug-users Irritable and f rustrating
Stressed and anxious Lonely and isolated
Frail and weak
Asexual
Easily confused
Depressed and depressing
Needy
Disabled
Work b
POSITIVE Energetic Reliable

Ambitious Committed
Tech-savvy Experienced
Hard-working (middle-aged) Hard-working
Socially skilled
Good mentors and leaders
Able to deal with change
NEGATIVE Narcissistic Incompetent and unproductive

Disloyal Unmotivated
Entitled Resistant to change
Lazy Harder to train and unable to learn
Unmotivated Not flexible
Easily distracted Not technologically competent
Media c
POSITIVE Attractive Healthy

Engaged
Productive
Self-reliant
NEGATIVE Troublesome Unattractive

Violent criminals Unhappy
Senile
Badly dressed
Inactive
Dependent
Unhealthy
Disempowered and poor
Vulnerable
Diabolical
a
For additional information, see references 16 and 33-40.
b
c
4
C HA PT E R 01
predominate in a given situation depend

其他年齡刻板印象往往因環境和⽂化⽽異 and older people. Examples of positive
largely on the age歲）。表
（17、21、25-28 of the person
1.1 提供了在being actions include offering discounts to
ageist (29) and the context, such as the younger or older adults who are unlikely to
簡⽽⾔之，年齡歧視涉及我們基於年齡對
世界各地不同機構環境中確定的刻板印象
place where the older or younger person is have a regular income.
他⼈和我們⾃⼰的思考（成⾒）、感覺
⽬錄。在特定情況下，哪種刻板印象占主
encountered (30, 31). Social and economic
changes and shifts in values within a （偏⾒）和⾏為（歧視）（⾒圖
In short, ageism involves how 1.1）。
導地位在很⼤程度上取決於年齡歧視者的 we think
society 本報告側重於基於年齡的刻板印象、偏⾒
年齡 (29)can lead to stereotypes evolving
和環境，例如遇到年長者或年 (stereotypes), feel (prejudice) and act
over time (32). 和歧視的負⾯影響，無論具體的想法、感
(discrimination) in relation to others and
輕者的地⽅ (30, 31)。隨著時間的推移，
ourselves based on age (see Fig. 1.1).
受或⾏為被認為是積極的還是消極的。
社會和經濟的變化以及價值觀的轉變會導
Prejudice is an emotional reaction or
致刻板印象的演變 (32)。
feeling, either positive or negative, that is This report focuses on the negative
directed towards
偏⾒是⼀種情緒反應或感覺，無論是積極 a person based on their implications of age-based stereotypes,
perceived group membership (1, 52). Prejudice prejudice and discrimination, regardless
的還是消極的，基於他們感知的群體成員
contributes to creating or maintaining of whether the specific thoughts, feelings
⾝份⽽指向⼀個⼈ (1, 52)。偏⾒有助於在
hierarchical status relations between groups or actions are perceived to be positive or
群體之間建立或維持等級地位關係
(53). In the case of ageism, prejudice (53)。is negative.
directed towards
在年齡歧視的情況下，偏⾒是基於對年齡 an individual or a group
based on perceptions of their age.
的看法⽽針對個⼈或群體的。 1.1.2 Institutional,
1.1.2 制度、⼈際關係和⾃我導向的年齡歧
視interpersonal and self-
憐憫或同情的感覺是對老年⼈的兩種常⾒
Feelings of pity or sympathy are two directed ageism
機構年齡歧視是指機構的法律、規則、社
偏⾒形式 (15)，它們會產⽣將⾃⼰排除在
common forms of prejudice towards older
adults (15), and they can(54)。反過來，年
老年⼈陪伴之外的願望 generate a desire 會規範、政策和實踐，它們根據年齡不公
Institutional ageism refers to the laws,
to exclude oneself
輕⼈可能會產⽣恐懼或厭惡的感覺，這通 from the company of 平地限制機會並系統地使個⼈處於不利地
rules, social norms, policies and practices of
older people (54). In turn, younger people 位institutions that unfairly restrict opportunities
(1, 53, 56)。它還指的是機構為證明其
常是基於他們是罪犯或罪犯的假設。
may provoke feelings of fear or aversion, and systematically disadvantage individuals
歧視包括由於⼈們在某些社會顯著群體中年齡歧視⽽培養的意識形態。
often based on the presumption that they on the basis of their age (1, 53, 56). It also
的感知或真實成員資格⽽對其實施的⾏
are delinquents or criminals. 雖然機構年齡歧視可能是機構中個⼈有意
refers to the ideologies that institutions
為、做法或政策，並對他們施加某種形式識和公開的努⼒造成的（在這種情況下，
foster to justify their ageism.
Discrimination consists of actions, practices 它與⼈際年齡歧視重疊），但它不⼀定需
的劣勢（消極歧視）或優勢（積極歧視）
or policies that are applied to people While institutional ageism can result from
要機構中個⼈的有意⽀持或任何對年輕⼈
(55)。
on account of their perceived or real conscious and overt efforts made by
就年齡歧視⽽⾔，歧視與針對⼈們年齡的
membership in some socially salient group 或老年⼈的偏⾒意識⼈們。⼈們常常無法
individuals in an institution (in which case
and that impose some form of disadvantage
⾏為（包括⾏動、做法和政策）有關。雇認識到這種制度性年齡歧視的存在，因為
it overlaps with interpersonal ageism), it
(negative discrimination) or advantage
主拒絕允許某⼈主持討論，因為他們認為 does not necessarily require the intentional
製度的規則、規範和做法是長期存在的，
(positive discrimination) on them (55). support of the individuals in an institution or
已經被儀式化並被視為正常現象。此外，
該⼈太年輕，或者因為他們認為該⼈太老 any awareness of bias towards younger or
⽽無法從中受益⽽不允許員⼯參加培訓課制度意識形態——通常是默認的——為
In relation to ageism, discrimination relates older people. Often people fail to recognize
to behaviours – including actions, practices
程，分別是，對年輕⼈和老年⼈的負⾯歧 “做事的⽅式”提供了理由(1, 53)。因此，
the existence of such institutional ageism
and policies – that are directed towards
視。積極⾏動的例⼦包括向不太可能有固雖然並非總是有意為之，但制度性年齡歧
because the rules, norms and practices of
people based on their age. Employers who the institution are of long-standing, have
視可以使將⼈們排除在權⼒和影響之外的
定收入的年輕⼈或老年⼈提供折扣。
refuse to allow a person to lead a discussion become ritualized and are seen as normal.
⾏為合法化，加強基於年齡和與年齡相關
because they consider the person to be too Moreover, institutional ideologies – often
young or who do not allow an employee 的假設的不對稱權⼒結構
tacit – offer justifications (57)。
for “the way
to attend a training session because they things are done” (1, 53). Thus, while not
consider the person to be too old to benefit always intentional, institutional ageism
from it are examples of, respectively, can legitimize the exclusion of people
negative discrimination towards younger from power and influence, reinforcing an
5
Fig. 1.1. The three dimensions of ageism include stereotypes, prejudice and
discrimination. These dimensions may be perceived as positive or negative
成⾒
偏⾒
歧視
asymmetric power structure that is based Thus, a key consideration in institutional

on age and age-associated assumptions ageism is not so much the intention, but the
(57). 因此，制度性年齡歧視的⼀個關鍵考慮因
disparate outcomes (55, 57, 58).
素與其說是意圖，不如說是不同的結果
因為製度性年齡歧視——如製度性種族主
B ecause institutional ageism – like (55, Examples of institutional ageism include:
57, 58)。
institutional racism or sexism – is not
義或性別歧視——並不總是個⼈公開偏⾒機構年齡歧視的例⼦包括：
always the result of overt bias on the part •
的結果，它通常必須從年齡組之間發⽣的 policies in the health sector that allow
of individuals, it often must be inferred ‧ 允許按年齡配給護理的衛⽣部⾨政策
care to be rationed by age (59); and
不同結果中推斷出來。例如，在醫療保健（59）；和
from the disparate outcomes occurring
領域，關於是否停⽌維持⽣命的治療（例 in the labour sector, discriminatory
between age groups. For instance, in ‧• 在勞動部⾨，歧視性僱傭做法或強制性
如呼吸機⽀持、⼿術或透析）的決定通常
health care, decisions regarding whether hiring practices or mandatory
退休年齡（42、43、60 歲）。
or not to withhold life sustaining therapies
因年齡⽽異，導致不同年齡組的結果不 retirement ages (42, 43, 60).
(e.g. ventilator support, surgery or dialysis)
同。這些不同的結果可以追溯到並⾄少部⼈際年齡歧視是指在兩個或更多個⼈之間
often vary by age contributing to different Interpersonal ageism refers to ageism
分歸因於機構的法律、政策或做法，然後 occurring during interactions between two
outcomes for different age groups. These 的互動過程中發⽣的年齡歧視。
在機構上將其視為年齡歧視。
disparate outcomes can then be traced back or more individuals.
and attributed, at least in part, to the laws,
polices or practices of an institution, which 在⼈際年齡歧視中，肇事者與年齡歧視的
In interpersonal ageism, the perpetrator is
is then considered institutionally ageist. 對像不同。
distinguished from the target of ageism.
6
C HA PT E R 01
Examples of interpersonal ageism include:

⼈際年齡歧視的例⼦包括： Self-directed ageism refers to ageism turned
⾃我導向的年齡歧視是指轉向反對⾃⼰的
against oneself. People internalize age-
年齡歧視。⼈們在反复暴露於這些偏⾒之
• disrespecting or patronizing older based biases from the surrounding culture
‧ 不尊重或光顧老年⼈和年輕⼈，在決策
and younger adults, ignoring their 後，將來⾃周圍⽂化的基於年齡的偏⾒內
after being repeatedly exposed to those
中無視他們的觀點或避免接觸和互動；
points of view in decision-making or 化，然後他們將這些偏⾒應⽤到⾃⼰⾝上
biases, and they then apply those biases to
avoiding contact and interactions; themselves (63).
(63)。
‧ 與老年⼈互動時使⽤過於通融的語氣和⾃我導向的年齡歧視的例⼦包括：
• using an overly accommodating tone Examples of self-directed ageism include:
簡單的詞彙和句⼦結構（稱為長者語）。
and simple vocabulary and sentence ‧ 20 多歲的⼈認為⾃⼰太年輕無法找到
這種類型的⾔論，通過假設老年⼈能⼒較
structure when interacting with ⼯作並且可能不願意申請；
• people in their twenties who think
older adults (known as elderspeak).
差，使他們幼稚，並增加了其他⼈認為他 ‧ 不相信在以後的⽣活中學習新技能是可
that they are too young for a job and
This type of speech, by assuming
們無能和無能的可能性，並對他們不尊重 may be reluctant to apply;
能的，並且對上⼤學或培養新愛好猶豫不
that older adults are less capable,
和不禮貌（61, 62）；決的老年⼈。
infantilizes them and increases • older individuals who do not believe
the likelihood that others will view it is possible to learn new skills
‧ 侮辱老年⼈，說他們因為年齡⽽⼀⽂不
them as incompetent and incapable, 年齡歧視表現出來的三個層⾯相互交織、
later in life and hesitate to enrol at
and treat them disrespectfully and
值，或侮辱年輕⼈，說他們因為年齡⽽輕 university or1.2）。
相互促進（⾒圖 take up a new hobby.
impolitely (61, 62);
率、⾃私或犯罪。
The three levels at which ageism manifests
• insulting older people by saying that itself are intertwined and mutually reinforcing
they are worthless because of their (see Fig. 1.2).
age, or younger people by saying
that they are thoughtless, selfish or
criminals because of their age.
Fig. 1.2. Interpersonal, institutional and self-directed ageism are intertwined and
mutually reinforcing
7
Ageist institutional rules, norms and

年齡歧視的製度規則、規範和做法，以及 longer recognized by its members, ageism
practices, and the ageist ideologies they
它們所培養的年齡歧視意識形態，可以塑 has become part of the subconscious
foster, can shape, and be shaped by, the framework of society, which can be
造和受個⼈態度的影響——這是⼈際年齡
attitudes of individuals – which underlie expressed through implicit ageism (65).
歧視的基礎——他們是這些機構和更廣泛
interpersonal ageism – who are members of
these institutions and wider society.
社會的成員。
1.2
At the same time, institutional and
同時，制度和⼈際年齡歧視可以內化並導
interpersonal ageism can be internalized HOW AGEISM WORKS
致⾃我導向的年齡歧視。
and lead to self-directed ⾃我導向的年齡
ageism. And
歧視會導致⼈們適應社會的年齡刻板印
self-directed ageism can result in people AND HOW IT ARISES
conforming to their society’s age stereotypes,
象，這反過來⼜會強化⼈際和製度上的年
which in turn reinforces interpersonal and
齡歧視。
institutional ageism. 1.2.1 Interactions between
stereotypes, prejudice and
1.1.3 Explicit and implicit discrimination
ageism
Because our thoughts, feelings and
People may not always be aware that they
⼈們可能並不總是意識到他們是年齡歧視 actions influence each other, the relation
are being ageist. Ageism can be either between stereotypes, prejudice and
者。年齡歧視可以是顯性的或隱性的，這
explicit or implicit, depending on a person’s discrimination is multidirectional (see Fig.
取決於⼀個⼈的意識⽔平或對年齡歧視的
level of consciousness or awareness of being 1.3). Stereotypes can influence prejudice
認識。在顯性年齡歧視中，⼀個⼈對他⼈
ageist. In explicit ageism, a person’s ageist and discrimination; discrimination can
thoughts, feelings and actions towards
或⾃⼰的年齡歧視想法、感受和⾏為是有 influence stereotypes and prejudice; and
others or themselves are conscious and
意識和有意的——也就是說，在他們的意 prejudice can influence discrimination
intentional – that is, within their awareness and stereotypes. For example, in English,
識和控制範圍內。
and control. using terms such as elderly to refer to
然⽽，在隱性年齡歧視中，⼀個⼈對他⼈ older adults has been shown to evoke
或他們⾃⼰的年齡歧視思想、感覺和⾏為
In implicit ageism, however, a person’s negative stereotypes of older people as
ageist thoughts, feelings and actions
是在沒有意識的情況下運作的，並且在很 frail and dependent (stereotypes) (66).
towards others or themselves operate
⼤程度上是無意的，並且超出了他們的控
without conscious awareness and are largely A study found that young adults with
制範圍 (64)。在隱性年齡歧視中，個⼈不
unintentional and beyond their control negative attitudes towards older adults
認識由年齡刻板印象引發的思想、感受和
(64). In implicit ageism, individuals do not showed less compassion towards them
recognize the thoughts, feelings and actions
⾏為，他們可能會將這種⾏為歸因於其他 and wanted to keep their distance from
that are triggered by age stereotypes, and them rather than show them empathy
因素來合理化。
they may rationalize such behaviour by (prejudice) (67). Another study showed
例如，雇主不會承認他們更願意僱⽤更年
attributing it to other factors. that e m ploye rs wh o h eld n e gative
輕的⼈，⽽是會援引年長候選⼈的個性或 stereot ypes about older employees
For example, rather than employers
缺乏特定培訓。當⼀種⽂化的年齡歧視態 were also more punitive towards them
acknowledging that they prefer to hire
度被內化並且其主要製度中的年齡歧視變 (discrimination) (68).
a younger person, they might invoke an
得如此常規和正常化以⾄於其成員不再承
older candidate’s personality or lack of These relationships between stereotypes,
認時，年齡歧視就成為社會潛意識框架的
specific training. When a culture’s ageist prejudice and discrimination are not
⼀部分，這可以通過隱含的年齡歧視來表
attitudes are internalized and the ageism automatic. The mere activation of a
within its
達（65 ）。 main institutions has become stereotype does not imply that people will
so routine and normalized that it is no inevitably have negative feelings and act in
8
C HA PT E R 01
discriminatory ways (69). These relationships result in self-directed ageism at any age.
are influenced by contexts, including laws For example, when individuals reach old
and culture (70). age, the ageing stereotypes internalized in
childhood and then reinforced for decades
Fig. 1.3. Stereotypes, prejudice and can become self-stereotypes (63). Indeed,
discrimination interact with and research has shown that older people
influence each other in multidirectional express attitudes towards their own group
relationships that are as negative as those expressed
by younger people towards older people
(75). For instance, older people in the
United States of America were more likely
than younger people to oppose federal
programmes that benefit them, and their
opposition to these programmes was
predicted by the stereotypes about ageing
that they held (63).
Stereotype-consistent behaviour can also

be triggered through what is known as
stereotype threat. Stereotype threat arises
when people underperform on a task due
to worries about confirming a negative
stereotype about their group (76, 77). For
instance, an older person may do less well
1.2.2 Ageism starts early in on a driving test or cognitive test due to
life and is reinforced over anxiety about confirming stereotypes about
time older people being bad drivers or mentally
slower. Furthermore, by behaving in a
Ageism starts in early childhood. From the stereotype-consistent manner, older adults
age of 4 years, children become aware of can help to reinforce prevailing attitudes,
their culture’s age stereotypes through which can give rise to further age prejudice
the cues they pick up from people around and discrimination.
them (71, 72). They begin to internalize and
use these stereotypes to make inferences 年齡歧視在某種程度上不同於其他“-主
and to guide their feelings and behaviour 1.3
義”，例如種族主義或性別歧視。其他“-主
towards people of different ages (12, 73).
For instance, children in preschool and AGEISM AND OTHER
義”涉及對在整個⽣命過程中不會變化的相對
primary school were shown drawings that 穩定的亞群的偏⾒，⽽年齡歧視則涉及對移
depicted a man at four stages of life, and "-ISMS"
動⽬標的偏⾒。⼈們在⽣活的不同階段屬於
two thirds of the children viewed the oldest 不同的年齡組，因此，在不同的時間或多或
man as being ‘‘helpless, incapable of caring Ageism is, to an extent, different from other
for himself, and generally passive’’ (63, 74). 少會犯下年齡歧視或成為年齡歧視的⽬標。
“-isms”, such as racism or sexism. Whereas
年齡歧視和其他“-主義”之間的另⼀個區別
other “-isms” involve bias against relatively
We also draw on our culture’s age 是每個⼈都容易體驗到它。
stable subpopulations that 與其他“-主義”
do not vary
stereotypes to perceive and understand across the life course,
(1, 78) 相比，年齡歧視也往往更容易被接受 ageism involves bias
ourselves and to guide our behaviour as against a moving target. People belong
和挑戰，⽽且在歐洲 28 個國家 (79) 中，它
members of a given age group, which can to different age groups at different points
已被證明比性別歧視和種族主義更為普遍。
9
in their lives and, thus, will be more or further reinforced ageism and ableism (86).
less likely to perpetrate or be a target of
ageism at different times. Another difference 在年輕⼈中，⾝體損傷可能尤其具有破壞
In younger people, physical impairment
between ageism and the other “-isms” is may be particularly undermining, as it
性，因為它挑戰了⼈們對積極、獨立和健全
that everyone is susceptible to experiencing challenges people’s expectations regarding
的年輕⼈的期望 (87)。年輕的有殘疾的成年
it. Ageism also tends to be more accepted active, independent and able-bodied young
and challenged less often than other “-isms” ⼈可能會受到蔑視或不尊重，因為他們違反
adults (87). Younger adults with a disability
(1, 78), and it has been shown to be more 了健全的⽂化規範，⽽年長的殘疾⼈可能會
may be treated with disdain or disrespect
pervasive than sexism and racism across 28 because they are violating the cultural norm
受到⽀持和同情。例如，美國的⼀項研究發
countries in Europe (79). of able-bodiedness,
現，與 whereas their older
65 歲及以上的⼈相比，在⼯作年齡
counterparts may be treated with support
Ageism can interact with other forms of 的成年⼈中，殘疾與被感知的歧視之間的聯
and empathy. For example, a study in the
年齡歧視可以與其他形式的偏⾒相互作⽤，
bias, such as sexism and ableism, and 繫更為明顯
United States (88)。
found that the link between
例如性別歧視和能⼒歧視，並加劇劣勢，這
exacerbate disadvantage, which may disability and perceived discrimination
殘障⼈⼠也被視為比同齡的非殘障⼈⼠明顯
可能會加劇對個⼈健康和福祉的影響
compound the impact on individuals’ health is more pronounced among working-age
年長或年輕。通常，他們要么被視為處於陳
(80-82)。越來越多的研究探索了不同“主
and well-being (80-82). A growing number adults relative to persons aged 65 and
舊衰退狀態的老年⼈，要么被視為能⼒和⾃
of studies
義”之間的相互作⽤和交叉。 have explored the interactions
年齡歧視和能 older (88).
and intersections between different “-isms”. 主性有限的孩⼦（89）。同時，有證據表
⼒歧視以及年齡歧視和性別歧視是兩種形式
Ageism and ableism and ageism and sexism 明，針對殘疾⼈的計劃、⽀出和⽬標在不同
People with disabilities are also treated as if
的交叉形式，已經進⾏了⼀些詳細的探討。
are two forms of intersection that have been they are either significantly older or younger
年齡組之間存在顯著差異，這表明存在年齡
explored in some detail. than people of the same age without
歧視 (90)。例如，在美國，對於年輕的殘疾
disability. Often they are viewed either as
Ageism and ableism ⼈來說，政府對每位受助者的⽀出要⾼得
1.3.11.3.1
年齡歧視和能⼒歧視 an older person in a stereotypical state of
多，⽽被年輕殘疾⼈拒絕的護理選擇（例如
decline or as a child with limited competence
Ableism 是指針對殘疾⼈或被認為有殘疾的
Ableism refers to the stereotypes, prejudice and autonomy (89). At the same time, there
機構護理）通常被認為是老年⼈可以接受的
⼈的刻板印象、偏⾒和歧視。年齡歧視和能
and discrimination directed against people is evidence that programmes, expenditures,
(90)。在瑞典，已發現殘疾政策比殘疾老年
⼒歧視以經常導致相互強化的⽅式緊密交織
with disabilities or those who are perceived and goals for people with disabilities differ
to have ⼈更好地為兒童和年輕⼈服務
substantially across age groups(91)。如果我
在⼀起 (4)。have a disability. Ageism and in ways that
ableism are closely intertwined in ways that 們考慮到老年⼈在殘疾⼈群中的比例過⾼，
suggest ageism (90). For example, in the
例如，鑑於通常與老年⼈相關的刻板印象
can often result in mutual reinforcement (4). United States, government
這就尤其成問題 (85)。 expenditures per
（即他們熱情但無能）與與殘疾⼈相關的刻
recipient are substantially higher for younger
板印象相同，它們可能會相互強化並阻⽌⼈
For instance, given that stereotypes individuals with disabilities, and care options
們認識到殘疾老年⼈的多樣性（
commonly associated with older 20)。⼈們
people rejected by younger people with disabilities
(i.e. they are warm yet incompetent)
還經常假設殘疾是老年⼈的常態 are the
(83, 84)， (e.g. institutional care) are often considered
same as those associated with people with acceptable for older adults (90). In Sweden,
這可能源於⼤多數殘疾⼈年齡較⼤的事實
disabilities, they may reinforce each other disability policies have been found to serve
(85)。儘管如此，這並不意味著⼤多數老年
and prevent people from recognizing the children and young adults better than
⼈都患有某種形式的殘疾。圍繞成功老齡化
diversity seen among older adults with a older persons with disabilities (91). This
disability (20). It is also often assumed that
的論述，強調在老年時保持健全的⾝體和有 is particularly problematic if we consider
disability is the norm in older age (83, 84),
能⼒的頭腦，可能進⼀步強化了年齡歧視和 that older people are disproportionately
which may stem from the fact that most represented in disability populations (85).
能⼒歧視（86）。
people with disabilities are older (85). Still,
this does not mean that most older people 1.3.2 Ageism and sexism
1.3.2年齡歧視和性別歧視
live with some form of disability. The 對老年性別歧視和年齡歧視的綜合影響的研
discourse around successful ageing, with its Research on the combined impact of sexism
究得出的結論是，老年女性——相對於年長
emphasis on maintaining able-bodiedness and ageism in older age has concluded that
and ablemindedness in older age, may have 和年輕男性和年輕女性——⾸當其衝受到多
older women – relative to older and younger
種形式的歧視。
10
C HA PT ER 01
men and younger women – bear the brunt

創造了“性別年齡歧視”⼀詞來涵蓋年齡和性 generally receive more thorough medical
of multiple forms of discrimination. examinations, more follow-up and more
別的交叉點，它指的是女性與男性相比⾯臨 evidence-based medical care than women
的年齡歧視差異
The term “gendered(92, ageism”
93)。女性往往處於雙
has been coined do, and men are also more likely to receive
重危險的境地，在這種情況下，與男性相
to cover the intersection of age and gender, preventive care (107-110).
and it refers to differences in ageism faced by
比，重男輕女的規範和對青年的關注導致老
women compared with men (92, 93). Women In employment, the disadvantages of being
年女性的地位惡化得更快（94）。這種雙重
are often in a situation of double jeopardy in too young or too old impact women more
危險也解釋了為什麼老年女性的外貌與老年
which patriarchal norms and a preoccupation than men. This suggests that in these age
男性 (95-99)
with 的不同。⽩髮和皺紋的男性被
youth result in a faster deterioration ranges, being a woman intensifies age
of older women’s
認為是傑出、睿智和經驗豐富的，⽽在許多 status compared with prejudice (60, 101), which not only has an
that of men (94). This double jeopardy also effect on a woman’s career but also on
⽂化中，⽩髮和皺紋被認為使女性看起來沒
explains why the physical appearance of her ability to access a pension in older
有吸引⼒。女性在通過使⽤染髮劑和抗衰老
older women is judged differently than that age (92). Compared with older men, older
產品來掩蓋衰老跡象⽅⾯也比男性⾯臨更⼤
of older men (95-99). Men with grey hair women typically have had fewer years in
and wrinkles
的壓⼒ are seen as distinguished, wise
(100-102)，⽽且她們成為不斷增長 the workforce, have earned less and are
and experienced,
的抗衰老美容⾏業的⽬標 whereas
(103)。grey hair and less likely to have pensions or substantial
wrinkles are considered to make women retirement savings.
年齡歧視和性別歧視之間的交叉表現的另外
look unattractive in many cultures. Women
兩種⽅式是通過針對年長寡婦的巫術指控和
also face greater pressure than men to hide 1.3.3 Other “-isms”
歧視。在撒哈拉以南非洲的部分地區，對巫
signs of ageing through the use of hair dye
儘管研究主要集中在年齡歧視與能⼒歧視和
and anti-ageing products (100-102), and they
術的指控很普遍，老年婦女受到迫害並被指 Although research has mainly focused on
are targeted by an ever-growing anti-ageing 性別歧視的交叉點上，但可能存在與刻板印
the intersections of ageism with ableism and
控導致厄運、疾病或死亡（104）。在世界許
beauty industry (103). 象、偏⾒和歧視形式⼀樣多的交叉點，包括
sexism, there may be as many intersections
多地⽅，年長的寡婦受到社會排斥或歧視。 as there are forms of stereotypes, prejudice
種族主義、階級主義、異性戀、同性戀恐懼
例如，他們被剝奪了繼承與丈夫共有的財產
Two other ways in which the intersection and discrimination, including with racism,
症和變性恐懼症。
between
的權利 (105,ageism
106)（⾒第 and sexism
2 章第manifest
2.2 節）。 are classism, heterosexism, homophobia and
through accusations of witchcraft and ⼀個尚未得到充分探索的重要交叉點是年齡
transphobia.
年齡歧視和性別歧視之間的相互作⽤可以體
discrimination directed against older widows. 歧視和種族主義之間的交叉點，但這⼀研究
現在許多不同的機構中。例如，在醫療保健
In parts of sub-Saharan Africa, accusations An important intersection that has not
領域正在增長。例如，在加拿⼤，有證據表
領域，老年婦女在獲得預防保健和治療⽅⾯
of witchcraft are widespread, with older been sufficiently explored is that between
明污名是⿊⼈女性青年獲得⼼理健康服務和
women being persecuted and accused of
存在差異。在美國進⾏的多項研究表明，老 ageism and racism, but this field of research
causing ill luck, disease or death (104). In ⽀持的障礙（111）。在美國，少數⺠族女性
is growing. For example, in Canada there is
年男性通常比女性接受更徹底的醫學檢查、
many parts of the world, older widows are 比其他受訪者（包括⽩⼈男性）更有可能報
evidence that stigma acts as a barrier to
更多的隨訪和更多循證醫療，⽽且男性也更
socially ostracized or discriminated against. 告基於年齡的不公平待遇（112）。
black female youth accessing mental health
有可能接受預防保健
For instance, they are (107-110)。
denied the right to services and support (111). In the United
另⼀個正在被越來越多地探索的交叉點是年
在就業⽅⾯，太年輕或太老的缺點對女性的
inherit the property they shared with their States minority women were more likely to
齡歧視、異性戀和性⾏為（113-115）。越來
husbands (105, 106) (see
影響⼤於對男性的影響。 Section 2.2 of
這表明，在這些年 report unfair treatment based on age than
Chapter 2). 越多的跨⽂化研究認識到，研究年齡、性別
other respondents, including white men (112).
齡段，女性會加劇年齡偏⾒ (60, 101)，這不
和性⾏為以及其他形式的排斥（包括基於種
僅會影響女性的職業⽣涯，還會影響她在老
The interaction between ageism and sexism Another intersection that is being increasingly
族和階級的排斥）如何共同作⽤對⼈們形成
年時獲得養老⾦的能⼒
can manifest in many (92)。與老年男性相
different institutions. explored is that of ageism and heterosexism
⼀系列不平等（或機會）的重要性。年齡。
For example,
比，老年女性的⼯作年限通常較短，收入較in health care, disparities and sexuality (113-115). A growing body
have been documented in terms of older 定性研究表明，老年女同性戀者在醫療保健
of cross-cultural research recognizes the
少，⽽且不太可能擁有養老⾦或⼤量退休儲
women’s access to preventive care and 系統和其他地⽅經常報告恐同、異性戀和年
importance of examining how age, gender
蓄。
treatment. Multiple studies conducted in the and sexuality work together and with other
齡歧視的經歷（116），並且年長的⿊⼈男女
United States have reported that older men forms of exclusion, including those based
同性戀者感到與⿊⼈社區疏遠，故意隱瞞⾃
⼰的性⾝份和性取向，並感到孤立（117）。
11
這些發現表明，如何管理這些⾝份可能會影
響個⼈對衰老過程的適應。
本章描述了什麼是年齡歧視及其運作⽅式。
它為報告的其餘部分提供了概念基礎。年齡
on ethnicity and class, to form a range of 歧視是指基於年齡對⼈們的刻板印象（我們
implicit. Age-based stereotypes, prejudice
inequalities (or opportunities) for people as and discrimination interact and mutually
的想法）、偏⾒（我們的感受）和歧視（我
they age. Qualitative studies revealed that reinforce each other. Ageism tends to start
們的⾏為⽅式）。它表現在三個層⾯——制
older lesbians report frequent experiences early in life and be reinforced over time
of homophobia, heterosexism and ageism 度層⾯、⼈際關係層⾯和⾃我導向層⾯——
through interactions between individuals
in the health care system and elsewhere 可以是顯性的，也可以是隱性的。
and their social environments. Ageism 基於年齡
can
(116), and that older black gay men and also interact and intersect with other “-isms”,
的刻板印象、偏⾒和歧視相互影響，相互促
lesbian women feel alienated from the black such as sexism, ableism and racism, thus
進。年齡歧視往往在⽣命早期開始，並隨著
community, deliberately conceal their sexual exacerbating disadvantage.
identity and orientation, and feel isolated 時間的推移通過個⼈與其社會環境之間的互
(117). These findings suggest that how these 動⽽得到加強。
The definition of 年齡歧視還可以與其他“-主
ageism proposed in this
identities are managed may have an impact report is the result of a decades-long process
義”相互作⽤和交叉，例如性別歧視、能⼒歧
on an individual’s adjustment to the ageing of refinement, and it enjoys considerable
視和種族主義，從⽽加劇劣勢。
process. consensus among ageism researchers.
本報告中提出的年齡歧視定義是經過數⼗年
細化過程的結果，在年齡歧視研究⼈員中享
Future priorities for understanding the
有相當⼤的共識。
nature of ageism should include:
Ageism can also interact and 理解年齡歧視本質的未來優先事項應包括：
intersect with other “-isms”, • promoting the use of the definition
such as sexism, ableism and proposed in this report to enable
racism, thus exacerbating cross-cultural comparisons of
disadvantage. research and practice;
• improving our understanding of the

Despite these advances in research,
儘管研究取得了這些進展，但仍需要進⼀步 way in which different languages and
further research is needed to explore cultures refer to ageism to improve
的研究來探索年齡歧視與這些其他“-主義”
the intersections between ageism and translatability;
之間的交叉點，以及它們引發的多重和復合
these other “-isms” and the multiple and
形式的歧視。
compounding forms of discrimination that • increasing awareness among all
they elicit. key stakeholders of what ageism
is, particularly in low- and middle-
income countries, to foster a shared
1.4 understanding of the issue and
stimulate action;
CONCLUSIONs AND
conducting further research on the
FUTURE DIRECTIONS •
ways in which ageism intersects
with other “-isms”, which will have
This chapter described what ageism is and important implications for the actions
how it works. It provides the conceptual taken to tackle ageism and other
basis for the rest of the report. Ageism forms of stereotypes, prejudice and
refers to the stereotypes (how we think), discrimination.
prejudice (how we feel) and discrimination
(how we act) directed towards people
based on their age. It manifests itself at
three levels – institutional, interpersonal and
self-directed – and can be either explicit or
12
C HA PT E R 01
REFERENCES
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https://doi.org/10.1080/00918369.2013.835603.
19
VERA , 82 ,
K Y R GY Z S TA N
20
C HA PT E R 01
CHAPTER 02
02
“ T here are c a s e s in the ho spital s w hen we have

to w ait in long queue s to s e e a do c tor and
w hen we are s e en , s ome do c tor s don’ t b other
to li s ten to ever y thing we have to s ay, let alone
examine u s prop erl y. When we s tar t telling the
do c tor s w hat our health problem s are, they
of ten s ay that the s e problem s are due to our age
and that they are natur al change s . I fe el ver y
unw ante d and helple s s but there are no place s
“
to go and complain ab out thi s . Even if we did
complain , I doubt they would li s ten to u s .
Ve ra , 8 2 , Ky r g y z s tan
©Malik A l y mkulov/ H elpAge International
21
21
Ageism against older people is widespread across

institutions, including those providing health and
social care, and in workplaces, the media and
others.
Ageism is pervasive across populations:
• 1 in 2 people worldwide are ageist;
• in Europe, 1 in 3 older people report having
02
Chapter been a target of ageism.
Ageism is more prevalent in low- and middle-
income countries.
2.1
Institutional ageism
Institutional ageism can manifest itself across
制度年齡歧視可以在不同的機構中表現出來，
different institutions, such as those providing
例如提供健康和社會護理的機構，以及⼯作場
health and social care, and in the workplace, the
所、媒體和法律系統。
media and the legal system.
2.1.1 Ageism in health and

social care
Health care rationing by age is widespread.

A systematic
2.1.1 review in 2020 showed that
健康和社會保健中的年齡歧視
in 85% (127) of 149 studies, age determined
本章提供了關於製度性年齡歧視、
This chapter presents evidence who received certain medical procedures or
o n th e s c ale of ins titutio nal
按年齡劃分的醫療保健配給很普遍。 2020 年
treatments (1). One study of five medical centres
⼈際年齡歧視和⾃我導向年齡歧視
ageism, interpersonal ageism and 的系統評價表明，在
in 149 項研究中，85%
the United States examined how age affected
的證據。第 2.1 節通過檢查制度年
self-directed ageism. Section 2.1 (127)
the 的年齡決定了誰接受了某些醫療程序或
decisions of medical staff to withhold life-
齡歧視如何在各種機構中表現出
describes the reach of institutional sustaining
治療 (1)。 therapies in 9000 patients who had
⼀項針對美國五個醫療中⼼的研究
來，描述了製度年齡歧視的範圍。
ageism by examining how it manifests illnesses with high mortality rates. Medical
調查了年齡如何影響醫務⼈員在 9000 名患有
itself
第 2.2 in a variety of institutions.
節調查了世界範圍內⼈際年 staff were more likely to withhold ventilator
Section 2.2 surveys 2.3
the 節概述了
evidence ⾼死亡率疾病的患者中停⽌維持⽣命治療的決
support, surgery and dialysis as the patient’s
齡歧視盛⾏的證據。
on the prevalence of interpersonal 定。increased.
age 隨著患者年齡的增長，醫務⼈員更有可能
For ventilator support, the rate
對⾃我定向年齡歧視的嚴重程度知
ageism around the world. Section 2.3 of decisions to withhold therapy increased
拒絕呼吸機⽀持、⼿術和透析。對於呼吸機⽀
之甚少。
presents an準確了解針對老年⼈的年
overview of what little is 15% with each decade of age; for surgery, 15%
the
持，決定停⽌治療的比率隨著年齡每增加
known about the magnitude of self-
齡歧視的規模是努⼒減少年齡歧視 increase per decade was 19%; and for dialysis,
directed ageism. Having an accurate 增加
it was15%；
12% (2).對於⼿術，每⼗年增加 19%；對
的關鍵第⼀步。
understanding of the scale of ageism 於透析，它是 12% (2)。
against older people is a critical first Older adults tend to be excluded from health
step for efforts to reduce it. research even though they account for a
22
C HA PT ER 02
disproportionate share of the total burden research on the topic and that the limited
老年⼈往往被排除在健康研究之外，儘
of disease and the use of prescription evidence indicated that nurses’ attitudes
管他們在疾病總負擔和處⽅藥和療法的
medicines and therapies. A systematic are complex and contradictory (6).
使⽤中佔了不成比例的份額。⼀項系統
review found evidence of ageism in all 49
studies
評價在所有 that investigated
49 項研究中發現了年齡歧視the link between Several studies also show that mental
age and exclusion from different types of 幾項研究還表明，⼼理健康專業⼈員沒
health professionals are not adequately
的證據，這些研究調查了年齡與被排除
health research (1). These studies showed that 有接受過與老年患者合作的充分培訓，
trained to work with older patients, lack the
在不同類型的健康研究之間的聯繫
older persons were systematically excluded (1)。 clinical skills needed to diagnose and work
缺乏診斷和與有⼼理健康問題的老年患
這些研究表明，老年⼈被系統地排除在
from clinical trials in cardiology, internal with older patients who have mental health
者合作所需的臨床技能，對這⼀⼈群持
⼼髒病學、內科、腎病學、神經病學、
medicine, nephrology, neurology, preventive problems, hold negative attitudes towards
medicine, psychiatr y, rheumatology, 消極態度並且不太願意與他們合作(7).
this population and are less willing to work
預防醫學、精神病學、風濕病學、腫瘤
oncology and urology, even though many 儘管對包括長期照護在內的社會照料的
with them (7).
學和泌尿學的臨床試驗之外，儘管所研
of the conditions under study are more 需求已經上升，並且隨著⼈⼝老齡化的
究的許多疾病在老年⼈中更為普遍。
prevalent in older age. Although the demand for social care,
反應預計還會進⼀步增加 (8)，但對包括
因此，參加許多臨床試驗的患者並不代 including long-term care, has risen and
長期照料在內的社會照料中年齡歧視表
Thus, the patients enrolled in many clinical
表患者在⼀般⼈群中的實際分佈，此類 is expected to rise further in response
trials are not representative of the actual 現的研究是有限的，尤其是在資源較少
to population ageing (8), research on
研究的結果——關於治療的安全性和有
distribution of patients in the general 的環境中
the (4)。儘管如此，現有的少數研
manifestations of ageism in social
效性——可能不適⽤於老年⼈群
population, and the findings of such(1)。對
research care, including long-term care, is limited,
究報告了長期護理中年齡歧視的明確表
–主要影響老年⼈群的帕⾦森病的研究清
on the safety and efficacy of treatments particularly in lower-resource settings (4).
現。例如，加拿⼤的⼀項研究發現，長
–楚地強調了這種排斥。對招募帕⾦森病
may not apply to older populations (1). Nonetheless, the few studies that exist
Research into項研究進⾏的系統分析發
Parkinson’s disease, which 期護理機構中的⼤多數老年居⺠將與護
report clear manifestations of ageism in
患者的 206
mainly affects older populations, clearly 理⼈員的交流視為年齡歧視。看護者使
long-term care. For example, a study in
現，其中近this
highlights 50%exclusion.
的研究排除了 79.3 歲
A systematic Canada found that most older residents
⽤控制性語⾔和幼稚和光顧的交流模式
以上的患者
analysis of 206(3)。research studies recruiting in long-term care institutions perceived
(9)。在以⾊列的長期護理機構中，由於
衛⽣和社會保健⼯作者對患者的年齡歧
patients with Parkinson’s disease found that communication with caregivers as ageist.
almost 50% of them excluded patients who 缺乏準確的醫療診斷、對老年居⺠的客
Caregivers used controlling language
視程度雖然被認為很⾼，但尚不確定 (4,
were older than 79.3 years (3). 觀化、經常忽視他們的需求以及試圖以
and infantile and patronizing patterns
5)。對衛⽣保健⼯作者（例如護⼠、⼀
犧牲⾃⼰的費⽤來省錢，年齡歧視是顯
of communication (9). In long-term care
般衛⽣保健提供者、醫學和護理專業學
The extent to which health and social care institutions in Israel, ageism was evident
⽽易⾒的（10）。
⽣）年齡歧視的
workers hold ageist12 篇⽂獻綜述的回顧得
attitudes towards through the lack of accurate medical
在澳⼤利亞，幾項調查和審查揭⽰了長
patients, while
出結論，證據相互⽭盾且不確定，⽽且 perceived to be high, is diagnoses, the objectification of older
uncertain (4, 5). A review of 12 literature 期護理部⾨存在年齡歧視，例如老年⼈
residents, the routine neglect of their
許多研究質量較差。
reviews of ageism among health-care 可獲得的服務類型、與老年⼈互動時使
needs and attempts to save money at their
鑑於年齡歧視與醫療保健機會減少有
workers (e.g. nurses, health-care providers expense (10).
⽤的語⾔以及對老年⼈偏好和能⼒的假
關，本綜述強調迫切需要對衛⽣和社會
in general, medical and nursing students)
設.作為回應，澳⼤利亞⼈權委員會向皇
concluded that the evidence is contradictory
保健⼯作者的年齡歧視進⾏⾼質量研究 In Australia, several inquiries and reviews
and 家委員會提交了⼀份關於老年護理質量
(5)。inconclusive,
2017 年護⼠對老年⼈護理態度的and that many of the revealed the presence of ageism in the
studies were of poor quality. 和安全的意⾒書，其中包括⼀系列關於
long-term care sector, for instance, in the
審查得出的結論是，關於該主題的研究 types of services available to older people,
如何通過採⽤⼈權觀點來解決長期護理
很少，⽽且有限的證據表明護⼠的態度
This review highlights the urgent need the language used when interacting with
中的年齡歧視問題的建議 (11)。
是複雜和⽭盾的
for (6)。 on ageism among
high-quality studies older people and in assumptions about
health and social care workers, given older people’s preferences and capabilities.
that ageism is linked to reduced health In response, the Australian Human Rights
care access (5). A 2017 review of nurses’ Commission made a submission to the
attitudes towards the care of older people Royal Commission into Aged Care Quality
concluded that there was a paucity of and Safety that included a series of
23
年齡偏⾒可能會影響衛⽣保健⼯作者在
recommendations
與患者互動時尋求的信息類型。 about how to 例如， address implications for the early detection and
ageism in long-term care by adopting a
⼀項研究發現，英國的精神科醫⽣從中 treatment of sexually transmitted diseases
human rights perspective (11). (STDs) or other conditions (see Chapter 3,
年男性中獲取性史的頻率要⾼於老年男
Section 3.1).
性 (12)，這可能對性傳播疾病
Age (STD) 或
bias may affect the type of information
其他條件（⾒第
that 3 章第 3.1
health-care workers seek節）。
during their A further example of the insidious presence
interactions with patients.
2019 年新型冠狀病毒 (COVID-19) For example,
⼤流a of ageism in health and social care has been
study found that psychiatrists in the United evidenced during the novel coronavirus
⾏已經證明了健康和社會護理中存在年
Kingdom take a sexual history much more 2019 (COVID-19) pandemic that has affected
齡歧視的另⼀個例⼦，該⼤流⾏已經從
frequently from middle-aged men than societies and economies to their core (see
根本上影響了社會和經濟（⾒專欄
from older men (12), which could have Box 2.1).
2.1）。
Box 2.1
Ageism and COVID-19
世衛組織於
WHO declared 2020the 年3 ⽉ 11 ⽇宣布
outbreak 2019coronavirus
of novel 年新型冠狀病毒病 disease (COVID-19)
2019 (COVID-19) 的爆發 a
為⼤流⾏ (13)。全球證據表明，老年⼈因這種疾病⽽⾯臨的病死率明顯⾼於年輕
pandemic on 11 March 2020 (13). Global evidence has shown that older people face
年齡組的⼈ (14,higher
a significantly 15)。那些患有影響免疫、⼼⾎管和呼吸系統的潛在疾病的⼈的病
case-fatality rate from this disease than people in younger
age groups (14,
死率也會增加，這些疾病在老年⼈中很常⾒15). The case-fatality rate is also
(16,increased in those with underlying
17)。在許多國家，有證據表明，
conditions that affect the immune, cardiovascular and respiratory systems, and
超過 40% 的與 COVID-19 相關的死亡與長期護理設施有關，在⼀些⾼收入國
these conditions are common in older age (16, 17). In many countries, evidence
家，這些設施中的這⼀數字⾼達
shows that more than 40% of deaths 80%related
(14)。to COVID-19 have been linked to long-
這種流⾏病不僅對世界各地許多老年⼈的⽣活造成了毀滅性的損失，⽽且還暴露
term care facilities, with figures being as high as 80% in these facilities in some
high-income countries (14).
了對老年⼈的年齡歧視、偏⾒和歧視。有報導稱，⼀些國家在獲得衛⽣服務和其
他關鍵資源⽅⾯存在歧視性做法，尤其是在長期護理機構中的老年⼈中 (18, 19)。
This pandemic has not only taken a devastating toll on the lives of many older
例如，在某些情況下，稀缺資源，例如呼吸機或重症監護病房，僅根據實際年齡
people around the world but also has exposed ageist stereotypes, prejudice and
進⾏分配 (20)。鑑於實際年齡僅與⽣理年齡或短期預後有中等程度的相關性，並
discrimination against older adults. There have been reports of discriminatory
practices in access to health services and other critical resources
且老年⼈在此次⼤流⾏的嚴重後果⽅⾯受到的影響最⼤（21， 22)。 in several
countries, especially among older
在不同國家，時間年齡也被⽤來確定物理隔離措施。例如，在英國，最初要求 people living in long-term care facilities (18, 19).
70
For example, in some contexts scarce resources, such as ventilators or access to
歲及以上的成年⼈⾃我隔離
intensive care units, have been4 個⽉ (23)；在波斯尼亞和⿊塞哥維那，在疫情爆發
allocated according only to chronological age (20).
期間，老年⼈在數週內不得離開家園 (24)；在哥倫比亞（25）和塞爾維亞
This can be considered unethical and ageist in the context of this pandemic, given
（26），封鎖措施僅針對老年⼈。許多國家解除封鎖措施的策略也按實際年齡進
that chronological age is only moderately correlated with biological age or short-
term prognosis, and that older people have been most affected
⾏了區分。例如，在阿拉伯聯合酋長國的幾個城市，60 in terms of severe
歲以上的⼈⼀旦在⼈⼝限
outcomes in this pandemic (21, 22).
制期後重新開放，就不得進入購物中⼼或餐館 (27)。同樣，在菲律賓，⼀旦解除
社區限製⽽恢復運營，60
Chronological age has also歲以上的⼈不得乘坐⾺尼拉⼤都會的四個鐵路系統
been used to determine physical isolation measures in
(28)。
different countries. For example, in the United Kingdom, adults aged 70 and older
were initially instructed to self-isolate for 4 months (23); in Bosnia and Herzegovina,
older adults were not allowed to leave their homes for several weeks during the
outbreak (24); and in Colombia (25) and Serbia (26), lockdown measures targeted
only older adults. Strategies for lifting lockdown measures in many countries also
made distinctions by chronological age. For example, in several cities in the United
Arab Emirates, people older than 60 years were not allowed to enter shopping malls
or restaurants once they reopened following the period of population confinement
24
C HA PT ER 02
(27). Similarly, in the Philippines, people older than 60 years were not allowed to
使⽤實⾜年齡作為⾝體隔離措施和延長禁閉期的唯⼀標準是歧視性的，因為它沒
take Metro Manila’s four railway systems once these resumed operations with the
有考慮到老年⼈非常多樣化的能⼒和需求。這些措施會增加社會孤立和孤獨的風
lifting of community confinement (28).
險，限制老年⼈進⾏⾃我保健⾏為的能⼒，並挑戰衛⽣和社會保健系統對老年⼈
Using chronological age as the sole criterion for physical isolation measures and
預先存在的醫療和社會需求做出反應的能⼒，這最終可能對老年⼈的健康和福祉
for extending (29-31)。在⼤流⾏期間，老年⼈與其傳統社交網絡（即家⼈、朋
產⽣不利影響 periods of confinement is discriminatory because it fails to account
for the very diverse capacities and needs of older populations. Such measures can
友、護理專業⼈員）的⾝體隔離也使他們⾯臨更⼤的歧視和虐待風險，無論是在
increase the risks of social isolation and loneliness, limit older people’s ability to
長期護理環境中還是在家中（
engage in self-care behaviours32-34）。此外，將這種疾病描述為“老年⼈的疾
and challenge the ability of health and social care
病”，只要求老年⼈進⾏⾝體隔離或建議年輕⼈呆在家裡保護他們的祖⽗⺟，可能
systems to respond to older peoples’ pre-existing medical and social needs, which
can ultimately have a detrimental impact (35)。
會阻礙年輕⼈和其他⼈遵循公共衛⽣指南 on older people’s health and well-being
(29-31). The physical isolation of older people from their traditional social network
年齡歧視也體現在⼤流⾏的新聞和媒體報導中，老年⼈通常被描繪成⼀個同質的
(i.e. family, friends, care professionals) in the midst of the pandemic has also put
弱勢群體，與其他年齡組有很⼤不同（36）。將老年⼈描繪成虛弱、易受傷害和
them at greater risk for discrimination and abuse, be it in long-term care settings
需要保護的形象忽視了老年⼈所體現的巨⼤多樣性。這種信息傳遞也可能對老年
or at home (32-34). In addition, portraying the disease as an “older person’s illness”,
by requiring only older adults to physically isolate or recommending that younger
⼈的健康和福祉產⽣嚴重影響。儘管有必要識別並告知⾯臨最⼤風險的⼈群，但
people stay home to protect their grandparents, may discourage younger people
圍繞年輕⼈和老年⼈的年齡歧視敘事存在使幾代⼈相互對抗的風險，正如標籤“嬰
and others from following public health guidelines (35).
兒潮⼀代移除者”的迅速傳播所表明的那樣該病毒嚴重影響老年⼈。事實上，在所
有關於老年⼈和
Ageism has alsoCOVID-19
manifested的 in Twitter
news and 交流中，近四分之⼀被歸類為年齡歧視
media coverage of the pandemic, with
older adults being generally portrayed as
(37)。⼀項基於中國微博平台（類似於 a homogeneous, vulnerable group
Twitter）的比較研究發現，與 that is
COVID-19
substantially different from other
和老年⼈相關的最受歡迎的主題是他們對社會的貢獻，但脆弱性和保護老年⼈的 age groups (36). Portraying older adults as frail,
vulnerable and in need of protection ignores the great diversity that is evidenced
必要性主題也是⽬前 (38)。在⻄班牙，對兩家全國性報紙的 501 個標題的分析發
in older age. Such messaging can also have serious impacts on the health and well-
現，其中 358 adults.
being of older 個 (71%) 以負⾯的⽅式描述了老年⼈
Although it is necessary to identify(39)。
and inform the populations
⽤於指導應對⼤流⾏的
who are most at risk, the COVID-19 數學模型也常常沒有考慮到長期護理的⼈群，
ageist narrative around younger and older people runs
the risk of pitting generations against each other, as illustrated by the rapid spread
這種遺漏是統計和數據中年齡歧視的⼀種形式，因為存在傳播風險這些設施中的
of the hashtag “boomer remover” in reference to the virus severely affecting older
COVID-19 感染率⾼於⼀般⼈群 (40)。
adults. In fact, nearly a quarter of all Twitter communication concerning older adults
COVID-19
and COVID-19 ⼤流⾏不僅暴露了不同環境中的年齡歧視，⽽且還為許多反映團結和
has been classified as ageist (37). A comparable study based on the
凝聚⼒的積極舉措提供了機會。例如，專⾨為老年⼈開發了在線信息
Chinese Weibo platform (which is similar to Twitter) found that the most (41)，開展
popular
themes related to COVID-19 and
了有關老年⼈⼼理健康的運動 (42)，還開發了數字技術及其使⽤⽀持，以幫助老 older persons concerned their contributions to
society, but the themes of vulnerability
年⼈在坐⽉⼦期間進⾏交流 and the need to protect older adults were also
(43) ）。老年⼈還通過響應熱線電話、遠程幫助兒童
present (38). In Spain, an analysis of 501 headlines across two national newspapers
完成家庭作業以及重返⼯作崗位（例如退休的前線衛⽣保健⼯作者）參與了許多
found that 358 of these (71%) portrayed older people in a negative way (39).
團結倡議。
The mathematical models
本專欄的內容基於對 2020of年COVID-19 that have been used to guide
5 ⽉進⾏的⽂獻的快速審查，並於 the 年
2020 response
8 ⽉使
to the pandemic have also often failed
⽤ Google 學術搜索中的搜索詞“年齡歧視”和“COVID-19”或“電暈”進⾏了重 to consider populations in long-term care,
an omission which is a form of ageism in statistics and data, given that the risk of
複。最初的審查通過使⽤ Google Scholar 中的“引⽤者”和“相關者”功能進⾏搜
spread of COVID-19 is higher in these facilities than in the general population (40).
索來補充，以便在找到相關⽂章後識別其他⽂章。還使⽤了更具體的搜索詞來識
別任何缺失的⽂章，包括“媒體”、“政策”、“封鎖”、“分類”、“長期護理”、“療
The COVID-19 pandemic has not only exposed ageism in different settings but
it has also presented the opportunity
養院”、“住宅護理”和“COVID- for many positive
19”或“電暈”。在 Google initiatives,
搜索中使⽤了相同的 reflective of
solidarity and cohesion. For example, online information has been specifically
搜索策略。由於這不是對證據的系統審查，因此可能遺漏了相關⽂獻，包括針對
developed for older adults (41), campaigns about older people’s mental health
年輕⼈或老年⼈的其他可能的年齡歧視表現形式的⽂獻。
have been conducted (42), and digital technologies and support for their use have
25
also been developed to help older people communicate during confinement (43).
Older persons have also taken part in many solidarity initiatives by responding to
helplines, remotely helping children with their homework and by returning to work,
in the case of retired front-line health-care workers.
The content of this box is based on a rapid review of the literature conducted
in May 2020 and repeated in August 2020 using the search terms “ageism”’ and
“COVID-19” or “corona” in Google Scholar. The initial review was supplemented by a
search using the functions “cited by” and “related to” in Google Scholar to identify
additional articles once a relevant article was found. More specific search terms were
also used to identify any missing articles, including “media”, “policy”, “lockdown”,
“triage”, “long-term care”, “nursing homes”, “residential care” and “COVID-19” or
“corona”. The same search strategy was used in Google search. As this was not a
systematic review of the evidence, it is possible that relevant literature was missed,
including that on other possible manifestations of ageism against younger or older
people.
2.1.2 Ageism in the workplace Across a range of sectors (e.g. hospitality,

在⼀系列⾏業（例如酒店、銷售、會計）
sales, accountancy), younger workers are
中，與中老年⼈相比，年輕員⼯更有可能
Several reviews have demonstrated that more likely to be interviewed and hired
2.1.2 ⼯作場所的年齡歧視
ageism in the workplace occurs throughout 接受⾯試和聘⽤ (48)。例如，在⻄班牙，
relative to both middle-aged and older adults
the work cycle: during recruitment, once 當雇主收到具有相同特徵的年長和年輕候
(48). For example, in Spain, when employers
someone is employed and during dismissal
⼀些評論表明，⼯作場所的年齡歧視發⽣ were presented with the curriculum vitae
選⼈的簡歷時，在六個職業中，年輕候選
or retirement processes (1, 44-47). Ageism
在整個⼯作週期中：招聘期間、⼀旦有⼈ of an older and a younger(49)。在這項研
⼈比中年候選⼈更受青睞 candidate who
in the workplace can limit older people’s had equivalent characteristics, younger
受僱以及在解僱或退休過程中 (1, 44-47)。究中，28 歲的候選⼈⾯試的回訪率比 38
income, as explained in Chapter 3. candidates were favoured over middle-
如第 3 章所述，⼯作場所的年齡歧視會限歲的候選⼈⾼
aged candidates 77%。隨著⼯作需要專業培
across six occupations
制老年⼈的收入。
For example, a systematic review of 60 訓或在受技術變⾰影響的⼯作場所，年齡
(49). In this research, candidates aged 28
studies found that employers were less years had a call-back rate for an interview
較⼤的申請⼈所經歷的劣勢可能會增加
likely to hire older applicants than younger that was 77% above that of the 38-year-old
例如，對 60 項研究的系統審查發現，與年 (50, 51)。這些研究結果與 2015 年的⼀項
applicants; that once employed, older candidates. The disadvantage experienced
輕的申請⼈相比，雇主不太可能僱⽤年長
workers had less access to training; and that 公眾認知調查相呼應，該調查發現超過⼀
by older applicants may increase with
的申請⼈；⼀旦就業，年齡較⼤的⼯⼈接
those who faced ageism in the workplace 半的歐洲⼈認為年齡對 55 歲及以上的求職
jobs that require specialized training or
were more likely to retire early (1).
受培訓的機會就會減少；那些在⼯作場所 in workplaces affected
者不利，但只有 16% 的⼈認為年齡⼩於 by technological
⾯臨年齡歧視的⼈更有可能提前退休 (1)。 change (50, 51). These research findings are
30 歲的求職者不利(52)。
A meta-analysis, which quantitatively echoed in a 2015 survey of public perception
summarized the effect of ageism on older that found more than half of Europeans
⼀項薈萃分析定量總結了年齡歧視對⼯作
workers in the workplace, found that the believed that age was a disadvantage for
process of hiring older workers, their career
場所老年⼯⼈的影響，發現僱傭老年⼯⼈ job applicants who were 55 years and older,
advancement, performance appraisals and
的過程、他們的職業發展、績效評估和⼈ but only 16% believed it was a disadvantage
evaluations of interpersonal skills were for jobseekers younger than 30 years (52).
際關係技能評估都受到年齡歧視的影響
all affected by ageism (44). The specific
(44)。下⾯提供的具體例⼦說明了在⼯作週
examples provided below illustrate the Ageism, for those in employment, affects
期的不同階段發⽣的年齡歧視的表現。
manifestations of ageism occurring during access to training opportunities, with older
different phases of the work cycle. workers being most affected. A study in
26
C HA PT ER 02
瑞⼠發現，所有年齡段的員⼯中有 53% 認
Switzerland found that 53% of employees of 兩項研究說明了老年⼈在媒體中的代表性
the individual and that inequalities in access
為年長的員⼯更難培訓，52%
all ages believed older workers 的⼈認為年
are harder to resources have little influence (58). 1.5%
不⾜。第⼀個發現在美國電視上只有
長的員⼯對具有挑戰性的⼯作不太感興趣
to train, and 52% believed older workers are 的⾓⾊是老年⼈，⽽且他們中的⼤多數都
less interested
(53)。 in challenging jobs (53). The
歐洲健康、老齡化和退休調查發 Two studies illustrate the underrepresentation
是次要⾓⾊，並且經常被描繪成喜劇效
Survey of Health, Ageing and Retirement in of older people in the media. The first found
現，在希臘、匈牙利、波蘭和⻄班牙，50 果，利⽤⾝體、認知和性⽅⾯的刻板印象
Europe found that nearly half of all employed that only 1.5% of characters on television in
歲以上的所有就業⼈員中有近⼀半報告沒
people older than 50 in Greece, Hungary, （60）。第⼆個是對德國黃⾦時段電視連
the United States were older people, and
有培訓機會
Poland and(54)。
Spain reported not having had 續劇的分析，發現只有
most of them had minor 8.5%
roles的主要⾓⾊
and were
training opportunities
年齡歧視也可能導致老年⼯⼈過早退休。 (54). often portrayed
是老年⼈（61）。 for comic effect, drawing
在比利時⼀項涉及年長⽩領⼯⼈的實驗研 on stereotypes of physical, cognitive and
社交媒體中的年齡歧視正受到越來越多的
Ageism may also contribute to older workers sexual ineffectiveness (60). The second,
究中，那些收到關於老年⼯⼈能⼒的負⾯
retiring prematurely. In an experimental 研究關注。⼀項基於
an analysis of prime time1200television
條推⽂重點關注 series
信息的⼈比那些收到正⾯信息的⼈更有可
study involving older white-collar workers 老年⼈和老年⼈在
in Germany, found that Twitter
only上的表現的研
8.5% of main
in Belgium, those presented
能表達提前退休的意圖 (55)。with negative characters were older adults (61).
究發現，推⽂中使⽤的語⾔往往強化了老
information about older workers’ abilities 年⼈作為⼀個無權、脆弱和同質的群體的
were then more likely to express intentions Ageism in social media is receiving increased
to retire early than those presented with 負⾯刻板印象，⽽衰老是⼀種需要抵制、
research attention. A study focusing on the
positive information (55). 減緩或偽裝
representation (62)。另⼀項對
of ageing and 354
older條推⽂的
people
研究發現，12%
on Twitter based(43) 包含年齡歧視語⾔
on 1200 tweets found
2.1.3 Ageism and the media that
(63)。對the language
84 個專注於老年⼈的 used in tweets often
Facebook
reinforces negative stereotypes of older
2.1.3 年齡歧視和媒體群組的分析發現，年齡歧視在這些群組中
Ageism is widespread in the media (56-59). adults as a disempowered, vulnerable
Representations on television and歲）。
年齡歧視在媒體中很普遍（56-59 很普遍。對介紹這些群體的描述的分析表
social and homogeneous group, and ageing
media and in
在電視、社交媒體和印刷品上的表現⾄關print are crucial because they 明，除了⼀個之外，所有⼈都關注負⾯的
as something to be resisted, slowed or
influence our everyday perceptions and disguised (62).
年齡刻板印象：74% (62/84)Another study of 354 tweets
譴責老年
重要，因為它們影響我們的⽇常觀念和互
interactions, including how we relate to found that 12% (43) contained ageist
動，包括我們如何與老年⼈相處，並且它⼈，27% (23/84) 將他們幼稚，37%
older people, and they shape how we each language (63). An analysis of 84 Facebook
們塑造了我們每個⼈如何看待⾃⼰變老的
see ourselves growing old (58). (31/84)that
groups 主張禁⽌他們來⾃公共活動，例如
focused on older individuals
⽅式 (58)。購物
found (64)。
that ageism was rife within the
A review of 25 empirical studies, conducted groups. An analysis of the descriptions that
對 1982 年⾄ 2020 年進⾏的 25 項實證研世界各地的媒體對老年⼈的描述各不相
from 1982 to 2020, that analysed the introduced the groups showed that all but
同。對來⾃世衛組織美洲、歐洲、東南亞
究進⾏的回顧，分析了歐洲和北美印刷和
visual representations of older people in one focused on negative age stereotypes:
電視廣告和節⽬中老年⼈的視覺表現，發
print and television advertisements and 74% 和⻄太平洋區域的⼀系列國家的 25 項研究
(62/84) excoriated older individuals,
programmes
現直到 in Europe and North America 27%
1990 年代，老年⼈的代表性不⾜並進⾏審查，這些研究審查了⼤眾媒體如何
(23/84) infantilized them and 37%
found that until the 1990s, older adults (31/84)
被負⾯描繪。在 1990 年代，儘管老年⼈的描繪老年⼈，發現這些社會之間存在重要
advocated banning them from
were underrepresented and portrayed public activities,
差異，以及亞洲國家（57）。例如，在中 such as shopping (64).
代表性仍然不⾜，但老年⼈的負⾯刻板印
negatively. In the 1990s, although older
像已從“沒有吸引⼒、不快樂、不健康、孤國香港特別⾏政區的印刷媒體中，脆弱性
adults continued to be underrepresented, Media portrayals of older people vary
there was a shift from negative stereotypes around
獨和依賴”轉變為“積極、享受⽣活和保持是⼀個主要主題（65），⽽在中國⼤眾媒
the world. A review of 25 studies
of older adults
健康⽣活⽅式”的新刻板印象。 58)。在這 as unattractive, unhappy, 體中，對老年⼈的孝敬則是突出的（66、
from a range of countries across the WHO
unhealthy, lonely and dependent to a Regions of the Americas, Europe, South-East
67）。對⼤韓⺠國和美國黃⾦時段電視廣
種對積極老齡化的描繪中，隱含著⼀種更
new stereotype of older adults as active, Asia and Western Pacific, which examined
微妙的年齡歧視形式：晚年⾝體健康是個告對老年⼈的描繪⽅式進⾏比較後發現，
enjoying life and maintaining a healthy how older people are portrayed in the
⼈的選擇和責任，⽽在獲取資源⽅⾯的不
lifestyle (58). Implicit in this shift to a mass 在⼤韓⺠國，老年⼈更有可能扮演重要⾓
media, found important differences
portrayal of
平等幾乎沒有影響 (58)。 positive ageing may lurk a more ⾊並得到積極的描繪（68）。
between these societies, as well as among
subtle form of ageism: that good health in Asian countries (57). For example, in the
later life is the choice and responsibility of print media in China, Hong Kong Special
27
Administrative Region, vulnerability was a

在⽇本，對五家主要商業電視台播放的⼤ Examples of arbitrar y limits include
約dominant theme (65), while in the Chinese
3000 條電視廣告的分析發現，與 1997 2.1.4 年齡歧視與法律制度
legislation that specifies upper age limits
mass media, filial respect for older people for organ transplantation
法律制度中針對老年⼈的年齡歧視已經在 regardless of
年相比，老年⼈在
was prominent (66,2007 67). 年以更受歡迎的
A comparison of the intrinsic capacity of the patient (74),
⽅式出現，出現的頻率更⾼，擔任的⾓⾊立法、法庭訴訟程序及其結果中對任意年
how older people were portrayed in prime and legislation that mandates retirement
time television advertisements
也更重要。代表性不⾜ (69)。⼀項要求尼 in the 齡限制的使⽤進⾏了研究
from work based solely on任意限制的例⼦
chronological
Republic of Korea
⽇利亞學⽣描述老年⼈在尼⽇利亞電影中 and the United States 包括規定器官移植年齡上限的立法，⽽不
age (75, 76).
found that older people were more likely to 管其內在能⼒如何患者 (74)，以及完全根
的表現的研究表明，他們認為老年⼈被描
play major roles and be positively portrayed Studies of court proceedings
據實際年齡強制退休的立法 (75,and their
76)。
繪成“邪惡”、“弱者”、“貧窮”和“惡魔”
in the Republic of Korea (68). outcomes have also identified the presence
（70）。對法庭訴訟程序及其結果的研究也確定了
of ageism. A study conducted in Israel
In Japan, an analysis of some 3000 年齡歧視的存在。在以⾊列進⾏的⼀項研
asked older women about their legal
television advertisements broadcast on the
年齡歧視和性別歧視在媒體中相互作⽤。究詢問了老年婦女在晚年離婚訴訟中的法
experience during divorce proceedings
five major commercial television stations in later life. These women reported that
律經驗。這些女性報告說，她們經歷了律
對 2000
found 部好萊塢電影的分析發現，女性
that older people were portrayed they experienced ageism in the way that
年齡越⼤，獲得的對話就越少：38% 的對師和法官對待她們的⽅式的年齡歧視
in more favourable ways, appeared more lawyers and judges treated them (77).
often and in more
話是由 22-31 歲的女性說的，20% 是由 important roles in 2007 (77)。以⾊列的另⼀項研究調查了律師對老
Another study in Israel, which examined
than in 1997.
42-65 Still, older people continued to
歲的女性說的。相比之下，男演員年⼈和老年⼈的知識和態度，發現律師對
the knowledge and attitudes of lawyers
be underrepresented (69). A study in which toward ageing and older persons, found
老年⼈的知識⽔平較低，但對老年客⼾的
隨著年齡的增長，台詞越來越多，⼀直到
Nigerian students were asked to describe that lawyers expressed low levels of
65歲。到了65歲，他們開始被認為老了。態度⼤多是中性和非年齡歧視 (78)。
how older people were represented in knowledge about ageing, but had mostly
Nigerian films showed 5%，女性佔
那時，男性只佔對話的 that they believed
3% 另⼀項研究闡明了年齡和性別對證⼈可信
neutral and non-ageist attitudes towards
older people were
(71)。世界各地都報導了女性在媒體中的代 portrayed as “wicked”, 度的影響
their older(79)。⼤約
clients (78).1300 名本科⽣閱讀
“weak”, “poor” and “diabolical” (70). 了⼀份案件摘要和證⼈陳述，其中證⼈的
表性遠低於男性的事實 (61, 68, 72, 73)。
Another study disentangled
性別和年齡（49、69、79 或 the effects
89 歲）各不
Ageism and sexism interact in the media. of age and sex on witness credibility (79).
An analysis of 2000 Hollywood films found 相同。研究發現，老年證⼈的可信度並不
Some 1300 undergraduate students read
that women are given less dialogue the a低於年輕證⼈，⽽且研究還發現，老年男
case summary and witness statement
older they get: 38% of dialogue was spoken 性（⽽非老年女性）被認為比中年證⼈更
in which the sex and age (49, 69, 79 or
by women aged 22–31 years and 20% by 89
可信。years) of the witness were varied. The
those aged 42–65 years. In contrast, male study found that older witnesses were not
actors get more lines as they age, up until perceived to be less credible than younger
age 65. At the age of 65, they begin to be witnesses, and the study also found that
viewed as old. At that point, men speak just older men, but not older women, were
5% of the dialogue and women speak 3% regarded as more credible than middle-
(71). The fact that women are far less likely aged witnesses.
to be represented in media than men are
has been reported from around the world 2.1.5 Other institutional
(61, 68, 72, 73). settings
2.1.4 Ageism and the legal Ageism manifests across a range of

2.1.5 其他機構設置
system other institutions and sectors, including
年齡歧視體現在⼀系列其他機構和部⾨，
housing, technology, finance, responses
Ageism against older people in the legal 包括住房、技術、⾦融、緊急情況應對以
to emergencies and in the way statistics
system has been studied with regard to the 及統計和數據的收集和彙編⽅式，所有這
and data are collected and compiled, all
use of arbitrary age limits in legislation, and of which have received less attention in
些都在研究中受到的關注較少。
in court proceedings and their outcomes. research.
28
許多信貸和貸款計劃，特別是在低收入和
中等收入國家，被發現歧視老年⼈，往往 C HA PT ER 02
使他們無法加入。女性尤其處於不利地位
——這是年齡歧視和性別歧視如何相互作
Housing Financial institutions in high-income
⽤的另⼀個例⼦——因為她們往往沒有獨
countries acknowledge that ageism is
住房立的收入，無法控制可以作為抵押的⼟地
In housing, age-based discrimination can widespread (88, 89). Yet studies on ageism
在住房⽅⾯，在篩選潛在租⼾、適⽤於租
occur during the screening of potential 等固定資產，並且對商業或正規就業部⾨
in the financial services are exceedingly
⼾的條款和條件以及要求⼈們離開的⽅式
tenants, in the terms and conditions that 的接觸有限（86、87
rare. A report by the）。 United Kingdom’s
apply to tenants and in the way people
⽅⾯，可能會出現基於年齡的歧視 (80)。 Financial Conduct Authority stated that
⾼收入國家的⾦融機構承認年齡歧視很普
are required to leave (80). For instance, in older people are likely to find themselves
例如，⽇本的⼀項研究表明，對老年租⼾遍 (88, 89)。然⽽，關於⾦融服務中年齡
Japan a study revealed that discrimination victims of age discrimination in financial
的歧視與幾個因素有關，包括擔⼼老年租
against older tenants was associated with 歧視的研究卻極為罕⾒。英國⾦融⾏為監
services because age – but not gender
⼾會與其他租⼾發⽣糾紛；
several factors including fear 擔⼼疏忽和安
that older 管局的⼀份報告指出，老年⼈可能會發現
or race – can be used as a risk factor in
tenants would get 並且擔⼼年長的租⼾
全問題，例如火災； into disputes with pricing financial products, and financial
⾃⼰在⾦融服務中成為年齡歧視的受害
other tenants; worries about negligence
會住很長時間，從⽽難以提⾼租⾦ (81)。 institutions can refuse to provide products
者，因為年齡——⽽不是性別或種族——
and safety problems, such as fires; and to certain age groups. For instance,
年齡歧視還表現在老年⼈住房缺乏可及
concerns that older tenants would stay a 可以作為⾦融產品定價的風險因素，⽽⾦
because insurance risks are not distributed
性、安全性和質量上 (82)。 to raise their
long time, making it difficult 融機構可以拒絕向特定年齡組提供產品。
uniformly across age bands, upper age
rent (81). Ageism can also manifest itself in 例如，由於保險風險在不同年齡段的分佈
limits are set for most new travel insurance
the lack of accessibility, safety and quality policies, and mortgages and private health
不均，⼤多數新的旅⾏保險政策都設置了
in housing for older people (82). insurance premiums are higher for older
年齡上限，老年⼈的抵押貸款和私⼈健康
people (90, 91).
技術
Technology 保險費更⾼ (90, 91)。
雖然技術有望改善老年⼈的⽣活，但老年 Natural disasters and conflict-related
While technology holds promise to improve emergencies
⼈和年輕⼈之間出現了數字鴻溝，部分原
the lives of older people, a digital divide ⾃然災害和與衝突有關的緊急情況
因是年齡歧視
has opened up (83-85)。例如，內化老年
between older and younger The neglect of older people during natural
近年來，在⾃然災害和與衝突有關的緊急
⼈無法掌握技術的刻板印象的老年⼈甚⾄
people that is partly due to ageism disasters and conflict-related emergencies
(83-85). For example, older adults年齡歧 who 情況下對老年⼈的忽視變得更加明顯
has become more visible in recent years
可能不會嘗試採⽤新技術（85）。
internalize the stereotype that older (92-97)。在受緊急情況（92）（包括⾃然
(92-97). Older people make up a large
視的刻板印像也可以解釋為什麼老年⼈很
people cannot master technology may not and increasing number of those affected
災害和衝突）影響的⼈群中，老年⼈的⼈
少被納入評估新數字技術設計的焦點⼩組
even try to adopt new technologies (85). by emergencies (92), including natural
數越來越多，⽽且越來越多。例如，圖 2.1
(84)。
Ageist stereotypes may also explain why disasters and conflicts. For example, Fig.
說明了⾃然災害對老年⼈的不成比例的影
older adults are seldom included in focus 2.1 illustrates the disproportionate impact
groups assessing the design of new digital 響 (93)。在為⼈道主義響應分配的資⾦中
natural disasters can have on older people
technologies (84). 也忽視了老年⼈。
(93). Older people2016 are 年的⼀份報告審查
also neglected
in funding allocated for humanitarian
了通過聯合國聯合呼籲程序提供的⼈道主
Financial institutions responses. A 2016 repor t examined
義資⾦，將其⽤作衡量老年⼈特定需求在
humanitarian funding delivered through
Many credit and loan schemes, particularly ⼈道主義規劃中得到反映的程度的代理指
the UN consolidated appeals process,
in low- and middle-income countries, 標 (94)。調查發現，在
using it as a proxy indicator2010
for年⾄ 2014 年
the degree
have been found to discriminate against to which the
間實施的 16 specific needs of older people
221 個項⽬中，只有
older people, often making it impossible are reflected in humanitarian
6%（1009 個）包括⼀項或多項針對老年 programming
for them to join. Women are particularly (94). It found that of the 16 221 projects
disadvantaged – a further example of how ⼈或將老年⼈與其他弱勢群體⼀起納入的
implemented between 2010 and 2014, only
ageism and sexism interact – as they often 活動。這些項⽬中只有
6% (1009) included one 51% (513)
or more 得到資
activities
have no independent income, no control over that
助。 either targeted older people or that
fixed assets such as land that could act as included older people alongside other
collateral and limited exposure to business vulnerable groups. Only 51% (513) of these
or the formal employment sector (86, 87). projects were funded.
29
offer in-kind or financial support to their

Fig. 2.1. Comparison of populations children or grandchildren. They volunteer.
affected by and fatalities during natural Many – especially those in countries with
disasters in Nepal and the Philippines, by
age no or limited retirement benefits – continue
to work in formal or informal employment
as long as they can (98). The dependency
ratio fails to reflect this.
A third example often pointed to is the

indicator of premature mortality, defined
as the percentage of 30-year-old people
who will die before their 70th birthday
from a range of diseases, including
cardiovascular disease, cancer, diabetes
or chronic respirator y disease. This
indicator is used by WHO and included in
the Sustainable Development Goals and
統計數據 has been interpreted as “a strong signal
年齡歧視還體現在收集和編制統計數據和 in favour of discriminating against older
數據的⽅式上。⽰例包括根本沒有收集有 people in the allocation of health resources
關老年⼈的數據，或者在收集此類數據時 and the collection of data” (99).
沒有對其進⾏分類。例如，許多公共衛⽣
Source: reproduced with permission from the Education
數據集側重於 15-49 歲的女性，或者將所
International Federation of Red Cross and Red
有數據歸為⼀個 >60 歲或 >65 歲的單⼀年
Crescent Societies (93). Education is a key institution in which
教育
ageism is only starting to receive attention.
齡組，從⽽隱藏了老年⼈之間的巨⼤差
Statistics and data 教育是年齡歧視才剛剛開始受到關注的關
In the United States, for instance, in 2014,
異。
鍵機構。例如，在美國，2014
nearly 300 000 adults aged 55年有近years 30
or
使⽤撫養比（老年⼈數
Ageism also manifests [年齡 > 60
itself 歲或way
in the > older were enrolled in higher education,
萬名 55 歲或以上的成年⼈接受⾼等教育，
65statistics
歲]/⼯作年齡成年⼈數and data are[15-64 歲]）是
collected and and 21.5% of the population aged 70 years
70 歲或以上的⼈⼝中有 21.5% 接受了某
compiled. Examples
年齡歧視的另⼀個例⼦，因為實際上，它 include data simply or older was enrolled in some form of
not being collected about older people 種形式的終⾝學習或成⼈教育（100 ）。
lifelong learning or adult education (100).
假設所有老年⼈⼈是依賴的。許多老年⼈
or when such data are collected, they are 美國⾼等教育中的年齡歧視有不同的形
繼續為經濟做出貢獻。老年⼈向他們的孩
not disaggregated. For instance, many Ageism in higher education in the United
式，這是歷史上⾼等教育按年齡劃分的結
⼦或孫輩提供實物或經濟⽀持。他們⾃
public health data sets focus on women States takes different forms, facilitated by
構所促成的。它可以表現為教職員⼯和學
aged 15-49 years or lump all data into a
願。許多⼈——尤其是那些在沒有退休福 the historically age-segregated structure
single age group of >60 years or >65 years, ⽣對老年⼈的態度以及老年⼈⾃⼰對重返
of higher education. It can manifest itself
利或退休福利有限的國家——盡可能繼續
thus hiding the vast diversity among older 學業的消極態度。
in attitudes directed年齡歧視的結構性障
against older people
從事正規或非正規就業（98）。撫養比率
people. on the part of staff and students and as
礙，例如缺乏資⾦和⽀持服務（例如技術
未能反映這⼀點。 negative attitudes on the part (101)。
of older
幫助），也經常阻礙老年⼈學習世
經常提到的第三個例⼦是過早死亡指標，
The use of the dependency ratio (the people themselves about returning to their
number of 界其他地⽅幾乎沒有關於教育中年齡歧視
定義為在 70older people [aged > 60 or > 65]/
歲⽣⽇前死於⼀系列疾病的 studies. Ageist structural barriers, such as
the number of working-age adults [aged 的證據。
a lack of funding and support services (e.g.
30 歲⼈⼝百分比，包括⼼⾎管疾病、癌
15–64]) is another instance of ageism as, in to help with technology), also often stand
症、糖尿病或慢性呼吸系統疾病。該指標
effect, it assumes that all older people are in the way of older people studying (101).
被世衛組織使⽤並包含在可持續發展⽬標
dependent. Many older people continue to Very little evidence on ageism in education
contribute to the economy. Older adults
中，並被解釋為“⽀持在衛⽣資源分配和數 is available from the rest of the world.
據收集⽅⾯歧視老年⼈的強烈信號”
30 （99）。
C HA PT ER 02
2.2 highly ageist attitudes (i.e. stereotypes and

prejudice) (102).
Interpersonal
This study also classified countries as low,
該研究還將國家的年齡歧視態度分為低、
ageism
⼈際年齡歧視 moderate,
中或⾼，發現 or high in ageist attitudes
57 個國家中有 34 個被歸類and
found that 34 of the 57 countries were
為中等或⾼（⾒圖 2.2）。年齡歧視發⽣
This section provides an overview of classified as moderate or high (see Fig.
本節概述了⼈際年齡歧視的普遍性，重點
the prevalence of interpersonal ageism, 2.2). 率最⾼的是低收入和中低收入國家（例如
The highest prevalence of ageism was
關注不同國家和⽂化中年齡歧視態度的普
focusing both on the prevalence of ageist 印度、尼⽇利亞和也⾨）：來⾃低收入和
in low-income and lower-middle-income
attitudes across countries and cultures, and countries
遍性，以及報告的年齡歧視經歷。中低收入國家的 (e.g. India,
39% Nigeria, and Yemen):
的調查參與者對年齡
reported experiences of ageism. 39% of survey participants from low-income
歧視的態度很⾼。這令⼈擔憂，因為世界
and lower-middle-income countries were
2.2.1
2.2.1 持有年齡歧視的態度
Holding ageist 上約有⼀半
high in ageist(48.3%)
attitudes.的⼈⼝⽣活在低收入
This is concerning,
attitudes given that about half (48.3%) of the9.3%，中
和中低收入國家：低收入國家為 world’s
根據 2010 年⾄ 2014 年間對來⾃ 57 個國 population
低收入國家為 lives in
39% low-income
(103)。 and lower-
An estimate of the prevalence of interpersonal middle-income countries:
⾼收入國家（例如澳⼤利亞、⽇本和波 9.3% in low-income
家的 83 000 多⼈進⾏的調查得出的⼈際
ageism based on a survey of more than countries and 39% in lower-middle-income
年齡歧視流⾏率估計數，該調查涵蓋了世蘭）的患病率較低：來⾃⾼收入國家的
83 000 people from 57 countries covering countries (103).
界所有六個區域，結果表明，每兩個⼈中
all six WHO Regions of the world, conducted 69% 的參與者對年齡歧視的態度較低，⽽
between 2010 and 2014, showed that at least
⾄少有⼀個⼈中度或⾼度年齡歧視。態度 Lower prevalence rates were found in
來⾃低收入和中低收入國家的這⼀比例為
one in every two
（即刻板印象和偏⾒）（102）。 people held moderately or higher-income
18%。 countries (e.g. Australia,
Box 2.2
The quality of the scales used to measure ageism
⽤於衡量年齡歧視的量表的質量
A systematic review of the scales used to measure ageism directed against older
對⽤於衡量針對老年⼈的年齡歧視的量表進⾏了系統審查，以評估其可靠性和有
people was carried out to evaluate their reliability and validity (i.e. their quality) (106).
效性（即質量）（106）。它確定了⽤於衡量年齡歧視的
It identified 11 different scales used to measure ageism, but 11only
種不同量表，但只
the Expectations
Regarding Aging scale met the three minimum standards for reliability and validity.
有“對老齡化的期望”量表滿⾜三個最低信度和效度標準。該量表僅評估對他⼈
This scale assesses only the stereotype dimension of ageism, both towards other
和對⾃⼰的年齡歧視的刻板印象維度。因此，它沒有評估年齡歧視的其他兩個⽅
people and towards oneself. Thus, it does not evaluate the other two dimensions
⾯：偏⾒和歧視。沒有⼀個量表具有⾼跨⽂化效度，這是進⾏任何跨國或跨⽂化
of ageism: prejudice and discrimination. No scale had high cross-cultural validity,
研究的嚴重限制。審查還發現，在許多不同的隱性年齡歧視衡量標準中，⾄少需
a serious limitation for conducting any cross-national or cross-cultural studies. The
review also found that of the many different measures of implicit ageism, none
要納入審查的三項研究都沒有對任何⼀項進⾏評估。據我們所知，⽤於衡量年齡
had been assessed in the minimum of three studies needed to be included in the
歧視的量表的質量，因為它影響其他年齡組或衡量機構年齡歧視，則知之甚少。
review. To our knowledge, even less is known about the quality of scales used to
審查的⼀個不可避免的結論是，現有的對年齡歧視流⾏率的估計，鑑於它們是使
measure ageism as it affects other age groups or to measure institutional ageism.
⽤通常缺乏可靠性和有效性的⼯具進⾏的，可能不准確。迫切需要開發和驗證⼀
個能夠準確衡量年齡歧視所有不同維度的真實程度和分佈的量表
An unavoidable conclusion of the review is that existing estimates of(106)。鑑於擁
the prevalence
of ageism, given they were carried
有可靠和有效的年齡歧視衡量標準的根本重要性，世衛組織及其合作者正在優先 out using instruments often lacking reliability
and validity, may not be accurate. There is urgent need to develop and validate a
開發這樣⼀個量表。
scale that can accurately measure the true magnitude and distribution of all the
different dimensions of ageism (106). Given the fundamental importance of having
a reliable and valid measure of ageism, WHO and its collaborators are developing
such a scale as a matter of priority.
31
Japan and Poland): 69% of participants from Australia, Canada, New Zealand, United
high-income countries were low in ageist Kingdom and the United States) and
attitudes compared with 18% from low- cultures in the WHO European Region (e.g.
income and lower-middle-income countries. Austria, Denmark, Greece and Sweden)
owing to the stronger collectivist traditions
Regarding distribution across sociodemographic
關於社會⼈⼝學特徵的分佈，對這些數據 of filial piety.
characteristics, analyses of these data showed
的分析表明，年輕⼈和男性中⾼度年齡歧
that the prevalence of highly ageist attitudes The analysis found evidence for the
分析發現了相反模式的證據：英語⽂化和
視態度的流⾏率略⾼，⽽在受教育程度較
was slightly higher among younger people opposite pattern: anglophone cultures and
世衛組織歐洲區域的⽂化似乎比世衛組織
低的⼈群中則明顯更⾼（102）。
and males, and it was markedly重要的 higher those in the WHO European region appear
among people who had less education 東南亞和⻄太平洋區域的⽂化更尊重老年
to hold older adults in higher esteem than
是，與之前的許多研究相比，本研究使⽤
(102). Importantly, this study used a more ⼈。然⽽，仔細觀察，情況更為複雜。
cultures in the WHO South-East Asia and
了更全⾯的年齡歧視衡量標準（⾒框
comprehensive measure of ageism than Western Pacific Regions do. On closer
例如，審查發現，中國、⽇本和⼤韓⺠國
2.2）。世衛組織非洲和東南亞區域是⼈⼝
many previous studies (see Box 2.2). The inspection, however, the picture is more
的⼈⺠對世衛組織東南亞和⻄太平洋區域
中持有中度或⾼度年齡歧視態度比例最⼤
WHO African and South-East Asia Regions complex.
的老年⼈表現出最⼤的消極態度。與北美
的兩個區域（分別為
were the two regions 85.2%
where和the largest
proportion of the population held moderately 和其他英語國家相比，非英語國家的歐洲
For instance, the review found that people
86.4%），⽽⻄太平洋區域的⼈⼝比例最
or highly ageist attitudes (85.2% and 86.4%, ⼈對老年⼈的負⾯影響最⼤。此外，與世
in China, Japan and the Republic of Korea
低——36.6 %——持有中度或⾼度年齡歧
respectively), whereas the Western Pacific exhibited the greatest negativity towards
衛組織東南亞和⻄太平洋區域的⼈相比，
視的態度（⾒圖
Region had the 2.3）。對數據的進⼀步
lowest proportion of the older people within the WHO South-East
兩個國家（法國和瑞⼠）的⼈對老年⼈的
分析表明，在任何世衛組織區域，男性和
population – 36.6% –holding moderately Asia and Western Pacific Regions. Non-
or highly ageist attitudes (see Fig. 2.3). A 負⾯看法更多。該分析還發現，對老年⼈
anglophone Europeans had the greatest
女性的年齡歧視態度沒有顯著差異
further analysis of the data showed that 的負⾯看法似乎是由最近⼈⼝老齡化的快
negativity towards older people compared
（102）。
there were no marked differences in ageist with North American and other
速⼈⼝變化驅動的（⾒第 5 章）。anglophone
attitudes between men and women in any countries. Additionally,
這些和其他發現突出了使⽤廣泛的地理概 people in two
WHO region (102). countries (France and Switzerland) had
括來理解當代對老年⼈的態度的不⾜（104,
more negative perceptions of older people
Ageism across countries and cultures 105）。
than people in the WHO South-East Asia
and Western
2019 Pacific Regions. This analysis
年對阿拉伯⽂化中對老齡化和老年⼈
跨國家和⽂化的年齡歧視
Variations in the rates of ageism across also found that negative views (107)。該
of older
態度的審查確定了七項實證研究
不同國家和⽂化的年齡歧視率的差異以及
countries and cultures and the factors that people appear to be driven by recent, rapid
評論描繪了⼀幅不確定和異質的圖景，並
may account for these variations are just
可能導致這些差異的因素才剛剛開始被探 demographic changes in population ageing
beginning to be explored. The analysis from 呼籲進⾏更多更好的研究。⼀些研究指出
(see Chapter 5).
索。世衛組織根據 57 個國家的數據進⾏
WHO presented above, based on data from 阿拉伯⽂化中對老齡化的看法比其他研究
的上述分析清楚地表明，世界各地的年齡
57 countries, clearly showed that rates of These and other findings highlight the
國家更積極
歧視率各不相同，低收入和中低收入國家
ageism vary across the world, with low- and inadequacy of using broad, geographical
lower-middle-income countries having the
的比率最⾼。 generalizations to understand contemporary
highest rates. attitudes towards older adults (104, 105).
2015 年對 37 篇論⽂的審查更深入地探討
了年齡歧視的跨⽂化差異問題 (104)。出發
A 2015 review of 37 papers explored the A 2019 review of attitudes towards ageing
點是普遍認為世衛組織東南亞和⻄太平洋
issue of cross-cultural variation in ageism and older people in Arab cultures identified
in greater depth (104). The starting point
區域（例如中國、印度、⽇本、菲律賓和 seven empirical studies (107). The review
was the prevailing belief that cultures in the
越南）的⽂化比英語國家的⽂化（例如澳 paints an inconclusive and heterogeneous
WHO South-East Asia and Western Pacific picture and calls for more and better
⼤利亞、加拿⼤、新新⻄蘭、英國和美
Regions (e.g. China, India, Japan, Philippines research. Some of the studies pointed to
國）以及世衛組織歐洲區域（例如奧地
and Viet Nam) hold older adults in higher more positive perceptions of ageing in Arab
利、丹麥、希臘和瑞典）的⽂化，因為孝
esteem than in anglophone cultures (i.e. cultures than in the other countries studied
道的集體主義傳統更為強烈。
32
C HA PT ER 02
Fig. 2.2. Map of countries showing countries classified as low, moderate or high in
ageist attitudes
Fig. 2.3. Prevalence of population holding moderarately or highly ageist attitudes

by WHO region, from a further analysis of data in reference 102
Note: The percentages apply only to the pooled data of the countries included in the analysis
for each region (e.g. the 12 countries in the WHO Eastern Mediterranean Region).
33
(e.g. France, the Netherlands), such as

（例如法國、荷蘭），例如對老年⼈更寬 revealed that young and old women have
more tolerance of older people, a stronger
容，對老年⼈對社會做出貢獻的意識更 been underrepresented in literature for
perception of older people as contributing the past 200 years, with the greatest
強，孝順感更強。但在有時在同⼀國家進
to society and a greater sense of filial piety. difference appearing in 1900 when the
⾏的其他研究中，更為消極的觀點佔了上
But in other studies, sometimes conducted term “old man” occurred more than three
within
風。 the same country, a more negative
不確定的調查結果可能與受訪者在性 times more often than did “old woman”.
view prevailed.
別、年齡、城市或農村居住地和教育⽔平The inconclusive findings
may be related to differences among the 2.2.2 Experiences and
2.2.2 ⼈際年齡歧視的經驗和認知
⽅⾯的差異有關。作者推測，這種差異也
respondents in terms of gender, age, urban perceptions of interpersonal
了解持有年齡歧視態度的⼈的比例很重
可能部分是由於規定對老年⼈的尊敬的社
or rural residence and education level. The ageism
會規範的壓⼒。
authors speculate 這可能會導致受訪者不願
that the differences may 要；然⽽，這些數字並不完整，可能被低
also partly be due
意表達對個別老年⼈的負⾯看法，但可以 to the pressure of social 估了。鑑於⼈們傾向於提供社會可接受的
Knowing the proportion of people who hold
norms that prescribe reverence for older ageist attitudes is important; however, these
反應，⽽不是選擇反映其真實態度和⾏為
更⾃由地批評⼀般老年⼈。
people. This may lead respondents to feel figures are incomplete and are likely to be
的反應，因此有關態度的數據可能被低估
reluctant to express negative views about underestimations. Data on attitudes are
individual older people, but freer to be （110）。除了關於態度的數據之外，關於
likely to be underestimations, given people’s
critical of older people in general. 報告遭受年齡歧視的⼈數的信息也很重
tendency to provide socially acceptable
跨時間的年齡歧視 responses instead of choosing responses that
要；然⽽，關於年齡歧視的跨國數據主要
Ageism across time reflect their true attitudes and behaviours
來⾃歐洲國家，並且只關注感知到的年齡
正如來⾃英語世界的有限證據所表明的那 (110). In addition to data on attitudes,
樣，與老年⼈有關的年齡刻板印象可能隨歧視。
Age stereotypes related to older adults information on the number of people who
著時間的推移變得更加消極
may have become more negative over 在歐洲
(108, 109)。然 report 28 個國家/地區，超過三分之⼀的
experiencing ageism is essential;
time, as suggested
⽽，缺乏關於流⾏率歷史趨勢的全球數 by limited evidence 65 歲或以上的⼈報告說是年齡歧視的⽬標
however, cross-national data on age-based
from the English-speaking world (108, 109). （即因年齡⽽受到侮辱、虐待或拒絕服
discrimination derive predominantly from
據。⼀項基於對美國歷史英語
However, global data on historical trends European countries and focus only on
（1810-2009）的務）。報告年齡歧視率較⾼的唯⼀年齡組
in prevalence are 4 億字語料庫進⾏分析
lacking. A study based perceived age discrimination.
的研究發現，在過去的
on an analysis of the 200 million word 是 15-24 歲（⾒第 5 章）。
400年中，年齡刻
Corpus of Historical American English 老年⼈以及所有其他年齡組也報告說，基
板印像以線性⽅式變得更加消極，並且年 Across 28 countries in Europe, more than
(1810–2009) found that age stereotypes 於年齡的歧視比基於性別、種族或⺠族背
齡刻板印像從積極轉變為消極⼤約在 1880 one in three people aged 65 years or older
have become more negative – in a linear 景的歧視要多（⾒圖
reported being a target of ageism (i.e.
2.4）（111）。關於
年。有兩個主要因素與這種轉變有關：老
way – during the past 200 years and that insulted, abused or denied services because
齡化的醫療化和
age stereotypes 65 switched
歲以上⼈⼝的比例 from being 認為 55 age).
of their 歲或 The 55 歲以上的⼈的歧視在歐盟
only age group to report
positive
(108)。 to negative around 1880. Two 非常普遍或相當普遍的⼈⼝比例，我們可
higher rates of ageism were those aged 15–24
main factors were
另⼀項研究使⽤ associated
Google Books 的 with this 以獲得更多近期的可比數據。調查結果從
Ngram years (see Chapter 5).
switch: the medicalization of ageing and 保加利亞的三分之⼆（63.1%）到丹麥的四
Viewer 搜索引擎，該引擎繪製了
the proportion 1800than
of the population older 年 Older people, along with all other age groups,
⾄652000
years年間出版的超過
(108). 500 萬本⼩說和分之⼀（23.6%）不等（⾒圖 2.5）
also reported experiencing more discrimination
非⼩說類書籍的詞頻，發現從 1900 年代初（112）。 based on age than discrimination based on
Another study,
開始，積極的術語從積極的術語轉變為消using Google Books’ Ngram sex, race or ethnic background (see Fig.
Viewer search engine, which charts word 2.4) (111). More recent comparable data are
極的術語關於老年⼈，這可能反映了對他
frequencies in more than 5 million fiction available about the proportion of people who
們態度的變化（109）。分析還顯⽰，在過
and non-fiction books published between perceive that discrimination against people
去的
1800200
and年裡，年輕女性和老年女性在⽂
2000, found that from the early aged 55 or older is very or fairly widespread
1900s there was a shift from more positive in the European Union. Findings vary from a
學中的代表性不⾜，最⼤的差異出現在
to fewer positive terms about older adults, high of two out of three people in Bulgaria
1900 年，當時“老⼈”⼀詞的出現頻率是
which may reflect a change in attitudes (63.1%) to a low of one out of four people in
“老婦⼈”的三倍多。
towards them (109). The analyses also Denmark (23.6%) (see Fig. 2.5) (112).
34
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Fig. 2.4. Percentage of people responding to the European Social Survey who reported
experiencing unfair treatment because of their age, sex or race or ethnic background,
by age group, 2008–2009 (includes only individuals who did not rate their experience
as 0 on a scale that ranged from 0, indicating they had never experienced unfair
treatment, to 4, indicating it was experienced very often)
Source: reproduced with permission from Abrams et al. (111).
Fig. 2.5. Comparison of perceptions of discrimination against people aged ≥ 55 years in
25 European Union countries
Source: reproduced with permission from Rychtaříková (112).
35
Although comparable cross-national data

儘管缺乏來⾃世界其他地區的關於年齡歧 the Middle East (118). Another example
from other parts of the world about includes traditional widowhood customs,
視的經驗和看法的可比跨國數據，但有⼀
experiences and perceptions of ageism such as the social ostracism of widows,
些針對特定國家的研究。例如，在巴⻄
are lacking, some country-specific 50
studies bans on remarriage and so-called cleansing
歲及以上⼈群的全國代表性樣本中，有
are available. For instance, in a nationally rituals. These so-called cleansing rituals,
representative
16.8% sample of people aged
的受訪者表⽰⾃⼰在過去⼀年中成 which occur in parts of sub-Saharan Africa,
50 years and older in Brazil, 16.8% of the sometimes require the widow to have sexual
為某種類型歧視的受害者。城市居⺠的這
population surveyed reported feeling that intercourse with a brother-in-law or another
⼀比例⾼於農村居⺠，最有可能發⽣在醫
they had been the victim of some type of man to remove evil spirits (115, 118).
療保健機構，最不可能發⽣在⼯作場所
discrimination during the past year. This
proportion was higher among urban dwellers
(113)。 Accusations of witchcraft, most of which
據報導，撒哈拉以南非洲國家經常發⽣對
than rural dwellers, most likely to occur in are directed at older women, are reported
health care settings, and least likely to occur 巫術的指控，其中⼤部分針對老年婦女。
to occur frequently in countries in sub-
at work (113). 此類指控可能導致老年婦女被排斥和忽
Saharan Africa. Such accusations may result
視，被趕出社區並被驅逐出社區，或者被
in the older woman being ostracized and
neglected, driven out and banished from
燒毀、⽤⽯頭砸死、⽤鐵鍊鎖起來，在某
Discrimination against widows her community, or burned, stoned, chained
and accusations of witchcraft 些情況下甚⾄被殺害 (115, 118)。例如，在
up and, in some instances, killed (115, 118). In
are examples of how ageism 坦桑尼亞聯合共和國，據報導，2004 年⾄
the United Republic of Tanzania, for instance,
interacts with sexism and puts 2009 年間約有
some 2500 older2500
women名老年婦女因被指控
were reportedly
older women in a situation of killed between 2004
使⽤巫術⽽被殺害（119）。在布基納法 and 2009 after being
double jeopardy. accused of witchcraft (119). In Burkina
索，數百名被指控使⽤巫術的老年婦女
Faso, hundreds of older women accused of
（被稱為
witchcraft les
(andmangeuses d’âmes，或靈
called les mangeuses d’âmes,
對寡婦的歧視——世界上約有
Discrimination against widows2.5 – of億寡婦
which 魂食者）要么被殺害，要么被放逐
or soul eaters) have been either killed (120)。
or
——以及對巫術的指控，兩者都經常針對
there are some 250 million in the world – banished (120). In northern
在加納北部，1000 Ghana, more than
多名據稱是女巫的老年
and accusations of witchcraft, both of which
老年婦女，都是年齡歧視如何與性別歧視 1000 older women
婦女被趕出家⾨，住在臨時營地 who were alleged to be
(121)。
often target older women, are examples of witches have been driven out of their homes
相互作⽤並使老年婦女處於雙重危險境地
how ageism interacts with sexism and puts and are living in makeshift camps (121).
的例⼦（114-116 ）。儘管關於對寡婦的歧
older women in a situation of double jeopardy
視和巫術指控的確切規模的定量數據很
(114-116). Although quantitative data about
the exact scale of discrimination against
少，但這些現像被廣泛報導，特別是但不 2.3
widows and accusations of witchcraft
僅限於在撒哈拉以南非洲（115、117、
are scarce, these phenomena are widely Self-directed
118）。寡婦遭受的不公正形式是多⽅⾯的
reported to occur, particularly, but not
——基於寡婦⾝份、性別和年齡的交叉點
exclusively, in sub-Saharan Africa (115, 117, ageism
118). The forms of injustice that widows are
——是多⽅⾯的，有些是普遍存在的，有
subjected to – based on the intersection of
些則更具⽂化特徵。 Self-directed ageism can have a serious
⾃我導向的年齡歧視會對⼈們的健康產⽣
their status as a widow, their gender, and impact on people’s health, as shown in
⼀個例⼦是盜竊寡婦的財產和剝奪其繼承嚴重影響，如第 3 章所⽰。但是關於⾃我
often their age – are manifold, with some Chapter 3. But cross-national population-
權，據報導這種情況發⽣在撒哈拉以南非
being widespread and others more culturally 導向的年齡歧視流⾏的跨國⼈群研究很少
based studies of the prevalence of self-
洲、南美洲、南亞和中東
specific. (118)。另⼀個例⾒。在巴拿⾺，⼀項研究發現，近⼀半
directed ageism are rare. In Panama, a
⼦包括傳統的寡婦習俗，例如社會排斥寡 study
(46.3%)found that almost
的 18-65 half (46.3%) of
歲受訪者回憶起⾄少⼀
One example is the theft of widows’ respondents aged
次⾃我導向的年齡歧視，通常是對個⼈⾝ 18–65 years recalled
婦、禁⽌再婚和所謂的清洗儀式。這些所
property and the denial of their inheritance, having engaged in self-directed ageism at
謂的淨化儀式發⽣在撒哈拉以南非洲的部
which is reported to occur in sub-Saharan 體缺陷的反應
least (122)。
once, usually in response to a personal
分地區，有時需要寡婦與姐夫或其他男⼈
Africa, South America, South Asia and physical deficit (122).
發⽣性關係以驅除邪靈 (115, 118)。
36
C HA PT ER 02
Several studies have explored self-

⼀些研究探討了對衰老的⾃我認知（即⼈ Future priorities for understanding the scale
perceptions of ageing (i.e. people’s of the problem should include:
們隨著年齡增長對⾃⼰的認知），有時被
perceptions of themselves as they age),
視為⾃我導向的年齡歧視的代表。
sometimes viewed as a proxy 例如， for self- • monitoring and tracking
+監測和追踪年齡歧視 ageism
directed ageism.
研究探索了根據不同社會⼈⼝特徵（包括 For instance, studies in a range of key institutions,
+在⼀系列關鍵機構中，尤其是在衛⽣和社
have explored the distribution of self-
性別、種族、⺠族和教育）對老齡化的⾃ particularly among health and social
perceptions of ageing according to different 會護理⼯作者、住房部⾨、法律系統和緊
care workers, in the housing sector,
我認知的分佈。德國的⼀項研究發現，對急情況期間，以及更普遍的低收入和中等
sociodemographic characteristics, including in the legal system and during
衰老的積極⾃我認知在中年增加，但在晚
gender, race, ethnicity and education. A emergencies, as well as in low- and
收入國家；
年減少（123）。
study in Germany • 關於性別與⾃我認知之
found that positive self- middle-income countries more
+使⽤正在開發的⼯具來衡量年齡歧視的所
perceptions of ageing
間關係的調查結果並不⼀致(124-126)。 increase in midlife收 generally;
but then decrease in later life (123). Findings 有不同類型和維度（⾒框 2.2）；
入和教育程度較⾼的⼈似乎比收入和教育 +使⽤這些新開發的⼯具進⾏基於⼈⼝的年
about the relation between gender and • using the instruments being
程度較低的⼈對老齡化有更積極的⾃我認
self-perception have been inconsistent 齡歧視調查，以更好地估計年齡歧視的全
developed to measure all of the
知 (124-126).
(123, 127)。
People with higher incomes and different types and dimensions of
球流⾏率、分佈和趨勢，包括⾃我導向的
education appear to have more positive ageism (see Box 2.2);
年齡歧視；
self-perceptions of ageing than people with
lower incomes and education (123, 127). • conducting population-based
• 對年齡歧視和其他“主義”之間的交叉點
surveys of ageism using these newly
developed instruments to better
進⾏研究，包括對寡婦的歧視和巫術指控
2.4 estimate the global prevalence and
的情況。
distribution of, and trends in, ageism,
Conclusions and including self-directed ageism;
future directions • conducting studies on the
intersection between ageism and
Ageism against older people is pervasive
針對老年⼈的年齡歧視在全球範圍內普遍 other “isms”, including on situations
globally. It manifests itself in all key of discrimination against widows and
存在。它體現在社會的所有關鍵機構中。
institutions in society. For example, in accusations of witchcraft.
例如，在醫療保健和社會保健⽅⾯，有時
health and social care, where health care
is sometimes rationed based on age;
根據年齡對醫療保健進⾏配給；在招聘、 in the Ageism affects billions of
workplace during
就業以及退休和解僱過程中的⼯作場所； recruitment, employment
people globally and constitutes
and processes of retirement and dismissal;
⽽在媒體中，老年⼈的代表性往往不⾜。
and in the media, where older people are both a serious and widespread
在全球範圍內，⾄少有⼆分之⼀的⼈對老
often underrepresented. human rights problem and a far-
年⼈持年齡歧視態度。在歐洲社會調查的 reaching public health problem.
Globally, at least one in two people hold
各個國家中，三分之⼀的老年⼈經歷過年
ageist attitudes towards older adults. Across
齡歧視。因此，年齡歧視影響了全球數⼗
the countries in the European Social Survey,
億⼈——⽽且其傳播範圍可能正在擴⼤。
one in three older people has experienced
年齡歧視既是⼀個嚴重⽽普遍的⼈權問
ageism. Thus, ageism affects billions of
people globally – and its spread may be
題，也是⼀個影響深遠的公共衛⽣問題，
increasing. Ageism constitutes both
本章和討論年齡歧視影響的第 a serious
3 章都表明
and widespread human rights problem and a
了這⼀點。
far-reaching public health problem, as both
this chapter and Chapter 3, which discusses
the impact of ageism, demonstrate.
37
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https://doi.org/10.1097/PSY.0000000000000364.
127. Kwak M, Ingersoll-Dayton B, Burgard S. Receipt of care and depressive symptoms in
later life: the importance of self-perceptions of aging. J Gerontol B Psychol Sci Soc Sci.
2014;69(2):325–35. https://doi.org/10.1093/geronb/gbt128.
45
GERTRUDE, 60,
K EN YA
46
C HA PT E R 01
CHAPTER 03
03
“ Teaching i s in my blo o d . It i s no surpri s e I felt

dev a s tate d w hen the G overnment told me at the
age of 5 0 that I mu s t s top work ing . T hey told me I
“
w a s old and that I should allow young p e ople to do
the teaching . I felt bit ter and angr y.
G e r tru d e , 6 0 , Ke ny a
©B enj B ink s / H elpAge International
47
47
年齡歧視縮短壽命；導致更差的⾝體健康和更
Ageism shortens妨礙從殘疾中恢復；
差的健康⾏為； lives; leads to poorer導致⼼
physical
health and worse health behaviours; impedes
理健康狀況變差；加劇社會孤立和孤獨；
recovery from disability; results in poorer 並
mental health; exacerbates social isolation and
降低⽣活質量。
loneliness; and reduces quality of life.
年齡歧視對個⼈和社會造成沉重的經濟損失，
Ageism takes a heavy economic toll on
導致經濟不安全和貧困，並使社會損失數⼗億
individuals and society, contributing to financial
美元。
insecurity and poverty and costing society
03
billions of dollars.
Chapter
3.1
The impact of
ageism on health
Ageism has a serious impact on all aspects of health,
年齡歧視對健康的⽅⽅⾯⾯都有嚴重影響，世界衛
which is defined by WHO as a state of complete
⽣組織將其定義為⾝體、⼼理和社會⽅⾯完全健康
physical, mental and social well-being and not merely
的狀態，⽽不僅僅是沒有疾病或虛弱（1）（⾒圖
the absence of disease or infirmity (1) (see Fig. 3.1).
3.1）。因此，年齡歧視構成了⼀個重要的、迄今
Ageism thus constitutes an important, and hitherto
為⽌被忽視的健康社會決定因素。其對健康的影響
neglected, social determinant of health. Its impact on
本章詳細介紹了年齡歧視對老年⼈
This chapter details the serious health is on par with, if not greater than, that of racism,
與種族主義（⼀種偏⾒和歧視形式，其健康後果已
impacts of ageism3.1）。
的嚴重影響（⾒圖 against第 older
3.1 a form of prejudice and discrimination whose health
得到廣泛研究）的影響相當，甚⾄更⼤（2）。
people (see Fig.3.1). Section 3.1 consequences have been widely studied (2).
節描述了年齡歧視對健康（包括福
describes the dramatic impact
祉）的巨⼤影響，例如導致可預防
ageism has on health (including on 本報告委託進⾏的⼀項關於年齡歧視對健康影響的
A global systematic review on the impacts of ageism
的死亡和嚴重的⾝⼼健康問題。
well-being), leading, for instance,第 on health commissioned for this report,
全球系統審查，其中包括來⾃ 45 個國家的which included
422
to preventable
3.2 節探討了老齡化對老年⼈和國 death and serious 422 studies from 45 countries, found that in 405 (96%)
項研究，發現在 405 項（96%）研究中，年齡歧
physical and mental health problems. studies, ageism was associated with worse outcomes
⺠經濟造成的嚴重經濟損失。總體視與所有檢查的健康領域的較差結果有關
Section 3.2 explores the heavy in all of the health domains examined (2) (see(2)
Box（⾒3.1).
⽽⾔，年齡歧視的影響如此嚴重，
economic toll ageism takes on older 框
The3.1）。對於⾃我導向的年齡歧視，年齡歧視與
association between ageism and health outcomes
其成本似乎如此之⾼，以⾄於只有
people and on national economies. was strongest for self-directed ageism. The effects of
健康結果之間的關聯最強。年齡歧視對健康的影響
Overall, the impact of ageism is so
適度影響的⼲預有可能顯著改善⽣ ageism on health are seen in all parts of the world,
遍及世界各地，⽽且隨著時間的推移⽽增加，並且
serious and its costs appear to be
活並顯著降低年齡歧視的經濟成 have increased over time, and are most likely to impact
so high that an intervention with only 最有可能影響弱勢群體。此外，受教育程度較低的
disadvantaged groups. Furthermore, older people with
本。
a modest effect has the potential 老年⼈更有可能遭受年齡歧視的健康後果。審查發
lower levels of education are more likely to experience
to improve lives substantially and 現，年齡歧視在所有
the health consequences 45 of
個國家和所有地區都存在
ageism. The review found
cut the economic costs of ageism there were(2)。然⽽，在納入的
健康影響 health impacts from422
ageism
項研究中， in all 45
significantly. countries and across all areas (2). However, of
78.2% 是在北美或歐洲進⾏的，只有 1 項研究是
在非洲進⾏的。
48
C HA PT ER 03
Fig. 3.1. The impacts of ageism on older people
the 422 studies included, 78.2% were 年齡歧視與較差的⾝體健康有關，並且會

found that older persons prone to self-
conducted in North America or Europe, directed ageism had an almost 20% higher
and only 1 study was conducted in Africa. 阻礙從殘疾中恢復。在調查年齡歧視對⾝
likelihood of dying over the six-year study
體疾病影響的
period than those52 項研究中，共有
with more positive50 self-
項
與最近的其他研究 (3-5) ⼀致，系統評價
Consistent with other recent studies (3-5), (96%)
perceptions
發現了相關性 (17). (2)。⾝體疾病通過
中發現的年齡歧視的許多健康後果似乎正
many of the health consequences of ageism 功能障礙、慢性病的存在以及急性醫療事
found in the
在增加。 systematic review appear to Ageism is linked to poorer physical health, and
這可能與⾦融衰退有關，因為研件和住院的次數來衡量。例如，在美國康
be increasing. This may be associated with it impedes recovery from disability. A total of
究表明，經濟危機會導致偏⾒和歧視的增涅狄格州的⼀項研究中，持有積極年齡刻
financial downturns, as research has shown 50 (96%) of the 52 studies that investigated
加
that(2,economic
6, 7)。儘管衛⽣保健⼯作者中年齡
crises lead to increases 板印象的老年⼈從嚴重殘疾中完全康復的
the impact of ageism on physical illness
歧視的總體證據尚無定論，如第
in prejudice and discrimination (2, 2 章所 found a link (2). Physical illness was measured
6, 7). 可能性比持有消極年齡刻板印象的老年⼈
Although the overall
⽰，但它可能正在增加，這可能是因為衛⾼ evidence of ageism by functional impairment, the presence of
44% (18)。
among health-care workers is inconclusive,
⽣⼯作者⾯臨越來越⼤的時間壓⼒ chronic conditions and the number of acute
(2)。年齡歧視會增加危險的健康⾏為。在該主
as shown in Chapter 2, it is possible that medical events and hospitalizations. For
it may be increasing, perhaps because of 題的所有 instance, 13
in a項研究
study (2) 中，經歷過年齡
in Connecticut, United
the growing time pressure health workers 歧視的⼈更有可能採取危險的健康⾏為，
States, older persons who held positive age
are under (2). stereotypes were 44% more likely to fully
例如飲食不健康、未按規定服藥、過度飲
recover from severe disability than those with
3.1.1 The impact of ageism on 酒或吸煙，或這些⾏為的某種組合。⼀項
negative age stereotypes (18).
physical health 針對愛爾蘭老年⼈的研究檢查了⾃我導向
Ageism increases risky health behaviours.
的年齡歧視與吸煙和飲酒之間的關係，表
Ageism is associated with earlier death
年齡歧視與早逝有關 (2)。這⼀發現在 10 明對衰老的更⾼認識和更強的情緒反應會 In all 13 studies of this topic (2), people
(2). This finding was consistent across 10 who had experienced ageism were more
項研究中是⼀致的，這些研究在澳⼤利增加吸煙的可能性 (19)。
studies that examined this ultimate end likely to adopt risky health behaviours,
亞、中國、德國和美國
point in Australia, China,(9-17)
Germany中檢驗了and the such as eating an unhealthy diet, not
這⼀最終終點。在中國，研究⼈員發現，
United States (9-17). In China, researchers taking their medication as prescribed,
在六年的研究期間，傾向於⾃我導向年齡
歧視的老年⼈的死亡可能性比那些⾃我認 49
知更積極的老年⼈⾼出近 20% (17)。

Box 3.1
Opportunities for research on the impact of ageism against older people
The systematic review commissioned for this report on the impact of ageism against
older people marks a major step forward in improving the quality of research in this
area (2). It was conducted according to the Preferred Reporting Items for Sys-
tematic Reviews and Meta-Analyses (PRISMA) guidelines (8), based on a search of
14 electronic databases, included only studies that used appropriate designs and
carefully assessed the quality of the studies. In addition, the review performed sen-
sitivity – sometimes called “what if” – analyses and showed that the findings would
have been the same if all of the studies had been of higher quality or included more
participants.
This review was unable to estimate the strength of the association between ageism
and its effects. To do this, studies would need to use more standardized and
comparable definitions and measures of these effects. Estimating the strength of
associations between ageism and its impacts, and more clearly demonstrating that
ageism is indeed the cause of these impacts, rather than simply being associated
with them, are areas where future studies and reviews should focus. The former
would provide information on the relative importance of the different impacts
of ageism, whereas the latter would increase our confidence that the relations
between ageism and its putative effects are real. Future studies might also try to
estimate the population attributable fraction for ageism at the level of countries,
regions and the world. The population attributable fraction is the proportional
reduction in population disease or mortality that would occur if exposure to a risk
factor – ageism in this case – was reduced. For instance, it would allow us to say
that if ageism was reduced by X%, longevity would be increased by Y%.
drinking excessively or smoking, or some Older people may be at greater risk of

由於缺乏針對老年⼈的信息和運動，老年
combination of these. A study of older STDs due at the lack of information and
people in Ireland that examined the relation ⼈患 STD targeted
campaigns 的風險可能更⼤。老年⼈也不
at them. Older people
between self-directed ageism and cigarette 太可能尋求診斷和治療，因為關於
are also less likely to seek diagnosis STD
and alcohol use, showed that greater and treatment because
的信息有限，老年⼈缺乏性健康服務，並 there is limited
awareness of, and stronger emotional information about STDs, a lack of sexual
且害怕遇到對其性⾏為的年齡歧視 (21)。
reactions to, ageing increased the likelihood health services for older people and a fear
of smoking (19). 將老年⼈排除在性病監測數據和研究之外
of encountering ageist attitudes towards
也可能通過降低老年⼈對性病風險的認識
their sexuality (21).
Ageism contributes to poor sexual and ⽽導致該⼈群中性病的增加 (21, 22)。
reproductive health and is associated with The exclusion of older people from
an increase in rates of Sexually transmitted surveillance data and research studies
年齡歧視會導致性健康和⽣殖健康不佳，
diseases (STDs). Epidemiological research on STDs may also have contributed to
from around the (STD)
並與性傳播疾病 world indicates
的發病率增加有 that rates the increase in STDs in this population by
of STDs
關。 are increasing in older people, and
來⾃世界各地的流⾏病學研究表明， reducing awareness of the risk of STDs
ageism may have a part to play in this (20-22). among older people (21, 22).
老年⼈的 STD 發病率正在上升，年齡歧
視可能在其中發揮了⼀定作⽤ (20-22)。
50
C HA PT ER 03
例如，在中國，2016 年男性所有性病病
例的 15.8% 和女性所有性病病例的
For example, in China, 15.8% of all9.8% STD More than 10% of older adults’ admissions to
cases in50
發⽣在 men and 9.8% of all STD cases
歲及以上的⼈群中，65 歲及以 in acute care may be caused by nonadherence
women occurred in those aged 50 years to medication regimens (34), and a quarter of
上的⼈群約佔新報告病例的 10%。 (23,
and older, and people aged 65 years and admissions of older adults to nursing homes
24)。
older accounted for some 10% of newly may be due to older people’s inability to
reported cases in 2016 (23, 24). self-administer medication (35).
在博茨瓦納這個世界上艾滋病毒流⾏率第
In Botswana, the country with the second
⼆⾼的國家，老年男性的艾滋病毒感染率
3.1.2 The impact of ageism on
highest HIV prevalence in the world, rates of mental health
從
HIV2004 年的 17.2%
prevalence in older增加到 2013
men have 年的
increased
27.8%，老年婦女從
from 17.2% in 2004 to2004
27.8%年的 16.3%
in 2013 and in Ageism is also associated with poorer
年齡歧視也與較差的⼼理健康有關。⼤約
增加到 2013 年的 21.9%（20 ）。 21.9%
older women from 16.3% in 2004 to mental health. Some 96% (42/44) of the
96% (42/44) 的研究 (2) 檢查了年齡歧視
in 2013 (20). studies (2) that examined the relationship
與⼼理健康之間的關係，發現有證據表明
between ageism and mental health found
⼈際和機構年齡歧視都可能導致不適當的
Both interpersonal and institutional 年齡歧視會影響精神疾病。在
evidence that ageism influenced 16 項研究
psychiatric
藥物使⽤，包括不適當的處⽅、多種藥物
ageism can contribute to inappropriate conditions. In
中，年齡歧視與抑鬱症的發作、抑鬱症狀 16 studies, ageism was
和藥物不依從性，所有這些都會產⽣嚴重
medication use, including inappropriate associated with the onset of depression,
隨時間增加和終⽣抑鬱症有關。當年長的
prescribing, polypharmacy and medication
的後果。 increases in depressive symptoms over
nonadherence, all of which can have serious 美國退伍軍⼈抵制負⾯的年齡刻板印象
time and lifetime depression. When older
consequences. 時，他們被發現不太可能出現⾃殺意念、
American veterans resisted negative age
有時缺乏關於老年⼈藥物療效和安全性的 stereotypes,
焦慮和創傷後應激障礙 they were (36)。
found to be less
信息，因為尚未進⾏必要的特定年齡臨床
Information is sometimes lacking about the likely
根據 to experience
2015 年的數據，全球約有 suicidal ideation, anxiety
633 萬例
efficacy and safety profiles of medications
試驗：這是⼀種機構年齡歧視形式，可能 and post-traumatic stress disorder (36).
for older people because the necessary 抑鬱症病例估計可歸因於年齡歧視，其中
導致不適當的處⽅和多種藥物治療 831 041 例發⽣在較發達國家，560
age-specific clinical trials have not been Based on figures for 2015, globally, about萬例
6.33
(25-27)。老年⼈護理協調不⼒、溝通不
conducted: this is a form of institutional million cases of depression
發⽣在⽋發達國家 (2)。 are estimated to
暢和對老年⼈藥物教育不⾜是機構和⼈際
ageism that can result in inappropriate be attributable
年齡歧視會加速認知障礙。審查中調查年 to ageism, with 831 041
prescribing and polypharmacy (25-27).
年齡歧視的形式，可導致藥物不依從性 cases occurring in more developed countries
齡歧視和認知障礙之間可能聯繫的五項研
Poor coordination of care for older people,
(28-30)。 and 5.6 million cases in less developed
ineffective communication and inadequate 究中有四項
countries (2).(80%) 發現了相關性 (2)。德
education of older adults about medication 國的⼀項研究在幾年內對 8000 ⼈進⾏了
主要由於不恰當的處⽅，⼤約 25% 的
are forms of institutional and interpersonal Ageism accelerates cognitive impairment.
跟踪，結果表明，以認知處理速度衡量，
70-79 歲患者遭受藥物不良事件，⽽
ageism that can lead to medication Four of the five studies (80%) in the review
對衰老的負⾯⾃我認知會加速認知能⼒下
nonadherence
20-29 (28-30).
歲患者中這⼀比例約為 4% (25, that investigated a possible link between
降，⽽積極的⾃我認知會減慢這種速度
ageism and cognitive impairment found
31, 32)。
Largely due to inappropriate prescribing, a(37)。
relationship (2). One of the studies, in
some 25% of patients aged 70–79 years Germany, followed up 8000 people over
這些發現補充了在幾個薈萃分析中總結的
多種藥物在老年⼈中很普遍，會導致許多
suffer from adverse drug events compared several years and revealed that
關於該主題的⼤量實驗研究 negative
(38-40)。這
with about 4% among those aged 20–29
負⾯後果：醫療保健成本增加、藥物不良 self-perceptions of ageing accelerated
years (25, 31, 32). 些表明，當老年⼈暴露於消極的刻板印像
cognitive decline as measured by cognitive
反應、內在能⼒降低以及老年綜合徵（如中時——無論他們是否意識到這⼀點——
processing speed, whereas positive self-
跌倒）的發⽣率增加
Polypharmacy, which (28, 33)。 among
is widespread perceptions slowed it down (37).
他們的認知能⼒和記憶⼒都會下降，這種
older people, results in a host of negative 現像被稱為刻板印象威脅（⾒第 1 章第
consequences:
超過 increased health care costs,
10% 的老年⼈入院急症可能是由於 These findings complement the large
1.2 節）。這些發現的⼀個含義是，老年
adverse medication
不遵守藥物治療⽅案 (34)，⽽入療養院的 reactions, reduced body of experimental studies on this topic
intrinsic capacity and higher occurrence of ⼈認知功能的臨床或⼯作場所評估結果較
summarized in several meta-analyses
老年⼈中有四分之⼀可能是由於老年⼈無
geriatric syndromes, such as falls (28, 33). 差可能部分是由於暴露於負⾯刻板印像中
(38-40). These have shown that when
法⾃⾏給藥 (35) . (39)。
51
older people are exposed to negative be associated among older people with
stereotypes – regardless of whether they greater fear of crime and an increased risk
are conscious of it – their cognitive ability of experiencing violence and abuse.
and memory decrease, a phenomenon
known as stereotype threat (see Chapter 1, General quality of life
Section 1.2). An implication of these findings
is that poorer results in clinical or workplace ⼀般⽣活質量
All 29 studies included in the 2020 systematic
assessments of cognitive functioning in older review年系統評價中納入的所有
2020 that looked at ageism and 29 quality
項研
adults may be partly due to exposure to of life found that
究都著眼於年齡歧視和⽣活質量，發現年 ageism had a negative
negative stereotypes (39). impact on quality of life (2). For instance, a
齡歧視對⽣活質量有負⾯影響 (2)。例
study that evaluated the impact of attitudes
媒體中的年齡歧視會對健康和認知表現產
Ageism in the media negatively impacts 如，⼀項研究評估了 20 個國家（包括巴
towards ageing and quality of life among
health and cognitive performance. Ageist
⽣負⾯影響。媒體中的年齡歧視刻板印象⻄和⼟耳其這兩個中等收入國家）老年⼈
older people in 20 countries – including two
stereotypes in the media can have a negative
會對老年⼈的⾃尊、健康狀況、⾝體健康 middle-income countries, Brazil and Turkey
對老齡化和⽣活質量的態度的影響，在所
impact on older people’s self-esteem, health – produced consistent findings across all
和認知表現產⽣負⾯影響 (12, 41, 42)。在有國家都得出了⼀致的結果：⽣活質量判
status, physical well-being and cognitive of the countries: quality-of-life judgements
媒體中低估或歪曲老年⼈並非無害，第
performance (12, 41, 42). Underrepresenting2 斷
made年齡在 60 ⾄ 100
by people aged歲之間的⼈製作的
between 60 and
章表明這種情況很普遍。⼀項薈萃分析發
or misrepresenting older people in the media 產品是老年男性和女性對健康相關情況的
100 years were the product of older men’s
is not harmless, and Chapter 2 showed that
現，僅僅短暫接觸媒體中的刻板印像對老 and women’s perceptions of health-related
看法以及對衰老⾃我的⾝體和社會⼼理⽅
it is widespread. A meta-analysis found that circumstances and
⾯的態度的產物 attitudes towards the
(45)。
年⼈在記憶任務中的表現產⽣微⼩的有害
no more than brief exposure to stereotypes physical and psychosocial aspects of the
影響（43）。
in the media had small, harmful effects on ageing self (45).
⼯作場所的年齡歧視與健康問題有關。在
older people’s performance on memory
tasks (43).
評估其健康影響的 27 項研究中，⼤多數 Social isolation and loneliness
研究預測⼯作場所年齡歧視會導致健康狀
Ageism in the workplace is associated Ageism contributes to social isolation and
年齡歧視導致社會孤立和孤獨，這在老年
況惡化 (2)。例如，⼀項針對芬蘭
with health problems. Workplace6ageism000 loneliness, which are widespread among
多名員⼯的研究表明，在⼯作中感知到的⼈中很普遍。社會孤立和年齡歧視對健康
predicted worse health in most of the 27 older people. And social isolation and ageism
studies that evaluated its health(44)。這
年齡歧視導致了隨後的長期病假 impacts 和長壽有嚴重影響。
have serious impacts on health and longevity.
(2). For instance, a study of more than
可能是由於連鎖反應，⼯作壓⼒⾸先增加年齡歧視在三個主要⽅⾯增加了社會孤立
6 000 employees in Finland revealed that Ageism increases
和孤獨。⾸先，年齡歧視會導致不受歡 social isolation and
了健康症狀的風險，然後增加了長期缺勤
perceived age discrimination at work led to loneliness in three main ways. First, ageism
(44)。迎、不受歡迎、被背叛和被社會拒絕的感
subsequent long-term sick leave (44). This can result in feelings of being undesired,
is probably due to a chain reaction in which 覺，這可能導致社交退縮。
unwanted, betrayed and socially 其次，就像在
rejected,
work stress first increases the risk of health ⾃我實現的預⾔中⼀樣，老年⼈可以內化
which can lead to social withdrawal. Second,
symptoms, which later increases long-term as in a self-fulfilling prophecy, older people can
年齡歧視的刻板印象——例如，老年是⼀
sickness absence (44). internalize ageist stereotypes – for instance,
個社會孤立和社會參與度低的時期——然
that old age is a time of social isolation and low
3.1.3 The impact of ageism on 後相應地採取⾏動，退出社會。第三，全
social participation – and then act accordingly,
social well-being 社會年齡歧視的法律、規範和慣例，例如
by withdrawing from society. Third, ageist
強制退休或⽣活環境的設計特徵（例如交
society-wide laws, norms and practices, such
3.1.3
Ageism年齡歧視對社會福祉的影響
can have a far-reaching impact on as mandatory retirement or design features
通不便、⼈⾏道開裂或不平整），可能成
年齡歧視會對老年⼈的總體⽣活質量產⽣
older people’s general quality of life and can of the living environment (e.g. inaccessible
為老年⼈參與社會活動的障礙，導致社會
also affect specific aspects of their social
深遠影響，也會影響他們社會福祉的特定 transport, cracked or uneven sidewalks), can
well-being. For instance, ageism can lead to 孤立和孤獨
act as barriers (46)。to older adults’ participation
⽅⾯。例如，年齡歧視會導致社會孤立和
social isolation and loneliness and restrict in social activities, leading to social isolation
孤獨，並限制老年⼈的性⾏為。
older people’s sexuality. Ageism 年齡歧視may also and loneliness (46).
也可能與對犯罪更加恐懼以及遭受暴⼒和
52 虐待風險增加的老年⼈有關。
C HA PT ER 03
在In 2020
a 2020年的⼀項審查中，在所有
review, ageism was found 13 to be
項a and view sexuality as a major component
risk factor for poor social relationships in all of their quality of life and well-being
研究這種關聯的研究中，年齡歧視被認為
13 studies that examined this association (2). (54, 56, 58-61). Yet the topic of older
是導致不良社會關係的⼀個風險因素
For instance, the negative self-perceptions people’s sexuality often remains taboo.
(2)。例如，中國老年⼈對衰老的負⾯⾃
of ageing held by older Chinese people were 在阿爾及利亞、埃及、印度尼⻄亞、墨⻄哥、摩洛哥、
When it is addressed, it is often from
associated with their dissatisfaction in the
我認知與他們對⼦女提供的社會⽀持的不尼⽇利亞和菲律賓等多個國家進⾏的研究⼀致發現，老
a biomedical perspective that portrays
social support
滿有關 (47)。 provided by their children (47). older people as asexual and assumes
年⼈繼續從事性活動，並將性⾏為視為他們⽣活質量和
decline in sexual function in
幸福感的重要組成部分（ later life. This
54、56、58-61）。然⽽，
Rates of loneliness and social isolation are assumption appears to be the result of
老年⼈的孤獨和社會孤立率很⾼。
high among older people. In Finland 在芬蘭and the 老年⼈性⾏為的話題往往仍然是禁忌。當它被解決時，
too narrow a definition of sexual function
United Kingdom, 40% of older adults living
和英國，⽣活在社區中的老年⼈中有通常是從⽣物醫學的⾓度將老年⼈描繪成無性戀並假設
(e.g. excluding solo, non-penetrative and
in the
40% community reported experiencing
報告說經歷過某種程度的孤獨 (48, 晚年性功能下降。這種假設似乎是由於對性功能的定義
same-sex sexual activity) and too great
some degree of loneliness (48, 49). In China, a過於狹隘（例如排除獨奏、非滲透性和同性性活動）以
focus on biological determinants of
49)。在中國，⽣活在社區的老年⼈中有
24.8% of older adults living in the community sexual function (e.g. declining levels
24.8% 表⽰他們有時感到孤獨，8.3% 經及過於關注性功能的⽣物學決定因素（例如睾酮⽔平下
reported that they sometimes felt lonely, of testosterone) to the exclusion of
常或總是感到孤獨
and 8.3%, often or (50)。
always felt lonely (50). 降）導致的結果。排除⼼理和社會決定因素（例如抑
psychological and social determinants
鬱、伴侶的存在與否以及與伴侶的關係特徵）（62）。
(e.g. depression, presence or absence
Multiple studies and reviews have shown that of partners and characteristics of the
多項研究和評論表明，社會孤立和孤獨對
social isolation and loneliness have serious relationship with a partner) (62).
老年⼈的死亡率、他們的⾝體健康和功能研究表明，老年⼈在晚年⽣活中經常會內化年齡歧視的
impacts on the mortality of older people, on
（例如⼼髒病、糖尿病、⾏動不便、⽇常
their physical health and functioning (e.g. 刻板印象和關於性⾏為的神話。他們不願表達⾃⼰的性
Research shows that older people often
heart disease, diabetes, mobility, activities of
⽣活活動）和他們的⼼理健康（例如抑鬱取向，並且常常不願與醫⽣討論性問題，因為害怕遭到
internalize ageist stereotypes and myths
daily焦慮和認知能⼒下降）（51-55）。
症、 living) and on their mental health (e.g. regarding sexuality in later life. They
反對。已發現老年女性將年齡歧視的美的⽂化規範內
depression, anxiety and cognitive decline) are reluctant
化，並認為⾃⼰沒有吸引⼒ to express their(63,sexuality
64)。
(51-55). and are often hesitant to discuss sexual
issues with their doctors for fear of being
Sexuality 在世界許多地⽅，老年婦女的性⾏為可能會⾯臨年齡歧
met with disapproval. Older women have
視和性別歧視的雙重危害。在撒哈拉以南非洲進⾏的⼀
been found to internalize ageist cultural
Sexuality is another important aspect of
性是年齡歧視可能影響的老年⼈關係的另 norms of beauty and to view themselves
項研究表明，植根於宗教和傳統習俗和信仰的神話、偏
older people’s relationships that ageism as unattractive (63, 64).
⼀個重要⽅⾯。儘管認識到性對於老年⼈⾒和誤解常常導致對性表現出興趣的老年婦女被判斷為
can impact. Despite a recognition that
來說很重要，但媒體對晚年性⽣活的年齡
sexuality is important to older people, ⾏為不當和不尊重：雙重標準並不適⽤男性
In many parts of the world, older women’s (65)。
歧視描述、醫療保健和長期護理提供者以
ageist portrayals of sexuality in later life sexuality may be exposed to the double
in the media, attitudes of health care and
及老年⼈本⾝的態度往往阻礙老年⼈⾃由 jeopardy of ageism and sexism. A study
衛⽣保健提供者的教育和培訓往往無法讓他們做好充分
long-term care providers）。老年⼈有
和充分地表達性⾏為（56 and of older in sub-Saharan Africa showed that myths,
解決老年⼈性健康問題的準備，許多⼈認為該主題超出
people themselves often impede the prejudices and misconceptions, rooted
權獲得性健康，世界衛⽣組織將其定義為
free and full expression of older people’s 了他們的實踐範圍
in (66-68)。在長期護理機構中，⼯作
religious and traditional customs
在性⽅⾯的⾝體、⼼理和社會福祉狀態
sexuality (56). Older people have a right ⼈員對老年⼈性⾏為的了解往往有限，他們不願意與老
and beliefs, often cause older women
to sexual health, defined by WHO as a
(57)。 who show an interest in sex to be
年⼈討論性⾏為。很少提供性表達所需的隱私；往往缺
state of physical, mental and social well- judged as behaving inappropriately and
乏明確的性政策；未來的居⺠很少被告知如何尊重他們
being in the sphere of sexuality (57). disrespectfully: a double standard that
的性和親密需求
does not apply to(56,
men68-70)。
(65).
Studies in multiple countries – including
A l g e r ia, Eg y pt, I n d o n e sia, M exi c o, Health-care providers’ education and
Morocco, Nigeria and the Philippines – training often does not prepare them
have consistently found that older people to adequately address sexual health in
continue to engage in sexual activities older people, and many consider the topic
53
to be outside their scope of practice Violence and abuse

(66 - 68). In long-term care facilities,
staff knowledge about sexuality among Ageism may increase the risk of violence
年齡歧視可能會增加對老年⼈實施暴⼒的
older people is often limited, and they being perpetrated against older people.
風險。根據最近對針對老年⼈的暴⼒⾏為
are uncomfortable discussing sexuality According to a recent global review of
with older people. The privacy required 的普遍性進⾏的全球審查，⼤約
the prevalence of violence against 15.7%
older
for sexual expression is rarely provided; 的老年⼈——或幾乎六分之⼀——是虐待
people, some 15.7% of older people –
clear policies regarding sexuality are or almost 1 in 6 11.6%
的受害者。⼤約 – are 的老年⼈是⼼理虐
victims of abuse.
often lacking; and prospective residents Some 11.6% of
待的受害者，6.8% 是經濟虐待的受害older people are victims
are seldom given information about how of psychological abuse, 6.8% of financial
their sexual and intimacy needs will be 者，4.2%
abuse, 4.2%是忽視，2.6% 是⾝體虐待，
of neglect, 2.6% of physical
respected (56, 68-70). 0.9% 的老年⼈是性虐待的受害者
abuse, (73)。
and 0.9% of older people are victims
儘管年齡歧視可能會增加針對老年⼈的暴
of sexual abuse (73).
⼒風險，但兩者之間聯繫的經驗證據仍然
Although it is possible that ageism
In many parts of the world, 有限 (74, 75)。對老年⼈的負⾯刻板印象
increases the risk of violence against older
older women’s sexuality （例如依賴和負擔）、偏⾒和歧視使他們
people, empirical evidence for the link
may be exposed to the 失去⼈性，並可能導致對老年⼈的暴⼒⾏
between the two remains limited (74, 75).
double jeopardy of ageism Negative
為更容易被允許 stereotypes of older people (e.g.
(75-77)。
and sexism. as dependent and burdensome), prejudices
年齡歧視可能是⾦融服務機構對老年⼈進
and discrimination dehumanize them
⾏經濟虐待的⼀個風險因素，被定義為這
and could contribute to making violence
At the same time, the promotion of active
與此同時，促進積極和成功的老齡化有時些機構針對或威脅老年⼈財務狀況的直接
against older people more permissible
and successful ageing may sometimes (75-77).
或間接做法。⼀個例⼦可能是向老年⼈出
可能會產⽣不切實際的性期望，這可能與
create unrealistic expectations concerning 售不適當的⾦融產品或迫使他們違背⾃⼰
⼀些老年⼈的現實不⼀致，這是⼀種更微
sexuality that may be at odds with the Ageism may act as a risk factor for the
妙的年齡歧視形式，會導致羞恥和⾃尊的
reality of some older people, a more subtle 的意願投資資產
financial abuse of(78)。
older people by financial
form of ageism
喪失（62 that contributes to shame
, 71)。 service institutions, defined as direct or
and loss of self-esteem (62, 71). indirect practices of these institutions that
target or threaten the financial well-being
Fear of crime of older people. An example might be
selling inappropriate financial products to
Ageism may have a role in how police
年齡歧視可能在警察和政策制定者如何將 older people or pressuring them to invest
and policy-makers treat older people as their assets against their will (78).
老年⼈視為特別容易受到犯罪的影響⽅⾯
being particularly vulnerable to crime,
發揮作⽤，在聳⼈聽聞的媒體描繪中（通
in sensationalistic media portrayals of –
常很少⾒）對老年⼈的襲擊以及將他們描
generally rare – attacks on older people 3.2
and in depictions of them as prisoners
繪成害怕離開他們的恐懼的囚犯家。老
of fear who are
年⼈的這種表現可能會被內化，導致老年terrified to leave their The economic
homes. Such representations of older
⼈⾼估他們的脆弱性並加劇他們對犯罪的
people may become internalized, lead impact of ageism
恐懼，從⽽導致老年⼈對犯罪的恐懼程度
to older people overestimating their
很⾼，但受害風險較低的悖論（72）。
vulnerability and fuel their fear of crime, Evidence of the economic impact of ageism
對個⼈和整個社會⽽⾔，年齡歧視的經濟
resulting in the paradox of older people is extremely limited, both for individuals
影響的證據極為有限。然⽽，現有證據表
having a high fear of crime, but a low risk and whole societies. What evidence exists,
of victimization (72). 明，年齡歧視的經濟成本可能很⾼。
however, suggests that the economic costs
of ageism may be high.
54
C HA PT ER 03
Estimates of the economic costs of health

對健康和社會問題的經濟成本的估計很重 or underemployment of older people
and social problems are important. They and dependency on social security, thus
要。他們從財務⾓度定義了社會問題的負
define the burden of the problem for society contributing to poverty among older adults
擔。它們可⽤於證明⼲預計劃的合理性，
in financial terms. They can be used to (83).
並且是評估計劃成本效益所必需的。估算
justify intervention programmes and are
required for assessing programmes’ cost–
可⽤於幫助制定政策和規劃優先事項，並 Laws that mandate retirement age have
規定退休年齡的法律有時被解釋為⼀種制
effectiveness. Estimates can be used to help sometimes been interpreted as being a form
度性的年齡歧視，導致老年⼈的經濟不安
指導研究資⾦的分配 (79-81)。它們對於
set policy and planning priorities and guide of institutional ageism that contributes to
了解健康和社會問題如何減緩社會和經濟
the allocation of research funds (79-81). 全。
older 然⽽，它們對老年⼈財務狀況的影響
people’s financial insecurity. However,
發展也⾄關重要。最後，經濟成本的估計
They are also critical for understanding how 並不直接，並且仍然是⼀個有爭議的問
their impact on older people’s financial
health and social problems slow social and
提⾼了健康和社會問題的可⾒度，從⽽提 status is not straightforward and continues
題，這取決於⼀個國家的國家養老⾦提供
economic development. Finally, estimates of
⾼了政治和資⾦的優先次序。 to be a matter of debate, depending on,
⽔平等因素（84、85）。
economic costs raise the visibility and, thus, among other factors, the level of provision
鑑於全球老年⼈⼝的增長，尤其是在低收
the political and funding priorities of health of state pensions in a country (84, 85).
入和中等收入國家，如《2030
and social problems. 年可持續
發展議程》(82) 所呼籲的那樣，在世界各
Given the growth in the population of older Although the cumulative
地消除⼀切形式的貧困取決於消除老年⼈
people globally, but particularly in low- and financial impact of ageism over
的貧困⼈們。消除老年⼈的貧困⾄少部分
middle-income countries, ending poverty in an employee’s lifetime has not
取決於解決年齡歧視問題。
all its forms everywhere, as called for by the been estimated, there is no
2030 Agenda for Sustainable Development doubt that ageism leaves people
3.2.1 depends on ending poverty among
(82), 老年⼈的年齡歧視、貧困和經濟不 less well off than they would
older people. And ending poverty among have been otherwise.
安全
older people depends, at least partly, on
年齡歧視可能會增加老年⼈貧困和經濟不
tackling ageism.
安全的風險。本報告的前⼀章關於年齡歧 T h e l o s s o f fi n a n cial s e c u r it y a n d
失去經濟保障並隨後陷入貧困可能對老年
3.2.1 Ageism, poverty and
視的範圍表明，年齡歧視發⽣在整個就業 subsequent fall into poverty can have
⼈造成破壞性影響。
devastating impacts 它們可能導致健康狀
financial insecurity among
周期，從招聘和招聘到培訓、晉昇機會和 on an older person.
older people 況迅速下降、死亡率過早以及對存在此類
They can result in a rapid decline in health,
保留，⼀直到退休。儘管尚未估計年齡歧
系統的國家福利系統的依賴
earlier mortality and dependency (86, 87)。然
on state
視對員⼯⼀⽣的累積財務影響，但毫無疑
Ageism may increase the risk of poverty welfare systems, where such systems exist
⽽，關於年齡歧視如何導致貧困的研究仍
問，年齡歧視使⼈們的⽣活不如其他情
and financial insecurity in older age. The (86, 87). Yet studies looking at how ageism
然很少。應該在⾼收入、中等收入和低收
previous chapter of this report, on the
況。 contributes to poverty remain rare. More
scale of ageism, showed that ageism occurs 入國家優先開展這⽅⾯的更多研究。
research in this area should be carried out
來⾃澳⼤利亞的⼀些證據表明，勞動⼒市
throughout the employment cycle, from as a matter of priority in high-, middle- and
場中的年齡歧視與老年⼈的失業或就業不
hiring and recruitment through to training, low-income countries.
⾜以及對社會保障的依賴有關，從⽽導致
advancement opportunities and retention,
and all the way to retirement. Although
老年⼈的貧困（83）。 3.2.2 The economic burden of
the cumulative financial impact of ageism ageism on society
over an employee’s lifetime has not been
estimated, there is no doubt that ageism 年齡歧視給社會造成數⼗億美元的損失，但迄今為⽌，
Ageism costs society billions of dollars, but,
leaves people less well off than they would 幾乎沒有對年齡歧視對更廣泛的社會和經濟，特別是在
to date, few estimates of the economic costs
have been otherwise. of ageism to the wider society and economy,
國家層⾯造成的經濟損失進⾏估計。⼀項關於⼯作場
particularly at the level of countries, have
所年齡歧視的研究發現，在美國⼀家擁有 10 000 ⼈的
There is some evidence from Australia that been carried out. A study on ageism in the
ageist discrimination in the labour market 公司中，⼯⼈因年齡歧視⽽離職導致約
workplace found that in a company of 10 000 5000 天無故缺
is associated with the unemployment 勤，每年損失約
persons 60 States,
in the United 萬美元的⼯資（88
disengagement ）。澳⼤利亞
的估計表明，如果 55 歲或以上的⼈就業率增加 5%，
每年將對國⺠經濟產⽣ 480 億澳元的積極影響 (89)。 5 5
of workers due to age discrimination led to 3.3

some 5000 unexcused days of absence and
about US$ 600 000 in lost salary payments Conclusions and
per year (88). Estimates in Australia suggest
that if 5% more people aged 55 or older future directions
were employed, there would be a positive
As a public health problem, ageism is an
impact of 48 billion Australian dollar on the 作為⼀個公共衛⽣問題，年齡歧視是⼀個
national economy annually (89). important social determinant of health that
重要的健康問題社會決定因素，但長期以
has too long been neglected. But ageism is
來⼀直被忽視。但年齡歧視也是⼀個具有
also a development and human rights issue
A study found that in the 嚴重後果的發展和⼈權問題。
with serious consequences.
United States, annually one in 本章借鑒了來⾃ 50 多個國家的約 500 項
every seven dollars spent on Drawing on some 500 studies from more
研究，表明與年齡歧視相關的陳規定型觀
health care for the eight most- than 50 countries, this chapter has shown
念、偏⾒和歧視對老年⼈的健康和福祉造
expensive conditions was due to that the stereotypes, prejudice and
成嚴重損害，年齡歧視每年給各國造成數
discrimination associated with ageism take
ageism.
⼗億美元的損失，它可能會加劇老年⼈的
a heavy toll on the health and well-being of
older people, that ageism costs countries
貧困。這些發現表明，是年齡歧視——⽽
在美國進⾏的關於年齡歧視對國⺠經濟的
The first study of the economic burden 不是老年⼈——給社會帶來了沉重的負
billions of dollars a year and that it may be
of the health
健康後果的經濟負擔的第⼀項研究於 consequences of ageism contributing to poverty among older people.
on a national economy, conducted in the 擔。 These findings suggest that it is ageism –
2020 年發表 (90)。該研究計算了所有年齡歧視會增加危險的健康⾏為，對⾝⼼
United States, was published in 2020 and not older people – that places a heavy
60 歲或
(90). The60study
歲以上的⼈在calculated8 the
種最昂貴的costs of 健康產⽣負⾯影響，加速認知能⼒下降，
burden on society.
健康狀況下，超過
ageism to the United 1 年對美國造成的年齡
States over 1 year in 減緩殘疾的恢復並縮短壽命。年齡歧視的
relation to the eight most expensive health Ageism increases risky health behaviours,
歧視的成本。這八種健康狀況是：⼼⾎管影響超越⾝體，破壞社會關係並導致老年
conditions for all persons aged 60 years negatively affects physical and mental
疾病、慢性呼吸道疾病、肌⾁骨骼疾病、
or older. The eight health conditions were: ⼈在社會上孤立和孤獨，這可能會增加他
health, accelerates cognitive decline,
損傷、糖尿病、與吸煙有關的疾病、精神
cardiovascular disease, chronic respiratory 們對犯罪的恐懼以及成為暴⼒和虐待⽬標
slows recovery from disability and reduces
障礙和非傳染性疾病。總體⽽⾔，該研究
disease, musculoskeletal disorders, injuries, 的風險。即使減少年齡歧視的⼲預措施只
longevity. The impacts of ageism extend
diabetes mellitus, smoking-related diseases,
發現，在美國，每年七分之⼀（總計 beyond the body, undermining social
630 會產⽣很⼩的影響，但它們可能會⼤⼤改
mental disorders and noncommunicable
億美元）⽤於治療八種最昂貴疾病的醫療善老年⼈的⽣活並為國家節省⼤量資⾦。 relationships and contributing to older
diseases. Overall, the study found that in the people being socially isolated and lonely,
保健費⽤是由於年齡歧視所致。對衰老的未來改善理解和指導⾏動以消除年齡歧視
United States, annually one in every seven and it may increase their fear of crime and
負⾯⾃我認知花費了 337 億美元；負⾯的
dollars – or US$ 63 billion in total – spent 的影響以及加強打擊這⼀現象的優先事項
risk of being a target of violence and abuse.
年齡刻板印象，285
on health care for the億美元；和年齡歧
eight most-expensive 應包括：Even if interventions to reduce ageism were
conditions was due
視，111 億美元。這些發現為實施⼲預措 to ageism. Negative self- to have only small effects, they could lead
perceptions of ageing cost US$ 33.7 billion; to big improvements in older people’s lives
施以減少年齡歧視提供了強有⼒的理由
negative age stereotypes, US$ 28.5 billion; and large savings for countries.
(90)。即使乾預措施僅產⽣適度影響，例
and age discrimination, US$ 11.1 billion. These
如將這些嚴重健康狀況的病例數減少
findings make a strong case for implementing Future priorities to improve understanding
interventions to reduce ageism
5%，但在美國，這將節省 31.5(90).
億美元或Even if and to direct actions on the impact of
an intervention
減少 only has a modest impact by, ageism as well as strengthen the case for
8520 億例這八種健康狀況。
for example, reducing the number of cases combating it should include:
of these serious health conditions by 5%, in
the United States this would amount to a • raising public awareness of the
savings of US$ 3.15 billion or 852 000 million far-reaching detrimental effects of
fewer cases of these eight health conditions. ageism;
56
C HA PT ER 03
• - filling the research gaps, including:

提⾼公眾對年齡歧視的深遠不利影響的認識； age, gender, race, disability,
- 填補研究空⽩，包括： sexual identity), contexts and
(i) demonstrating that the countries;
(i) 證明年齡歧視與本章確定的影響之間的關係確實是因果關係，⽽不僅僅是關聯（⾒
relationships between ageism
框 3.1）； and the impacts identified in this • producing estimates of the economic
(ii) 開展更多關於年齡歧視在低收入和中等收入國家的影響的研究；
chapter are indeed causal and not impacts of ageism and 和 determining
simply associations (see Box 3.1);
(iii) 了解年齡歧視的影響是否以及如何因個⼈特徵（例如年齡、性別、種族、殘疾、 how ageism contributes to poverty
among older people, its wider
性認同）、背景和國家⽽異；
(ii) generating more research on costs to national economies, and
the impacts of ageism in low- and how ageism contributes to slowing
- 估計年齡歧視的經濟影響，確定年齡歧視如何導致老年⼈貧困、其對國⺠經濟的更
middle-income countries; and social and economic development,
⼤成本，以及年齡歧視如何導致社會和經濟發展放緩，特別是在低收入和中等收入國 particularly in low- and middle-
(iii) understanding if and how the income countries.
家。
impacts of ageism vary across
individual characteristics (e.g.
57
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63
ISABEL , 80,
T HE PLURIN AT I O N A L
S TAT E O F B O LI V I A
64
C HA PT E R 01
CHAPTER 04
04
“ O lder p e ople are di s criminate d again s t at 孩⼦、兒

老年⼈在家裡受到歧視，是因為家⼈不理解他們。
home b e c au s e the f amil y don’ t under s tand
媳、鄰居不理解，歧視和虐待就這樣開始了。然⽽，公共機
them . T he children , the daughter- in - law, the
構是年齡歧視最嚴重的肇事者。
neighb our s don’ t under s tand and thi s i s how the
di s crimination and abu s e b e gin s . H owever public
“
in s titution s are
伊莎⾙爾，80 the wor s t p erp etr ator s of age
歲，玻利維亞多⺠族國
di s crimination
©Sebastian .
Ormachea / HelpAge International
I s ab e l , 8 0 , T h e Plurinatio nal S tate o f B o li v ia
©S eba s tian O rmachea / H elpAge International
65
65
Individual characteristics associated with

與對老年⼈實施⼈際年齡歧視相關的個⼈特徵包括
perpetrating interpersonal ageism against older
年齡、性別、教育、對死亡的焦慮或恐懼、某些性
people are age, sex, education, anxiety about or
fear of death, certain personality traits, contact
格特徵、與老年⼈的接觸以及有關衰老的知識。
with older people and knowledge about ageing.
與成為⼈際年齡歧視⽬標相關的個⼈特徵是年齡較
Individual characteristics associated with being
⼤、健康狀況較差和護理依賴。
a target of interpersonal ageism are older age,
⼈際年齡歧視的主要背景決定因素是該國的健康預
poorer health status and care dependence.
期壽命以及在某些專業和職業部⾨⼯作。
The main contextual determinants of
與⾃我導向的年齡歧視相關的個⼈特徵是⼼理和⾝
interpersonal ageism are the healthy life
expectancy of the country and working in certain
體健康狀況較差，並且缺乏與孫輩的積極接觸。
professions and occupational sectors.
04
Chapter Individual characteristics associated with self-
directed ageism are having poorer mental and
physical health and lacking positive contact with
grandchildren.
Findings in this chapter are primarily based on a

本章的研究結果主要基於對老年⼈年齡歧視決定因
Identifying the determinants of ageism
確定年齡歧視的決定因素——風險 comprehensive
素的全⾯系統回顧 systematic review of the determinants
(1)。僅報告那些在風險或保護
– both the risk and protective factors of ageism against older adults (1). Only those
因素和保護因素——是製定減少年因素與年齡歧視之間發現明確關聯的決定因素。
– is a prerequisite for developing determinants for which a clear association was found
齡歧視的有效策略的先決條件。風
effective strategies to reduce ageism. 審查中檢查了許多其他可能的決定因素——例如種
between a risk or protective factor and ageism are
險因素是增加年齡歧視可能性的特
Risk factors are characteristics that 族和⺠族、⼯作或照顧老年⼈、社會經濟地位、就
reported.
increase
徵。 the likelihood of ageism.
保護因素是降低年齡歧視可能業狀況、集體主義或傳統⽂化的⼀部分——要么沒
Protective factors are characteristics Dozens of other possible determinants – such as race
性或提供風險緩衝的特徵。要想奏有發現與年齡歧視有關，要么結果喜憂參半。其中
that decrease the likelihood of and ethnicity, working or caring for older people,
效，減少年齡歧視的策略必須針對
ageism or provide a buffer against ⼀些可能的決定因素以及其他未審查的因素——例
socioeconomic status, employment status, being part
導致年齡歧視的決定因素。
risk. To work, strategies to reduce 如社會福利體系的存在和全⺠健康覆蓋——需要進
of a collectivist or traditional culture – were examined
ageism must target the determinants in the review, and either no association with ageism
⼀步調查。此外，系統評價中包含的研究很少是在
that cause
本章第 ageism.
4.1 節重點討論⼈際年齡歧 was found or the results were mixed. Several of
低收入和中等收入國家進⾏的 (1)。
these possible determinants, as well as others not
視的決定因素。它研究了與作為肇
Section 4.1 of this chapter focuses 本章對迄今為⽌確定的年齡歧視的主要決定因素的
examined – such as the presence of a social welfare
事者和⼈際年齡歧視的⽬標相關的
on the determinants of interpersonal 概述進⾏了補充，並對有⼤量實證⽀持的三種主要
system and universal health coverage – require further
個⼈特徵以及⼈際年齡歧視的背景
ageism. It examines individual investigation. Furthermore, few of the studies included
年齡歧視理論進⾏了簡要調查。年齡歧視理論是詳
characteristics
決定因素。第 4.2associated
節討論了⾃我定 with in the systematic
細說明產⽣年齡歧視的潛在因果機制的解釋。review were conducted in low- and
being a perpetrator and a target middle-income countries (1).
向年齡歧視的決定因素。沒有發現
of interpersonal ageism and the
關於機構年齡歧視的決定因素的證
contextual-level determinants of This chapter supplements the overview of the main
據，這是⼀個顯著的差距。
interpersonal ageism. Section 4.2 determinants of ageism identified to date with a
addresses the determinants of self- brief survey of three of the main theories of ageism
directed ageism. No evidence was for which there is considerable empirical support.
found about the determinants of Theories of ageism are explanations that specify the
institutional ageism, a notable gap. underlying causal mechanisms that produce ageism.
66
C HA PT E R 04
For strategies to reduce ageism to be

為了使減少年齡歧視的策略有效，必須 Among health and social care professionals,
然⽽，在衛⽣和社會保健專業⼈員中，
effective, the causal mechanisms that are however, age and sex/gender have not
針對可修改的因果機制 (2-4)。作為年齡和性別/性別並不總是被發現是年齡
modifiable must be targeted (2-4). The always been found to be determinants
減少年齡歧視的有效策略發展的基礎的
specific programme theories or theories of 歧視的決定因素。
of ageism. A 2013 包括 25 項研究的
systematic review that
具體計劃理論或變⾰理論借鑒了這種更
change that underlie the development of 2013 年系統評價發現，年齡和性別並不
included 25 studies found that age and
effective strategies to reduce ageism draw
廣泛的、有經驗⽀持的年齡歧視理論 gender were not consistent predictors of
是護⼠對老年患者態度的⼀致預測因素
on such broader, empirically supported nurses’ 但在希臘和瑞典的護理專業學⽣
(19)。 attitudes towards older patients (19).
(5-7)。
theories of ageism (5-7). But among nursing students and registered
和註冊護⼠中，發現年輕（<25
nurses in Greece and Sweden, young 歲）和 age
男性是老年患者年齡歧視的重要危險因
(< 25) and being male were found to be
4.1 important
素 (20,21)。 risk factors for ageism towards
older patients (20,21).
受過更多教育年限的醫⽣不太可能對老
Determinants of 年患者有年齡歧視 (22)。還發現在老年
Physicians with more years of education
interpersonal 學課程中接觸有關老齡化的內容也可以
were less likely to be ageist towards older
改善對社會護理中老年⼈的看法和態度
ageism patients (22). Being exposed to content
about ageing
(23)。 in gerontological courses
這為醫療保健專業⼈員的未來教
was also found to improve perceptions
育活動帶來了希望，這些活動旨在增加
This section provides an overview of
本節概述了⼈際年齡歧視的主要決定因 about and attitudes towards older adults
the main determinants of interpersonal 有關老齡化和老齡化的知識。
in social care (23). This holds promise for
素，包括與年齡歧視的肇事者或⽬標相
ageism, including individual characteristics future educational activities for health-care
關的個⼈特徵以及⼈際年齡歧視的背景
associated with being a perpetrator or target professionals that aim to increase knowledge
決定因素（⾒表
of 4.1）。 determinants of
ageism and contextual about ageing and older age.
interpersonal ageism (see Table 4.1).
Anxiety about ageing and fear of
4.1.1 Individual characteristics death
associated with being a
perpetrator of ageism 對衰老有更⾼程度的焦慮或對死亡的恐
Individuals with a higher level of anxiety about
ageing or a fear of death display increased
懼的個體表現出更⾼的年齡歧視態度
ageist儘管這些發現來⾃數量有限的研
(1)。 attitudes (1). Although these findings
Age, sex or gender, and education come from a limited number of studies,
究，但它們⽀持被稱為恐怖管理理論的
they support the well-established theory of
A recent57study in 57 countries found that 成熟的年齡歧視理論（⾒框
ageism known as terror management4.1），該理 theory
最近在個國家/地區進⾏的⼀項研究
being younger, male and having a lower 論認為老年⼈對年輕⼈構成⽣存威脅並
(see Box 4.1), which posits that older adults
發現，年輕、男性和受教育程度較低會
level of education increase the likelihood present an existential threat to 作為⼀
產⽣死亡焦慮，因為他們服務於 younger
增加⼀個⼈成為⾼度年齡歧視者的可能
of a person being highly ageist. The effect people and generate death anxiety because
個⼈的死亡率和脆弱性的不斷提醒
性。
of 教育的影響比年輕或男性更顯著，
education was more marked than those they serve as a constant reminder of one’s
of being younger or male, which increase （24）。
mortality and vulnerability (24).
這只會略微增加老年⼈的年齡歧視風險
the
(8)。risk of ageism against older people
受教育程度較低也會增加個⼈中度
only slightly (8). Having a lower level of Personality traits
年齡歧視的可能性
education (8)。之前的⼩型研究
also increases the probability
在性別 (9-13)、年齡 (14-16)
of an individual being moderately和教育 ageist ⼀些研究還發現，具有隨和、外向、盡
A few studies have also found that individuals
(17, Previous
(8). smaller studies have 然⽽，
18) ⽅⾯顯⽰了類似的結果。 shown with the personality traits of agreeableness,
責和個⼈集體主義等⼈格特徵的個體不
similar results regarding (1)。
這些發現並不總是⼀致的 sex or gender extroversion, conscientiousness and personal
太可能成為年齡歧視者——也就是說，
(9-13), age (14-16) and education (17, 18). collectivism are less likely to be ageist – that
However, these findings have not always 這些特徵是防⽌年齡歧視的保護因素
is, these characteristics act as protective
been consistent (1). （1）。
factors against ageism (1).
67
Table 4.1. Determinants of ageism against older people
TYPE OF DETERMINANT TYPE OF ASSOCIATION
Age Younger More ageism (risk factor)
Sex/gender Male More ageism (risk factor)
Education Lower level More ageism (risk factor)

INDIVIDUAL-LEVEL DETERMINANTS
Anxiety about or fear of

Higher More ageism (risk factor)
death
PERPETRATOR
Agreeableness, extroversion,
Personality traits conscientiousness and a Less ageism (protective factor)
collectivistic orientation
Contact with older age

groups, particularly the
quality of the contact,
Higher quality contact Less ageism (protective factor)
including grandparent–
INTERPERSONAL AGEISM
grandchild contact and

intergenerational f riendships
Knowledge about ageing Greater knowledge about ageing Less ageism (protective factor)
Age Older More ageism (risk factor)

TARGET
Health status and care Poorer health status and greater More ageism (risk factor)
dependence care dependence
Proportion of older adults in

Unclear
country
Healthy life expectancy of

CONTEXTUAL-LEVEL
Lower More ageism (risk factor)

country
DETERMINANTS
Some professions and

Profession and occupational
occupational sectors (e.g. high More ageism (risk factor)
sector
technology)
Positive presentation with more Less ageism (protective factor)

在模擬現實⽣活環境帶有更多信息的正⾯演⽰
information
Presentation of older people
的實驗研究中介紹老
in experimental studies that
simulate real-life settings
年⼈ Comparison with younger people More ageism (risk factor)
Mental and physical health Poorer More ageism (risk factor)

INDIVIDUAL-LEVEL
SELF-DIRECTED
DETERMINANT S
AGEISM
Contact with grandchildren More contact Less ageism (protective factor)
68
C HA PT E R 04
Box 4.1
Three theories of ageism that have empirical support
有經驗⽀持的三種年齡歧視理論
Theories of ageism point to the underlying causal mechanisms that produce ageism.
Specific programme theories or theories of change that underlie the development of
年齡歧視理論指出了產⽣年齡歧視的潛在因果機制。特定的計劃理論或變⾰理論是
effective strategies to reduce ageism draw on these broader, empirically supported
製定減少年齡歧視的有效策略的基礎，這些理論借鑒了這些更廣泛的、有經驗⽀持
theories of ageism.
的年齡歧視理論。
Terror management theory: Terror management theory suggests that ageism
results from our fear of death. It holds that humans’ ubiquitous needs for meaning
恐怖管理理論：恐怖管理理論表明，年齡歧視源於我們對死亡的恐懼。它認為，⼈
and self-esteem arise, in part, as efforts to secure ourselves psychologically from the
類對意義和⾃尊的無處不在的需求出現，部分原因是為了在⼼理上保護⾃⼰免受死
awareness of mortality. Older individuals present an existential threat to younger
people because they remind them that death is inescapable. Our fears of death,
亡意識的影響。老年⼈對年輕⼈構成⽣存威脅，因為他們提醒他們死亡是不可避免
physical decay and loss of dignity and self-worth generate negative reactions
的。我們對死亡、⾝體腐爛以及喪失尊嚴和⾃我價值的恐懼導致了對老年⼈的負⾯
towards, and a desire to distance ourselves from, older people, which manifest as
反應，並希望與老年⼈保持距離，這表現為對老年⼈的刻板印象、偏⾒和歧視。有
stereotypes, prejudice and discrimination against older people. It is proposed that
⼈提出，通過學習更直接地承認和應對與我們的⾝體和凡⼈本性相關的恐懼，我們
by learning to acknowledge and cope more directly with fears associated with our
physical and mortal natures, we can(24,
可以對抗這些恐懼並減少年齡歧視 counter these fears and reduce ageism (24, 32,
32, 33)。
33).
群際威脅理論和群際接觸理論：群際威脅理論認為，個⼈對外群的反應是敵對的，
Intergroup threat theory and intergroup contact theory: Intergroup threat theory
特別是當外群被認為具有潛在危害時，會構成真正的或像徵性的威脅。真正的威脅
holds that individuals react in hostile ways towards out-groups, particularly when out-
是指對⼀個群體的權⼒、資源和福利的威脅，⽽像徵性的威脅是對⼀個群體的世界
groups are perceived as potentially harmful, posing either real or symbolic threats.
Real threats refer to threats (34)。這⼀理論可以幫助解釋為什麼代表與中年⼈
觀、信仰體系和價值觀的威脅 to a group’s power, resources and welfare, whereas
symbolic threats are threats to a group’s world view, belief system and values (34).
直接競爭的年輕⼈可能會在社會上經歷年齡歧視。即使在個⼈沒有識別出來⾃外部
This theory can help explain why younger adults, who represent direct competition
群體的特定威脅的情況下，他們也可能選擇表現出偏⾒，這有助於在他們的群體
to middle-aged adults, may experience ageism in society. Even in cases in which
（內部群體）和其他群體（外部群體）之間建立積極的區別 (35)
individuals do not identify a specific threat from an out-group, they. may choose to
demonstrate biases that can help create a positive distinction between their group
群際接觸理論可以被視為群際威脅理論的另⼀⾯。群體間接觸理論認為，在最佳條
(in-group) and other groups (out-groups) (35).
件下群體之間的接觸減少了群體間威脅及其伴隨的刻板印象、偏⾒和歧視。它這樣
做的因果機制包括減少對群體間接觸的焦慮以及增加觀點採擇和同理⼼。增強對外
Intergroup contact theory can be viewed as the flip side of intergroup threat
群體的了解也發揮了作⽤，儘管作⽤不⼤。假設最佳條件是讓各組享有平等的地位
theory. Intergroup contact theory holds that contact between groups under optimal
conditions reduces intergroup threat and its concomitant stereotypes, prejudice and
和共同的⽬標；營造⿎勵群體間合作的情境；並得到權威、法律或習俗的⽀持 (25,
discrimination. The causal mechanisms
36-38)。群體間接觸理論已經在不同種族和族裔群體、⾝體殘疾和⼼理健康狀況 through which it does this involve reducing
anxiety about intergroup contact and increasing perspective-taking and empathy.
的⼈以及不同年齡組的⼈中進⾏了廣泛的測試
Enhanced knowledge about the out-group also (37,plays
38)。代際接觸策略主要基於群
a role, albeit less strong.
際接觸理論。
Optimal conditions are hypothesized to be having the groups share equal status
and common goals; fostering situations that encourage intergroup cooperation; and
having the support of authorities, law or custom (25, 36-38). The theory of intergroup
contact has been extensively tested with different racial and ethnic groups, people
with physical disabilities and mental health conditions, as well as with people of
different age groups (37, 38). Intergenerational contact strategies are largely based
on intergroup contact theory.
69
Stereotype embodiment theory: This theory proposes that members of

刻板印象體現理論：該理論提出，被污名化群體的成員傾向於從社會中吸收關於⾃
stigmatized groups tend to assimilate stereotypes about themselves from society,
⼰的刻板印象，從⽽導致負⾯的⾃我認知，⽽不是影響他們的健康 (39)。刻板印
leading to negative self-perceptions than can influence their health (39). Stereotype
象理論有四個主要組成部分。⾸先，它有助於解釋⼈們從很⼩的時候就內化在其⽂
embodiment theory has four main components. First, it helps explain the process
化中顯著的年齡刻板印象的過程。其次，它認為刻板印象可以無意識地運作。第
by which people internalize, from an early age, the age stereotypes that are salient
in their culture. Second, it holds that stereotypes can operate unconsciously.
三，隨著⼈們達到與特定年齡相關的某些⾥程碑，例如退休，刻板印像變得突出。
Third, stereotypes gain salience as people reach certain milestones associated
第四，刻板印象通過三個主要途徑體現：⽣理、⾏為和⼼理。⽣理途徑與考慮到衰
with a particular age, such as retirement. Fourth, stereotypes are embodied
老的負⾯看法適⽤於⾃⼰⽽引起的⽣理壓⼒有關。例如，在潛意識中暴露於負⾯年
through three main pathways: physiological, behavioural and psychological. The
齡刻板印象的老年⼈表現出對壓⼒的⼼⾎管反應增強（40）。⾏為途徑通過⾏為
physiological pathway is related to the physiological stress caused by considering
that the negative perceptions of ageing are applicable to oneself. For instance,
的改變起作⽤，例如⼈們對變老持消極態度⽽不參加體檢，因為他們認為在老年時
older individuals subliminally exposed to negative age stereotypes
⽣病是正常的。⼼理途徑涉及產⽣作為⾃我實現預⾔的期望(39, demonstrated
41)。這些途徑中
a heightened cardiovascular response to stress (40). The behavioural pathway acts
的每⼀個都為乾預提供了潛在的⽬標。例如，⼼理和⾏為途徑可以通過教育⼲預來
through changes in behaviours, such as people who view growing old negatively not
改變，從⽽改變老年⼈被認為是正常的⾏為。儘管這⼀理論主要⽤於解釋老年⾃我
attending medical examinations because they consider illness to be normal in older
age. The psychological pathway involves the generation of expectations that act as
導向的年齡歧視，但由於⼈們從童年開始就暴露於不同年齡組的刻板印像中，因此
self-fulfilling prophecies(39, 41). Each of these pathways offers potential targets for
同樣的機制很可能在其他年齡段的⾃我導向年齡歧視中起作⽤。
interventions. For instance, the psychological and behavioural pathways could be
changed by educational interventions that alter what is considered normal in older
age. Although this theory has been mainly used to explain self-directed ageism in
older age, it is likely that the same mechanism operates in self-directed ageism at
other ages since people are exposed to stereotypes about different age groups
from childhood onwards.
Contact with older age groups and older people (28). The rarity of such
這種代際友誼的罕⾒性可能部分解釋了第
intergenerational friendships may partly
有相當多的證據表明，與年齡較⼤的⼈接
There is considerable evidence that having
2 章 (28, 29) 中記錄的普遍存在的年齡歧
explain the widespread ageism documented
contact with people in older age groups,
觸，特別是質量較⾼的接觸，可以降低年視。例如，在 25 個歐盟國家中，⼤約
in Chapter 2 (28, 29). For instance, in 25
particularly higher quality contact, reduces
齡歧視的可能性——也就是說，質量較好 18% 的 18-30
European Union歲年輕⼈報告說有
countries some 70 18%歲of
the likelihood of ageism – that is, better young people aged
或 70 歲以上的朋友。在這項研究中，年 18–30 years reported
的接觸可以作為防⽌年齡歧視的保護因
quality contact acts as a protective factor having friends who were aged 70 years or
素。輕女性比年輕男性更不可能擁有跨年齡友
against ageism. older. In this study, younger women were
誼（28）。
less likely than younger men to have cross-
A systematic review has shown that better
⼀項系統評價表明，與老年⼈、特別是與 age friendships (28).
quality contact, both with older people in
祖⽗⺟和其他親屬的更好質量的接觸可以
general and with grandparents and other This is pertinent when considering possible
這在考慮可能的⼲預措施以減少年齡歧視
減少年齡歧視 (1)。這證實了之前審查的結
relatives in particular, reduced ageism (1). interventions to reduce ageism because
時是相關的，因為可以組織活動將不同的
果This
(25, 26)。研究代際友誼與年齡歧視之
confirms findings from previous reviews activities can be organized to bring different
(25, 26). Studies examining the link25
between 世代聚集在⼀起。
generations together.這⼀風險因素對年齡歧
The influence of this
間的聯繫的研究很少（27）。在個歐
intergenerational friendships and ageism 視的影響可以通過群體間接觸理論（⾒框
risk factor on ageism can be explained
盟國家進⾏的⼀項研究發現，那些報告跨
are rare (27). A study in 25 European Union through intergroup contact theory (see Box
4.1）來解釋，該理論認為更多地接觸老年
年齡友誼的⼈往往不那麼年齡歧視，這適
countries found that those who reported 4.1), which posits that greater exposure to
⼈或年輕⼈有助於減少對他們的偏⾒ (30,
⽤於年輕⼈和老年⼈
cross-age friendships (28)。
tended to be less older or younger people can help decrease
31)。
ageist and that this applied to both younger prejudice towards them (30, 31).
70
C HA PT E R 04
Knowledge about ageing older adults are perceived might depend on

the health status associated with their age
Evidence suggests that having knowledge
有證據表明，了解有關衰老的知識可以防 rather than on age itself (67).
about ageing protects against ageism.
⽌年齡歧視。換句話說，⼀個⼈對衰老的
In other words, the greater a person’s 4.1.3 Contextual determinants
了解越多，他們就越不傾向於年齡歧視。
knowledge about ageing, the less ageist of interpersonal ageism
在為本報告進⾏的審查中所包括的研究
they tend to be.
中，有 18 項研究發現了解衰老與年齡歧 Proportion of older people in a
Of the studies included in a review conducted country
視較少有關 (42-59)，⽽ 5 項研究發現兩
for this report that examined the relationship
者之間沒有關聯
between knowledge 兩者之間或它是混合或不
about ageing and 最近在
A recent57rigorous
個國家進⾏的⼀項嚴格的研究
study conducted in 57
⼀致的（60-64）。
ageism, 18 found that having knowledge countries
有超過 80that
000had a sample of more than
名參與者的樣本，發現⼀
about ageing was associated with less
除了⼀項研究外，所有研究都使⽤了相同 80 000 participants
個國家的老年⼈比例越⾼，該國的年齡歧 found that the higher
ageism (42-59), and five studies found that
的衰老知識衡量標準，即衰老事實測驗， the proportion of older people in a country,
視就越少——也就是說，老年⼈的比例很
there was either no association between the less ageism there was in the country
其作為衡量衰老知識的有效性受到質疑
the two or that it was mixed or inconsistent ⾼作為防⽌年齡歧視的保護因素
– that is, having a high proportion(8)。
of older
(65)。另⼀個限制是，這些研究通常沒有
(60-64). 之前的研究得出了相反的結論：⼀個國家
people acts as a protective factor against
具體說明這種知識可以防⽌年齡歧視（即 ageism (8).
的老年⼈比例越⾼，對他們的年齡歧視就
All but one of these studies used the same
刻板印象、偏⾒或歧視）的哪個維度。越⼤ (12, 68)。對於這些不⼀致的發現，
measure of knowledge of ageing, the Facts Previous studies had come to the opposite
on Ageing Quiz, whose validity as a measure ⼀個可能的解釋是，重要的可能是老年⼈
conclusion: that the higher the proportion
of knowledge of ageing has been questioned 比例的變化率，⽽不是比例本⾝。⼈⼝年
of older people in a country, the greater
(65). Another limitation is that these studies the ageism against them (12, 68). A possible
齡結構變化較快的國家可能更容易出現年
do not generally specify which dimension explanation
齡歧視 (69)。for these inconsistent findings
or dimensions of ageism (i.e. stereotypes, is that it may be the rate of change in the
prejudice or discrimination) this knowledge proportion of older people that matters and
protects against. not the proportion itself. Countries whose
population age structures are changing
4.1.2 Individual characteristics faster might be more prone to ageism (69).
associated with being a
target of ageism Healthy life expectancy
Age ⼀個國家的健康預期壽命越低——即新⽣
The lower the healthy life expectancy in a
country – that is, the average number of
兒可以預期完全健康的平均年數——個⼈
As people age their likelihood of being a
隨著⼈們年齡的增長，他們成為年齡歧視 years that a newborn can expect to live
持有⾼度或中等年齡歧視態度的可能性就
target of ageism increases: the older the
⽬標的可能性會增加：⼈越老，他們就越 in full health – the higher the likelihood of
person, the more likely they will be a target 越⾼ (8)。 holding highly or moderately
individuals
有可能成為年齡歧視的⽬標
of ageism (1). (1)。健康⽣活預期較低的國家更有可能出現健
ageist attitudes (8).
康狀況不佳的老年⼈，⽽⼈們越來越多地
Health status and care dependence Countries with a lower expectancy for
接觸老年健康狀況不佳的⼈可能會強化對
隨著⼈們年齡的增長，他們成為年齡歧視 healthy life are more likely to have older
Being in poor health or care dependent has 變老的消極態度。
adults in poor health,反過來，隨著年齡的增
and increasing people’s
⽬標的⼀項研究發現，健康狀況不佳或依長，年齡歧視的態度可能會內化，並可能
been found in one study to be a risk factor exposure to those who have poor health
賴護理是對老年⼈產⽣負⾯看法的⼀個風
for negative perceptions of older people 以⾃我導向的年齡歧視的形式應⽤於⾃
in older age is likely to reinforce negative
險因素 (66)。 study
(66). Another 另⼀項研究發現，可能存
found a possible bias attitudes towards getting older. 3In章所
⼰，這會降低健康和功能，如第 turn,
against older adults who are ill or more care
在對⽣病或更依賴護理的老年⼈的偏⾒ ageist attitudes are likely to be internalized
述。這突出了需要投資於促進健康老齡化
dependent
（67）。 (67). This suggests that how
這表明如何看待老年⼈可能取決 as one grows older, and are likely to be
做法並使個⼈活得更久、更健康的政策
於與其年齡相關的健康狀況，⽽不是年齡 (70)。
71
本⾝（67）。會增加：⼈越老，他們就越
有可能成為年齡歧視的⽬標 (1)。
applied to oneself in the form of self- be a risk factor. Several studies found that
directed ageism, which can decrease health older workers are given more negative
and functioning, as explained in Chapter 3. evaluations when the same evaluator is also
This highlights the need to invest in policies rating younger workers (73-75).
that promote healthy ageing practices and
allow individuals to live longer and healthier This direct comparison might influence
這種直接比較可能會造成年齡變得特別突
lives (70). ratings of the targets of ageism by creating
出的情況，從⽽影響對年齡歧視⽬標的評
a situation in which age becomes especially
While having a lower proportion of older
雖然⼀個國家的老年⼈比例較低可能是⼈級，即使所有其他特徵都相同。這⼀決定
salient, even when all other characteristics
people in a country may be a risk factor
際年齡歧視的⼀個風險因素，⽽對健康⽣因素對旨在減少年齡歧視的戰略具有潛在
are equal. This determinant has potential
for interpersonal ageism, and a lower implications for strategies aiming to
影響，特別是對於教育⼲預和運動。
活的較低預期同樣也是⼈際年齡歧視的⼀
expectancy for healthy life is likewise a reduce ageism, in particular for educational
個風險因素，但最近在 57 個國家進⾏的使⽤最佳演⽰⽂稿 – 例如正⾯和⾜夠的
risk factor for interpersonal ageism, a interventions and campaigns.
recent study in 57 countries found that因
⼀項研究發現，總的來說，這兩種風險 in 個性化信息，並避免與年輕⼈進⾏比較
the aggregate these
素也增加了⼀個國家⾼度或中度年齡歧視 two risk factors also ——當呈現給老年⼈時，可能有助於減少
Using an optimal presentation – e.g. positive
increase the likelihood of a country being and with enough individuating information,
年齡歧視。
的可能性(8)。
highly or moderately ageist (8). and avoiding comparison with younger
people – when presenting an older person
Profession and occupational sector could potentially help reduce ageism.
Ageism is reported to be widespread

據報導，年齡歧視在某些類型的專業和職
in cer tain types of professions and
業領域普遍存在，例如計算機編程、在線
4.2
occupational sectors, such as computer
營銷和酒店，以及新技術和初創企業等部
programming, online marketing and Determinants of
hospitality,
⾨ and in sectors such as 來描
(71)，使⽤了“矽⾕年齡歧視”⼀詞 new
technologies and start-ups (71), with the
述這種現象（72）。
self-directed
term “Silicon Valley ageism” being used to
describe this phenomenon (72).
ageism
Presentation of older people in This section provides an overview of the
本節概述了⾃我導向年齡歧視的主要決定
experimental studies main determinants of self-directed ageism,
因素，包括⾝⼼健康、與孫輩的接觸以及
including mental and physical health, contact
在模擬現實⽣活環境的實驗研究中（例如
In experimental studies that simulate real- 有關衰老的知識（⾒表
with grandchildren and 4.1）。
knowledge about
life contexts (e.g. through the use of videos,
通過使⽤視頻、⼩插曲、簡歷評估），⼈ ageing (see Table 4.1).
vignettes, evaluation of curriculum vitae),
們是如何被呈現的（即是否消極或籠統地
how people are presented (i.e. whether 4.2.1 Mental and physical
描述為老年⼈，或者是否⽤更積極、更詳
negatively or generically described as an health
細的描述來描述他們）
older person or whether和特定信息）影響
they are described
with more positive, detailed and specific
他們成為年齡歧視⽬標的可能性。 The few studies that have explored the
為數不多的探討影響老年⼈⾃我導向年齡
information) influences their likelihood of
積極的表現會減少年齡歧視，消極的表現 factors that influence self-directed ageism in
歧視的因素的研究發現，⼼理和⾝體健康
being the target of ageist attitudes. older people have found that individuals with
會增加年齡歧視 (1)。在模擬就業環境的狀況不佳的⼈更有可能對⾃⼰表現出年齡
poor mental and physical health are more
研究中，將個⼈與年輕⼈還是老年⼈進⾏
A positive presentation decreases ageism, 歧視
likely(1)。這再次凸顯了投資於與老齡化
to exhibit ageism towards themselves
比較也可能是⼀個風險因素。
and a negative presentation 幾項研究發 increases it (1). This highlights
相關的政策和乾預措施的必要性，這些政 again the need to invest
(1). In studies that
現，當同⼀評估者也對年輕⼯⼈ (73-75) simulate employment in ageing-related
策和乾預措施使個⼈能夠過上更長壽、更 policies and interventions
contexts, whether individuals are compared that allow individuals to live both longer and
進⾏評級時，老年⼯⼈會得到更多的負⾯健康的⽣活。
with a younger or an older person can also healthier lives.
評價。
72
C HA PT E R 04
4.2.2 Contact with determinants of ageism (i.e. the proportion

grandchildren of older adults in a country, the expectancy
for healthy life in a country and being
Older people who have positive contact
與孫輩有積極接觸的老年⼈不太可能受到 in certain professions and occupational
with their grandchildren are less likely to be sectors).
刻板印象威脅的負⾯影響，這是⼀種⾃我
negatively affected by stereotype threat, a
導向的年齡歧視 (76)。
form of self-directed 刻板印象威脅是指
ageism (76). Stereotype Limited evidence is available about the
關於⾃我導向年齡歧視的決定因素（即⾝
老年⼈擔⼼他們可能會證實對老年⼈的負
threat refers to an older person’s fear that determinants of self-directed ageism (i.e.
⼼健康以及與孫輩的接觸）的證據有限。
they might confirm negative stereotypes
⾯刻板印象，因此在與刻板印象相關的任 mental and physical health and contact
about older people and, thus, perform more 減少年齡歧視的策略不太可能奏效，除非
with grandchildren). Strategies to reduce
務（例如數學或其他認知能⼒測試）上表
poorly on a task related to the stereotype, 它們針對那些 (i) 已被證明是年齡歧視的
ageism are unlikely to work unless they
現更差。
such as a test of mathematical or other target those determinants that (i) have
主要原因和 (ii) 可以改變的決定因素（⾒
cognitive ability. been shown
框 4.2）。 to be the main causes of
ageism and (ii) are modifiable (see Box 4.2).
4.2.3 Knowledge about
ageing Future priorities for understanding the
determinants of ageism are outlined below.
•One study in Australia and the United
在澳⼤利亞和英國進⾏的⼀項調查⾃我
Kingdom that examined self-directed ageism
導向年齡歧視的研究似乎表明，對衰老有 • Current research gaps in relation to
⽬前與⼈際年齡歧視的決定因素有
seemed to indicate that participants who those determinants of interpersonal
更多了解的參與者可能對⾃⼰的衰老感覺關的研究空⽩，⽬前缺乏證據或尚
have greater knowledge about ageing may ageism, for which evidence is
更積極，但結果並不具有決定性 (50)。
feel more positively about their own ageing, 無定論，應予以解決。
currently 這些包括社
lacking or inconclusive,
鑑於⾃我導向的年齡歧視似乎很普遍並對
but the results were not conclusive (50). 會經濟地位和社會福利制度的存
should be addressed. These include
健康和福祉產⽣深遠的影響（⾒第 3 socioeconomic
在。還應調查幾乎沒有證據的⾃我 status and the
Given that self-directed ageism appears to presence of
導向和製度性年齡歧視的決定因 a social welfare system.
章），將我們對⾃我導向的年齡歧視的其
be widespread and has profound effects on The determinants of self-directed
他決定因素的知識擴展到迄今為⽌確定的
health and well-being (see Chapter 3), it will 素。institutional
and 必須在各個國家（包括低收入ageism, for which
兩個之外。
be important to extend our knowledge of 和中等收入國家）開展關於所有形
little evidence is available, should
other determinants of self-directed ageism also be investigated. It is essential
式年齡歧視的決定因素的研究，以
beyond the two identified so far. that studies on the determinants of
評估它們是否因⽂化和背景⽽異。
all forms of ageism are conducted
同樣重要的是，開展研究以評估年
across countries, including low-
4.3 齡歧視的不同決定因素的相對重要
and middle-income countries,
性和因果狀況（⾒框
to assess whether they 4.2）。
vary
Conclusions and across cultures and contexts. It is
equally important that studies are
future directions conducted to assess the relative
importance and causal status of
Considerable evidence is available about
關於⼈際年齡歧視的決定因素，有⼤量證 different determinants of ageism
the determinants of interpersonal ageism,
據可供使⽤，包括年齡歧視的⼈（即年 (see Box 4.2).
both for those who perpetrate ageism (i.e.
齡、性別、教育⽔平、對死亡的焦慮或恐
age, sex, level of education, anxiety about Our improved understanding of
• 我們對年齡歧視決定因素的更好理
懼、個性、過去與老年⼈的接觸）和那些
or fear of death, personality, past contact the determinants of ageism should
解應該⽤於為⽀持制定減少年齡歧
成為年齡歧視的⽬標的⼈
with older people) and for （即年齡、健康
those who are be used to inform the theories of
targets of it (i.e. age, health status and 視策略的變⾰理論和計劃理論提供
change and programme theories
狀況和對他⼈的依賴）。有⼀些關於年齡
dependence on others for care). Some 信息。
that underpin the development of
歧視的背景決定因素的證據（即⼀個國家
evidence is available about the contextual strategies to reduce ageism.
的老年⼈比例、⼀個國家對健康⽣活的預
期以及在某些專業和職業部⾨）。
73
Box 4.2 Opportunities for research on the determinants of ageism against older people
對老年⼈年齡歧視的決定因素進⾏研究的機會
The systematic review on the determinants of ageism towards older people (1), on
本章⼤部分內容所依據的對老年⼈年齡歧視決定因素的系統評價 (1) 代表了在尋求
which much of this chapter is based, represents a significant step forward in research
確定年齡歧視決定因素的研究⼯作中向前邁出的重要⼀步。本綜述遵循
efforts seeking to identify the determinants of ageism. This review, which PRISMA
followed
the PRISMA
指南 (77)，基於對 guidelines (77), was based on searches200
14 個數據庫的搜索；收錄了⼤約 in 14 databases; included
篇英⽂、法⽂和⻄班牙⽂
some 200 papers in English, French, and Spanish
的論⽂，根據多層次框架確定了年齡歧視的 that identified 14 determinants
14 個決定因素；並仔細評估了納入研
of ageism categorized according to a multilevel framework; and carefully assessed
究的質量。
the quality of the studies included.
然⽽，這項系統評價揭⽰了基礎研究的⼀些局限性。⼀半的研究被評估為中等質
量。另⼀個限制是，由於研究中評估的風險因素的異質性，不可能使⽤薈萃分析技
However, this systematic review revealed several limitations in the underlying
studies. Half of the studies were assessed as being of medium quality. Another
術來提供有關每個風險因素與年齡歧視之間關聯強度的信息，因此，它們的相對重
limitation was that due to the heterogeneity of risk factors evaluated in the studies,
要性。
it was not possible to use meta-analytic techniques that would have provided
未來的研究應考慮使⽤更標準化的風險因素定義和衡量標準，以提⾼可比性，並允
information about the strength of the association between each risk factor and
許對結果進⾏薈萃分析
ageism and, thus, an idea (1)。未來研究應解決的另⼀個限制是，⼤多數研究本質上
of their relative importance.
是相關的，因此無法評估決定因素的因果狀態。針對與年齡歧視沒有因果關係的風
Future research should consider using more standardized definitions and measures
險因素設計⼲預措施會增加⼲預措施不起作⽤的可能性 (78, 79)。
of risk factors to increase comparability and allow findings to be subject to meta-
analysis (1). A further limitation, which future studies should address, was that most
studies were correlational in nature, and so the causal status of the determinants
could not be assessed. Designing interventions to target risk factors that are not
causally related to ageism increases the likelihood that the interventions will not
work (78, 79).
74
C HA PT E R 04
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79
MRIDUL , 29,
IND I A
80
C HA PT E R 01
CHAPTER 05
05
“ A s a youth , I ju s t b e come another numb er of the

‘demo gr aphic di v idend ’ or an i s sue to b e re s ol ve d ,
completel y di sre garding my p olitic al and s o cial
engagement . A s a youth , if I w ant to do s omething
for s o ciet y, ‘ volunte ering and learning’ i s sugge s te d
by p e ople alread y earning ver y well , even if I have
b e en doing that for more than a de c ade. With each
dollar gi ven to me, ex tr a s tandard s of accountabilit y
and tr an sparenc y are al s o conveye d formall y/
“
informall y a s if b eing young mean s incomp etent ,
c arele s s and /or corrupt .
M ridul , 2 9 , I n d ia
©Mridul Upadhy ay / UN Major Group
for Children and Youth
81
81
Little is known about ageism against younger

people (those aged < 50 years), with most of
the evidence focusing on
⼈們對針對年輕⼈（<50 its prevalence and
歲的⼈）的年齡歧視知
manifestations.
之甚少，⼤多數證據都集中在其流⾏和表現上。
Ageism against younger populations occurs in
針對年輕⼈的年齡歧視發⽣在⼯作場所、法律和政
institutions such as the workplace and the legal
治體係等機構中，在歐洲，這種情況似乎比針對老
and political systems, and in Europe it appears
to be more prevalent than ageism against older
年⼈的年齡歧視更為普遍。
people.
年齡歧視對年輕⼈的影響仍然知之甚少。
The impact of ageism against younger people is
針對年輕⼈的年齡歧視的主要決定因素包括某些性
still poorly understood.
格特徵、是否與其他年齡組有接觸、健康狀況和護
05
Chapter The main determinants of ageism against
理依賴，以及在某些職業或部⾨⼯作。
younger populations include certain personality
traits, whether there is contact with other age
groups, health status and care dependence, and
working in certain professions or sectors.
5.1
The scale of ageism
against younger people
Ageism against younger populations manifests across a
range of institutions including the workplace, the legal
system and politics. There is also growing evidence of
interpersonal ageism directed against younger adults
from population-based studies, which suggest that in
Europe it may be more prevalent than interpersonal
ageism against older people. No evidence is available
on the magnitude of self-directed ageism in younger
populations.
5.1.1 Institutional ageism
This chapter surveys what

本章調查了對年輕⼈（即 is
50 歲以下的 Ageism in the workplace
known about ageism
⼈）的年齡歧視的已知情況。第 5.1 節涵 against
younger people, that is, those 儘管沒有系統評估年齡歧視如何影響⼯作場所中的年輕⼈，但最
Although no reviews have systematically assessed how
蓋了針對年輕⼈的年齡歧視程度的證據；近的⼀項範圍界定審查發現，越來越多的證據表明，對這⼀群體
aged < 50 years. Section 5.1 ageism affects younger populations in the workplace,
第covers
5.2 節，其影響；和第
evidence on the 5.3 of
scale 節，針對的年齡歧視在他們就業後表現得最為明顯，尤其是在薪酬和福利
a recent scoping review found increasing evidence
年輕⼈的年齡歧視的決定因素。
ageism against younger people; that
⽅⾯ (1)。 ageism towards this group manifests itself
這更適⽤於年輕女性⽽不是年輕男性，這是⼀種年齡
Section 5.2, its impact; and most markedly once they are employed, especially
歧視與性別歧視交織在⼀起的案例。年輕員⼯還報告說感覺不
Section 5.3, the determinants of in terms of pay and benefits (1). This applies more to
ageism against younger people. 被重視，受到負⾯的年齡刻板印象和貶低評論，並且由於他們看
younger women than younger men, a case of ageism
起來年輕⽽被普遍認為無能 (1)。 2015 年歐洲⼯作條件調查的
82 數據包括來⾃ 35 個國家的近 44 000 名⼯⼈，發現在就業⼈員
中，年齡歧視在 20 歲和 59 歲達到頂峰（⾒圖 5.1）（2）。
C HA PT ER 05
intersecting with sexism. Younger workers Ageism in the legal system

also report not feeling valued, being subject
to negative age stereotypes and belittling ⼀項針對年輕⼈的年齡歧視的範圍審查發
A scoping review of ageism directed towards
comments and being generally perceived as younger populations found that crimes
現，與年長的罪犯相比，年輕罪犯犯下的
incompetent because they look young (1). committed by younger offenders elicited
罪⾏會引起更⼤的憤怒，被認為是更嚴重
Data from the European Working Conditions greater anger, were perceived to be more
Survey 2015, which included nearly 44 000 的違法⾏為，並被認為應該受到更嚴厲的
serious transgressions and considered to
workers in 35 countries, found that among 懲罰。
deserve當考慮犯罪受害者的年齡時，調查
more severe punishment than those
those employed, age discrimination peaked committed by older offenders. Findings are
結果喜憂參半，⼀些研究表明，當受害者
mixed when the age of the victim of crime
at the ages of 20 years and again at 59 years
是老年⼈時，更認真地評估違法⾏為並收
(see Fig. 5.1) (2). is considered, with some studies showing
到更嚴厲懲罰的建議，⽽其他研究則表明
that transgressions were evaluated more
Ageism may also force younger workers 年齡沒有影響
seriously and (1)。美國的⼀項研究發
received recommendations
年齡歧視也可能迫使年輕⼯⼈失業。
for more severe punishment when the victim
out of employment. A study conducted 現，當僱員年輕⽽不是年長時，雇主最有
2002 年⾄ 2005 年在澳⼤利亞進⾏的⼀
was an older adult (4)。
in Australia between 2002 and 2005 that 可能贏得法庭訴訟 and others showing no
項研究調查了導致 1259 名 15
looked at the circumstances ⾄ 24to歲員
leading the effect of age (1). A study in the United States
⼯被解僱的情況，報告稱⼤約 8%15
dismissal of 1259 employees aged 的案件
to 24 found that employers were most likely to
years, reported that about
是由於年齡歧視造成的 8% of cases were win a court case when the employee was
(3)。
due to age-based discrimination (3). younger rather than older (4).
需要更多的研究來檢查招聘期間發⽣的針
More research is needed to examine ageism Ageism and politics
對年輕⼈的年齡歧視，以確定這是由於候
against younger people occurring during
hiring to determine if it is due to the age
選⼈的年齡還是其他因素，如資格和⼯作 An increasing number of studies have also
越來越多的研究也探討了年齡歧視在政治
of the candidate or other factors, such
經驗、職位與申請⼈、⼯作級別或⼯作環 explored how ageism manifests itself in
as qualifications and work experience, fit 中的表現，發現存在懷疑、否認或駁回青
politics, finding that there is a tendency to
境的契合度（例如動態與穩定）（1）。
between the position and the applicant, 年和兒童聲⾳的傾向；
doubt, deny or dismiss the 規範他們的⾝份；
voices of youth
job level or workplace context (e.g. dynamic 並且通常限制他們在政治和倡導運動中的
and children; regulate their identities; and
versus stable) (1). generally
努⼒ limit their efforts in political and
(1)，例如，通過拒絕他們在政治討論
advocacy movements (1), for example, by
中的投入或提出有關青年組織者觀點真實
dismissing their input in political discussions
Fig. 5.1. Percentage of employees 性的問題。
or raising questions about the authenticity
experiencing age discrimination during 政治上對年輕⼈的年齡歧視與性別歧視和
of youth organizers’ perspectives.
the past 12 months by age, Europe, 2015
種族主義相互作⽤。⼀項研究調查了參與
Ageism towards younger people in politics
青年項⽬的年輕女性勞⼯活動家的經歷，
interacts with sexism and racism. One
發現女性的年齡與她們的性別和種族⾝份
study looked at the experiences of young
交叉，造成系統性的劣勢和不利的經歷
women labour activists participating in youth
programmes and found that the age of the
(5)。
women intersected with their gender and racial
另⼀項研究發現，埃及的年輕女性活動家
identity to create systemic disadvantage and
在擔任政治⾓⾊或參與正式機構時，往往
unfavourable experiences (5).
因年齡和性別⽽受到限制 (6)。
Another study found that young women
activists in Egypt often faced limitations due
to their age and gender in filling political
Source: reproduced with permission from Mullan roles or engaging with formal institutions (6).
et al. (2).
83
Studies simulating mayoral elections found

模擬市長選舉的研究發現，與性別或種族 being seen as friendly, competent and
that the age of the political candidate had
相比，政治候選⼈的年齡對投票⾏為的影 viewed with respect, and having high moral
more influence on voting behaviour than sex or standards.
響更⼤，中年候選⼈比年輕候選⼈更受青
gender or race, with middle-aged candidates
睞 (7, 8)。over younger candidates (7, 8).
preferred Reported experiences of interpersonal
根據根據年齡對⼈們的地位和權⼒⽔平進 ageism
Middle-aged adults, especially men, have the
⾏調查的研究，中年⼈，尤其是男性，擁
greatest status, wealth and power, according In the European Social Survey (2008–2009),
有最⼤的地位、財富和權⼒。年輕⼈被認在歐洲社會調查（2008-2009 年）中，
to studies that examined the level of status those aged 15–24 years reported experiencing
為擁有最低的地位、財富和權⼒
and power accorded to people (1)。 based on 15-24
the most歲的⼈報告說他們因為年齡⽽受到
unfair treatment because of their
their age. Younger adults were perceived to 最不公平的對待：55%
age: 55% of them thought的⼈認為有⼈對他
that someone had
have the lowest status, wealth and power (1). shown them a
們缺乏尊重或對待他們很差（⾒圖lack of respect or treated them
2）。
badly (see Fig. 5.3).
5.3)。此外，與其他所有年齡組⼀樣， Also, like every other
Other institutions age group, those aged 15–24 years reported
15-24 歲的⼈報告稱，他們遭受的基於年
experiencing more discrimination based on
Little research has investigated if and how
很少有研究調查針對年輕⼈的年齡歧視是齡的歧視比基於性別、種族或⺠族背景的
age than discrimination based on gender,
ageism against younger people manifests in race or ethnic background
歧視要多（⾒圖 2.4）（10）。(see Fig. 2.4) (10).
否以及如何在其他機構中表現出來，例如
other institutions, such as health care, the 因此，針對年輕⼈的製度和⼈際年齡歧視
醫療保健、媒體和⾦融機構。關於住房歧
media and financial institutions. Regarding Thus, the evidence of institutional and
視，加拿⼤ 2002 年的⼀份報告發現，年的證據僅限於世衛組織歐洲區域。缺乏關
housing discrimination, a 2002 report in interpersonal ageism directed against
Canada found that younger applicants were
輕的申請⼈有時會因年齡太⼩不能獨⾃⽣於針對年輕⼈的⾃我定向年齡歧視規模的
younger people is limited to the WHO
sometimes rejected by landlords for being
活⽽被房東拒絕 (9)。證據。
European Region. Evidence on the scale
too young to live alone (9). of self-directed ageism against younger
people is lacking.
5.1.2 Interpersonal ageism
Ageist attitudes towards younger 5.2

adults
The impact of
While no comparable, global cross-national
雖然沒有關於對年輕⼈的年齡歧視態度的
data are available about ageist attitudes ageism against
可比全球跨國數據，但似乎普遍傾向於報
towards younger adults, there appears
告對年輕⼈⽽不是老年⼈的積極情緒
to be a general tendency to report(10,less
younger people
positive feelings towards younger rather
11)。
than older adults (10, 11).
在基於第四波歐洲社會調查 Evidence for the impact of ageism on
younger people is extremely limited –
（2008-2009）的分析中，該調查包括
In an analysis based on the fourth wave of only 10 studies were identified – and has
28
the個歐洲國家約 55 000
European Social 名年齡在
Survey 15 歲
(2008–2009), produced inconsistent findings (1).
which included a representative sample
或以上的參與者的代表性樣本，在⼀系列
of some 55 000 participants aged
範圍內，年輕⼈的評分低於老年⼈積極的 15 Ageism may affect health when it intersects
years or older in 28 European countries, with other “-isms”. One study in Brazil,
刻板印象 (10)。如圖 5.2 所⽰，⼆⼗多歲
younger adults received lower ratings than which investigated the impact of different
的⼈在調查中檢查的四個特徵中獲得較低
older adults across a range of positive forms of discrimination on mental disorders,
的評分，包括被視為友好、有能⼒和受到
stereotypes (10). As illustrated in Fig. 5.2, showed that ageism on its own was not
people in their twenties received lower
尊重，以及具有⾼道德標準。 associated with mental disorders, but it
ratings across the four characteristics was associated when it co-occurred with
examined in the survey, which included racism or classism, or both (12).
84
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Fig. 5.2. Likelihood that most people view those aged 20–29 and those older than 70
years as possessing certain characteristics (mean scores across European Social Survey
countries, 2008–2009; scale ranged from 0, indicating not at all likely, to 4, indicating
very likely)
Fig. 5.3. Percentage of people in countries in the European Social Survey (2008–2009)
who thought someone showed a lack of respect or treated them badly because of their
age, by age group (includes only individuals who did not rate their experience 0 on a
scale that ranged from 0, indicating they had never experienced this treatment, to 4,
indicating they had experienced it very often)
Evidence suggests that ageism has a limited age discrimination had the biggest impact
impact on younger people’s well-being and on people’s happiness and life satisfaction
self-esteem. A study that included a large between the ages of 40 and 70 years and
sample of Europeans revealed that perceived the smallest impact on those aged between
85
20 and 30 years and 70 years and older (13). among older people – such as serious
In support of these findings, another study health and economic effects – remain largely
found that age discrimination had no impact unexplored among younger people.
on younger adults’ well-being (14).
Two other studies showed that ageism 5.3

had a limited impact on younger people.
The first reported that the more self- The determinants
conscious younger workers were about
being stereotyped, the worse their mood of ageism against
and the less satisfied they were with older
co-workers (15). The second concluded that
younger people
age-biased communication behaviours had
only a slightly negative impact on younger Different individual characteristics associated
adults’ self-esteem or life satisfaction with being a perpetrator of ageism or being
relative to older adults. However, when older a target of ageism have been identified in
adults were perceived as adjusting their the literature, as have a series of contextual
speech style to younger people, younger determinants of ageism directed towards
people’s sense of collective self-esteem was younger populations (1).
enhanced (16).
5.3.1 Individual characteristics
Findings about the impact of ageism on associated with being a
cognitive performance are inconsistent. perpetrator of interpersonal
Two studies examined the impact of ageism
younger people’s exposure to negative age
stereotypes on their cognitive performance.
One found that it had a negative impact (17), Several individual characteristics may be
the other that it had a positive impact, but associated with becoming a perpetrator of
only when younger people saw themselves ageism against younger people, including sex
as under the control of powerful people; or gender, age, a lack of cross-generational
otherwise, it had no effect (18). friendships and certain personality traits
(see Table 5.1).
In the workplace, studies show that perceived
age discrimination reduces both younger The findings regarding sex or gender as a
and older people’s commitment to the determinant for perpetrating ageism against
organization (19, 20). A qualitative study younger people are inconsistent. Some
also revealed that ageism affected the work studies suggest that women might be less
identities of younger female workers and led ageist against younger people than men,
them to consciously portray themselves as while others found there was no difference
older and less feminine through their dress, (11, 22-24).
speech and behaviour (21).
The overall picture is unclear about whether
While this limited body of evidence has older or younger age is a risk factor for
identified some negative effects of ageism perpetrating ageism against younger
against younger people, the findings people (1). For instance, in a study on the
are weak and inconsistent. Furthermore, visual inspection of faces, older people
important effects of ageism identified spent more time examining the faces
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Table 5.1. Determinants of ageism against younger people
TYPE OF DETERMINANT TYPE OF ASSOCIATION
Sex Unclear
Age Unclear
INDIVIDUAL-LEVEL DETERMINANTS
PERPETRATOR
Less ageism (protective

Agreeableness factor)
Personality traits
Conscientiousness More ageism in workplace
(risk factor)
Contact with other age groups,

including grandparent–grand- More intergenerational f riend- Less ageism (protective
child contact and intergenera- ships factor)
tional f riendships
INTERPERSONAL AGEISM
More ageism (in some profes-

Sex Female
sional contexts) (risk factor)
Health status and care

Poorer health More ageism (risk factor)
dependence
TARGET
Profession and occupational Some professions and occupa-

More ageism (risk factor)
sector tional sectors (e.g. teaching)
CONTEXTUAL-LEVEL
DETERMINANTS
Presentation of younger people

More detailed information Less ageism (protective
in experimental studies that
about the younger person factor)
simulate real-life settings
of people their own age than the faces to predict more ageism towards the
of people of other ages, as did younger performance of younger workers (28).
people (25). Other studies indicate that
younger people may sometimes display A study in 25 European Union countries
more ageist attitudes towards people their found that older people who reported
own age rather than other age groups having cross-age friendships tended to be
(26, 27). less ageist against younger people than
those who did not report such friendships.
The personality trait of agreeableness However, older people were still more
is associated with having less ageist ageist against younger people than younger
attitudes towards younger people (26). people who reported having cross-age
Conscientiousness, however, appears friendships were against older people (29).
87
GLOB
5.3.2 Individual characteristics simulate real-life contexts, the more

associated with being a target information that is presented about a
of interpersonal ageism younger person, the less likely it is that
they will be subject to ageism (30, 33-35).
There is limited evidence about the
individual characteristics that may be 5.3.4 Institutional and self-
associated with becoming a target of directed ageism
ageism.
There is no evidence about determinants
There is some evidence that being female of institutional ageism against younger
may, in certain professional occupations, people, nor is there any evidence about
increase the likelihood of being a target of determinants of self-directed ageism
ageism directed against younger people. among younger people.
For instance, one study showed that
students had lower expectations about the
performance of young, unattractive female 5.4
teachers than of young, unattractive male
teachers or teachers of other ages (30). Conclusions and
Being in poor health or care dependent has future directions
also been found in one study to be a risk
factor for negative perceptions of younger Too little is known about the scale, impact
people (31) and determinants of ageism against
younger people. However, there is some
5.3.3 Contextual determinants evidence that it occurs in the workplace
of interpersonal ageism and in legal and political systems. In
Europe, the only region for which data are
Profession and occupational sector has available, attitudes towards younger people
been identified as a possible contextual are often more negative than they are
determinant of interpersonal ageism. towards older people; and younger people
In some professions, there is limited report experiencing more aged-based
evidence of ageism against younger people. discrimination than any other age group.
For instance, in an experimental study,
preference was shown by participants The impact of ageism against younger
for hiring a middle-aged applicant over a p eople, par ticularly the cumulative
young applicant for a job as a tour guide, impact over the life course, is not well
despite the candidates having the same understood. The main determinants of
qualifications (32). Another study suggests ageism against younger people include
that younger teachers are held to higher the personality traits of agreeableness
standards of professional competence than (protective factor) and conscientiousness
older teachers (30). (risk factor), having contact with other
age groups (protective factor), being care
The amount of information provided about dependent or in poor health (risk factors)
a younger person has also been described and working in certain professions or
as a possible contextual determinant sectors (risk factors). Future priorities for
of ageism. In experimental studies that increasing our understanding of ageism
88
C HA PT ER 05
directed against younger people should younger people often make up the
include: bulk of the population (see Box
5.1);
• monitoring ageism in a range of
institutional settings, including the • ensuring that our improved
workplace and legal and political understanding of the scale, impact
institutions; and determinants of ageism
against younger people informs
• improving our understanding of the strategies that are adopted to
all aspects of the problem – its address ageism against younger
scale, impact and determinants people.
– especially in low- and middle-
income countries, where there is
currently almost no research and
Box 5.1
Opportunities for research on ageism against younger people
The findings about ageism directed against younger populations are mainly
based on a scoping review commissioned for this report (1). This review used a
comprehensive search strategy that included 13 different databases and three
different languages (English, French and Spanish). It included 263 quantitative and
qualitative studies and provided the first systematic effort to assemble evidence
about ageism towards younger people, defined as those younger than 50 years. The
scoping review was supplemented by an appraisal of the quality of the evidence on
the impact and determinants of ageism against younger people.
One limitation of the studies identified was that many were cross-sectional in
nature. This makes it difficult to establish whether the associations found – between
ageism and impacts, on the one hand, and determinants and ageism, on the other –
are, in fact, causal. Another limitation relates to the inconsistent terminology used
to refer to ageism against younger people (e.g. adultism, kiddism), which makes
comparability across studies complicated.
Future research should explore the determinants and prevalence of ageism

against younger people across high-, middle- and low-income countries, including
institutional, interpersonal and self-directed ageism. It is most important to
investigate the impact of ageism on younger populations, including its health and
economic impacts, both in the shorter term and cumulatively over the life course.
If ageism against younger people turns out to be widespread but to have a limited
impact, then perhaps addressing it should be less of a priority than reducing ageism
against older people. It is possible, however, that cumulatively over the life course
ageism against younger people takes a serious toll. We also encourage researchers
to conduct more studies on ageism as it affects children, given that this is an area
that is relatively underexplored.
89
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33. Kite ME, Johnson BT. Attitudes toward older and younger adults: a meta-analysis. Psychol
Aging. 1988;3:233–44. https://doi.org/10.1037/0882-7974.3.3.233.
34. Kite ME, Stockdale GD, Whitley BE Jr, Johnson BT. Attitudes toward younger and older
adults: an updated meta‐analytic review. J Soc Issues. 2005;61:241–66.
https://doi.org/10.1111/j.1540-4560.2005.00404.x.
35. Kite ME, Wagner LS. Attitudes toward older adults. In: Nelson TD, editor. Ageism:
stereotyping and prejudice against older persons. Cambridge (MA): MIT Press; 2002:129–61.
91
K H A L E D, 2 6 ,
EGY PT
92
C HA PT E R 01
CHAPTER 06
06
“ A s a young man intere s te d in work ing in human

right s , I s tar te d work ing in thi s f ield earl y by
engaging in v ariou s ac ti v itie s and f rom then I
“
f ace d a lot of di s crimination due to my young age.
K hal e d , 2 6 , Eg y p t
©K hale d Emam / UN Major Group
93
Policies and laws can be used to reduce or

政策和法律可⽤於減少或消除針對任何年齡組的
eliminate ageism against any age group.
年齡歧視。
Policies and laws to reduce or eliminate ageism
例如，減少或消除年齡歧視的政策和法律包括解
include, for instance, legislation addressing age
決年齡歧視和不平等問題的立法、確保尊重所有
discrimination and inequality, policies to ensure
respect for the dignity of all persons regardless of
⼈的尊嚴的政策和⼈權法。
age and human rights laws.
⼀些直接證據表明，政策和法律減少了年齡歧
Some direct evidence shows that polices and
視，還有間接證據表明政策和法律減少了其他“主
06
Chapter laws reduce ageism, and there is indirect
義”（例如種族主義、性別歧視），因此也可以減
evidence that policies and laws reduce other
“-isms” (e.g. racism, sexism) and could, therefore,
少年齡歧視。
also work to reduce ageism.
6.1
What they are
and how
they work
本章提供有關可⽤於消除或減少年齡歧視的第⼀個策略
The enactment of policies
的信息：政策和法律。第 6.1and laws constitutes an
節描述了這⼀策略以及它
important strategy that can be used to reduce or
政策和法律的製定是⼀項重要的戰略，可⽤於減少或消
eliminate ageism, especially discrimination on the grounds
除年齡歧視，尤其是年齡歧視 (1)。政策是為影響社會中
of age (1). Policies are plans, commitments or courses of
的特定問題⽽採取的計劃、承諾或⾏動⽅針。政策通常
action that are undertaken to affect a given issue within
a society. Policies generally provide a framework against
提供⼀個框架，可以根據該框架測試或衡量提案或活
which proposals or activities can be tested or measured.
動。政策的例⼦包括申訴機制和就業和衛⽣機構的⾏動
Examples of policies include complaints mechanisms and
計劃，旨在消除基於年齡的歧視並賦予⼈們權利，以主
plans for action in employment and health institutions
本章提供有關可⽤於消除或減少年
This chapter provides information 張平等獲得和參與的權利。法律對應於特定國家或社區
that seek to eliminate age-based discrimination and to
about the first strategy that can be
齡歧視的第⼀個策略的信息：政策 empower people to claim their rights to equal access
承認的規範其成員⾏為的規則體系，並且可以通過施加
used
和法律。eliminate
to or reduce ageism:
第 6.1 節描述了這⼀策略 and participation. Laws correspond to the system of
懲罰來強制執⾏。法律還有助於保障對所有⼈權的保
policy and law. Section 6.1 describes rules that a particular country or community recognizes
以及它如何在減少年齡歧視⽅⾯發
this strategy and how it works in 護，並使個⼈能夠向政府問責。可以區分國際法和國內
as regulating the actions of its members and that it may
揮作⽤。ageism.
reducing 第 6.2Section
節提供了其有效6.2 presents 法。國際法規定了簽署國在相互⾏為和對待國家邊界內
enforce by imposing penalties. Laws also help guarantee
evidence on its
性的證據，⽽第 6.3 節提供了來⾃effectiveness whilst 個⼈⽅⾯的法律責任和義務。國際公約或條約和國際習
the protection of all human rights and enable individuals
Section 6.3 provides examples of this
不同國家和地區的此類⼲預的⽰ to hold their governments to account. A distinction
慣是國際法的兩個重要淵源。國內法通常稱為國內法，
type of intervention from different can be made between international and national law.
例。第 6.4 節概述了此類⼲預的是指存在於特定國家/地區的那些法律。雖然不同，但
countries and regions. Section 6.4 International law defines the legal responsibilities and
成本和可以提⾼其有效性的特徵。
outlines the cost of this type of 政策和法律密切相關；例如，政策可以轉化為立法，⽽
obligations of signatory states in their conduct with
intervention and characteristics that 立法可以包括制定新政策的義務。如何在減少年齡歧視
each other and in their treatment of individuals within
can improve its effectiveness. state boundaries.第
⽅⾯發揮作⽤。 International conventions or treaties
6.2 節提供了其有效性的證據，⽽
第 6.3 節提供了來⾃不同國家和地區的此類⼲預的⽰
94 例。第 6.4 節概述了此類⼲預的成本和可以提⾼其有
效性的特徵。
C HA PT E R 06
and international custom are two important of the protected groups, as well as prohibit
sources of international law. National law, the use of demeaning visual depictions of a
which is often referred to as domestic law, particular group, which can lower implicit bias
refers to those laws that exist within a against members of that group (14).
particular country. Although distinct, policies
and laws are intimately linked; for example, The legal treatment of ageism, and age
對年齡歧視的法律處理，特別是年齡歧
policy can be translated into legislation, discrimination specifically, entails certain
視，會帶來⼀定的困難。在許多情況下，
and legislation can include an obligation to difficulties. There may be a range of
formulate new policy. 年齡被認為是區分不同⼈群的合理和合法
circumstances in which age is considered a
理由 (16)。例如，使⽤基於年齡的區分來
rational and legitimate reason for distinguishing
政策和法律減少年齡歧視的⽅式有四⽅
The way in which policies and laws can between different groups of persons (16). For
確定誰有權享受養老⾦福利，過去曾被提
⾯。⾸先，根據威懾理論，取締特定⾏為
reduce ageism is fourfold. First, according example, the use of an age-based distinction
出作為區分不同年齡組的合理理由，理由
或做法可以將這種⾏為減少到持續實施制
to deterrence theory, outlawing a given to determine who is entitled to pension
是不存在其他實際或公平的⽅法來決定誰
裁的程度
behaviour(2, or3)。例如，當反歧視法律到
practice can reduce that benefits has been presented in the past as
behaviour to the extent that sanctions are 有權享受養老⾦福利。應該符合條件
a rational reason for distinguishing between
位時，雇主不太可能歧視，因為這些法律
consistently imposed (2, 3). For example, different age groups based on the argument
(17)。⿎勵平等尊重不同年齡的⼈的尊嚴有
產⽣的預期成本等於違規成本（例如律師
employers are less likely to discriminate that no other practical or fair way
時也可能需要區別對待年齡組 exists to
(18)。這意
費、罰款）乘以被抓到的可能性(4).
when anti-discrimination laws are in place, decide who should qualify (17). Encouraging
味著並非所有形式的基於年齡的差別待遇
其次，政策和法律可以通過創建⼀個明確
given that these create an expected cost equal respect for the dignity of people of
of a magnitude that equals the cost of the 都可能構成不當歧視。關鍵問題是基於年
different ages may also, on occasion, require
的社會規範來幫助減少年齡歧視，即年齡
violation if caught (e.g. attorney’s fees, fines) 齡的差別待遇是否破壞了尊嚴、⾃主和參
treating age groups differently (18). This means
歧視在社會上是不可接受的 (2, 5-7)。已
times the probability of being caught (4). that not all forms of differential treatment
與的⼈權原則，以及⽤於評估其合法性的
證明了解⼀個⼈社區的立場會影響⼀個⼈ on the basis of age may qualify as wrongful
正當性測試是否受到年齡歧視的陳規定型
表達的偏⾒程度，即使是私下表達的態度
Second, policies and laws can help reduce discrimination. The key question is whether
ageism by creating a(7-12)。 clear social norm 觀念、假設和偏⾒的污染。
differential treatment on the grounds of
並且沒有批評的可能性
that ageism is socially unacceptable (2, 旨在解決年齡歧視的政策和法律多種多
age undermines the human rights principles
第三，根據認知失調理論（13），政府層
5-7). Being aware of the stance of one’s of dignity, autonomy and participation and
樣，包括反年齡歧視和平等立法和政策，
⾯的政策和法律通過強迫⼈們改變他們的
community has been shown to impact the whether the justification tests used to assess
這些立法和政策規定了確保充分尊重所有
⾏為，最終也可以改變⼤多數⼈的潛在態
extent of prejudice one expresses, even its legitimacy are contaminated by ageist
⼈的尊嚴和地位平等的⾏動，⽽不論其年
度，因為他們需要調和他們的態度和他們
when attitudes are stated privately and stereotypes, assumptions and prejudice.
there is no possibility of criticism (7-12). 齡；旨在改變老年⼈或年輕⼈觀念的政
的態度之間的不⼀致。⾏為。第四，法律
Policies and laws aimed at tackling ageism
策；和⼈權法，該法提供了⼀個系統，將
和政策可以增加周圍⼈群（例如⼯作場
Third, according to the theory of cognitive are quite varied and include anti-age
老年⼈和年輕⼈的⼈權編成法典，並使這
所）的多樣性並塑造物理和感官環境，這
dissonance (13), government-level policies discrimination and equality legislation
些權利具有可執⾏性。不同的機制⽤於實
反過來⼜會影響個⼈表現出的隱性偏⾒的
and laws, by forcing people to change and policies that define actions to ensure
their behaviour, can eventually change 施和監督政策和法律，包括⼈權機構、法
adequate respect for the dignity and equality
程度 (14, 15)。例如，規範⼯作場所歧視的
most people’s underlying attitudes too, as 院、監察員和致⼒於維護條約和確保平等
of status of all persons irrespective of their
法律可以增加受保護群體代表的存在，並
they will need to reconcile the dissonance age; policies that aim to change perceptions
的機構。
禁⽌使⽤貶低特定群體的視覺描繪，這可
between their attitudes and their behaviour. of older or younger people; and human rights
以降低對該群體成員的隱性偏⾒
Fourth, laws and policies can(14)。 increase law, which provides a system that codifies the
diversity in the surrounding population (e.g. human rights of older and younger persons
in the workplace) and shape the physical and makes those rights enforceable. Different
and sensory surroundings, which can, in mechanisms are used to implement and
turn, affect the degree of implicit bias that monitor policies and laws, including human
individuals exhibit (14, 15). For example, laws rights agencies, courts, ombudspersons and
regulating discrimination in the workplace bodies working to uphold treaties and to
can increase the presence of representatives ensure equality.
95
6.2 fewer older workers as a means to avoid

exposure to possible litigation (26).
How well 國家反歧視立法在⼀系列⾼收入國家的其
他領域（例如種族、性別或性別和性取
The effect of national anti-discrimination
they work legislation has been further studied in
向）的影響已得到進⼀步研究，並且在很
other areas (e.g. race, sex or gender and
⼤程度上發現它有助於減少歧視（7，
評估國家法律和政策的效果是⼀項長期挑
Evaluating the effect of national laws and sexual orientation) in a range of high-income
policies is a long-standing challenge, in part 23、30-32）。評估國家反歧視法律影響
countries, and it has largely been found that
戰，部分原因是難以將觀察到的變化歸因
due to the difficulty of attributing observed 的最系統的努⼒是對這些法律的影響評
it helps to reduce discrimination (7, 23, 30-
於法律或政策的實施，特別是當隨機對照
changes to the implementation of laws 估，這些法律涉及 12 個不同國家的各種理
32). The most systematic effort to assess the
試驗不可能、負擔得起、符合倫理或不可
or policies, especially when randomized effects of national anti-discrimination laws
由（例如年齡、性別或性別和殘疾），包
⾏時（19- 22)。所討論的政策或法律是否
controlled trials are not possible, affordable, looked at impact assessments of these laws,
括歐洲和其他國家的幾個國家。⾼收入國
ethical or feasible
確實產⽣了觀察到的影響，或者這些影響 (19-22). Does the policy or which addressed various grounds (e.g. age,
law in question actually produce the(19, effects 家，如澳⼤利亞、加拿⼤和美國
sex or gender, and disability) in 12(23)。
different
是由其他⼀些混雜因素引起的嗎？
observed, or are these effects caused by 所有分析的研究都強調了通過反歧視法所
countries, including several in Europe as
20)。現有的研究通常側重於使⽤法律的影
some other, confounding factor? (19, 20). The well as other high-income countries such as
帶來的好處，包括所有個⼈在社會中的更
響和效果、實施法律的措施及其有效性、
studies that do exist generally focus on the Australia, Canada and the United States (23).
⾼參與度，包括就業和教育。此外，有效
impact and effect of the use of the law, the
這些措施對實現總體社會政策⽬標的貢
measures put in place to enforce the law 的反歧視法的採⽤有助於縮⼩受保護群體
Benefits resulting from the adoption of
獻，以及對社會政策的影響。某些群體的
and their effectiveness, the contribution of 與普通⼈群之間的薪酬差距，並提⾼這些
anti-discrimination laws were highlighted
社會經濟地位 (23)。
the measures to the achievement of overall in all of the analysed
群體的受教育程度 studies and included
(23)。反歧視立法的執
在年齡歧視領域，已開展的少數研究集中
social policy goals, and the effect on the higher participation of all individuals in
⾏也會降低更廣泛社區對歧視的接受程度
在澳⼤利亞、加拿⼤、歐洲和美國就業領
socioeconomic position of certain groups society, including in employment and
(23). 和⼈際歧視的程度 (7)。 the adoption of
education. Additionally,
域的反歧視法。這些研究普遍發現了這些
衡量國際法的直接或間接影響同樣具有挑
effective anti-discrimination laws helped
法律的積極影響 (24-29)。例如，美國於
In the field of ageism, the few studies 戰性，因為通常很難在條約體係與國內層
narrow the pay gap between protected
1967
that 年出台的《就業年齡歧視法》僅承認
have been carried out have focused groups and the general population and
⾯的立法或政策改⾰之間建立決定性的因
對老年⼯⼈的偏⾒，對老年⼯⼈的整體就
on anti-discrimination laws in the field of increase educational attainment in these
果關係 (33)。儘管如此，越來越多的證據
employment in Australia, Canada,
業產⽣了很⼩的積極和顯著影響 Europe
(24)。它 groups (23). The enforcement of anti-
and the United States. These studies have ⽀持這樣⼀種假設，即制定和批准國際條
discrimination legislation can also reduce the
禁⽌雇主根據員⼯的實際年齡採取和執⾏
generally found positive effects of these laws 約的過程以及對國家績效的宣傳和監督可
acceptability of discrimination in the broader
強制性退休政策（某些⾏政職位的員⼯以
(24-29). For example, the introduction of the community and the extent of interpersonal
以促進國家層⾯的法律、政策和實踐的變
及消防員和執法⼈員除外）（28、29）。
Age Discrimination in Employment Act in discrimination (7).
化。⼀些案例研究和聯合國官⽅報告和審
儘管如此，⼀些研究表明，如果沒有充分
the United States in 1967, which recognizes
only bias against older workers, caused 查都說明了這⼀點，這些報告和審查評估
Measuring the direct or indirect effects of
起草和執⾏，反年齡歧視法可能會產⽣意
a small positive and significant effect on 了各國批准《殘疾⼈權利公約》(34,
international law is equally challenging, 35)、
as
想不到的後果，例如當公司僱⽤較少的老
overall employment for older workers (24). it is often difficult
《消除⼀切形式歧視公約》後國家層⾯的 to establish a conclusive
年⼯⼈作為避免可能⾯臨訴訟的⼀種⼿段
It has prohibited employers from adopting causal link between a treaty system
變化。對婦女的歧視 (36, 37) 和《消除⼀
時and(26)。
enforcing mandatory retirement policies and legislative or policy reforms on the
on the basis of an employee’s chronological 切形式種族歧視國際公約》(38)。
domestic level (33). Still, mounting evidence
age (with limited exceptions for employees supports the assumption that the process
in certain executive positions, as well as of formulating and ratifying an international
firefighters and law enforcement officers) (28, treaty and advocacy and monitoring of state
29). Still, some studies have shown that when performance can contribute to changes in
not adequately drafted and enforced, anti- law, policy and practice at the national level.
age discrimination laws can have unintended This is illustrated in several case studies
consequences, such as when companies hire and in official UN reports and reviews
96
C HA PT E R 06
另⼀項著眼於
that assessed 20 changes
個國家批准六項聯合國at the national 六個例⼦說明了世界不同地區旨在解決針
older people. The first four examples relate
level following countries’ ratification of the
⼈權條約所帶來的變化的研究發現，個別對老年⼈的年齡歧視問題的不同類型的政
to international and regional instruments,
Convention on the Rights of Persons with whereas
策和法律。 the前四個例⼦涉及國際和區域⽂
last two relate to national
國家採取切實措施將條約規範納入其國內
Disabilities (34, 35), the Convention on the instruments. Examples on the use of policy
法律結構和⽂化 (39)。重要的是，⼀些研書，⽽後兩個例⼦涉及國家⽂書。框 6.1
Elimination of All Forms of Discrimination and law to tackle ageism against younger
究甚⾄報告說，即使在控制其他關鍵因素
against Women (36, 37) and the International 顯⽰了使⽤政策和法律解決針對年輕⼈的
populations are shown in Box 6.1.
Convention on the Elimination of All Forms
的情況下，⾄少《消除對婦女⼀切形式歧年齡歧視的例⼦。
of Racial Discrimination (38). Another study
視公約》對婦女權利的影響很⼩，但具有 6.3.1 Political Declaration and
that looked at the changes resulting from Madrid International Plan of
統計學意義和積極影響
the ratification of six(40,UN 41) .
human rights Action on Ageing
在區域層⾯，有證據表明，歐洲⼈權法院
treaties in 20 countries found that individual
6.3.1 政治宣⾔和⾺德⾥老齡問題國際⾏動
countries took tangible steps to incorporate
對《歐洲⼈權公約》的執⾏不僅導致個別 In 2002, the UN General Assembly endorsed
treaty norms into their domestic legal 計劃Political Declaration and Madrid
the
原告獲得賠償，⽽且歐洲政府也在修改有
structures and cultures (39). Importantly, a 2002 年，聯合國⼤會通過了政治宣⾔和⾺
International Plan of Action on Ageing
關同性戀權利和年齡等問題的立法。歧視
couple of studies have even reported that (MIPAA) (42).
德⾥老齡問題國際⾏動計劃 (MIPAA)
(33)。
at least the Convention on the Elimination of
(42)。
⼈權法院的其他例⼦包括美洲⼈權法院，
All Forms of Discrimination Against Women In Article 5, the declaration makes a
had a small but statistically significant and 在第 5 條中，宣⾔承諾消除⼀切形式的歧
commitment to eliminating all forms of
根據《美洲⼈權公約》進⾏裁決，以及非
positive effect on women’s rights, even when 視，包括年齡歧視。
discrimination, MIPAA
including 得到 159 個
age discrimination.
洲⼈權和⼈⺠權利法院，根據《非洲⼈權
other key factors were controlled for (40, 41). Endorsed by 159
政府的認可，不具有法律約束⼒，其實施 governments, MIPAA is
和⼈⺠權利憲章》進⾏裁決，其產出正在 not legally binding, and its implementation
是⾃願的。
增長 (33)。
At the regional level, there is evidence that is voluntary.
the enforcement of the European Convention 每五年，各國都會分析 MIPAA 的實施狀
on Human Rights by the European Court 況以及取得進展所需的⾏動。該過程涉及
Every five years, countries analyse the state
of Human Rights has not only resulted in 公⺠社會和老年⼈參與的參與性因素，旨
of implementation of MIPAA and the actions
individual plaintiffs being awarded damages required to make progress. The process
在幫助各國接收對其已實施的政策和計劃
but also in European governments revising involves a participatory element to engage
的反饋。在國家層⾯進⾏審查和評估後，
legislation on such matters as gay rights civil society and older persons, and it is
and age discrimination (33). 聯合國區域委員會整合信息。審查和評估
designed to assist countries in receiving
過程以聯合國社會發展委員會的全球審查
feedback on the policies and programmes
Other examples of human rights courts that
告終。 they have implemented. Following
include the Inter-American Court of Human review and appraisal at the national level,
本政治宣⾔通過後，在國家⼀級制定消除
Rights, which rules under the American UN Regional Commissions consolidate
Convention on Human Rights, and the 年齡歧視政策⽅⾯取得的進展是通過其監
the information. Reviews and appraisal
African Court on Human and People’s Rights, 測過程以及專⾨研究報告的，這些研究普
processes culminate with a global review by
which rules under the African Charter on the UN Commission
遍發現政府已逐步製定和實施法律和政策 for Social Development.
Human and People’s Rights and whose 措施，以防⽌年齡歧視（43-46 歲）。
output is growing (33). The progress made in developing policies
to eliminate age discrimination at the
country level following the adoption of this
6.3 political declaration is reported through its
monitoring processes as well as through
Examples dedicated studies that generally have found
that governments have gradually developed
Six examples illustrate different types of and implemented legal and policy measures
policies and laws from different parts of to prevent age discrimination (43-46).
the world that aim to tackle ageism against
97
Box 6.1 Policy and law to reduce or eliminate ageism against younger people
減少或消除針對年輕⼈的年齡歧視的政策和法律
As illustrated in the examples in this box, policies and laws have also been used as
如本專欄中的⽰例所⽰，政策和法律也被⽤作消除或防⽌針對年輕⼈的年齡歧視
strategies to eliminate or prevent ageism against younger people, although there
的策略，儘管對其有效性的研究有限。例如，聯合國⼤會於
is limited research about their effectiveness. For example, the 1996 年通過的《到
World Programme
of Action
2000 for Youth to the Year 2000 and Beyond, adopted by the UN General
年及以後世界青年⾏動綱領》為改善世界各地青年狀況的國家⾏動和國際
Assembly in 1996, provides a policy framework
⽀持提供了政策框架和實際指導⽅針（ and practical guidelines for national
59)。它旨在⽀持年輕⼈充分享受所有⼈
action and international support to improve the situation of young people around
權和基本⾃由，⿎勵政府採取⾏動打擊侵犯這些權利和⾃由的⾏為，並促進不歧
the world (59). It is intended to support the full enjoyment of all human rights and
視和容忍、機會均等、團結、安全和參與在所有年輕女性和男性的社會中。聯合
fundamental freedoms by young people, encourage governments to take action
國⼤會和社會發展委員會每兩年收到⼀份秘書長的報告，並就涉及青年的政策和
against violations of these rights and freedoms, and promote non-discrimination
and tolerance, equality of opportunity, solidarity, security and the participation
計劃通過⼀項決議。
in society of all young women and men. Every 2 years, the UN General Assembly
伊比利亞美洲地區也是通過 2008 年⽣效的伊比利亞美洲青年權利公約促進和保
and the Commission for Social Development receive a report from the Secretary-
護年輕⼈權利的先驅。該公約規定了 15 ⾄and
General and adopt a resolution on policies 24programmes
歲⼈群的具體權利並承認他們作
involving youth.
為發展中的戰略參與者 (60)。它還於 2016 年通過了⼀項附加議定書，澄清並加
The Iberoamerican region has also been a pioneer in promoting and protecting
強了公約的⼀些條款。例如，它允許延長公約中考慮的年齡上限，以期使青年的
the rights of younger people through the Iberoamerican
定義適應每個國家的法律和⼈⼝現實（61）。 Convention on Rights of
《公約》沒有類似於國際條約監
Youth, which entered into force in 2008. This Convention lays out specific rights
測機構的監測系統，但它建立了⼀個跟踪系統，要求締約國每兩年向伊比利亞美
for people aged between 15 and 24 years and recognizes them as strategic actors
洲青年組織秘書長提交⼀份報告
in development (60). It also has (62)。共有七個國家批准了該條約：多⺠族玻利
an additional protocol, adopted in 2016, which
clarifies and strengthens some of the Convention’s articles. For example, it allows
維亞國、哥斯達黎加、多米尼加共和國、厄瓜多爾、洪都拉斯、⻄班牙和烏拉
for an extension of the upper age limit considered in the Convention, with a view
圭。
to adapting the definition of youth to the legal and demographic realities of
另⼀個例⼦是 2009 年 8 ⽉⽣效的《非洲青年憲章》，它強調了 15 ⾄ 35 歲青
each country (61). The Convention does not have a monitoring system similar to
年的權利、義務和⾃由。它還為製定增強青年權能的國家⽅案和戰略計劃鋪平了
international treaty monitoring bodies, but it has established a tracking system
道路。它旨在確保青年免受⼀切形式的歧視並參與該地區的決策，包括參與非洲
through which state parties are required to submit a report every two years to the
Secretary-General of the Iberoamerican Youth Organization (62).
國家的發展議程。它沒有規定具體的後續和監督機制，但第 A total of seven
28 條規定了非洲聯
countries have ratified this treaty: The Plurinational State of Bolivia, Costa Rica,
盟委員會的職責，以確保締約國尊重其承諾並履⾏憲章規定的職責（62、
Dominican Republic, Ecuador, Honduras, Spain and Uruguay.
63）。共有 39 個非洲國家批准了該憲章，因此受其條款的約束 (64)。
Another example is the African Youth Charter, which entered into force in August
2009 and underscores the rights, duties and freedoms of youths aged 15 to 35
years. It also paves the way for the development of national programmes and
strategic plans for the empowerment of young people. It aims to ensure that youth
are protected against all forms of discrimination and involved in decision-making in
the region, including in the development agendas of African countries. It does not
provide for a specific follow-up and monitoring mechanism, but Article 28 sets out
the responsibilities of the African Union Commission to ensure that state parties
respect their commitments and fulfil the duties outlined in the Charter (62, 63). A
total of 39 countries in Africa have ratified the charter and, therefore, are bound
by its provisions (64).
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6.3.2 The employment Union’s anti-discrimination and equality

歐盟各國都出台了這項立法，並取得了⼀
equality framework directive agendas, was responsible for introducing
些重要成果。它在歐洲聯盟的反歧視和平
of the European Union anti-age discrimination laws in many Member
等議程中將年齡與其他理由並列，負責⾸
States for the first time, increased the scope
A milestone in protection from age 次在許多成員國引入反年齡歧視法，在少
of protection in those few States that already
歐盟防⽌年齡歧視的⼀個⾥程碑是 2000
discrimination in the European Union was 數已經制定了⼀些立法的國家中擴⼤了保
had some legislation in place (27, 48) and set
年Council
11 ⽉ 27Directive
⽇的理事會指令 2000/78/EC
2000/78/EC of 27 minimum standards throughout the European
護範圍。位 (27, 48) 並在整個歐盟制定最
建立了就業和職業平等待遇的總體框架，
November 2000 establishing a general Union. It also helped to challenge structural
低標準。它還有助於挑戰勞動⼒市場的結
該指令實施了⼀個結構，以確保個⼈在就
framework for equal treatment in employment inequalities in the labour market, such as the
and occupation, which implemented a 構性不平等，例如在招聘廣告中使⽤年齡
use of upper age limits in job advertisements
業和職業⽅⾯的平等他們的年齡，以及其
structure for ensuring equality for individuals 上限 (50)。
(50).
他受保護的特徵 (47)。該指令限制了歐盟
in employment and their occupation 儘管通過該指令取得了進步，但仍有改進
成員國的國家法律允許雇主根據年齡對僱
regardless of their age, among other Despite the advances achieved through this
的地⽅。例如，給予國家司法管轄區以擱
員進⾏不同待遇的情況，從⽽確立了防⽌
protected characteristics (47). The Directive Directive, there are still areas for improvement.
limits the circumstances under which national 置平等待遇的廣泛⾃由裁量權導致了整個
For example, the broad discretion afforded
歧視的最低要求。成員國必須確保對那些
law in European Union Member States may 歐盟國家實踐和防⽌年齡歧視的不同程度
to national jurisdictions to set aside equal
認為⾃⼰受到歧視的⼈有司法或⾏政程
permit employers to subject employees to treatment has led to diverging national
（51）。此外，該框架僅關注就業，並未
序，並且必須提供製裁指導，其中可能包
different treatment on the grounds of age, practices and levels of protection against
涵蓋可能發⽣年齡歧視的其他重要領域，
括賠償 (27)。該指令還要求成員國促進社
thus establishing minimum requirements for age discrimination across the European
protection against discrimination. Member 例如教育、住房和社會保護（⾒第
Union (51). Also, the framework focuses 2 only
會對話，旨在通過“監督⼯作場所做法、集
States must ensure there are judicial or 章）。
on employment and does not cover other
體協議、⾏為準則和通過研究”（47、
administrative procedures for those who 2008 年，歐盟委員會提出了⼀項新的指令
important areas in which age discrimination
48）促進平等待遇。
believe they have been discriminated against might occur, such as education, housing and
草案，以保護⽣活在歐盟的每個⼈免受基
歐盟委員會負責評估成員國的國家立法，
and must provide guidance on sanctions, social protection (see Chapter 2).
於年齡、殘疾、性取向和宗教或信仰的⼯
看其是否正確反映了指令的要求。如果沒
which may include compensation (27). The
Directive also requires Member States to 作場所以外的歧視（例如在獲得商品和服
In 2008, the European Commission proposed a
有，委員會可以對相關成員國啟動侵權程
promote social dialogue with the aim of 務⽅⾯）。如果通過，該法律將完善歐盟
new draft Directive to protect everyone living
序。反過來，歐盟法院在具體條款不確定
fostering equal treatment through “the in the European Union against discrimination
框架，為年齡提供與法律規定的種族和性
或不明確的情況下幫助推進對指令的解釋
monitoring of workplace practices, collective beyond the workplace (e.g. in access to
別⽬前存在的類似⽔平的保護（52）。
(49)。
agreements, codes of conduct and through goods and services) that is based on age,
research” (47, 48). disability, sexual orientation and religion or
belief. If adopted, this law would complete
The European Commission is responsible the European Union framework by affording
for assessing the national legislation of age a similar level of protection as currently
Member States to see if it correctly reflects exists for race and gender under law (52).
the requirements of the Directive. If it does
not, the Commission can launch infringement 6.3.3 The African Union
procedures against the Member State Protocol on the rights of
concerned. In turn, the Court of Justice of the older persons
European Union helps advance interpretation
of the Directive in cases of uncertainty or lack The African Union Protocol to the African
of clarity in specific clauses (49). Charter on Human and People’s Rights on the
Rights of Older Persons in Africa is another
All countries of the European Union have major development. Adopted in January
introduced this legislation, and it has achieved 2016, this protocol is the product of many
a number of important outcomes. It placed years of consultations, and it reinforces the
age alongside other grounds in the European commitments made in the 2002 African
99
Union Policy Framework and Plan of Action and promoting the rights of older persons.
on Ageing (53). The Protocol prohibits all As for the protected rights, the Convention
forms of discrimination against older persons establishes the rights to equality and non-
(Article 3), and it covers a range of rights discrimination on the grounds of age, to life
including access to health services, and the and dignity, to independence and autonomy,
rights to employment, social protection and to work and education, to physical and mental
education, thus providing a framework for health and to give free and informed consent
governments to protect those rights. Still, in the realm of health care, among others.
the Protocol does not explicitly prohibit
discrimination on the basis of age, which may By adopting this Convention, countries
limit its interpretation at the national level. across the region show their commitment to
addressing ageism and the denial of human
The Protocol, if ratified and implemented, rights in older age, and they have recognized
has the potential to improve older Africans’ that explicit, legally binding human rights
enjoyment of their rights. This Protocol has standards, and the accountability mechanisms
been ratified by two countries, Benin and that accompany them, are necessary to do
Lesotho. Twelve additional countries have this. The Convention entered into force in
signed the Protocol, which indicates their 2017, and seven countries have ratified the
willingness to ratify it (54). treaty: Argentina, the Plurinational State of
Bolivia, Chile, Costa Rica, Ecuador, El Salvador
6.3.4 The Inter-American and Uruguay. It is too soon to evaluate
Convention on Protecting its effectiveness, but it is expected that
the Human Rights of Older its ratification will help establish minimum
Persons regional standards for protecting the rights of
older persons and it will have strong potential
to encourage countries to adopt new public
The Inter-American Convention on Protecting policies and legislative frameworks (56).
the Human Rights of Older Persons is the first
regional treaty that fully safeguards older 6.3.5 Uruguay’s legal and policy
people’s human rights. It explicitly prohibits frameworks
discrimination on the grounds of age (Article
5); encourages positive attitudes towards The national legal and policy frameworks of
and dignified, respectful and considerate Uruguay prohibit any discrimination on the
treatment of older persons; and promotes basis of age and guarantee older and younger
the recognition of older people’s experience, persons equal and effective legal protection
wisdom, productivity and contributions to the against discrimination. The Constitution
development of society (55). establishes that everyone is equal before the
law (Article 8), and the country has taken a
Countries ratifying the Convention must number of measures to counter age-based
adopt measures to prevent, sanction and discrimination in specific sectors, including
eradicate violations of the rights of older employment, by means of affirmative action
persons. They must also adopt and implement policies and a specific ban on discriminating
affirmative measures to carry out the rights against any worker on the grounds of age.
set forth in the Convention, including policies,
plans and legislation. It is also the duty The Institución Nacional de Derechos
of states to establish and promote public Humanos (National Institution of Human
institutions that specialize in protecting Rights) and the Oficina del Defensor del
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C HA PT E R 06
Pueblo (Ombudsperson’s Office) was formally and autonomous institution that attempts
established in 2012 to promote and protect to bring about conciliation between parties
human rights, as defined by Uruguayan in a dispute. Cases in which conciliation
law. Other mechanisms have also been cannot be reached may be referred to the
established in the country to promote and Equal Opportunities Tribunal. In 2014, the
protect human rights including the Defensor Commission referred two cases related to
del Vecino de Montevideo (Office of the Public age-based discrimination to the Tribunal (58).
Defender of Montevideo), which promotes No comprehensive assessment of the Equal
and defends the rights of all inhabitants of Opportunities Act has been conducted.
Montevideo, and the Secretaría de Derechos
Humanos (Human Rights Secretariat), which
is in charge of monitoring and evaluating the 6.4 Key
human rights situation. Also, Uruguay was
the first state to deposit the instrument of characteristics
ratification of the Inter-American Convention
on Protecting the Human Rights of Older and costs
Persons, on 18 November 2016.
Few methodologically rigorous studies have
很少有⽅法學嚴謹的研究試圖評估有助於
These existing legal and policy instruments sought to assess the factors that contribute
could be further strengthened by providing 解決年齡歧視的法律和政策有效性的因
to the effectiveness of laws and policies in
adequate human, technical and financial 素。然⽽，⼀些研究確實提供了⼀些關於
tackling ageism. A few studies do, however,
resources (57) and ensuring greater offer some indication about the potentially
可以提⾼其有效性的法律和政策的潛在重
coordination between the National Institution important characteristics of laws and policies
要特徵的跡象，其中⼀項研究全⾯審查了
of Human Rights and the Ombudsperson’s that can increase their effectiveness, including
Office. There is also a need for studies to
12 個國家的國家反歧視法律的接受度和有
one that comprehensively examined the
further evaluate the impact of these legal 效性的因素，這些法律和政策側重於
factors contributing to the acceptance 年齡 and
and policy frameworks in Uruguay. 和殘疾等理由of(23)。
effectiveness national儘管如此，該分析中
anti-discrimination
laws in 12 countries that focus on grounds
包含的幾項研究具有有缺陷的設計或提供
6.3.6 Equal Opportunities Act such as age and disability (23). Still, several
的⽅法學信息有限，這限制了可以得出的
of Mauritius studies included in this analysis had flawed
結論 (23)。
designs 下⾯概述了其中⼀些潛在的重
or provided limited methodological
While the Constitution of Mauritius does 要特徵。 which limits the conclusions that
information,
not explicitly refer to discrimination based can be derived (23). Some of these potentially
on age, specific enactments, such as important characteristics are outlined below.
the Equal Opportunities Act of 2012,
do explicitly prohibit such discrimination • 強有⼒的監督和執法機制：幾項研究將薄
Strong monitoring and enforcement
in various spheres of activity, namely mechanisms: several studies
弱的執法機制確定為限制反歧視法律成功
employment; education; the provision of identified
的⼀個重要因素（23,weak enforcement
27, 32,65)。監測
goods, services or facilities; accommodation; mechanisms as one important
access to premises and sports; and societies, 和執⾏機制可以採取多種形式，包括設立
factor limiting the success of anti-
registered associations and clubs. The Equal 全國委員會或委員會、平等機構或監察
discrimination laws (23, 27, 32,
Opportunities Act established the Equal 員。Monitoring and enforcement
65).
Opportunities Commission and the Equal mechanisms can take multiple
Opportunities Tribunal, which consider forms, including the establishment
complaints about the infringement of of national councils or commissions,
rights protected under the Act. The Equal equality bodies or ombudspersons.
Opportunities Commission is an independent
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GLOB
• Public awareness about the law or

• 公眾對法律或政策的認識及其條 internal monitors that make it more
policy and clarity on its provisions:
款的明確性：反歧視立法似乎最有 difficult to conceal a dissonance
anti-discrimination legislation appears between expressed and actual
效，如果同時在各級提⾼認識並傳
to be most effective if accompanied by behaviours.
播有關政策或法律的信息（7、
awareness raising and dissemination
23、27、48、65
of information about, the 66)。為了使
policy or • 現有的社會規範：當反歧視法建立
Existing social norms: the
law at various
立法和政策在特定社區產⽣影響， levels (7, 23, 27, 48, 65, implementation
在社會中已經被廣泛遵守的規範的 and effectiveness
66). For legislation and policy to have of an anti-discrimination law are
⾄少⼀些公眾成員需要意識到它的基礎上並使其正式化時，反歧視法
effects in a given community, at least enhanced when the law builds on and
存在。
some 這是必要的，以確保立法對
members of the public need 的實施和有效性就會得到加強
formalizes a norm within the society
特定個⼈產⽣⼯具性影響，使個⼈
to be aware of its existence. This is (23)。
that was already widely observed
necessary to ensure that legislation
旨在避免法律中的具體處罰，並使 (23).
has an instrumental
個⼈意識到如果他們遇到違法⾏ effect on a given
individual such that the individual • Public consultation: the meaningful
公眾諮詢：法律或政策可能影響到
為，他們可以提出投訴，在這⽅⾯
aims to avoid the specific penalties in engagement of the people whom
的⼈的有意義的參與對於確保他們
案例，年齡歧視。
the 同樣重要的是，
law and also for individuals to be the law or policy is likely to affect is
aware that they can file complaints if 的需求和關切得到滿⾜⾄關重要
essential to ensure that their needs
法律或政策的條款要明確，並包括
they experience violations of the law, (68, 71)。 are met (68, 71).
and concerns
有關誰可以在什麼條件下提起訴訟
in this case, age discrimination. It is
以及舉證責任是什麼的信息。
equally important for the provisions The estimated costs of policies and laws
政策和法律的估計成本差異很⼤，取決於
of the law or policy to be clear and vary widely and depend on factors such as
地理覆蓋範圍（例如國際、區域或國
include information about who can file the geographical coverage (e.g. international,
a case and under what conditions, and 家）、政策或立法的規定、⽀持實施的培
regional or national), the provisions of the
what the burden of proof is. 訓需求以及所需的監測和執⾏機制等因素
policy or legislation, the need for training to
support
（ 23)。implementation
⼀項研究估計了新公共衛⽣法的 and the monitoring
• Strong civil society activism: domestic
強⼤的⺠間社會積極性：國內非政 and enforcement mechanisms required (23).
立法部分的成本，發現在新⻄蘭和美國等
nongovernmental organizations can One study estimated the cost of the law-
府組織可以在改⾰過程中發揮重要⾼收入國家，新公共衛⽣立法的平均成本
play an important role in the process making component of a new public health
作⽤，並有助於增強舉報違法⾏為
of reform and can help enhance 在
law,382
and 000
found美元之間和 98 萬美元
that in high-income countries,
或在執⾏條約、公約或政策⽅⾯取
the impact of reporting about (72)。
such as儘管如此，這些估計並未將執⾏法
New Zealand and the United States,
violations
得的進展的影響 of laws or progress
(36, made in
40, 67)。 the average cost of new public health
律條款或與監督和執法相關的成本考慮在
implementing treaties, conventions or legislation ranges between US$ 382 000 and
內。
policies (36, 40, 67). US$ 980 000 (72). Still, these estimates did
not factor in the costs of implementing the
• Resource availability: a lack of
資源可⽤性：缺乏資源，包括執法 provisions of the law or those associated with
resources, including funding for monitoring and enforcement.
和監督機構的資⾦，會對政策和法
enforcement and monitoring
律的實施產⽣負⾯影響 (23,the
bodies, can negatively affect 40,
67-69)。
implementation of policies and laws 6.5
(23, 40, 67-69).
Conclusions and
⺠主國家：有證據表明，國際法在
Democracies: Evidence suggests
•
that international laws may be most
穩定或鞏固⺠主國家⽅⾯可能最有
future directions
effective in stable or consolidating
效 (69, 70)，因為這些國家更有可
democracies (69, 70) because these Evidence shows that enacting policies
能遵守條約義務，因為內部監督者
may be more likely to adhere to treaty and laws can be an important strategy to
的存在使得更難隱瞞之間的不⼀致
obligations, due to the presence of reduce or eliminate ageism, and it appears
表達的和實際的⾏為。
102
C HA PT E R 06
The UN Open-Ended Working Group on Ageing and the possibility of a new UN

Box 6.2
convention on the rights of older persons
聯合國老齡問題不限成員名額⼯作組和新的聯合國老年⼈權利公約的可能性
The UN General Assembly established the Open-Ended Working Group on Ageing
in 2010 (78). Its purpose is to strengthen the protection of older people’s rights
聯合國⼤會於
by reviewing how 2010existing
年成立了老齡問題不限成員名額⼯作組
instruments address these rights,(78)。其⽬的是通過
identifying gaps in
protection and exploring the feasibility
審查現有⽂書如何處理老年⼈權利、確定保護⽅⾯的差距以及探索制定新⽂書和 of developing new instruments and measures.
It is the first intergovernmental body outside of the UN Human Rights Council that
措施的可⾏性來加強對老年⼈權利的保護。它是聯合國⼈權理事會之外第⼀個每
annually brings together national human rights institutions (79) with UN Member
年將國家⼈權機構（79
States, nongovernmental個）與聯合國會員國、非政府組織和聯合國機構聚集在⼀
organizations and UN agencies. Since its establishment,
起的政府間機構。⾃成立以來，⼯作組就老年⼈⽣活的關鍵領域進⾏了討論，包
the Working Group has held discussions about key areas of older people’s lives,
including discrimination, health and long-term care, autonomy and independence,
括歧視、健康和長期護理、⾃主和獨立、社會排斥、社會保障、暴⼒和虐待以及
social exclusion, social security, violence and abuse, and end-of-life and palliative
臨終和姑息治療。關⼼。⾃ 2019 年以來，會員國已經能夠提交在⼯作組會議上
care. Since 2019, Member States have been able to present recommendations
談判達成的建議，供聯合國⼤會審議
negotiated in Working Group sessions for (80)。根據為促進老年⼈權利⽽提出的建
consideration by the UN General Assembly
議，⼈權理事會於 2014 年⾸次任命了老年⼈享有所有⼈權問題獨立專家
(80). Based on the proposals made to improve the promotion of older people’s(81)。
rights,
in 2014 the Human Rights Council appointed for the first time an Independent Expert
⼯作組是討論制定有關老年⼈權利的國際⼈權條約或公約的主要論壇。事實上，
on 2012
在 the Enjoyment of All Human Rights by Older Persons (81).
年，聯合國⼤會要求⼯作組審議關於促進和保護老年⼈權利和尊嚴的國
際法律⽂書的提案，並儘早提出⼀份提案，其中包含應被包含在現有機制未充分
The Working Group is the primary forum for debate on the development of an
解決的此類⽂書中
international human(82)。聯合國秘書長進⼀步強調需要建立更強有⼒的法律框架
rights treaty or convention regarding the rights of older persons.
來保護老年⼈的⼈權，包括加快⼯作組制定國際法律⽂書提案的努⼒(83)。
Indeed, in 2012, the UN General Assembly requested that the Working Group consider
proposals for an international legal instrument to promote and protect the rights
聯合國公約是具有法律約束⼒的⽂件，可通過法律強制執⾏，概述特定群體（例
and dignity of older persons and present, at the earliest possible date, a proposal
如婦女）的權利或解決特定問題（例如酷刑）。任何联合國會員國都可以批准⼀
containing, the main elements that should be included in such an instrument that are
項聯合國公約，從⽽同意遵守
not addressed sufficiently by existing mechanisms (82). The UN Secretary-General
,has further highlighted the need to build stronger legal frameworks to protect the
human rights of older persons, including by accelerating the efforts of the Working
按其規則。⼀旦⼀個國家批准了⼀項公約，它必須要么調整其國家
Group to develop proposals for an international legal instrument (83).
法律和政策或通過新的立法以實施該條約中包含的權利。因此，公約可以提供⼀
個基於權利、公平和社會正義的框架，以指導應對⼈⼝老齡化的政策。它可以⿎
A UN convention is a legally binding document, which is enforceable by law, that
勵⼀種範式的轉變，即從老年⼈被視為福利的被動接受者到老年⼈被視為積極的
outlines the rights of a specific group (e.g. women) or addresses a specific issue (e.g.
torture). Any UN Member State can ratify a UN convention, thereby agreeing to abide
權利持有者。
by its rules. Once a country ratifies a convention, it must either adapt its national
聯合國會員國就如何最好地促進和保護老年⼈的⼈權表達了各種觀點，包括通過
laws and policies or adopt new legislation to put into effect the rights included in
加強使⽤現有法律⽂書或起草專⾨⽂書。⼯作組繼續專注於更深入、更開放、更
that treaty. Thus, a convention can provide a framework based on rights, equity and
實質性的討論，以充分了解問題，確定需要進⼀步闡述的要素並考慮適當的解決
social justice to guide policy responses to demographic ageing. It can encourage a
⽅案。
paradigm shift from one in which older people are considered as passive recipients of
welfare to one in which older people are seen as active rights holders.
UN Member States have expressed a variety of views on how to best promote

and protect the human rights of older persons, including through enhancing the
use of existing legal instruments or drafting a dedicated instrument. The Working
Group continues to focus on more in-depth and open, substantive discussions to
fully understand the issues, identifies elements that require further elaboration and
considers appropriate solutions.
103
to be affordable. Policies and laws aimed

證據表明，制定政策和法律可以成為減少 and policies that may be ageist and
at tackling ageism are quite varied and
或消除年齡歧視的重要策略，⽽且似乎是 improve access to justice for those
can include legislation addressing age making complaints on the grounds
可以負擔得起的。旨在解決年齡歧視的政
discrimination and inequality, policies to of age discrimination or ageism more
策和法律多種多樣，可以包括解決年齡歧
ensure respect for the dignity of all persons broadly. Although there has been
視和不平等問題的立法、確保尊重所有⼈
regardless of age, and human rights laws. steady progress in the adoption of
Along with educational interventions and
的尊嚴的政策，無論年齡⼤⼩，以及⼈權 national legal and policy provisions
intergenerational contact activities, policies prohibiting discrimination on the basis
法。除了教育⼲預和代際接觸活動外，政
and laws are among the most important of age (17), their scope and coverage
策和法律也是打擊年齡歧視的最重要戰略
strategies to include in any effort to combat are uneven compared with guarantees
之⼀。
ageism. against discrimination on other
grounds. Many inconsistencies and
Future priorities in relation to policy and gaps also exist in terms of specificity,
legislation interventions are detailed below. alignment with international law, legal
and material scope, protection from
• International policy and both direct and indirect discrimination,
legislative guarantees against age differential treatment and exceptions,
discrimination should be increased. In as well as in terms of monitoring
international law, there is no specific and access to remedies (51). There is
legal instrument to dispel prejudice also a need to develop protections
and discrimination against older from intersectional and cumulative
people, and most international human discrimination through policies and
rights instruments do not explicitly laws (e.g. discrimination based on
list age as a prohibited ground of both age and disability) (73-76).
discrimination. An international
convention could turn aspirations • Public awareness about anti-
into binding obligations and result discrimination and human rights laws
in national legislation and policy, as and policies should be increased.
has happened with other conventions
such as the Convention on the Rights • It is important to conduct research
of Persons with Disabilities (34, to improve understanding of the
35), the International Convention effectiveness of existing and new anti-
on the Elimination of All Forms of discrimination legislation and policies
Racial Discrimination (38) and the at the national and international levels
Convention on the Elimination of (see Box 6.3).
all Forms of Discrimination Against
Women (36, 37). Support for the • Estimates of the costs of policy and
development of a new UN treaty on legislation interventions should be
the human rights of older persons improved. Without accurate and
has increased recently, especially comparable estimates of cost, the
since the establishment of the UN cost–effectiveness of interventions
Open-Ended Working Group on can neither be estimated nor
Ageing (see Box 6.2). compared. WHO’s cost–effectiveness
and strategic planning model (known
• It is critical to develop and enforce as WHO-CHOICE) can be used for
national anti-discrimination laws and costing the implementation of new
policies, modify or repeal existing laws laws and policies (77).
104
C HA PT E R 06
Box 6.3
Opportunities for research on policy and law
Although no systematic reviews are available about the effects of policies and laws
on addressing ageism, evidence on the effectiveness of laws in tackling ageism and
other “-isms” supports the use of this strategy to reduce or eliminate it. It will be
important for future research to focus on conducting rigorous impact assessments
of existing and new anti-discrimination laws and on policies aiming to eliminate
ageism, as well as to assess the contributing factors to effectiveness (23). It is
key that studies are conducted in low- and middle-income countries and that they
also investigate the impact of these interventions on tackling ageism beyond the
employment sector, given that most of the evidence has focused on employment-
related outcomes in only a limited range of countries.
Given that randomized controlled trials are not always a possible or ethical design
when evaluating policies and laws, future studies could use a range of techniques
to address the challenges of attributing observed changes to the implementation
of a given law or policy, for example, by using a statistical technique known as
differences in differences, which aims to isolate the effect of a law on specific
outcomes. Using this type of analysis, studies have compared, for example, the
outcomes of older workers before and after a change in discrimination law (e.g.
the introduction of the Age Discrimination in Employment Act in 1967 in the United
States or changes in state laws) with those of an unaffected control group, such as
younger workers or older workers in countries without legal changes, or both (24).
Additional methods have also been proposed to overcome other challenges

encountered in evaluating laws and policies using observational designs, for
example, by using regression discontinuity designs, instrumental variables or near–
far matching approaches to address the issue of unobserved confounders (19). Or
propensity score matching (i.e. a statistical matching technique that attempts to
estimate the effect of a policy by accounting for the covariates that predict exposure
to the policy) can be used to address the issue of constructing a comparison
population when a well-matched comparator is not immediately available (19).
Qualitative comparative analysis is another method that has been increasingly used
(84). This is a mixed quantitative and qualitative technique that is based on multiple
case studies and that aims to determine which logical conclusions multiple case
studies support and which can help explain why change happens in some cases but
not others (85).
105
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HAITI
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C HA PT E R 01
CHAPTER 07
07
“ I am not a shame d to b e an old p er s on; it i s a s tage

in life w hich i s inev itable. I think we ne e d to teach
“
p e ople that s tigmatizing p e ople b e c au s e of their
age i s w rong .
CELIN, 61, HAITI

©Jo s eph Jn - Florley / H elpAge International
113
Educational interventions include instruction that

教育⼲預包括傳遞信息、知識和技能的指
transmits information, knowledge and skills, as
well as activities to enhance empathy through
導，以及通過⾓⾊扮演、模擬和虛擬現實
role-playing, simulation and virtual reality.
增強同理⼼的活動。
Research shows that educational interventions are
研究表明，教育⼲預是減少針對老年⼈的
among the most effective strategies for reducing
年齡歧視的最有效策略之⼀。
ageism 尚不清楚它
against older people. Nothing is known
about their effectiveness for reducing ageism
們在減少針對年輕⼈的年齡歧視⽅⾯的有
against younger people.
效性。
07
Chapter These interventions are feasible and affordable.
這些⼲預措施是可⾏且負擔得起的。
教育⼲預在任何減少年齡歧視的努⼒中都
Educational interventions have a central role to
play in any effort to reduce ageism.
可以發揮核⼼作⽤。
7.1
What they are and
how they work
減少年齡歧視的教育⼲預涉及多種活動，這些活動
Educational interventions to reduce ageism refer
to diverse activities, which are often combined.
通常是結合在⼀起的。其中包括傳遞信息、知識、
These include instruction that transmits information,
技能和能⼒的教學，旨在減少年齡歧視、偏⾒和歧
knowledge, skills and competencies aimed at reducing
視。教育⼲預還包括旨在通過換位思考來增強同理
ageist stereotypes, prejudice and discrimination.
⼼的活動，例如使⽤⾓⾊扮演、模擬和虛擬現實。
Educational interventions also include activities
intended to enhance empathy through perspective-
許多教育⼲預措施還包括代際接觸的要素，或者與
taking, using, for instance, role-playing, simulation
成熟的代際接觸⼲預措施相結合（⾒第 7.2 節）and
virtual reality. Many educational interventions also
（1、2）。
either include an element of intergenerational contact
教育⼲預可以⾯對⾯或在線提供。⾯對⾯和在線教
or are combined with fully fledged intergenerational
學可能包括納入特定課程（例如老年病學、老年學
contact interventions (see Section 7.2) (1, 2).
本章第
Section7.1 節描述了教育⼲預——
7.1 of this chapter describes 或老齡化與健康）的關於年齡歧視的講座或模塊，
educational interventions –第the
解決年齡歧視的第⼆種策略。 Educational interventions can be delivered either face-
或納入課程（例如醫學、護理和社會⼯作學校）。
second strategy to address ageism. to-face or online. Face-to-face and online instruction
7.2 節回顧了有關其有效性的現有⾯對⾯的教育⼲預也可以在服務學習（即學習與社
Se c tio n 7.2 reviews available may include lectures or modules on ageism that are
證據，第
evidence 7.3 on 節提供了來⾃不同國
their effectiveness, 區服務相結合，提供務實的指導和反思，同時滿⾜
integrated into specific courses (e.g. on geriatrics,
家的此類⼲預的⽰例。
and Section 7.3 provides 本章還在第
examples of gerontology or ageing and health) or whole courses
社區需求）、臨床輪換或實習（例如學⽣跟隨醫
this 節中介紹了可以使這種⼲預更
7.4 type of intervention from various addressing ageism that are integrated into curricula
⽣）和指導（即在此期間更有經驗或知識淵博的⼈
countries. This chapter also presents,
有效的特徵及其成本。 (e.g. in medical, nursing and social work schools). Face-
in Section 7.4, those characteristics 有助於指導經驗不⾜的⼈）。⼤多數⼲預措施是在
to-face educational interventions can also take place
that can make this intervention more 正規教育環境（即學校、學院、⼤學）中進⾏的，
during service learning (i.e. learning combined with
effective, as well as its costs. community service to provide pragmatic instruction
只有少數是在非正規學習環境（例如⼯作場所或社
區中⼼）中進⾏的 (3, 4)。
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C HA PT E R 07
and reflection while simultaneously meeting Most educational interventions – both those
community needs), clinical rotations or that seek primarily to transmit knowledge
attachments (e.g. students shadowing and those that aim to enhance empathy –
physicians) and mentoring (i.e. during which have targeted interpersonal ageism, rather
a more experienced or knowledgeable than self-directed or institutional ageism,
person helps to guide a less experienced and most of the interventions that have
person). Most interventions have taken place been evaluated were implemented in high-
in formal educational settings (i.e. schools, income countries.
colleges, universities), and only a few have
taken place in non-formal learning settings
(e.g. a workplace or community centre) (3, 4). 7.2
Educational inter ventions that seek
主要尋求傳播信息和知識的教育⼲預假設
How well
primarily to transmit information and
成⾒、偏⾒和歧視是無知、錯誤信息、誤
knowledge operate on the assumption that they work
解和簡單化思維的結果。提供準確的信息
stereotypes, prejudices and discrimination
are the result of ignorance, mistaken
和反成⾒的例⼦，消除對特定年齡組的誤 A 2019年對旨在減少年齡歧視的
2019 systematic review of 23 educational
23 項教
information, misconceptions and simplistic
解並教授更複雜的思維技能，使⼈們能夠 interventions aimed
育⼲預措施的系統審查得出了令⼈⿎舞的 at reducing ageism
thinking. Providing accurate information and reached encouraging conclusions (1). It found
有意識地重新考慮和更新他們的信念、感
counter-stereotypic examples, dispelling 結論educational
that (1)。研究發現，教育⼲預對老年⼈
interventions had a small to
受和⾏為，從⽽減少年齡歧視
misconceptions about a particular (1,age
5-9)。
group 和老年⼈的態度（標準化平均差異為
medium effect on attitudes towards ageing
增強同理⼼的活動是⼀種教育⼲預，越來
and teaching more complex thinking skills and older people (a standardized mean
0.34）有中⼩影響，包括刻板印象和偏
allow people to consciously reconsider and
越多地⽤於解決年齡歧視問題。同理⼼是 difference of 0.34), including on stereotypes
⾒。它還發現了對衰老知識的⼩到中等影
update their beliefs, feelings and behaviours and prejudice. It also found a small to medium
指感知他⼈情緒並想像他⼈可能在想什麼響（標準化平均差異為 0.41），包括對衰
and lead to a decrease in ageism (1, 5-9). effect on knowledge of ageing (a standardized
或感受什麼的能⼒（10）。增強同理⼼的老過程的信息和誤解的影響
mean (1, 14,
difference of 0.41), including 15)。
effects on
活動旨在產⽣對另⼀個⼈或群體的痛苦的
Empathy-enhancing activities are a type of information and misconceptions about the
educational intervention that is increasingly
認同和意識，通常是通過⽤於對抗刻板印 ageing process (1, 14, 15).
used to address ageism. Empathy refers
象、偏⾒和歧視的觀點採擇練習。
to the ability to sense other people’s
這些練習旨在增加情感投入、同情⼼和幫
emotions and to imagine what someone Educational interventions
助的願望。例如，此類⼲預使⽤⾓⾊扮演
else might be thinking or feeling (10). to reduce ageism refer to
Empathy-enhancing activities aim to
活動、模擬遊戲和沈浸式虛擬現實，讓參 diverse activities, which are
generate identification with, and awareness
與者從不同的⾓度想像或體驗世界，從⽽ often combined. These include
of, another person’s or group’s suffering,
挑戰刻板印象和偏⾒
generally through (11-13)。
perspective-taking instruction that transmits
⼤多數教育⼲預措施——包括主要尋求傳
exercises used to counter stereotypes, information, knowledge, skills
播知識和旨在增強同理⼼的⼲預措施——
prejudice and discrimination. and competencies aimed at
都針對⼈際年齡歧視，⽽不是⾃我導向或 reducing ageist stereotypes,
Such exercises seek to increase emotional
製度性年齡歧視，⽽且⼤多數已評估的⼲
prejudice and discrimination.
engagement, compassion and the desire to
預措施都是在⾼收入國家實施的.
help. Such interventions use, for example,
role-play activities, simulation games and Twe nt y - o n e of th e 23 e du c atio nal
納入審查的 23 項教育⼲預措施中有 21
immersive virtual reality to allow participants inter ventions included in the review
to imagine or experience the world from 項來⾃美國，1
were 項來⾃澳⼤利亞，1
from the United States, 1 was項來
from
a different perspective, thus challenging ⾃中國台灣，這些都是⾼收入國家 (1)。
Australia and 1 from Taiwan, China, all of
stereotypes and prejudices (11-13). which are high-income countries (1).
115
在低收入和中等收入國家，教育⼲預措施
It is likely that educational interventions intergenerational element was conducted
也可能有助於減少年齡歧視，但需要在那
will also work to reduce ageism in low- and among elementary, middle, high-school and
middle-income本系統評價證實了先前對解
裡進⾏測試。 countries, but they need university students.
to be tested there. This systematic review
決學⽣年齡歧視的教育⼲預措施的審查結
confirms the findings of a previous review The intervention consisted of 10 workshops
果，這表明教育⼲預措施改變了與年齡歧
of educational interventions for addressing about human development across the life
視相關的態度和知識
ageism among students, (2)。該審查還駁斥
which suggested course, and it included lectures, discussions,
that educational
了兩項較舊且不太嚴格的教育⼲預措施審interventions change both movies and pamphlets, all focusing on issues
attitudes and knowledge
查的不確定結果，其中⼀項評估了對醫學 related to ageism important to ageing. The intervention also
(2). The review also dispels the inconclusive included conversations with older adults.
⽣和醫⽣的影響
findings of two (16)，另⼀項評估了對醫
older and less rigorous
療保健提供者的影響
reviews of educational(17)。
interventions, one of Before the intervention, the elementary,
which assessed impacts on medical students middle and high-school students were
and doctors (16) and the other on health- found to be more ageist than their university
care providers (17). counterparts. The intervention led to lower
scores on the Fraboni Scale of Ageism,
indicating less ageism, for all groups of
It is likely that educational students, with the largest decrease on the
interventions will work to affective dimension of the scale. The study
reduce ageism in low- and also found that ageism was more prominent
middle- income countries, but among nursing and medical students than
they need to be tested there. other types of university students (18).
7.3.2 Life-story documentaries

7.3 in the United States
Examples In a face-to-face educational intervention
in the United States, students watched and
Four examples illustrate different types then discussed life-story documentaries.
of educational interventions from various For instance, one told the story of Sam
parts of the world. The first, from Iran, is Ballard and his four marriages; it included
an educational intervention that includes his reflections on finding love, losing love,
an intergenerational element. The second and the meaning of love and relationships
and third, from the United States and over his life.
Australia, concern interventions aimed at,
respectively, high-school students and Another told the story of Mary Starke Harper,
university students. All three primarily rely an African American woman from Alabama,
on classroom-based instruction. The last is who became a psychologist, social scientist
an empathy-enhancing activity that used and a nurse; was awarded an honorary law
virtual reality to counter ageism among degree; and advised six presidents on policy
university students in the United Kingdom. and research into mental health and ageing.
7.3.1 Workshops and The intervention was found to strengthen

conversations in Iran students’ sense of kinship and belonging
with older people, their engagement with
In the Mazandaran Province in Iran, an and interest in older people, and how
educational inter vention with an enthusiastic they felt about and how
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C HA PT E R 07
impressed they were with older adults. would like older people to understand about
It also led to decreases in antagonism them. The main question for this session was,
and antipathy towards older people and “What would I like back from older people
avoidance of older people. However, it did (for a mutually respectful interaction)?”
not lead to more positive feelings towards
older people (e.g. “I like older people” or Session 4 aimed to foster positive and
“I feel positively towards older people”), a respectful interactions between adolescents
greater sense of comfort with older people and older individuals by teaching interpersonal
or to less discriminatory attitudes towards skills. The main question for this session was,
older people (19). “What can I do (i.e. how can I behave) to
increase mutually respectful interactions?”
7.3.3 Curriculum-based This session was designed to overcome
intervention in Australia adolescents’ tendency to avoid initiating
interactions with older individuals for fear
A face-to-face educational intervention for of negative reactions and uncertainty about
high-school students in Australia consisted how to cope.
of four interactive weekly sessions, involving
group discussions, games, role-plays and This intervention led to greater knowledge
case studies. It was integrated into a health and fewer misconceptions about older
and society curriculum. The high-school people, less negative bias, more positive
students were also given homework during attitudes (including stereotypes) and
which they had to practice the new skills they improved social skills related to older people.
had learned with older people in their lives.
Almost all of the students were in contact 7.3.4 Virtual reality in the
with older people, such as grandparents, United Kingdom
other relatives or family friends (20).
A research team in the United Kingdom
Session 1 encouraged students to discuss used three virtual reality activities to foster
what it means to be an older person in empathy for older people among university
today’s society to help them consider older students (11). In the first activity, students
people’s perspectives. The main question used an app to create a visual image of
for this session was, “What might older themselves as an older person. In the
individuals expect of me?” second, aimed to simulate the experience
of social exclusion and isolation that many
Session 2 aimed to raise self-awareness of older adults experience, students wore a
ageist attitudes and stereotypes. The main virtual reality headset that gave them the
question for this session was, “What have experience of taking part in a dinner during
older individuals done for or contributed to which they were not included in interactions.
society?” Its goal was to challenge students’ In the third activity, students were guided
perceptions of older people and broaden through an immersive experience of
their understanding of older people’s completing several everyday tasks in the
lives to help students move beyond hasty home of an older person with moderate
judgements about whether older people frailty (e.g. making a hot drink, answering
deserve respect. the door). Through virtual reality, the
speed of their movements and reactions
Session 3 promoted mutual respect through was slowed, their hearing was dulled and
asking adolescents to reflect on what they their vision blurred. The students reported
117
GLOB
becoming more aware of older adults’ 隨著時間的推移⼩劑量可能比專⾨的課程

the form of a dedicated course over
experiences and having increased empathy one semester
更好。 and infusing the same
⼀項研究比較了教學模式，發現在
and respect for older people. information over the whole of the
⼀個學期內以專⾨課程的形式接收信息並
curriculum led to improvements in
在整個課程中註入相同的信息都可以改善
attitudes towards older people, but
7.4 對老年⼈的態度，但隨著時間的推移，注
infusion over time worked marginally
better than a dedicated
入的效果略好於專⾨課程course(21) (21).
Key characteristics
Presenting information in a positive
and costs •
以積極的態度呈現信息可以幫助抵消預先
light can help counteract pre-
存在的關於老年的刻板印象和偏⾒。
existing stereotypes and prejudices 教育
⽬前尚不清楚哪種教育⼲預⼦類型更有
It is not known which subtype of educational ⼲預中的⼀個挑戰是在⼀⽅⾯對老齡化問
about older age. A challenge in
效：基於教學的還是增強同理⼼的。也不
intervention is more effective: instruction- educational interventions is striking
題誠實和全⾯，另⼀⽅⾯不要描繪得過於
知道每個⼦類型的哪些特徵（例如在線或
based or empathy-enhancing. Nor is it the right balance between, on
消極⽽最終適得其反之間取得適當的平衡
known which characteristic of each subtype
課堂教學；⾓⾊扮演、模擬或虛擬現實） the one hand, being honest and
(e.g. online or classroom-based instruction; (22, 23)。風險在於，當努⼒呈現老齡化
comprehensive about ageing and,
與更⾼的有效性相關（⾒框 7.1）。
role-playing, simulation or virtual reality) is 的積極和消極⽅⾯時，參與者可能會關注
on the other, not painting too
associated with greater effectiveness (see negative a picture that ends up
並記住那些強化他們先前存在的消極刻板
Box 7.1). being counterproductive (22,正如對老年⼈
印象和偏⾒的經歷和信息。 23).
The risk is that when efforts are
在實驗研究中的表現的研究所表明的那
made to present both the positive
Presenting information in 樣，在製定教育⼲預措施時，在積極⽅⾯
and negative facets of ageing,
a positive light can help participants may focus on4and
犯錯可能是可取的（⾒第章）。當先
counteract pre-existing remember the
前存在的刻板印象和偏⾒被周圍的⽂化重experiences and
stereotypes and prejudices information that reinforce their pre-
新點燃時，減少刻板印象和偏⾒的⼲預措
existing negative stereotypes and
about older age.
施的效果也往往會很快消散 (6)。
prejudices. It is probably advisable
to err on the side of positivity
確定哪些特徵與有效性相關的挑戰是教育
A challenge to identif ying which when developing educational
⼲預的異質性。
charac teristic例如，雖然系統評價中的
s are associated with interventions, as research on the
effectiveness is the heterogeneity of
⼤多數研究主要依靠課程和講座來傳遞信 presentation of older people in
educational interventions. For example,
息和知識，但有些研究還包括代際接觸、 experimental studies suggests
while most of the studies in the systematic (reviewed in Chapter 4). The
⾓⾊扮演或模擬的元素。
review relied primarily 然⽽，⼀些研究
on courses and effects of interventions to reduce
為教育⼲預的潛在重要特徵提供了⼀些提
lectures to transmit information and stereotypes and prejudice also
⽰，這些概述如下。
knowledge, some also included an element tend to dissipate quickly when pre-
of intergenerational contact, role-playing or existing stereotypes and prejudices
simulation. Nevertheless, several studies are rekindled by the surrounding
provide some pointers to potentially culture (6).
important characteristics of educational
interventions, and these are outlined below. • 需要進⾏⼩組討論或技能培訓以加強教
Group discussions or skills training
is育。僅由信息引起的對老年⼈態度的改變
required to reinforce education.
• Small doses over time may be Changes in attitudes towards
往往會很快消退，除非這些改變得到後續
better than a dedicated course. older people brought about by
活動的加強，例如⼩組討論或社交技能培
One study compared modes of information alone tend to fade
instructional delivery and found 訓 (9, 24,
quickly 25)。
unless they are reinforced by
that both receiving information in subsequent activities, such as group
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C HA PT E R 07
Box 7.1
Opportunities for research on educational, intergenerational, and combined
educational and intergenerational interventions
The findings on educational interventions, intergenerational contact interventions

and combined educational and intergenerational contact interventions are based
on a high-quality systematic review and meta-analysis commissioned for this
report: the first such meta-analysis in the field (1). This review included 63 studies
and was conducted in accordance with the PRISMA guidelines (29). A total of
14 electronic databases were searched, and the quality of individual studies
was carefully appraised as well as the body of evidence across studies for each
outcome.
However, the quality of the underlying studies was not high. Only six of the
63 studies were randomized controlled trials. More than half of the studies
were rated as being at high risk of bias on four or more of the six dimensions
assessed using the Cochrane Risk of Bias tool. The Grading of Recommendations
Assessment, Development, and Evaluation (GRADE) tool was used to assess the
quality of the body of evidence across studies for each of the ageism outcomes:
the overall quality was rated as moderate for three of the outcomes and low
and very low for the remaining two (30). In future, researchers should strive to
conduct studies of higher quality with less risk of bias.
The essential characteristics of interventions should also be identified with

greater rigour. This will (i) allow interventions to be optimized, (ii) help identify
which characteristics contribute to effectiveness when two or more interventions
are combined, and (iii) provide some guidance on the characteristics of a strategy
that are key to its effectiveness, especially in a new context in which interventions
cannot be retested. The Template for Intervention Description and Replication
checklist and guide (31) was developed by an international team of experts to
promote full and accurate descriptions of interventions. We encourage researchers
to use this checklist and guide when they plan and report on evaluations of
interventions to reduce ageism.
discussions or social skills training professionals through role-play

(9, 24, 25). activities made two suggestions.
可以通過匯報和讓學⽣扮演老年⼈的⾓⾊來增強⾓⾊扮演的效果。 First, it is important for students to
對旨在通過⾓⾊
• The effects of role-playing can be
扮演活動增強學⽣健康專業⼈員同理⼼的⼲預措施的系統審查提出了兩個建議。 play not only the role of the health ⾸
enhanced by debriefing and by professional but also that of the older
先，學⽣不僅要扮演衛⽣專業⼈員的⾓⾊，還要扮演老年患者的⾓⾊，這⼀點很重
having students play the part of the patient. Second, a debriefing session
要。其次，應該包括⼀個匯報會議，讓學⽣將⾓⾊扮演的經驗轉化為移情⾏為
older person. A systematic review should be included to allow students
of interventions that sought to
(26)。 to translate the experience of role-
enhance empathy in student health playing into empathic behaviours (26).
119
• The key characteristics of effective

有效虛擬現實⼲預的關鍵特徵包括確 which tend to increase with age. The
virtual reality interventions include intervention takes half a day and involves
保參與者完全沉浸在場景中並體驗老
ensuring that participants are fully some 30 students at a time. It is estimated
年⼈⾝體的感覺。
immersed in a scene虛擬現實越有效
and experience to cost about US$ 33 per workshop per
地模擬在另⼀個⼈的世界中，⼀個⼈
what it is like to be in an older student, which is relatively affordable.
person’s body. The more effectively
在那個世界中的真實感覺就越好（即 Knowing the cost of effective interventions
virtual reality simulates being in
沉浸感越強），似乎產⽣的同理⼼就 is impor tant. Without accurate and
the world of the other person and comparable estimates of cost, the cost–
越多。⼀個⼈通過另⼀個⼈的⾝體
the greater the feeling one is really effectiveness of interventions cannot be
體驗世界的印象越多（即體現感越
in that world (i.e. the greater the estimated. Further accurate estimates of
強），產⽣的同理⼼就越⼤（12）。
sense of immersion), the more educational interventions are required.
empathy seems to be generated.
And the more an individual has
the impression of experiencing 7.5
the world through another’s
body (i.e. the greater the sense Conclusions and
of embodiment), the greater the
empathy generated (12). future directions
• A review of virtual reality-based
對⽤於培訓衛⽣專業⼈員有關精神疾 Evidence shows that educational interventions
證據表明，教育⼲預措施可有效減少年齡
simulations used to train health
病的基於虛擬現實的模擬的審查發 are effective in reducing ageism and
professionals about mental illness 歧視，⽽且似乎可以負擔得起。
appear 然⽽，這
to be affordable. Such interventions
現，與沒有衛⽣保健背景的⼈相比，
found that such interventions seem 種⼲預是非常異質的。
are, 它們包含不同類型
however, quite heterogeneous.
此類⼲預似乎對具有衛⽣保健背景的
to have a larger impact on the They encompass disparate types of
的⼲預措施，例如尋求在課堂環境或在線
⼈的同理⼼產⽣更⼤的影響
empathy of those with a health- interventions, such as those that seek to
環境中傳遞信息和知識的⼲預措施以及增
care background
（27）。 compared to
該審查還強調了此類⼲預 transmit information and knowledge in a
強同理⼼的活動，包括⾓⾊扮演、模擬遊
those without (27). This review also classroom setting or online and empathy-
措施的最佳內容及其實施⽅案缺乏共戲和沈浸式虛擬現實。
highlights the lack of consensus enhancing activities that教育⼲預和代際接
include role-play,
識，這些要點也與⽤於減少年齡歧視
on the optimal content of such 觸活動是減少年齡歧視最有效的⼲預措
simulation games and immersive virtual
的虛擬現實⼲預措施有關。
interventions and on the protocols reality. Educational interventions8 and
施，兩者結合使⽤效果很好（⾒第
for their delivery, points that intergenerational contact activities are
章）。
also are relevant to virtual reality among the most effective interventions for
interventions used to reduce ageism. reducing ageism, and the two work well
when combined (see Chapter 8).
Evidence shows that Future priorities for educational interventions
educational interventions are should include:
effective in reducing ageism
and appear to be affordable. • developing, testing and scaling
在所有國家製定、測試和擴⼤教育⼲預措
up educational interventions in all
老齡化遊戲是為數不多的被證明是有效的教育⼲預措施之⼀，施，以減少針對老年⼈的年齡歧視，尤其
countries to reduce ageism against
The
其成本已被估計 (23, Aging
28)。 Game is one of the few
在衰老遊戲中，醫學⽣會經歷模是在低收入和中等收入國家，這些國家在
older people, but particularly in
educational inter ventions shown to
擬的⾝體、感官和認知缺陷，這些缺陷往往隨著年齡的增長⽽正規（例如學校、學院、⼤學）和非正規
low- and middle-income countries
be effective and whose cost has been where they are rare, across) 教育環境；
（例如⼯作場所）很少⾒ formal
增加。⼲預需要半天時間，⼀次涉及約 30 名學⽣。估計每
estimated (23, 28). In the Aging Game, (e.g. school, colleges, universities)
個學⽣每個研討會的費⽤約為 33 美元，相對來說可以負擔得
medical students experience simulated and non-formal (e.g. workplaces)
起。了解有效⼲預措施的成本很重要。
physical, sensory and如果沒有準確和可比
cognitive deficits, educational settings;
較的成本估算，就無法估算⼲預措施的成本效益。需要進⼀
步準確估計教育⼲預措施。
120
C HA PT E R 07
• developing, testing and scaling up

開發、測試和擴⼤教育⼲預措施，以減少 replicated more easily and their
educational interventions that reduce essential characteristics be better
⾃我導向和機構年齡歧視，但很少有這種
self-directed and institutional ageism, identified (see Box 7.1);
措施可⽤；
few of which are available;
• estimating the cost and cost–
• describing the characteristics of
以標準化⽅式描述⼲預措施的特徵，以便在缺乏此類估算的情況下估算教育⼲預的
effectiveness of educational
the interventions in a standardized
更容易複製⼲預措施並更好地識別其基本 interventions
成本和成本效益。 such estimates
where
way, so the interventions can be are lacking.
特徵（⾒框 7.1）；
121
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123
O L I P C I A , 74 ,
HAIT OIL I P C I A , 74 ,
HAITI
C HA PT E R 01
CHAPTER 08
08
“ I think that it i s imp or tant [that] the w hole s o ciet y

and the government in par ticular fo cu s on creating
“
a mutual under s tanding b et we en younger and
older p e op le.
O lip c ia , 74 , H ai ti
©Jo s eph Jn - Florley / H elpAge International
125
Intergenerational contact interventions aim to

foster interaction between different generations.
Research shows that intergenerational contact
and educational interventions are among the
most effective interventions for reducing ageism
against older people, and they are promising for
reducing ageism against younger people.
Interventions that combine education and
intergenerational contact also work to reduce
ageism against older people and they have
a slightly larger effect on attitudes than
intergenerational contact interventions used
alone, but they have little effect on knowledge
about ageing.
08
Chapter Intergenerational contact interventions should be
included in any comprehensive effort to reduce
ageism, along with relevant policies, laws and
educational interventions.
8.1
What they are and how
they work
代際接觸⼲預旨在促進不同代⼈之間的互動，它們是
Intergenerational contact interventions aim to foster
解決年齡歧視的重要策略。它們通常涉及將老年⼈和
interaction between people of different generations, and
they are an important strategy to tackle ageism. They
年輕⼈聚集在⼀起，共同完成任務，以⿎勵跨代聯繫
本章討論另⼀種消除年齡歧視的有效策
This chapter discusses another typically involve bringing together older and younger
和理解 (1)。
effective strategy to eliminate
略：代際接觸⼲預。 people to work cooperatively on tasks to encourage
ageism: intergenerational contact 代際接觸活動通常分為直接接觸和間接接觸。直接接
cross-generational bonding and understanding (1).
第 8.1 節描述了這種⼲預及其在解決年齡
interventions. 觸涉及⾯對⾯的互動，這可以發⽣在各種情況下，例
歧視⽅⾯的作⽤。第 8.2 節回顧了有關 Intergenerational contact activities are often divided
如老年⼈和年輕⼈⼀起玩遊戲、園藝、製作藝術或進
其有效性的證據，第 8.3intervention
Section 8.1 describes this 節提供了此類⼲ into those that involve direct contact and those that
⾏⾳樂治療或相互教學；年輕⼈訪問療養院或與老年
and how it works
預的真實⽰例。第 8.4in 節總結了可以使
addressing involve indirect contact. Direct contact involves face-
ageism. Section 8.2 reviews the
⼈⼀起進⾏服務學習；老年⼈與年輕⼈進⾏長時間的
to-face interaction, which can occur in various contexts,
這種⼲預更有效的因素及其成本的證據。
evidence on its effectiveness and 訪談或討論，反之亦然；或老年⼈和年輕⼈住在⼀
such as older and younger people playing games,
Section 8.3 provides real-world 起，有時也稱為家庭共享。以學校為基礎的計劃是最
gardening, making art or engaging in music therapy
examples of this type of intervention. together or teaching each other; younger people visiting
常⾒的代際直接接觸活動之⼀。這些可能涉及老年⼈
Section 8.4 summarizes the evidence nursing homes or doing service learning with older
每週與學⽣會⾯⼀兩個⼩時，例如，分享故事、⼀起
on the factors that can make this people; older people conducting extended interviews or
intervention more effective and its 畫畫或分享食譜和⼀起做飯。
holding discussions with younger people or vice versa;
costs. or older and younger people living together, sometimes
126
C HA PT E R 08
referred to as home-sharing. School-based a positive encounter with a person from

programmes are among the most common another age group (2).
direct intergenerational contact activities.
These might involve older people meeting Intergroup contact theory explains how
群際接觸理論解釋了代際接觸⼲預如何減
with students once a week for an hour or intergenerational contact interventions
two, for instance, to share stories, paint 少年齡歧視。 work in reducing 在最佳條件下促進群體之間
ageism. Facilitating
together or share recipes and cook together. 的接觸，可以在較⼩程度上減少群體間的
contact between groups under optimal
conditions reduces intergroup prejudice and
偏⾒和刻板印象，通過減少對群體間接觸
祖⽗⺟和孫輩之間的代際友誼和接觸也是的焦慮和增加觀點採擇和同理⼼
Intergenerational friendships and contact stereotypes, to a lesser extent, by(4,
reducing
5)。
between grandparents and grandchildren anxiety about intergroup contact and
可以潛在減少年齡歧視的直接代際接觸形
are also forms of direct intergenerational 當兩個群體具有平等的地位和共同的⽬
increasing perspective-taking and empathy
式 (2)。由於壽命的延長，比以往任何時
contact that can potentially reduce ageism 標，並且當存在群體間合作以及權威、法
(4, 5).
候都有更多的年輕⼈擁有在世的祖⽗⺟。
(2). Thanks to increased longevity, more 律或習俗的⽀持時，就會出現最佳條件
與祖⽗⺟的關係也為許多年輕⼈提供了與
young people have living grandparents (2, Optimal conditions
4-6)（⾒第 occur when
4 章⽅框 4.1）。both基於這
groups
than ever before in history. Relationships
老年⼈的第⼀次也是最頻繁的接觸 (1)。⼀理論的⼲預措施的評估，包括減少年齡 have equal status and common goals,
with grandparents also provide many and when there is intergroup cooperation
在世界某些地區（例如非洲、東歐、拉丁
younger people with their first and most 歧視的⼲預措施，表明群體間接觸的影響
and the support of authorities, law or
美洲和加勒比地區），孫⼦與祖⽗⺟住在
frequent contact with older adults (1). 可以從乾預的直接參與者推廣到整個外群
custom (2, 4-6) (see Box 4.1 in Chapter 4).
⼀起的隔代家庭很常⾒，要么是因為孩⼦
Skipped-generation households, in which 體 Evaluations
(4, 5)。 of interventions based on this
grandchildren live
被患有艾滋病的⽗⺟成為孤兒，要么是因 with their grandparents, theory, which have included interventions
are common in
為他們的⽗⺟因⼯作⽽遷移 (3)。 some parts of the world to reduce ageism, demonstrate that the
(e.g. Africa, eastern Europe, Latin America effects of intergroup contact can generalize
雖然代際友誼和祖⽗⺟孫之間的接觸嚴格
and the Caribbean), either due to children beyond the immediate participants in the
來說並不構成乾預措施，⽽且迄今為⽌還
being orphaned by parents who had AIDS or intervention to the entire out-group (4, 5).
沒有研究以孫祖⽗⺟接觸或代際友誼對年
because their parents migrated for work (3).
齡歧視的影響為主要⽬的，本節將討論這
While intergenerational friendships and
些問題，因為他們的重要性。
8.2
contac t bet ween grandparents and
間接代際接觸⼲預需要參與者在沒有直接
grandchildren do not, strictly speaking, How well they work
或⾯對⾯接觸的情況下接觸另⼀個年齡
constitute interventions, and no study to
date has examined
組。有時會區分擴展的和想像的間接接 the effect of grandchild– Intergenerational
與教育⼲預⼀樣，代際接觸策略是減少針 contact strategies are
grandparent contact or intergenerational among the most effective interventions for
觸。例如，當已知年齡相仿的朋友有另⼀對老年⼈的年齡歧視的最有效⼲預措施之
friendship on ageism as its main purpose, reducing ageism against older people, along
個年齡組的朋友時，就會發⽣擴展的間接⼀。
they are addressed in this section due to with educational interventions.
接觸。它基於這樣⼀種想法：你的朋友就
their importance. 越來越多的證據表明，基於代際接觸的⼲
是我的朋友。想像間接接觸的⼯作原理是預措施可以減少針對老年⼈的年齡歧視。 Evidence is increasing that interventions
Indirect intergenerational contact interventions
讓⼈們想像與另⼀個年齡段的⼈有積極的⼀項系統評價包括對旨在減少老年⼈年齡 based on intergenerational contact work
entail participants being exposed to another to reduce ageism against older people. A
接觸group
age (2)。without a direct or face-to-face systematic
歧視的 21 review種不同代際接觸⼲預措施的評
that included evaluations
encounter. Extended and imagined indirect 估，發現它們對態度的影響很⼩（標準化
of 21 different intergenerational contact
contact are sometimes distinguished. interventions aimed at reducing ageism
平均差異為 0.18），包括對陳規定型觀念
Extended indirect contact occurs when, for against older people found that they had
和偏⾒的影響 (7)。它還表明，這些⼲預
instance, a friend of a similar age is known a small effect on attitudes (a standardized
to have friends in another age group. It is 措施對知識有中等影響（標準化平均差為
mean difference of 0.18), including on
based on the idea that a friend of yours is 0.53），包括對衰老過程的信息和誤解
stereotypes and prejudice (7). It also showed
a friend of mine. Imagined indirect contact that
（⾒第 these interventions
7 章，框 7.1）。 had a moderate
works by asking people to imagine having effect on knowledge (a standardized mean
127
difference of 0.53), including on information 8.3

and misconceptions about the ageing process
(see Chapter 7, Box 7.1). Examples
該評價中的所有研究均來⾃⾼收入國家，
All of the studies in the review were from Th e firs t of th e fo u r exa m ples of
high-income countries, except for(7)。因
只有⼀項來⾃中上收入國家中國 one from intergenerational contact interventions
China, an upper-middle-income country presented in this section involves older and
此，儘管有⼀些理由假設此類⼲預措施也
(7). So although there are some grounds to younger people playing video games together
適⽤於低收入或中等收入國家，但這並不
assume that such interventions will also work in Singapore. The second example, from
確定 (8-11)。系統評價還評估了結合教育
in low- or middle-income countries, this is China, Hong Kong Special Administrative
not certain (8-11). The systematic review also
和代際接觸活動的⼲預措施的效果（⾒框 Region, describes a form of service learning
evaluated the effects of interventions that
8.1）。 for nursing and medical students. The third
combined educational and intergenerational example discusses an intervention in Portugal
在審查中，在 40 (see
contact activities 項代際接觸以及代際接
Box 8.1). in which students engaged in sustained
觸和教育⼲預措施中，只有兩項針對參與 intergenerational contact by sharing older
者⾃⾝衰老的焦慮，這與⾃我導向的年齡
In the review, only t wo of the 40 people’s homes. The last example involves
intergenerational contact and combined
歧視有關。沒有⼀個涉及製度性年齡歧視 only brief, imagined intergenerational contact
intergenerational contact and educational among students in the United Kingdom.
（7）。
interventions targeted anxiety about
本系統評價的結果證實了先前評價的結
participants’ own ageing, which is related to 8.3.1 Video games in
果。例如，包括 54 項研究對老年⼈的偏
self-directed ageism. And none addressed Singapore
institutional ageism (7).
⾒的測試組間接觸理論的⼲預措施的系統
This intergenerational intervention in
審查發現⼲預措施是有效的 (5)，另⼀項新加坡的這種代際⼲預涉及老年⼈和年輕
The results of this systematic review confirm Singapore involved direct contact between
對代際接觸計劃的審查也是如此
the findings of previous reviews. For(2)。
instance, ⼈之間的直接接觸，他們在兩個⽉內結對
older and younger people who paired up to
雖然關於此類⼲預措施在減少針對年輕⼈
a systematic review of interventions testing 玩了六次電⼦遊戲。
play video games six times年齡較⼤的參與者是
over two months.
intergroup contact theory that included
的年齡歧視⽅⾯的有效性的證據有限，但 The older participants
從當地社區的活動中⼼招募的，平均年齡 were recruited from
54 studies looking at prejudice
它仍然是有希望的（專欄 8.2）。 against activity centres in the local community and
為 76 歲；較年輕的參與者是從當地學校
older people found that the interventions had a mean age of 76 years; the younger
重要的是要強調代際接觸除了減少年齡歧
were effective (5), as did another review of 招募的，平均年齡為
participants 17 歲。
were recruited from local schools
視還有其他好處。例如，對於老年⼈來
intergenerational contact programmes (2). ⼀起玩電⼦遊戲的年輕和年長參與者都報
and had a mean age of 17 years.
說，它可以改善健康和社會⼼理福祉，增告了群體間焦慮（例如，他們感到不那麼
While only limited evidence is available about
強⾃尊，並且可以減少痛苦，減少孤獨 Both younger and older participants who
尷尬和⾃我意識，並且在與其他群體的成
the effectiveness of such interventions to played video games together reported more
感，增強社會聯繫感並加強代際團結員互動時更加⾃信）和態度（例如，按照
reduce ageism against younger people, it is positive changes in intergroup anxiety (e.g.
（2， 20, 21)。
nevertheless promising (Box 8.2). 愚蠢——明智、無聊——有趣和不活躍
they felt less awkward and self-conscious,
——活躍）比沒有⼀起玩電⼦遊戲的對照
and more confident when interacting with
It is im p o r tant to e m phasize that members
組參與者。 of the other group) and attitudes
結果表明，享受遊戲對減少老
intergenerational contact has other benefits (e.g. as measured along the dimensions
年⼈的代際焦慮和改善態度具有重要作
in addition to reducing ageism. For older of foolish–wise, boring–interesting and
people, it can, for example, lead to improved ⽤，但在年輕參與者中則不然（16）。
inactive–active) than participants in the
health and psychosocial well-being, and control group, who did not play video games
increased self-esteem, and it can reduce together. The results showed that enjoyment
distress, decrease loneliness, lead to a of the game had an important role in reducing
greater sense of social connectedness and intergenerational anxiety and improving
strengthen intergenerational solidarity (2, attitudes among older people but not among
20, 21). the younger participants (16).
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C HA PT E R 08
Box 8.1
Combined educational and intergenerational contact interventions
Educational and intergenerational contact interventions are frequently implemented

together. A total of 19 of the 63 studies included in a systematic review commissioned
for this report consisted of such combined interventions (7).
Interventions that combined education and intergenerational contact had a slightly

larger effect on attitudes towards older adults (a standardized mean difference of
0.43), including on both stereotypes and prejudice, than those that involved only
intergenerational contact (a standardized mean difference of 0.18). But there was no
difference in effects on attitudes between interventions that combined education
and intergenerational contact and those that used only education. Nor were there
any differences in effects on attitudes between education-only and intergenerational
contact-only interventions. Also, combined interventions had no significant effect on
knowledge, but education-only and intergenerational contact–only interventions had,
respectively, small and moderate effects on knowledge (7, 12, 13).
Further analyses combined results from education-only, intergenerational contact–

only, and combined education and intergenerational contact interventions and
produced several noteworthy findings (7). The analyses found that although these
interventions had a small effect on attitudes and knowledge in high-school and
university-level age groups, they were not effective in improving attitudes in pre-
primary and primary school–aged children. No studies examined their effect on
knowledge in pre-primary and primary school students. The analyses also revealed
that the dose of the intervention was not related to improvements in attitudes or
knowledge. Finally, interventions also appeared to increase younger participants’
level of comfort when interacting with adults, but seemed to have no effect on their
prejudicial attitudes towards their own ageing (a proxy for self-directed ageism).
Eighteen of the 19 combined interventions included in the review were implemented

in the United States and one was in Canada (7). So we cannot be completely sure
whether these findings about combined interventions apply to low- or middle-income
countries.
Example: Positive Education about Ageing and Contact Experiences from the United
States
The Positive Education about Ageing and Contact Experiences (PEACE) programme
is an example of a combined education and intergenerational contact intervention
to reduce ageism that was aimed at younger people and delivered online (14). The
intervention consisted of presenting a series of true/false statements about ageing
and older people. For instance, participants had to decide whether the statement
“depression is more frequent among older adults than among younger people” was
true or false. For the educational component, the correct responses and accompanying
explanations were provided after the participant had answered the questions.
129
The contact component was a form of indirect, extended contact and consisted
of an additional response to the question about depression that described an
intergenerational relationship in a positive way: “Max (aged 22 years) … admires
Charles’ positive take on life and hopes to be more like him. …”
When tested, this simple, easy to implement and presumably inexpensive online
intervention improved attitudes towards older people and knowledge about
ageing. Potentially, it could be developed into a more in-depth intervention and
delivered widely online to reduce ageism. An evaluation of the PEACE programme
found that the combined intervention was generally not any more effective at
reducing ageism outcomes than either the educational or the intergenerational
contact components alone (14).
8.3.2 Service learning in direct intergenerational

Aconchego 計劃於 2004contact.
年在葡萄牙開 In this
China, Hong Kong Special programme,
始，⿎勵持續、 older people provide housing
Administrative Region to university students and, in exchange,
代際直接接觸。在這個項⽬中，老年⼈為
students help alleviate older people’s
This intervention for nursing and medical ⼤學⽣提供住房，作為交換，學⽣幫助減
loneliness and isolation.
這項針對中國香港特別⾏政區護理和醫學
students in China, Hong Kong Special 輕老年⼈的孤獨感和孤立感。
⽣的⼲預措施包括三個部分：半天的介紹
Administrative Region, consisted of three This programme carefully matches older
該計劃將獨居的老年⼈與需要住宿的學⽣
性⼯作坊、10
components: 週的互動期和半天的代際分
a half-day introductory people who live on their own with students
精⼼配對，密切關注相互的期望、興趣和
享會。
workshop,在互動期間，老年⼈和學⽣配對，
a 10-week interaction period and who need accommodation, paying close
a half-day intergenerational sharing session. 個⼈經歷。起初，對該項⽬的需求主要來
attention to mutual expectations, interests
他們確定了相互學習的⽬標（例如關於年
During the interaction period, older adults ⾃尋找住宿的學⽣，但隨著時間的推移，
and personal histories. At first, demand for
齡相關的變化、老年慢性病的挑戰或晚年
and students were paired, and they identified the programme came mainly from students
隨著老年⼈對項⽬的熟悉和信任度增加，
健康的⽣活⽅式）。
mutual learning objectives 然後兩⼈每週⾒⾯⼀
(e.g. about age- looking for accommodation, but in time,
老年⼈的需求也隨之增加。該計劃始於波
到兩個⼩時。
related changes, 他們討論了諸如與年齡相關
the challenge of chronic as older people became more familiar
illness in old age, or a healthy lifestyle in 爾圖，這座城市擁有⼤量學⽣和老年⼈；
with the programme and trusted it more,
的變化、老年慢性病的挑戰以及晚年健康
later life). Then the⽬標是讓年幼的學⽣了
pairs met from one to 然後在⾥斯本和科英布拉這兩個有很多學
demand from older people increased. The
⽣活⽅式等話題。
two hours per week. They discussed topics programme started in Porto,
⽣的城市復制了它。儘管 a city with
Aconchego 計
解衰老的現實以及年長的伴侶如何應對。
such as age-related changes, the challenge of large populations of students and older
劃已受到仔細監測，但尚未評估其對年齡
該⼲預措施增加了醫學和護理專業學⽣對
chronic illness in old age and having a healthy people; it was then replicated in Lisbon
lifestyle in later life. The goal was for younger
歧視的影響 (23, 24)。
and in Coimbra, two other cities with
衰老的整體知識和他們對老年⼼理健康需
students to learn about the reality of ageing 這種模式已經傳播到⼤約
many students. Although 16 the個國家，包
Aconchego
求的理解，並減少了他們對老年⼈的消極
and how their older partners coped. 括澳⼤利亞、比利時、加拿⼤和韓國；有
programme has been carefully monitored,
態度 (22)。
its impact on ageism has
時它被稱為家庭共享 not been evaluated
(25)。雖然對家庭共
The intervention increased medical and (23, 24).
享計劃的⼀些定性評估與年齡歧視以外的
nursing students’ overall knowledge of ageing
and their understanding of mental health 結果有關
This model(26)，但尚未進⾏嚴格的評估以
has spread to some 16 countries,
needs in old age and reduced their negative 評估其對年齡歧視的影響。
including Australia, Belgium, Canada and
attitudes toward older adults (22). the Republic of Korea; sometimes it is
known as home-sharing (25). While some
8.3.3 Home-sharing in qualitative evaluations of home-sharing
Portugal programmes have been carried out in
relation to outcomes other than ageism
The Aconchego programme, which started (26), no rigorous evaluation assessing their
in Portugal in 2004, encourages sustained, impact on ageism has been conducted.
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C HA PT E R 08
Box 8.2
Intergenerational contact interventions to reduce ageism against
younger people
The evidence is promising for the effectiveness of using intergenerational contact

strategies to reduce ageism against younger people. A rapid review conducted for
this report identified five studies evaluating the effectiveness of these strategies
that used a design with a comparison group (either randomized or not randomized)
(15-19). All of these studies examined ageism against both younger and older people.
Four of the studies found that such interventions work to reduce ageist attitudes
towards younger people (15-17, 19), while one found they made no difference (18).
Example: The Young–Old Link and Growth Intergenerational Programme in China,

Hong Kong Special Administrative Region
An example of one of these interventions is The Young–Old Link and Growth

Intergenerational Programme in China, Hong Kong Special Administrative Region.
This programme aimed to combat age-related stereotypes and facilitate positive

interactions between younger and older adults in China, Hong Kong Special
Administrative Region (19). It comprised six sessions that brought together
167 older people from community social services and 179 younger people from
secondary schools. The programme was run by social workers who specialized in
working with younger and older people.
The first stage – the foundation stage – consisted of two rounds of training of
the social workers selected to deliver the intervention. The second stage – known
as the stimulation stage – provided information to the participants to help them
get to know one another. This stage consisted of two 2-hour sessions, one for
older people and one for younger people. Older people watched a video on youth
development to better understand the needs of contemporary youth, and younger
people engaged in exercises that simulated the impairments that older people
may have (e.g. blurred vision). The third stage – known as the consolidation stage
– consisted of two day-long sessions attended by both groups together. The first
involved setting collective goals (i.e. identifying sightseeing locations suitable
for both generations), and the second, achieving the goals (i.e. visiting the sites
together). This was followed by two additional 2-hour sessions, in which older
and younger people participated together, focused on preparing, rehearsing and
delivering group presentations about the sites visited.
An evaluation found positive changes in intergenerational attitudes, an increased

sense of comfort with participants of a different generation, and increased
interactions on the parts of both the younger and older participants. However,
the changes were generally larger for the younger participants than for the older
participants (19).
131
GLOB
根據群際接觸理論，代際接觸活動的
8.3.4 Imagined contact in the against older people appears to be
最佳條件之⼀是確保群體處於平等地
United Kingdom the unequal status between the
位。減少年輕⼈對老年⼈的年齡歧
younger and older participants.
A brief intervention based on a form of Unequal status can arise when
視計劃失敗的⼀個共同特徵似乎是年
indirect and imagined intergenerational tasks favour the skills of one group
輕和年長參與者之間的不平等地位。
contact was used with the aim of reducing over the other, or there are unequal
當任務有利於⼀組的技能⽽不是另⼀
both explicit and implicit negative attitudes numbers in the different age groups
towards older people among undergraduate 組的技能時，或者不同年齡組的⼈數
or differing levels of familiarity with
students in the United Kingdom. 或對環境的熟悉程度不同時，就會出
the environment. For instance, an
intervention taking place
現不平等的地位。例如，在⼀所學in a school,
The students were instructed to spend two which might be unfamiliar to older
校進⾏的⼲預，對於老年⼈來說可能
minutes imagining themselves meeting an people, and that includes many
older stranger for the first time. They were 並不熟悉，並且包括許多年輕⼈，⽽
younger people and only a few older
also asked to imagine that they found out 只有少數老年⼈，很可能會造成不平
people is likely to create unequal
some interesting and unexpected things status. Having
等的地位。 lower status in a
在接觸情況下處於較低
about the person. contact situation
的地位可能會加劇預先存在的參與活 may exacerbate
pre-existing anxieties about
This simple and inexpensive intervention 動的焦慮。
participating如果群體之間的地位明
in activities. If the status
led to reductions both in explicit negative 顯不平等，代際活動實際上可能會增
between groups is markedly unequal,
attitudes towards older people (e.g. the intergenerational
加偏⾒ (2, 4)。 activities may
students felt less cold, less suspicious, less actually increase prejudice (2, 4).
hostile) and in implicit bias in favour of young
people over older people. The authors note, • The quality of the contact between
代際活動中群體之間接觸的質量（例
however, that imagined contact likely has less groups in intergenerational activities
如老年⼈和年輕⼈相處得如何或他們
powerful and long-lasting effects than direct, (e.g. how well older and younger
感覺情感上的親密程度）是另⼀個關
face-to-face intergenerational contact (27). people get on or how emotionally
鍵因素，在減少對老年⼈的刻板印象
close they feel) is another key
和偏⾒⽅⾯，它可能比接觸頻率更重
factor that may be more important
8.4 than 1）。
要（ the frequency of contact in
通過組織建立信任的任
reducing stereotypes and prejudice
Key characteristics 務、避免任何⼀⽅光顧另⼀⽅的情況
against older people (1). Better
以及⿎勵參與者相互分享個⼈信息的
quality contact can be fostered
and costs ⾃我披露，可以促進更好的接觸質
by organizing tasks that build
confidence,
量。 avoiding situations
然⽽，⿎勵⾃我披露需要謹慎
Several studies provide some indication about
幾項研究提供了⼀些關於哪些因素有助於 in which either
的設計：研究表明，老年⼈講述過去 party patronizes
which factors contribute to the effectiveness the other and encouraging self-
代際接觸的有效性的跡象，包括祖⽗⺟和
of intergenerational contact, including 的故事會增加接觸的親密程度，但如
disclosure during which participants
孫輩之間以及不同代⼈之間的朋友之間。
between grandparents and grandchildren 果老年⼈洩露過多的個⼈信息，則會
share personal information with
and between friends of different generations. one another. However, encouraging
導致溝通不暢和負⾯結果（2, 28,
self-disclosure requires
29)。因此，重要的是要包括雙⽅的 careful
• According to intergroup contact design: research suggests that
平衡數量的⾃我披露，並且過去的故
theory, one of the optimal conditions older adults telling stories about
for intergenerational contact activities 事不要過於個⼈化
the past increases the(2)。
closeness of
is to ensure that the groups are of contact, but if older adults divulge
equal status. A common feature of too much personal information, it
unsuccessful programmes to reduce can lead to poor communication and
ageism among younger people negative outcomes (2, 28, 29). Thus,
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C HA PT E R 08
it is important to include balanced to enhance the positive impact on ageism

⼀些可能在⼲預中被操縱的因素似乎增強
amounts of self-disclosure from both that contact between grandparents and
parties and for the stories of the past 了祖⽗⺟和孫⼦女之間以及不同代際朋友
grandchildren and between friends of
not to be too personal (2). 之間的接觸對年齡歧視的積極影響。
different 這些
generations can have. These factors
partly overlap with
因素與上述成功的代際接觸⼲預的特徵部 the characteristics of
• Activities that increase cooperation
通過⽬標共享增加合作和減少年齡 the
分重疊。 successful intergenerational contact
through goal sharing and that reduce interventions discussed above.
組之間競爭的活動似乎很重要，這
competition between age groups
與組間接觸理論中的最佳條件的想
appear to be important, in keeping •
⼀項系統評價發現，
A systematic review found that
法保持⼀致。
with the idea of促進合作以外的活動
optimal conditions in 與祖⽗⺟接觸的質量和頻率都具有強⼤且
both the quality and frequency of
intergroup contact theory. Activities
包括參加藝術和⼿⼯藝項⽬、代際 contact with grandparents have
獨立的減少年齡歧視的作⽤ (30)。然⽽，
than foster cooperation include 同
合唱團和管弦樂隊以及烹飪等。 robust and independent
⼀些研究表明，要使良好的接觸對祖⽗⺟ ageism-
taking part in, for instance, arts and reducing effects (30). However, some
樣重要的是確保避免確認對任何⼀的態度產⽣積極影響，還需要相對頻繁 (2,
crafts projects, intergenerational research suggests that for good-
個群體的負⾯刻板印象的活動或任
choirs and orchestras and cooking. 31)。⾼質量的接觸似乎以雙⽅更多的⾃我
quality contact to positively affect
It is equally important to ensure
務，以及不參與項⽬的旁觀者的存表露和觀點為特徵；年輕⼈將祖⽗⺟視為
attitudes towards grandparents, it
that activities or tasks that confirm
在以及個⼈可以完全迴避接觸的情 also needs to be
個⼈；年輕⼈避免使⽤過於通融的語⾔， relatively frequent
negative stereotypes about either (2, 31). High-quality contact seems
況 (2)。有時被稱為長者語⾔（例如，不與老年⼈
group are avoided, as well as the to be characterized by increased
presence of onlookers who are not 使⽤嬰兒談話）；
self-disclosure and和年輕⼈對互動幾乎沒
perspective-
participating in the programme and 有焦慮………………………………………
taking by both parties; younger
situations in which individuals can people treating grandparents as
sidestep contact altogether (2). individuals; younger people avoiding
using overly accommodating speech,
• A review found that the more well 在年齡歧視中，雙⽅的⾃我披露、觀點採
sometimes referred to as elderspeak
⼀項審查發現，⼲預措施的結構和
structured and carefully designed 擇和同理⼼似乎起著關鍵作⽤（2）。
(e.g. not using baby talk with older
設計越精⼼，效果就越好（例如，
the interventions were, the more adults); and younger people having
確保教師受過良好培訓，向參與者
effective they were (e.g. ensuring little anxiety about interacting
提供明確的指導，並使⽤乾預協
that instructors are well trained, clear with grandparents (2, 31). Although
instructions are given to participants,
議）（20）。 little research has examined the
and intervention protocols are used) characteristics of intergenerational
(20). friendship that lead to a reduction
in ageism, it appears that self-
• One study points to the potential
⼀項研究指出了參與者如何分組的 disclosure, perspective-taking and
importance of how participants are empathy by both parties play key
潛在重要性，無論是成對還是更⼤
grouped, whether in pairs or larger roles (2).
的混合年齡組。它表明，與在較⼤
groups of mixed ages. It suggests
群體中進⾏的活動（例如唱歌或演
that activities performed in child– • Parental encouragement and shared
older adult dyads (e.g. structured
奏樂器）相比，在兒童中進⾏的活 family identity also play roles in
conversations and moving to music) the impact that contact between
動（例如結構化對話和隨著⾳樂移
had a more positive effect on grandchildren and grandparents has
動）對刺激互動具有更積極的影響
stimulating interaction than activities on ageism. Generally, grandchildren
（例如唱歌或演奏樂器）（15）
occurring in a larger group (e.g. who identify more strongly with their
singing or playing an instrument) (15) family and whose parents encourage
relationships with their grandparents
Several factors, which could potentially have more favourable perceptions of
be manipulated in an intervention, appear older adults (29).
133
• Findings about the effect on ageism

關於與老年⼈同住或同住對年齡歧 education-only interventions, and they
of living or having lived with an older had no effect on knowledge. Education-
視的影響的研究結果尚無定論
person are inconclusive (32-35). More only and intergenerational education-only
(32-35)。
research is 需要更多的研究來闡明
required to clarify the interventions had, respectively, small and
因素的作⽤，例如老年⼈的健康狀
roles of factors such as the state of moderate effects on knowledge.
health of the older person, the type
況、關係類型（例如祖⽗⺟、其他
of relationship (e.g. grandparent, Future priorities in relation to intergenerational
與代際接觸⼲預相關的未來優先事項應包
親屬、非親屬）、關係的質量和
other relative, non-relative), the contact interventions should include the
代際⽣活的⽂化規範 (29, and
36, 括以下內容：
quality of the relationship following:
37)。
the cultural norms governing
intergenerational living (29, 36, 37). • It is essential to develop, test and
必須開發、測試和擴⼤僅代際接觸以及結
scale up intergenerational contact-
合教育和代際接觸的⼲預措施，以減少所
Little information is available about the costs
關於代際接觸⼲預成本的信息很少。然 only and combined educational-
of intergenerational contact interventions. 有國家，尤其是低收入和中等收入國家針
and intergenerational-contact
⽽，⼀些評論強調，此類⼲預措施的成本
However, several reviews emphasize that the 對老年⼈和年輕⼈的年齡歧視。
interventions to reduce ageism
可能很低（尤其是那些基於想像和擴展的
costs of such interventions are likely to be against both older and younger
間接接觸⽽老年⼈無需參與的⼲預措施）
low (particularly those based on imagined people in all countries, but especially
並且此類⼲預措施易於實施
and extended indirect contact (1, 2, 7) older
in which .例 in low- and middle-income countries.
people are not
如，在新加坡，老年⼈和年輕⼈⼀起玩電 required to participate) and
such interventions are easy to implement • There is a need to identify
需要確定代際接觸⼲預措施的基本特徵，
⼦遊戲的⼲預措施可能是負擔得起的，⽽
(1, 2, 7). For instance, the intervention in the essential characteristics
且易於實施（16）。以及在聯合⼲預措施中正確組合代際和教
Singapore in which older儘管如此，仍需要
and younger people of intergenerational contact
對這些⼲預措施的成本進⾏準確估計。
played video games together is presumably 育成分（⾒框
interventions8.2）。
and the right mix of
affordable and straightforward to implement intergenerational and educational-
(16). Still, exact estimates of the costs of components in combined
these interventions are needed. interventions (see Box 8.2).
• Interventions that aim to reduce

8.5 應制定旨在減少⾃我導向和機構年齡歧視
self-directed and institutional ageism
的⼲預措施。
should be developed.
Conclusions and
It is important to estimate the
future directions • 重要的是估計代際接觸和聯合教育和代際
costs of intergenerational contact-
接觸⼲預的成本。
only and combined educational-
Evidence shows that interventions that
證據表明，促進代際接觸的⼲預措施是減 and intergenerational-contact
foster intergenerational contact are among interventions.
少針對老年⼈的年齡歧視的最有效⼲預措
the most effective interventions for reducing
施之⼀。它們似乎也負擔得起並且相對
ageism against older people. They also • Equally important is the need for
同樣重要的是需要進⼀步研究以確定祖⽗
appear
容易實施。 to be affordable and relatively easy further research to determine the
⺟和孫⼦女之間的接觸以及代際友誼導致
to implement.
雖然將教育和代際接觸相結合的⼲預措施 optimal conditions under which
年齡歧視減少的最佳條件。
contact between grandparents這應該遵循and
對態度（包括偏⾒和刻板印象）的影響略通過開發和測試⼲預措施來促進這些關係
While interventions that combined education grandchildren and intergenerational
⼤於僅涉及代際接觸的⼲預措施，但它們
and intergenerational contact had a slightly friendships lead to reductions in
並減少年齡歧視。
的影響並不比僅教育⼲預措施⼤，⽽且它
larger effect on attitudes, including on ageism. This should be followed
prejudice
們對知識沒有影響 and stereotypes, than those that
. 僅教育和僅代際教育 by the development and testing
involved intergenerational contact alone, of interventions to foster these
⼲預措施對知識的影響分別較⼩和中等。
they did not have a larger effect than relationships and reduce ageism.
134
C HA PT E R 08
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137
BUAKHIAW, 84,
T H A IL A ND
138
C HA PT E R 01
CHAPTER 09
09
“ We don’ t have control over other p e ople’s

“
thought s . What we c an do i s to control and shap e
our ow n thought s and b ehav iour.
B u ak hiaw, 8 4 , T hailan d
©Paib o on Ye elar / FO PD E V / H elpAge International
139
根據其在其他領域的有效性的⼀些證據，
Based on some evidence for their effectiveness
運動可能是減少年齡歧視的⼀個有希望的
in other areas, campaigns may be a promising
strategy to reduce ageism.
策略。
Research on strategies to mitigate the impact
在年齡歧視發⽣後減輕其影響的策略研究
of ageism after it has occurred is still at an early
仍處於早期階段。
stage. Nonetheless,儘管如此，⼀些⽅法可
some approaches may
能有希望減輕負⾯刻板印象的影響。
hold some promise for lessening the impact of
negative stereotypes.
減輕年齡歧視影響的運動和戰略都應在擴
Both campaigns and strategies to mitigate the
⼤規模之前盡可能嚴格地進⾏進⼀步發展
impact of ageism should be further developed
和測試。
and tested as rigorously as possible before they
09
are scaled up.
應制定和測試其他減輕年齡歧視各個⽅⾯
Chapter
影響的策略——刻板印象、偏⾒和歧視。
Other strategies to mitigate the impacts of all
dimensions of ageism – stereotypes, prejudice and
discrimination – should be developed and tested.
9.1
Campaigns
9.1.1 What they are and how they

work
Campaigns are purposive attempts to inform or influence

behaviours in large audiences within a specified period
This chapter discusses two strategies by using an organized set of communication activities
本章討論了兩種解決年齡歧視的策略，這
to address ageism that are supported and featuring an array of mediated messages delivered
些策略得到有限證據的⽀持，但很有希
by limited evidence, but which hold 運動是有⽬的的嘗試，通過使⽤⼀組有組織的傳播
through multiple channels to produce non-commercial
望。第 9.1 節調查了減少年齡歧視運動的
promise. Section 9.1 surveys the 活動，並以通過多種渠道傳遞的⼀系列中介信息為
benefits to individuals and society (1, 2).
evidence for campaigns to reduce
證據，這是⼀種經常使⽤的策略，但沒有特⾊，在特定時期內通知或影響⼤量受眾的⾏為，
ageism, a strategy often有⼀些證據表明
直接證據表明其有效性。 used, but Campaigns use either traditional media (e.g. television/
從⽽為個⼈和社會帶來非商業利益 (1, 2) .
for which there is no direct evidence cinema advertising, radio, billboards, the press, signs
運動在其他領域的有效性提供了理由認為
of effectiveness. That there is some in活動使⽤傳統媒體（例如電視/電影院廣告、廣播、
buses, taxis, etc.) or new media (e.g. social media,
它們也可能有助於減少年齡歧視。
evidence for the effectiveness 第 of 9.2 廣告牌、新聞、公共汽⾞上的標誌、出租⾞等）或
targeted landing pages, pay-per-click advertising,
節總結了在年齡歧視發⽣後減輕對老年⼈
campaigns in other areas provides digital banners and signage, Facebook, Twitter, YouTube
新媒體（例如社交媒體、有針對性的登陸⾴⾯、按
grounds to think they
的影響的戰略證據； might also
然⽽，其中⼀些只是 advertisements, etc.) (3).
點擊付費廣告、數字橫幅和標牌、Facebook、
work to reduce ageism. Section
潛在的策略。 Twitter、YouTube 廣告等）(3)。
9.2 summarizes the evidence for Campaigns generally seek to reduce ageism either
strategies to mitigate the impact of 運動通常尋求通過改變個⼈⾏為直接或間接通過改
directly, by changing individual behaviour, or indirectly,
ageism against older people after it by變法律和政策以及轉變社會規範來減少年齡歧視。
changing laws and policies and shifting social norms.
has occurred; however, some of these Often, they do both. When they operate indirectly,
通常，他們兩者兼⽽有之。當它們間接運作時，運
are only potential strategies. campaigns seek to influence policy-makers, civil
動會尋求影響決策者、⺠間媒體和公眾，以提⾼問
題的知名度，改變對造成問題的責任⼈的看法並動
140
員選⺠，所有這些都是為了創造有利於改變的環境
個⼈⾏為 (1, 4, 5)。近年來，運動越來越多地被⽤於
C HA PT E R 09
society, political and opinion leaders, the of 36 other systematic reviews, as well as
media and the general public to increase three new systematic reviews of primary
the visibility of an issue, alter perceptions studies (3). It summarized the evidence for
of who is responsible for causing the issue mass media campaigns targeting six risk
and mobilize constituencies, all to create factors for noncommunicable diseases:
an environment conducive to changes in alcohol use, diet, illicit drug use, physical
individual behaviour (1, 4, 5). In recent years, activity level, sexual and reproductive
campaigns have increasingly been used to health, and tobacco use (3).
address ageism, as the examples in Section
9.1.3 illustrate. The review found moderate evidence
審查發現中等證據表明⼤眾媒體運動可以減
that mass media campaigns can reduce
少久坐⾏為並影響與性健康相關的⾏為和尋
9.1.2 How well they work sedentary behaviour and influence sexual
求治療的⾏為（例如，通過使⽤幫助熱線戒
health-related behaviours and treatment-
沒有⾼質量的研究證明減少年齡歧視運動的
No high-quality studies demonstrate the 菸和性健康服務）。
seeking behaviours (e.g.對煙草使⽤和⾝體活動
through the use of
有效性 (6)。測試運動的有效性本質上是具
effectiveness of campaigns to reduce helplines to quit smoking and sexual
⽔平的影響的證據喜憂參半。 health
對酒精使⽤產
ageism (6). Testing
有挑戰性的，這可以解釋為什麼很少有⼈評 the effectiveness services). The evidence
⽣影響的證據有限，對非法藥物使⽤沒有影 for an impact on
of campaigns is inherently challenging, tobacco use and level of physical activity
估年齡歧視運動（⾒框 9.1）（7-9）。儘響。運動對⾏為改變的影響似乎比對知識和
which may explain why so few ageism was mixed. The evidence for an impact on
管如此，仍有⼀些證據來⾃解決其他健康問
campaigns have been evaluated (see Box 意識的影響要⼩。
alcohol use was limited, and there was no
題和其他形式的陳規定型觀念、偏⾒和歧視
9.1) (7-9). Still, some evidence exists from impact on illicit drug use. Campaigns appear
campaigns addressing other health issues
的運動。 to have less of an impact on behaviour
總體⽽⾔，證據表明健康運動的有益效果很
and other forms of stereotypes, prejudice
對健康運動有效性⽂獻的最全⾯評價之⼀包 change than on knowledge and awareness.
⼩，即使結果有些不同 (3, 10, 11)。
and discrimination.
括對 36 篇其他系統評價的系統評價，以及 Overall the evidence suggests that health
對初級研究的三篇新系統評價
One of the most comprehensive (3)。它總結
reviews of campaigns have a small beneficial effect,
the literature on the effectiveness of health
了針對非傳染性疾病的六個風險因素的⼤眾 even if the findings are somewhat mixed
campaigns includes a systematic review
媒體宣傳活動的證據：酒精使⽤、飲食、非 (3, 10, 11).
法藥物使⽤、⾝體活動⽔平、性健康和⽣殖
健康以及煙草使⽤ (3)。 Box 9.1
Opportunities for research on campaigns to reduce ageism

研究減少年齡歧視運動的機會
Campaigns are more difficult to evaluate using rigorous designs than many other
與許多其他類型的⼲預措施相比，使⽤嚴格的設計更難評估運動 (7-9)。trials
types of interventions (7-9). It is difficult to use randomized controlled 很難 to
使⽤隨機對照試驗來評估⼤多數活動 (9)。整群隨機試驗是嚴格的設計，偶爾
evaluate most campaigns (9). Cluster–randomized trials are rigorous designs that
are occasionally used instead,
會使⽤，但它們也具有挑戰性 (9, 12, 13)。 but they are also challenging (9, 12, 13).
在⼤多數情況下，活動使⽤較弱的設計進⾏評估，這些設計會產⽣我們不太⾃
In most cases, campaigns are evaluated using weaker designs that produce findings
信的結果 (7-9,
in which we have13)。
less 事實上，當使⽤較弱的設計來評估⼀項活動時，該活動通
confidence (7-9, 13). Indeed, when a weaker design is used
常會誤導性地發揮作⽤，這是使⽤更嚴格的設計評估同⼀活動時的兩倍
to evaluate a campaign, the campaign often – misleadingly – appears to work (14)。
twice
as well as when the same campaign is evaluated using a more rigorous design (14).
優先事項是盡可能對旨在減少年齡歧視的運動進⾏最嚴格的評估，並提供指導
（7、9、15、16）；⼀旦它們的有效性得到證明，下⼀步就是確定它們的基本
The priority is to conduct the most rigorous evaluations possible of campaigns
特徵。
aiming to reduce ageism, and guidance is available (7, 9, 15, 16); once their effec-
tiveness is demonstrated, the next step is to identify their essential characteristics.
141
A review of systematic reviews evaluating Take a Stand Against Ageism: an

mass media campaigns for reducing international campaign
prejudice and discrimination against people
對評估⼤眾媒體運動以減少對⼼理健康狀
with mental health conditions found that Take a Stand Against Ageism is an
況患者的偏⾒和歧視的系統評價的審查發
campaigns had small to moderate positive ongoing campaign taking place in different
現，運動對與污名相關的知識、態度和預
impacts on stigma-related knowledge, regions of the world, and it is led by
期⾏為（即與⼼理健康狀況不佳的⼈接觸
attitudes and intended behaviour (i.e. desire HelpAge International, a global network of
for contact with people with a mental health
的願望）產⽣了⼩到中等的積極影響。條 organizations working with and for older
condition)
件）（17）。 (17). people. The campaign takes its name from
the theme for the 2016 International Day of
An earlier review found that mass media Older Persons (6).
較早的⼀項審查發現，⼤眾媒體⼲預對減
interventions had a small to moderate effect
on reducing negative attitudes towards
少對有⼼理健康狀況的⼈的負⾯態度有⼩ The aims of the campaign are to increase the
people with mental health conditions, but
到中等的影響，但它們對歧視的影響是混 awareness of ageism among HelpAge network
they had mixed effects on discrimination (18). members, campaigners and supporters and
合的 (18)。 to increase the visibility of older people’s
High-quality evidence is sparse about lived experiences of ageism to ensure that
關於致⼒於減少基於種族和⺠族的刻板印
campaigns that work to reduce stereotypes, older people are no longer denied their rights
prejudice and discrimination based on race
象、偏⾒和歧視的運動，⾼質量的證據很 simply because of their age.
and ethnicity, and it shows a mixed picture
少，⽽且它顯⽰了⼀幅混合圖景
(19-21). Campaign resources are available from
(19-21)。 HelpAge International and include guides to
Thus, campaigns may offer a promising conducting consciousness-raising workshops
strategy to tackle ageism. Even if campaigns
因此，運動可能會提供⼀種解決年齡歧視 and ageism role-plays (22).
have only a small effect,
的有希望的策略。 with sufficient reach
即使運動只有很⼩的影
and penetration at the population level they This campaign comprises many ongoing
響，在⼈⼝層⾯有⾜夠的影響和滲透，它
could nevertheless bring about significant campaigns, and the activities vary across
們仍然可以帶來顯著的變化（18）。
change (18). countries. For instance, in Bangladesh
more than 2000 older and younger
9.1.3 Examples people, development workers, students
and journalists formed a human chain to
This section highlights a few international
本節重點介紹⼀些國際和本地活動，其中 demand government action to support a UN
and local campaigns, including one run by a
⼀項由團體聯盟發起，另⼀項由全球網絡 Convention on the rights of older people.
coalition of groups and another by a global Activities organized in Mozambique included
發起。第⼀個例⼦描述了在幾個低收入和
network. The first example describes a march in Maputo, two radio debates with
中等收入國家開展的全球運動。
a worldwide campaign taking place in representatives from the government and
第⼆個例⼦是澳⼤利亞正在進⾏的以研究
several low- and middle-income countries. older people’s associations, and a health fair.
為基礎的全國性運動，⽽第三個例⼦涉及
The second example is an ongoing, The EveryAGE Counts campaign in
加拿⼤的創新型城市運動。雖然前⾯的例
research-based, national campaign in Australia
⼦側重於減少針對老年⼈的年齡歧視的運
Australia, while the third concerns an
動，但框
innovative9.2 提供了⼀個減少針對年輕⼈
city-based campaign in Canada. EveryAGE Counts is an ongoing advocacy
While the previous examples focus on
的年齡歧視運動的例⼦。 campaign in Australia that was launched in
campaigns to reduce ageism against older 2018 and is run by a coalition of organizations
people, Box 9.2 provides an example of aimed at tackling ageism against older
a campaign to reduce ageism against Australians. Its vision is “a society where
younger people. every person is valued, connected and
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Box 9.2
Not Too Young to Run: a campaign to reduce ageism against younger people
in politics
In November 2016, the global campaign Not Too Young to Run was launched
by a partnership including the UN and several other international and
nongovernmental organizations (25). It aims to address ageism against younger
people in the political process by promoting their right to run for public office.
In a fast-changing world where more than 50% of the population is younger than
30 years-old, but less than 2% of elected legislators are, the campaign highlights
the fact that the active participation of young people in electoral politics is
essential to ensure thriving and representative democracies worldwide (26).
The campaign seeks to (i) raise awareness of the lack of young people in public
office by collating global statistics by country concerning youth and politics and
also identifying barriers to participation; (ii) advocate for the rights of young people
to run for public office and leadership positions, and for increased participation of
young people in politics and government; government; and (iii) gather input and
ideas from young people around the world with regards to their participation in
political decision-making processes through an online public consultation. The
campaign also highlights young leaders already in elected positions and tries to
inspire young people to run for office.
The campaign scales up the movement of the same name that was started by
civil society groups in Nigeria in May 2016. This movement contributed to the
Nigerian Government enacting legislation in 2018 that reduced the age limit for
state legislators and those in the federal House of Representatives from 30 years
to 25 years; for senators and governors, from 35 to 30 years; and for the president
from 40 to 35 years (25, 26).
respected regardless of age and functional barriers to participation for older people
health” (23). (e.g. in the workplace and health care); and
increasing the diversity and accuracy of
The overall goal is to build strong, new representations of older people in the media,
foundations to enable current and future arts and public discussions.
generations to age well. The campaign
seeks to shift entrenched negative social Campaign activities have included pledge-
norms about ageing and older people and signing events at Parliament House during
to reframe older age as a valid, positive and which participants acknowledge that they
meaningful part of life. “stand for a world without ageism” (23);
hosting or participating in community-based
EveryAGE Counts seeks to bring about social events to build awareness of the campaign
change by engaging in advocacy, political and increase membership; and developing
engagement and public campaigning for and disseminating materials such as a quiz
policy change; addressing specific structural (Am I ageist?) and a magazine (The real old),
143
which encourages people to think about • Dose: Generally, the longer the
ageism and to speak out against it (23). duration of and the greater the
intensity or exposure to the
Research has played an important part in the campaign, the more effective it will
development of the campaign. For instance, be. However, consensus is lacking
a research project looking at the drivers of about the exact dose necessary
ageism provided the foundational evidence for a successful campaign (3). The
that informed the campaign’s strategy (23). US Centers for Disease Control
and Prevention has suggested
The Best Before Date campaign in that advertisements for tobacco
Canada prevention campaigns should be
aired for at least six months to
The B est B efore Date campaign in affect awareness, 12–18 months to
Peterborough, Canada, was a city-wide establish the campaign’s themes
marketing campaign aiming to tackle ageism, and have an impact on attitudes and
that took place in 2013-2014. Launched 18–24 months to have an impact on
as part of Seniors’ Month, it sardonically behaviour (27).
showed people of all ages with a fake “best
before” date tattooed on their forehead to • Framing: Framing can influence
highlight the stigma related to ageing. our perceptions, attitudes, actions
and how ageing and other issues
The campaign included television spots, are perceived and responded to
YouTube videos, print and radio ads, and an (28-30). Framing refers to how
interactive website where users could take an issue is communicated, where
a quiz to find out their own best before the communication starts, what is
date and upload a picture of themselves to emphasized, how it is explained and
have the date “tattooed” on their forehead. what is left unsaid.
The campaign aimed to reduce ageism
by changing perceptions in Peterborough • Types of messaging and
that older adults are a drain on resources denormalizing behaviour: In anti-
and a nuisance, old-fashioned and out of ageism campaigns, it is preferable
touch with new ways and technology and to present simple messages about
an impediment to people’s busy everyday achievable actions and images that
lives. It also aimed to emphasize the valuable avoid reinforcing the two extremes
knowledge and experience older people can of ageing – the heroes of ageing
offer the community. However, no findings and bodily decline (6). In general,
about the impact of this campaign are campaign messages that denormalize
available (6, 24). a behaviour (i.e. increase its social
unacceptability, thus reinforcing
9.1.4 Key characteristics the perception that it is neither
mainstream nor a normal activity in
Based on research that evaluated campaigns society) may be more effective than
addressing other areas and the limited other types of messages (3).
evidence about anti-ageism campaigns (6),
the following characteristics of campaigns • Interactive and social media
against ageism may be associated with channels: Health campaigns,
effectiveness. particularly sexual health campaigns,
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C HA PT E R 09
that have interactive components interventions may sometimes result

(e.g. personalized emails) and use in enhanced effects (e.g. smoking
social media appear to be more cessation), this is not always the
effective than those using static case (e.g. for campaigns to increase
components (e.g. having someone physical activity, reduce childhood
watch an online video) (3, 31, 32). obesity and the risks of cancer)
(34-37).
• Community engagement: Engaging
community representatives – • The role of culture: Cultural
including older and younger people appropriateness contributes to the
– when developing campaigns is effectiveness of health campaigns,
likely to be important. One way this particularly international campaigns
can be done is by having community and campaigns in multicultural
representatives help design the societies. Guidance for ensuring
campaign and by using participatory cultural appropriateness is available
action research. Community (29, 38-41). Culture can also be
representatives can contribute by an entry point for engaging in
identifying experiences of ageism focused collective dialogue about
and helping to design communication ageism with local communities,
tools (6). opinion leaders, faith-based leaders,
traditional elders and other agents of
• Funding and partnerships: Ensuring change. Such dialogues can become
there is sustainable, long-term and the starting point for culturally
flexible funding is likely to benefit informed campaigns that are
campaigns. This often requires designed with local representatives
obtaining money from several sources and other communication activities
(e.g. government departments, grant (e.g. using digital media, video and
funding agencies). It also appears storytelling) (42).
helpful to be associated with a larger
programme (e.g. WHO’s Age-Friendly
Cities and Communities Programme)
and to work in partnership (e.g. 9.2
with health-care providers or media
studios) (6). Potential
• Combining campaigns: Effects may strategies for
be enhanced when campaigns
against ageism are combined
mitigating the
with other strategies. There is
some limited evidence that when
impact of ageism
mass media campaigns are used 很少有研究評估了在年齡歧視發⽣後減輕
as awareness tools, compliance Very few studies have evaluated strategies
其影響的策略或潛在策略。
with laws and regulations may be – or potential strategies – for mitigating the
increased (e.g. using seat belts, ⼀項使⽤⽇本全國調查數據的研究發現，
impact of ageism after it has occurred.
alcohol regulations) (11, 33). However, 遭受年齡歧視會對老年男性的⼯作滿意度
although combining strategies into A study using data
產⽣負⾯影響。 from a national survey in
然⽽，來⾃經理和同事的
multicomponent and multilevel Japan found that
更⾼⽔平的社會⽀持降低了感知歧視的影 being subject to perceived
響 (43)。
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GLOB
age discrimination negatively affected job

在美國進⾏的⼀項有中國背景的老年參與 negative ageist stereotypes and perhaps
satisfaction in older men. However, elevated other forms of ageism, although this has not
者的⼲預保護他們免受刻板印象威脅的影
levels of social support from managers and yet been demonstrated. If this were shown
響。⼲預提醒參與者他們的儒家價值觀。
co-workers decreased the impact of the to be the case, such laboratory experiments
它由參與者閱讀劇本，⾸先，他們應該為
perceived discrimination (43). might have the potential to be turned into
他們尊重老年⼈⾓⾊的古老傳統感到⾃ interventions to mitigate the effects of
An intervention in the United States with ageism after it has occurred.
豪，其次，讓他們放⼼，這些價值觀已經
older participants of Chinese background
成功地傳遞給了年輕⼀代。刻板印象威脅
protected them against the effects of
包括被告知他們將進⾏記憶測試以了解衰
stereotype threat. The intervention reminded 9.3
participants of their Confucian values. It
老如何影響記憶，並將結果與年輕⼈的結
consisted of participants reading a script
果進⾏比較。嚴格來說，⼲預並沒有在年
Conclusions and
that, first, stated they should be proud of
齡歧視（即刻板印象威脅）發⽣後減輕其
their ancient traditions that honour the role future directions
影響，⽽是讓參與者在年齡歧視發⽣之前
of older adults and, second, reassured them
that these values had been successfully
預防其影響。儘管如此，⼈們可以假設它 Campaigns to reduce ageism and strategies
transmitted to the younger generation. The 減少年齡歧視的運動和減輕其影響的策略
for mitigating its impact are potentially
也可能在年齡歧視發⽣後減輕其影響
stereotype threat consisted of being told that 是解決年齡歧視的潛在重要策略，但對它
important strategies to address ageism,
(44)。
they would be taking a memory test to see but research on them is limited. Developing
們的研究有限。進⼀步發展它們並產⽣更
其他幾項研究在實驗室實驗中表明，讓參
how ageing affects memory, and the results them further and generating more evidence
多證明其有效性的證據應該是優先事項。
與者接受內隱的、積極的年齡刻板印象可
would be compared with those of younger of their effectiveness should be priorities.
people. The intervention
以改善⾝體機能 did not, (47,
(45, 46)、記憶⼒ strictly
speaking, mitigate the effects of ageism 9.3.1 Campaigns
48) 和⼼⾎管測量 (49)。
(i.e. the stereotype threat) after it occurred,
隱含或潛意識刻板印象的使⽤是指以⼀種
but rather inoculated participants against 沒有對減少年齡歧視的運動進⾏有效性評
No campaigns to reduce ageism have been
允許感知但沒有完全意識的⽅式暴露——
the effects of ageism before it occurred. 估。但是，根據有關其他健康領域（例如
evaluated for effectiveness. But based
Nonetheless, one can hypothesize that it
例如，通過在屏幕上⾼速閃爍的⽂字。 on evidence about the effectiveness of
性健康）以及減少與⼼理健康狀況相關的
might also work to mitigate the effects of campaigns in other areas of health – such as
陳規定型觀念、偏⾒和歧視的運動有效性
這種暴露於隱含的、積極的年齡刻板印象
ageism after it has occurred (44). sexual health – and in reducing stereotypes,
可能不僅會產⽣上述有益影響，⽽且可能的證據，運動是打擊年齡歧視的有希望的
prejudice and discrimination related to
會減輕暴露於
Several other studies have shown in laboratory 戰略。
mental health conditions, campaigns
experiments that exposing participants
負⾯的年齡歧視刻板印象，也許還有其他 represent a promising strategy to combat
to implicit, positive age stereotyping 下⽂描述了與減少年齡歧視運動相關的未
ageism.
形式的年齡歧視，儘管這尚未得到證實。
improved physical function (45, 46), memory 來優先事項。
如果情況確實如此，此類實驗室實驗可能
performance (47, 48) and cardiovascular Future priorities in relation to campaigns to
有可能轉變為乾預措施，以在年齡歧視發
measurements (49). reduce ageism are described below.
• 需要使⽤盡可能最嚴格的設計來開展和
⽣後減輕其影響。
The use of implicit or subliminal stereotypes 測試針對不同形式的年齡歧視（即制度、
• There is a need to develop and test
refers to being exposed in a way that allows ⼈際關係和⾃我導向的年齡歧視）的運動
campaigns that address different
for perception but without full conscious （⾒專欄 forms9.1）。
of ageism (i.e. institutional,
awareness – for instance, through words interpersonal
• 在低收入和中等收入國家開展、實施和 and self-directed
being flashed on a screen at high speed. ageism) using the most rigorous
評估運動⾄關重要。
designs possible 最近對反年齡歧視運
(see Box 9.1).
It is possible that such exposure to implicit, 動的審查中僅包括⼀項運動
positive age stereotypes may not only have – 國際助老會組織的全球運動
• (6)（⾒第
It is critical to develop, implement
the beneficial effects noted above but also and evaluate campaigns
9.3.1 節） – 在低收入和中等收入國家開 in low- and
may mitigate the effects of exposure to middle-income countries. Only one
展。
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C HA PT E R 09
of the campaigns included in a recent Some are laboratory experiments rather than
減輕年齡歧視影響的策略研究仍處於早期階
review of anti-ageism campaigns fully developed
段。只有少數研究可⽤。 interventions. Nonetheless,
– the global campaign organized these strategies may hold some promise
by HelpAge International (6) (see 有些是實驗室實驗，⽽不是完全成熟的⼲預
for lessening the impact of negative
Section 9.3.1) – took place in low- and 措施。儘管如此，這些策略可能有希望減
stereotypes.
middle-income countries. 輕負⾯刻板印象的影響。
Given the pervasiveness of ageism and its
鑑於年齡歧視的普遍性及其嚴重⽽深遠的影
• The cost and cost–effectiveness serious and far-reaching impacts – described
‧of應估計反年齡歧視運動的成本和響（分別在第 2 章和第 3 章中進⾏了描
anti-ageism campaigns should in Chapters 2 and 3, respectively – future
成本效益。
be estimated.活動可能很昂貴。
Campaigns can be因述），與減輕年齡歧視影響相關的未來優先
priorities in relation to mitigating the impact
expensive. Hence,
此，確保它們具有成本效益⾄關重 it is critical to 事項應包括：
of ageism should include:
ensure that they are cost-effective. • 調查暴露於隱含的積極刻板印像是否有助
要。在所有健康領域的運動成本效
Evidence for the cost–effectiveness • investigating whether exposure to
益的證據極其有限，除了吸煙，有於減輕消極刻板印象和其他形式的年齡歧視
of campaigns in all areas of health implicit positive stereotypes might
中等的成本效益證據 (3)。than for
is extremely limited, other 的影響，如果是，如何將其從實驗室發現轉
help mitigate the effects of negative
smoking, for which there is moderate 變為可擴展的⼲預措施；
stereotypes and other forms of
evidence of cost–effectiveness (3). ageism and, if so, how this could be
• 制定、測試和擴⼤戰略，以減輕年齡歧視
turned from laboratory findings into
各個⽅⾯的影響——即刻板印象、偏⾒和歧
scalable interventions;
9.3.2 Strategies for mitigating 視。
the impact of ageism • developing, testing and scaling up
strategies to mitigate the impact
Research on strategies to mitigate the of all dimensions of ageism – that
impact of ageism is still at an early stage. is, stereotypes, prejudice and
Only a handful of studies are available. discrimination.
147
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151
BERKEHAN, 21,
T URKE Y
S I S AY, 6 5 ,
E T HIOPIA
152
C HA PT E R 01
CHAPTER 10
10
“ We ne e d to ac t now a s youth and c all the world

“
to ac tion for the f uture we are dreaming of, and
c apable of creating .
B e rke han , 2 1 , Turkey

©B erkehan Erk ılıç / UN Major Group
“
T he world should prohibit and di s c ard all ne gati ve
s tere ot y p e s and end the di s crimination of older
p e ople. O nce thi s i s done, the world would b e
surpri s e d of the thing s older men and women c an “
contribute. A world w ithout agei sm would make
ever y gener ation […] p o siti ve in their outlo ok on life.
S i s ay, 6 5 , Ethio p ia
©Erna M ente snot Hint z / H elpAge International
153
為了預防和應對年齡歧視，應優先考慮有最佳證據
To prevent and respond to ageism, priority should
⽀持的三種策略：政策和法律、教育⼲預和代際接
be given to the three strategies supported by
the best evidence:
觸⼲預（建議 1）。policy and law, educational
interventions and intergenerational contact
各國改進數據和研究以更好地了解年齡歧視以及如
interventions (Recommendation 1).
何減少它同樣重要（建議 2）。每個利益相關者在
It is equally important for countries to improve data
解決年齡歧視⽅⾯都可以發揮作⽤，並且應該成為
and research to gain a better understanding of
ageism and how to reduce it (Recommendation 2).
改變關於年齡和老齡化的敘述運動的⼀部分（建議
3）。這些建議應盡可能⼀起實施，以最⼤限度地
Every stakeholder has a role to play in addressing
ageism and should be part of the movement
發揮其影響。
10
to change the narrative around age and ageing
Chapter
(Recommendation 3).
These recommendations should be implemented
together where possible to maximize their impact.
實施這些建議需要不同部⾨（例如衛⽣和社會保
Implementing these recommendations requires strong
健、教育、⼯作和就業、法律和媒體）和參與者
commitment and the involvement of different sectors (e.g.
health and social care, education, work and employment,
（例如政府、⺠間社會組織、聯合國機構、發展組
legal and media) and actors各個年齡段的企業和⼈
織、學術和研究機構、 (e.g. governments, civil society
organizations, UN agencies, development organizations,
群）。每項建議都為這些不同的利益相關者群體確
academic and research institutions, businesses and people
定了關鍵⾏動。
of all ages). Each recommendation identifies key actions
各國必鬚根據其具體情況調整這些建議。
for these different stakeholder groups. 在可能的
情況下，應⽀持包含所有關鍵建議的多管⿑下的⽅
It is essential that countries tailor these recommendations
法，因為通過協調⼀致的綜合⾏動最有可能發⽣變
to their specific contexts. Where possible, a multipronged
⾰性變⾰。that includes all key recommendations
approach
should be favoured, as it is through concerted and
comprehensive action that transformative change is
關於年齡歧視的全球報告匯集了有關
The Global report on ageism has most likely to occur.
assembled the best scientific
年齡歧視的最佳科學信息，以了解和
information about ageism to understand
幫助改善所有年齡段⼈群的⽣活。
and help improve the lives of people of
基於前幾章的證據，本章提出了三項
10.1
all ages. Building on the evidence in
建議，以幫助利益相關者採取⾏動在
the preceding chapters, this chapter Recommendation 1:
世界範圍內預防和消除年齡歧視。
presents three recommendations to
assist stakeholders in taking action to
這些建議屬於聯合國作為“健康老齡
invest in evidence-based
prevent and eliminate ageism across
化⼗年：2021-2030”的⼀部分⽽倡
the world. These recommendations
strategies to prevent
導的全球打擊年齡歧視運動的範疇。
fall under the umbrella of the Global
campaign to combat ageism that the
and respond to ageism
United Nations is championing as
part of the Decade of Healthy Ageing: Governments, civil society organizations, UN agencies,
2021-2030. development organizations and other stakeholders
154
C HA PT ER 10
should draw upon the evidence-based

政府、⺠間社會組織、聯合國機構、發 Under optimal conditions, contact between
solutions presented in this report to
展組織和其他利益相關者應利⽤本報告 different age groups can reduce intergroup
effectively tackle ageism. prejudice and stereotypes, and the effects
中提出的循證解決⽅案來有效解決年齡 may generalize beyond the immediate
歧視問題。
First, countries should implement policies participants in the intervention to the
and laws with adequate legal and material
⾸先，各國應實施具有⾜夠法律和物質 entire out-group. Intergenerational contact
scope to prohibit age discrimination and
範圍的政策和法律，禁⽌年齡歧視，促 interventions are among the most effective
to foster the equal rights of all persons interventions to reduce ageism against older
進所有⼈不分年齡的平等權利。同樣重
regardless of their age. It is equally important people, and they show promise for reducing
要的是，各國修改或廢除允許年齡歧視
that countries modify or repeal existing laws ageism against younger people. In addition,
的現有法律或政策，並建立執法機制和
or policies that permit age discrimination they appear to be affordable and relatively
and that they put in place enforcement
監督機構以確保有效實施。 easy to implement.
mechanisms and monitoring bodies to ensure
還可以增加反對年齡歧視的國際政策和
effective implementation. 10.1.1 Specific actions by
立法保障。在國際法中，⽬前沒有具體 stakeholder group
的法律⽂書來保護成年⼈的⼈權，消除
International policy and legislative guarantees
against age discrimination could also be
基於年齡的偏⾒和歧視，⼤多數國際⼈ Below is an overview of the specific actions
以下概述了不同利益相關者群體可以採
increased. In international law, there is
權⽂書都沒有明確將年齡列為禁⽌歧視 that can be taken by different groups of
取的具體⾏動，以實施以證據為基礎的
currently no specific legal instrument to stakeholders to implement evidence-based
的理由。
protect the . human rights of adults and to 戰略，以減少或預防年齡歧視。
strategies to reduce or prevent ageism.
其次，國家政府和其他⾏為者應設計和
dispel prejudice and discrimination against
people on the basis of their age, and most
提供正規和非正規教育活動，因為這些 Governments can:
international human rights instruments do
是解決年齡歧視的最有效策略之⼀，⽽
not explicitly list age as a prohibited ground • build human and institutional
且很可能是負擔得起的。教育活動可以 • 建立⼈⼒和機構能⼒，以製定和實施
of discrimination. capacities to develop and implement
通過使⽤⾓⾊扮演、模擬和虛擬現實等以證據為基礎的戰略來解決年齡歧視問
evidence-based strategies to tackle
⽅式傳遞信息或增強對其他年齡段的⼈
Second, national governments and other 題；ageism;
actors should design and deliver formal and
的同情⼼，從⽽幫助消除對不同年齡段 • 起草和實施禁⽌基於年齡歧視的法律
non-formal educational activities because • draft and implement laws and
和政策，修改或廢除任何直接或間接基
的誤解，減少偏⾒和歧視。這些類型的
these are among the most effective strategies policies that prohibit discrimination
⼲預措施可以在各級教育中實施，從幼
to tackle ageism and are also likely to be 於年齡歧視⼈們的現有法律或政策；應
on the grounds of age, and modify or
兒園到⼤學和終⾝學習平台。
affordable. Educational activities can help 與老年⼈和年輕⼈協商採取這些⾏動；
repeal any existing laws or policies
to dispel misconceptions about different
第三，應投資於代際接觸⼲預，旨在促 • that
建立執法機制和監督機構，以有效實
directly or indirectly discriminate
age groups and reduce prejudice and
進不同代⼈之間的互動和接觸。 against people on the basis of their
施解決歧視、⼈權和不平等問題的法律
discrimination by transmitting information age; these actions should be taken in
在最佳條件下，不同年齡組之間的接觸和政策；
or enhancing empathy towards people of consultation with older and younger
可以減少群體間的偏⾒和刻板印象，其
other ages through perspective-taking, for • people;
批准保護老年⼈或年輕⼈權利的現有
instance, by using role-playing, simulation and
影響可能會從乾預的直接參與者推廣到區域條約；
virtual reality to reduce ageism. These types
整個外群體。代際接觸⼲預是減少針對 • • put in place enforcement mechanisms
⽀持通過國際法制定進⼀步的保護措
of interventions can be implemented across and monitoring bodies to enable the
老年⼈的年齡歧視的最有效⼲預措施之施並批准可能製定的任何新⽂書；
all levels of education, from kindergarten to effective implementation of laws and
⼀，它們顯⽰出減少針對年輕⼈的年齡
university and life-long learning platforms. • policies
在正規和非正規教育部⾨開展教育活
addressing discrimination,
歧視的希望。此外，它們似乎價格合理動，以解決針對不同年齡組的年齡歧視
human rights and inequality;
Third, investments should be made in
且相對容易實施。問題；
intergenerational contact interventions, •
• ratify existing regional treaties that
為代際接觸⼲預的實施提供資源。
which aim to foster interaction and contact protect the rights of older or younger
between people of different generations. adults;
155
• support the development of further of laws addressing discrimination

• 倡導制定解決歧視和不平等問題的法
protections through international law and inequality, and strengthen their
律及其執⾏，並幫助監督這些法律的實
and ratify any new instruments that participation in these activities;
may be developed; 施；
• • 培養老年⼈和年輕⼈的能⼒，以倡導
design and deliver evidence-based
• implement educational activities educational programmes and
和監督解決歧視和不平等問題的法律的
across formal and non-formal intergenerational activities to tackle
實施，並加強他們對這些活動的參與；
education sectors to tackle ageism ageism against different age groups
aimed at different age groups; • 設計和提供循證教育計劃和代際活
and incorporate these activities into
動，以解決針對不同年齡組的年齡歧視
existing programmes, if possible;
• provide resources for the 問題，並在可能的情況下將這些活動納
implementation of intergenerational seek and establish collaboration
• 入現有計劃；
contact interventions. between older people’s organizations
• 尋求並建立老年⼈組織和青年組織之
and youth organizations to
United Nations agencies and 間的合作，以⿎勵代際活動和合作。
encourage intergenerational
development organizations can: activities and collaborations.
• ⽀持各國實施以證據為基礎的戰略來
• support countries in their Academic and research institutions
解決年齡歧視問題；
implementation of evidence-based can:
strategies to tackle ageism;
• 為打擊年齡歧視的全球運動的發展做
• • design and deliver evidence-
設計和提供循證教育計劃和代際活
出貢獻；
• contribute to the development of the based educational programmes
• 在聯合國系統內建立對年齡歧視的理動，以解決針對不同年齡組的年齡歧視
Global campaign to combat ageism; and intergenerational activities to
解以及使⽤循證策略識別和解決年齡歧問題。tackle ageism against different age
視的能⼒；
• build understanding within the UN • 與政府和⺠間社會合作，確定有助於
groups;
system of ageism and the capacity 解決年齡歧視的三項循證⼲預措施的基
• 確定並修改現有的年齡歧視政策和做
to identify and address it using • work with governments and civil
本特徵——改變政策和法律，並通過教
法； evidence-based strategies; society to identify the essential
• 資助致⼒於解決中低收入國家年齡歧育活動和代際接觸進⾏⼲預。
characteristics of the three evidence-
identify and revise existing ageist
視問題的⺠間社會組織。
• based interventions that work to
policies and practices; tackle ageism – making changes
in policies and law and intervening
• fund civil society organizations through educational activities and
working to address ageism in low- intergenerational contact.
and middle-income countries.
The private sector can:
Civil society organizations can:
•• 在企業中製定和實施政策和乾預措
develop and implement policies
• advocate for the development of and interventions in businesses to
施，以預防和應對年齡歧視的情況（例
laws addressing discrimination and prevent and respond to instances
如，通過制定代際指導計劃）；
inequality and their enforcement, and of ageism (e.g. by developing
also help monitor the application of • 培養僱員和雇主發現和應對年齡歧視
intergenerational mentorship
these laws; 的能⼒； programmes);
• 監控電影、電視劇、廣告、雜誌和報
• build the capacity of older and • build the capacity of employees and
紙⽂章、書籍和其他形式媒體的製作，
younger adults to advocate for employers to detect and respond to
and monitor the implementation 以確保它們沒有年齡歧視。
ageism;
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• monitor the production of movies, 更好地了解年齡歧視對老年⼈和年輕⼈的

revised to reflect the latest scientific
television series, advertisements, 影響以及年齡歧視的代價——對於個⼈整
evidence in order to identify outdated
magazine and newspaper articles, concepts and biased approaches (e.g. the
個⽣命歷程和更廣泛的社會——對於說服
books and other forms of media to use of the dependency ratio).
政策制定者和公眾了解年齡歧視的深遠影
ensure that they are not ageist.
響和動員他們去解決。我們對年齡歧視對
A better understanding of the impacts of
年輕⼈的影響缺乏了解，這是⼀個必須解
ageism against older and younger people
and the costs of ageism – for individuals
決的差距。只有更好地了解年齡歧視對年
10.2 across their life course and for the wider
輕⼈⼀⽣的影響，我們才能確定問題的嚴
society – is critical to persuade policy-
Recommendation 2: 重程度和應得到的優先重視。
makers and the public of the far-reaching
成功解決年齡歧視還需要更好地了解針對
impacts of ageism and to mobilize them to
improve data and tackle it. Our lack of understanding of the
老年⼈和年輕⼈的年齡歧視的決定因素，
research to impact of ageism against younger people
包括風險和保護因素、它們的相對重要
is a gap that must be addressed. It is only
性、因果地位以及決定因素在不同國家和
gain a better by gaining a better understanding of the
⽂化中是否相同。
impacts of ageism against younger people
understanding of 最重要的是，成功解決年齡歧視問題需要
across their life course that we will be able
to establish how serious a problem it is and
進⾏持續和協調的研究⼯作，以完善現有
ageism and how to what priority it deserves.
的有效策略，包括政策和法律、教育和代
reduce it 際接觸⼲預。它還需要進⼀步研究有前景
Successfully addressing ageism will also
的戰略（例如運動），改進對每種可能戰
require gaining a better understanding of
Successfully addressing ageism will require
成功解決年齡歧視問題需要提⾼我們對其 the determinants of ageism against older
略的成本效益的估計，然後擴⼤那些已被
improving our understanding of all aspects and younger people, both risk and protective
各個⽅⾯的理解以及如何減少它。應該收證明既有效⼜具有成本效益的戰略。
of it and how to reduce it. More and factors, their relative importance, their
集更多更好的定量和定性數據，特別是在
better quantitative and qualitative data 還需要實施研究，以幫助確定有效戰略的
causal status and whether determinants
低收入和中等收入國家，關於針對老年⼈
should be collected, particularly in low- 基本組成部分；在多中⼼和多國試驗中開
are the same across countries and cultures.
and middle-income countries, about the
和年輕⼈的各種形式的年齡歧視的流⾏和發和測試新策略；使現有戰略適應新環
prevalence and distribution of all forms of Most importantly,
境；並探索 successfully addressing
• 持續、⼤規模實施減少年齡
分佈情況——即制度性的、⼈際關係的和
ageism against older and younger people ageism will require undertaking sustained
⾃我導向的。同樣重要的是更好地估計特
– that is, institutional, interpersonal and 歧視戰略的障礙和促進因素。
and coordinated research efforts to refine
定機構中年齡歧視的流⾏情況，例如健康
self-directed. It is equally important to ⽀持測試世衛組織正在與其他合作夥伴制
existing effective strategies, including policy
obtain better estimates of the prevalence
和長期護理、⼯作場所、媒體和法律系定的年齡歧視測量量表；
and law, educational and intergenerational
of ageism in specific institutions, such as contact interventions. It will also require
為了幫助完成這些任務，各國開展準備情
統。這些數據應使⽤可靠、有效、跨⽂化
health and long-term care, the workplace, further research into promising strategies
有效且具有可比性的年齡歧視測量量表來況和能⼒評估以確定需要加強的領域，以
the media and legal systems. These data (e.g. campaigns), improved estimates of the
收集。世衛組織正在與其他夥伴合作，著
should be collected using measurement 便能夠成功地擴⼤減少年齡歧視的戰略也
cost–effectiveness of each possible strategy
scales for ageism that are reliable, valid,
⼿製定這樣⼀個衡量年齡歧視的量表。很重要；例如，需要對⼈⼒和機構資源、
and then the scale up of those strategies
cross-culturally valid and comparable. WHO
需要修訂⽤於政策和計劃制定和評估的措 that have been shown to be both effective
資⾦、政治意願和⽀持以及協調和治理進
is initiating, in collaboration with other and cost-effective.
施、⽅法和數據⼯具，以反映最新的科學⾏評估。
partners, the development of such a scale
證據，以便識別過時的概念和有偏⾒的⽅
to measure ageism. 低收入和中等收入國家必須是所有數據收
Implementation research will also be
法（例如，撫養比的使⽤）。集和研究領域的重中之重，因為關於年齡
required to help identify the essential
Measures, methodologies and data tools that components of effective strategies; develop
歧視各個⽅⾯的⼤多數數據和研究來⾃世
are being used for policy and programme and test new strategies in multicentre
界上少數⼈⼝居住的⾼收入國家。這些國
development and evaluation need to be and multi-country trials; adapt existing
家也是⼀個優先事項，因為在低收入和中
低收入國家中年齡歧視的發⽣率最⾼，⾄
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少對老年⼈⽽⾔是這樣。
strategies to new contexts; and explore • support testing of the measurement

the barriers to and facilitators of sustained, scale for ageism that WHO is
large-scale implementation of strategies to developing with other partners;
reduce ageism.
• include modules on ageism against
To help with these tasks, it will also be younger and older people in national
important for countries to carry out social surveys and in national data
readiness and capacity assessments to collection exercises addressing
pinpoint those areas that need to be ageing and health and other relevant
strengthened to be able to successfully topics, drawing on a validated scale
scale up strategies to reduce ageism; for ageism, such as the one that is
assessments will be needed of, for instance, being developed by WHO and other
human and institutional resources, funding, collaborators.
political will and support and coordination
and governance. United Nations agencies and
development organizations can:
Low- and middle-income countries must be
a top-most priority across all areas of data • include modules about ageism
collection and research, since the majority against younger and older people in
of data and research on all aspects of international surveys that they help
ageism comes from high-income countries conduct, such as the Demographic
where a minority of the world’s population and Health Survey;
lives. These countries are also a priority
because the highest prevalence of ageism, • increase capacities for research
at least against older people, was seen in and data collection, and fund
low- and lower-middle- income countries. researchers working on ageism,
particularly in low- and middle-
10.2.1 Specific actions by income countries;
stakeholder group
• review statistical concepts,
Below is an overview of some of the specific data collection instruments and
actions that can be taken by different groups methodological approaches used in
of stakeholders to improve the data and policy development and assessment
research about ageism. in order to identify and revise any
that may be age-biased;
Governments can:
• support the collection and
• allocate resources to those aspects dissemination of age-disaggregated
of ageism-related research judged information about older and younger
to be a priority in the country and people;
channel those resources through
relevant national science-funding • develop with WHO a valid
bodies and foundations; measurement scale for ageism and
encourage governments and research
• modify any national or local data institutions to use it in stand-alone
collection approaches that may be studies or ensure it is integrated into
age-biased; other data collection efforts.
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Civil society organizations can: • financially support research on

ageism through relevant national
• contribute to the evaluation and science-funding bodies and
monitoring of strategies to reduce foundations.
ageism and collaborate with
researchers to support applied
research on ageism; 10.3
• advocate for governments to Recommendation 3:
revise age-biased data collection
instruments and methodological build a movement
approaches, to continue to build
a strong evidence base about to change the
ageism and to use validated scales
for ageism, such as the one that narrative around
is being developed by WHO and
collaborators; age and ageing
• produce evidence, in collaboration Ageism is endemic and will continue to
年齡歧視是地⽅性的，除非採取適當的⾏
with research institutions, of the spread unless appropriate action is taken,
動來預防和應對年齡歧視，否則將繼續蔓
lived experience of ageism from the both to prevent ageism and to respond
perspectives of older and younger 延。我們都可以發揮作⽤。國家（各級和
to it. We all have a role to play. Countries
people and of the impact it has on 所有機構）、國際組織（包括聯合國機
(at all levels and across all institutions),
their lives. international
構、非政府組織、跨國公司）、國家組organizations (including UN
agencies, nongovernmental
織、社區和個⼈都可以加入運動，改變圍 organizations,
Academic and research institutions multinational corporations), national
can: 繞年齡和老齡化的敘述。
organizations, communities and individuals
⼀些國際機構、區域機構和聯合國機構要
can all join the movement to change the
• conduct high-quality research narrative around age and ageing.
么已經在努⼒解決年齡歧視問題，要么擁
to address the gaps in data and 有與減少年齡歧視⾼度相關的任務或活
research identified in this report and A number of international agencies, regional
動，包括處理⼈權、國際法、經濟問題和
to develop and scale up effective and institutions and UN bodies are either already
cost - effective strategies to reduce 可持續發展的機構。國際非政府組織和私
working to address ageism or have mandates
ageism, in consultation with people 營部⾨可以幫助提⾼當地和全球反年齡歧
or activities highly relevant to reducing
in the relevant age groups; ageism, including those dealing with human
視公⺠、雇主和企業實體的意識，並採取
rights, international law, economic matters
⾏動減少其⾃⾝結構內的年齡歧視。儘管
• support testing of the measurement and sustainable development. International
scale for ageism that WHO is 有共同努⼒，但所有這些機構和利益相關
nongovernmental organizations and the
developing with other collaborators 者群體之間的協調仍然不⾜。這應該得到
private sector can help raise awareness
and encourage its uptake across locally and globally as anti-ageist citizens,
補救，以避免不必要的重複，並從匯集專
research activities on ageism. employers and corporate entities and
業知識、網絡、資⾦和國內資源的經濟中
act to reduce ageism within their own
The private sector can: 受益，並採取集體⾏動減少這些機構內的
structures. Although there have been
年齡歧視。
joint efforts, coordination across all these
• conduct comprehensive and agencies and stakeholder groups is still
rigorous evaluations of ageism in the insufficient. This should be remedied to
workplace; avoid unnecessary duplication and to
159
benefit from the economies of pooling Governments can:

expertise, networks, funding and in-country
resources and to take collective action to • convene and coordinate national
reduce ageism within these institutions. and local multisectoral and multi-
stakeholder coalitions to prevent and
Developing a global coalition to drive this
應該探索建立⼀個全球聯盟來推動這⼀運 respond to ageism;
movement and help change the narrative
動並幫助改變關於年齡和老齡化的敘述，
around age and ageing should be explored • contribute to the global coalition
以改善在該領域⼯作的不同利益相關者群
to improve cooperation and communication aiming to change the narrative
體之間的合作和溝通。⼀個聯盟可以實現
between different stakeholder groups around age and ageing, including by
working in this area. A coalition could achieve
更好的知識共享、就預防和應對年齡歧視 sharing knowledge and experience.
better sharing of knowledge, agreement on
的⽬標達成⼀致，以及協調⾏動。例如，
goals to prevent and respond to ageism, United Nations agencies and
研究⼈員和從業⼈員網絡可以極⼤地增強
and coordination of action. For example, a development organizations can:
世界的知識基礎，並有助於完善乾預策
network of researchers and practitioners
略、討論⽅法和批判性地審查研究結果。
could greatly enhance the world’s knowledge • develop and contribute to the
base as well as help refine the intervention
與政府當局、服務提供商和倡導團體的⼯ global coalition aiming to combat
strategies, discuss methodologies and ageism, particularly by bringing
作⼀起，更廣泛的信息和想法交流對於未
critically examine research results. the organization’s expertise to the
來的進展⾄關重要。致⼒於改變年齡和老 coalition (e.g. the International
齡化敘事的倡導團體以及致⼒於性別歧
A broader exchange of information and ideas Labour Organization could support
is crucial to future progress, alongside the
視、種族主義和殘疾歧視的倡導團體是打 policies and legislation in the
work of government authorities, service
擊年齡歧視的重要合作夥伴，因為他們可 workplace);
providers and advocacy groups. Advocacy
以調動資源、收集和傳達有關重要問題的
groups working on changing the narrative • support governments and civil
信息並開展可能影響決策者的運動.
around age and ageing as well as those society organizations seeking
working on sexism, racism and ableism are
因此，建立⼀個聯盟可以促進循證戰略的 to build capacity to implement
important partners in combating ageism
實施、信息交流、聯合研究和宣傳⼯作的 evidence-based strategies;
because they can mobilize resources, gather
發展，可以獲得很多好處。 develop technical guidance to help
and convey information about important •
problems and mount campaigns that can different stakeholders change the
impact decision-makers. narrative around age and ageing;
Therefore, much could be gained by • take steps to end ageism within

developing a coalition that can facilitate the UN and within developmental
the implementation of evidence-based organizations, including by reviewing
strategies, the exchange of information, the existing policies and practices and
development of joint research and advocacy developing new norms and standards
work. as required.
10.3.1 Specific actions by Civil society organizations can:

stakeholder group
• advocate to encourage
Below is an overview of some of the specific governments to combat ageism,
actions that can be taken by different groups and also develop national
of stakeholders to build a movement to coalitions to support advocacy
change the narrative around age and ageism. efforts;
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• identify systematic ageism

and report it to the relevant 10.4
authorities (e.g. equality bodies,
ombudsperson, national human Conclusions
rights institutions);
It has taken more than 50 years since the
⾃年齡歧視這個詞被創造以來，已經花了
• join and contribute to the word ageism was coined to build an evidence
global coalition and support
50 多年的時間來建立⼀個證據基礎，這將
base that will allow transformative change in
the implementation of actions 使我們所有⼈對年齡和衰老的思考、感受
how we all think, feel and act towards age
recommended by the coalition; 和⾏為⽅式發⽣變⾰。
and ageing.
今天我們可以⾏動了。本報告確定了解決
• raise awareness of and build Today we can act. This report has identified
全球年齡歧視的三個關鍵戰略：改變政策
understanding in communities three key strategies to tackle ageism across
about what ageism is and why we 和法律，以及通過教育活動和代際接觸進
the world: making changes in policies and
should all work to challenge it. ⾏⼲預。
laws and 它進⼀步概述了應該進⾏的研究
intervening through educational
activities and intergenerational contact.
領域，以促進我們對這種現象的理解以及
Academic and research It has further
如何最好地解決它。 outlined areas for research
institutions can: that should be pursued to advance our
每個⼈都可以⽽且必須做些什麼來結束年
understanding of this phenomenon and how
• contribute knowledge and 齡歧視。如果政府、聯合國機構、發展組
best to tackle it.
information to the global 織、⺠間社會組織以及學術和研究機構實
coalition; Everybody can and must do something
施那些被證明有效的戰略，如果他們投資
to put an end to ageism. If governments,
help monitor and evaluate
於進⼀步的研究，如果個⼈和社區挑戰他
• UN agencies, development organizations,
programmes and activities aimed 們遇到的每⼀個年齡歧視實例，我們將
civil society organizations and academic 共
at tackling ageism. 同創造⼀個老少皆宜的世界。
and research institutions implement those
strategies that have been found to be
The private sector can: effective, if they invest in further research
and if individuals and communities challenge
• contribute to the global coalition every instance of ageism that they encounter,
by implementing evidence-based we will together create a world for all ages.
interventions in businesses and
sharing information about best
practices.
161
162
GLOSSARY
Ableism refers to the stereotypes, prejudice and discrimination directed towards individuals
with disabilities or those who are perceived to have a disability. Ableism assumes that people
with a disability are defined by their disabilities and are inferior to individuals who do not
have a disability.
Age is the time lived since birth. Although correlated with biological processes, age is also
socially and culturally shaped.
Ageing is the process of becoming older and represents the accumulation of changes over
time, encompassing physical, psychological and social changes. The changes that constitute
and influence ageing are complex. At a biological level, ageing is associated with the gradual
accumulation of a wide variety of molecular and cellular damage. Over time, this damage
leads to a gradual decrease in physiological reserves, an increased risk of many diseases and
a general decline in the capacity of the individual. Ultimately, it will result in death.
Ageism refers to the stereotypes, prejudice and discrimination directed towards others or
oneself based on age.
Attitudes include both stereotypes and prejudice.
Campaign refers to purposive attempts to inform or influence behaviours in large audiences

within a specified period by using an organized set of communication activities and featuring
an array of mediated messages delivered through multiple channels to produce non-commercial
benefits to individuals and society.
Care dependence arises when an individual’s functional ability has fallen to a point where
they are no longer able to undertake the basic tasks that are necessary for daily life without
the assistance of others.
Denormalization refers to increasing the social unacceptability of a behaviour by reinforcing

the perception that it is neither a mainstream nor a normal activity in the society in question.
Determinants refer to both risk and protective factors. Risk factors are characteristics that
increase the likelihood of a particular outcome, ageism in the case of this report. Protective
factors are characteristics that decrease the likelihood of an outcome or provide a buffer
against risk. To be effective, interventions must target causal determinants that change the
outcome – that is, reduce ageism – and not just determinants that are associated – perhaps
spuriously – with the outcome.
Discrimination consists of any actions, practices, laws or policies that are applied to people
based on their perceived or real membership in a socially salient group and that impose
some form of direct or indirect disadvantage (negative discrimination) or advantage (positive
discrimination) on them. In the case of age-based discrimination, these actions, practices and
policies are directed at people perceived to belong to a specific age group.
163
Educational activities or programmes refer to any activities that provide

instruction with the intention of improving knowledge, skills and competencies. Formal
education refers to education or learning that takes place in a formal institution of
learning, such as a school or university; follows a syllabus; has clear learning objectives;
and is officially accredited. Non-formal education or learning is usually intentional and
takes place in an institution such as a workplace or community centre. However, it does
not necessarily follow a syllabus, nor is it necessarily accredited.
Effect size is a quantitative measure of the strength of a relationship between two

variables that uses a standard metric. It is particularly useful for quantifying how effective
one intervention is in relation to another.
Elder abuse is a single or repeated act or a lack of appropriate action occurring within
any relationship in which there is an expectation of trust, that causes harm or distress to an
older person. Elder abuse can take various forms, such as financial, physical, psychological
and sexual. It can also be the result of neglect.
Elderspeak refers to the adjustments to speech patterns that are sometimes made by
younger people when communicating with older adults, such as speaking more slowly
or more loudly, shortening sentences or using limited or less complex vocabulary. These
simplified speech patterns are implicitly based on the assumption that older adults are
cognitively impaired or incapable of understanding normal speech.
Empathy refers to the ability to sense other people’s emotions, coupled with the ability
to imagine what someone else might be thinking or feeling.
Explicit ageism refers to ageism that is consciously and intentionally engaged in by

a person. It is often contrasted with implicit ageism, which operates largely outside of
conscious awareness.
Framing refers to how information on a given issue is packaged and presented. Through
framing, issues can be highlighted and placed within a particular context to encourage
or discourage certain interpretations. Framing thus exercises a selective influence over
how people view reality.
Gendered ageism refers to the intersection between ageism and gender bias and
may account for differences in the ageism faced by women and men.
Health is a state of complete physical, mental and social well-being and not merely the
absence of disease or infirmity.
Human rights are the rights people are entitled to simply because they are human
beings, irrespective of their age, citizenship, nationality, race, ethnicity, language, gender,
sexuality or abilities. When these inherent rights are respected, people are able to live
with dignity and equality, free from discrimination. The concept of human rights has its
origins in a wide range of philosophical, moral, religious and political traditions, and it
has evolved over time.
164
Impact refers to the consequence, effect or influence of one thing on another.
Implicit ageism is ageism that is engaged in by a person without conscious awareness

and intention.
Institutional ageism refers to the laws, rules, norms, policies and practices of institutions
– and the ideologies that are fostered to justify them – that unfairly restrict opportunities
and systematically disadvantage individuals based on their age.
Intergenerational contact activities and interventions aim to foster interaction

and contact between people of different generations or age groups, often to reduce ageism.
They can either involve direct contact through face-to-face interactions or indirect contact
through, for instance, virtual conversations or imagined contact.
Interpersonal ageism refers to ageism occurring during interactions between two or

more individuals. In interpersonal ageism, the perpetrator is distinguished from the target
of ageism.
Intersectionality is a theoretical framework for understanding how different aspects of a

person’s social and political identities combine (e.g. gender, sex, race, class, sexuality, religion,
disability, physical appearance) and may potentiate each other to shape an individual’s or
group’s experience and create unique modes of discrimination and privilege.
Law is the system of rules that a particular country or community recognizes as regulating
the actions of its members and that may be enforced by imposing penalties. It includes
international law and national law. International law defines the legal responsibilities of states
in their conduct with each other and their treatment of individuals within state boundaries.
National law or domestic law refers to those laws that exist within a particular country.
Older person is a person whose age has passed the median life expectancy at birth. In
this report, persons above the age of 50 are considered older persons.
Policies refer to decisions, plans and actions that are undertaken to achieve specific goals
within a society.
Prejudice is an affective reaction or feeling that is directed towards an individual who

belongs to a specific social group. In the case of ageism, prejudice is directed towards
individuals perceived to belong to a specific age group, regardless of whether they actually
belong to that group.
Protective factors are characteristics that decrease the likelihood of an outcome (ageism
in this report) or provide a buffer against risk.
Racism refers to the stereotypes, prejudice or discrimination directed against people based
on their race, and it usually involves the belief that one’s own race is superior to other races.
There is now wide agreement that the concept of race is primarily a social construct without
biological meaning, and it is only a very weak proxy for human genetic diversity.
165
Ratification defines the international act whereby a state indicates its consent to be bound
to a treaty or convention.
Risk factors are characteristics that increase the likelihood of an outcome (ageism in this
report).
Self-directed ageism refers to ageism turned against oneself. People internalize biases
based on age from the surrounding culture after being repeatedly exposed to them, and they
then apply the biases to themselves.
Sexism is prejudice, stereotyping or discrimination, typically against women and girls, on

the basis of sex or gender.
Sexuality is a central aspect of being human, which encompasses sex, gender identities
and roles, sexual orientation, eroticism, sexual pleasure, intimacy and reproduction. Sexuality
is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values,
behaviours, practices, roles and relationships. While sexuality can include all of these
dimensions, not all of them are always experienced or expressed. Sexuality is influenced by
the interaction of biological, psychological, social, economic, political, cultural, legal, historical,
religious and spiritual factors.
Social care refers to assistance with the activities of daily living, such as personal care or
maintaining a home.
Social norms are rules or expectations of behaviour that apply within a specific social
or cultural group. Often unspoken, these norms offer social standards of appropriate and
inappropriate behaviour, governing what is (and is not) acceptable and coordinating our
interactions with others. A variety of external and internal pressures are thought to maintain
cultural and social norms. Thus, individuals are discouraged from violating norms by the threat
of social disapproval or punishment and the feelings of guilt and shame that result from the
internalization of norms.
Standardized mean difference is used as a summary statistic in meta-analyses when

the studies all assess the same outcome but measure it in different ways (e.g. if all of the
studies measure depression, but they use different scales to measure it). In such a case, it
is necessary to standardize the results of the studies to a uniform scale before they can be
combined. The standardized mean difference expresses the size of the intervention effect in
each study relative to the variability observed in that study.
Stereotype threat arises when people underperform on a task due to concerns about
confirming a negative stereotype about their group. For instance, an older person may do less
well on a driving test or cognitive test due to anxiety about confirming stereotypes about
older people being bad drivers or mentally less capable.
Stereotypes are cognitive structures that store our thoughts, beliefs and expectations about
the characteristics of members of social groups. In the case of ageism, age stereotypes are
used to make inferences about, and guide behaviour towards, people of a given age group.
166
Stereotyping is the process of applying stereotypes, which can lead to overgeneralizations
that consider every person within a given social group to be the same.
Younger person is a person who is younger than the median life expectancy at birth. In
this report, people younger than the age of 50 are considered to be younger people.
Youth is a period of transition from childhood to adulthood. For statistical purposes, youth
is often considered to encompass people between the ages of 15 and 24, although there is
little consensus on the exact age range.
Well-being refers to the total universe of human life domains, including the physical, mental
and social aspects, that make up what can be called a “good life”. It includes domains such
as happiness, satisfaction and fulfilment.
167
168
INDEX
A C
Ableism 10 Campaigns 140–145, 146–147
Abuse 54 Canada
Academic institutions, actions 156, 159, 161 campaigns 144
Aconchego programme 132 housing 84
Adult education 30 long-term care 23
Adultism xix racism and ageism 11
Adverse drug events 51 Care dependence 71, 88
Advertisements 27, 28 Childism xix
African Court on Human and People’s Rights 97 Children, development of ageism 9
African Union Protocol 99–100 China
African Youth Charter 98 loneliness 53
Age, determinant of ageism 67, 71, 86–87 media portrayal of older people 28
Ageism mortality 49
definition 2–8 sexually transmitted diseases 51
measurement scales 31 China, Hong Kong Special Administrative
other “-isms” and 9–12 Region
terminology xix intergenerational contact intervention
theories 69–70 130, 131
Aging Game 120 media portrayal of older people 27–28
Anti-ageing industry 11 Civil society organizations 102, 156, 159,
Anti-discrimination laws 96, 99 160–161
Anxiety about ageing 67 Cleansing rituals 36
Attitudes 31–34, 84 Clinical trials 23, 51
Australia Cognitive dissonance 95
campaigns 142–144 Cognitive function 51–52, 86
educational intervention 117 Community engagement 145
long-term care 23–24 Conflict-related emergencies 29
poverty 55 Contact with older people see
workplace ageism 56, 83 Intergenerational contact interventions
Context, interpersonal ageism 71–72, 88
B Convention on the Elimination of All Forms
Beauty industry 11 of Discrimination Against Women 97
Belgium, workplace ageism 27 Convention on the Rights of Persons with
Best Before Date campaign 144 Disabilities 97
Botswana, HIV 51 Costs see Economic costs
Brazil Country-related variations in ageism 32–34,
impact of ageism 84 71–72
perception of ageism 36 Court proceedings 28
Build a movement to reduce ageism xviii, COVID-19 pandemic 24–26
159–161 Credit schemes 29
Burkina Faso, witchcraft 36 Crime
Butler, Robert xix fear of 54
169
victims of 83 people 72
Cross-cultural differences 32–34 Explicit ageism 8
Culturally appropriate campaigns 145 Extended indirect contact 127
D F
Data collection xvii–xviii, 30, 157–159 Facebook 27
Decade of Healthy Ageing: 2021–2030 xx Facts on Ageing Quiz 71
Definition of ageism 2–8 Family identity 134
Democracies 102 Fear of death 67, 69
Denormalizing behaviour 144 Film dialogue 28
Dependency ratio 30 Financial abuse 54
Depression 51 Financial insecurity 55
Determinants of ageism xvi, 65–79, 86–88 Financial institutions 29
Deterrence theory 95 Finland
Development organizations, actions 156, loneliness 53
158, 160 workplace ageism 52
Direct intergenerational contact 126–127 Framing 144
Disability 10, 49 Friendships 70, 87, 127, 133–134
Discrimination 3, 5, 8–9
Domestic law 95 G
Gender, determinant of ageism 67, 86
E Gendered ageism 11, 28, 29, 36, 53, 88
Economic costs Germany
ageism against older people 54–56 cognitive decline 51
campaigns 145, 147 self-perception of ageing 37
educational interventions 120 television characters 27
intergenerational contact interventions 134 Ghana, witchcraft 36
laws and policies 102, 104 Government actions 155–156, 158, 160
Education Grading of Recommendations Assessment,
as a determinant of ageism 67 Development, and Evaluation (GRADE) 119
institutional ageism against older people 30 Grandchildren and grandparents 70, 73,
interventions to reduce ageism xvii, 127, 133–134
113–123, 128, 129–130, 155 Group discussion 118–119
Egypt, ageism in politics 83
Elderspeak 7 H
Empathy-enhancement 115 Health care 4, 11, 22–26, 56
Employment see Workplace Health-care workers 22, 23, 24, 49, 67, 130
Enforcement of laws and policies 101 Health impact of ageism 48–54, 56
European Convention on Human Rights 97 Health status 71, 72, 88
European Union, employment equality Healthy life expectancy 71–72
framework directive 99 HelpAge International 142
EveryAGE Counts 142–144 Heterosexism 11–12
Evidence-based strategy implementation Higher education 30
xvii, 154–157 HIV 51
Experience of ageism 34–36, 84 Hollywood films 28
Expectations Regarding Aging scale 31 Home-sharing 132
Experimental studies, presentation of older Homophobia 12
170
Housing Korea, media portrayal of older people 28
ageism in 29, 84
home-sharing 132 L
Human rights legislation 97 Language xix, xx
Humanitarian programmes 29 Laws xvii, 93–111, 155
Legal system, ageism in 28, 83
I Life-story documentaries 116–117
Iberoamerican Convention on Rights of Lifelong learning 30
Youth 98 Literature 34
Imagined indirect contact 127, 132 Loan schemes 29
Impact of ageism xvi, 47–63, 84–86 Loneliness 52–53, 128
Implicit ageism 8 Long-term care 23–24, 54
Implicit bias 95
Implicit stereotypes 146 M
Indirect intergenerational contact 127 Mauritius, Equal Opportunities Act (2012) 101
Individual characteristics Measures of ageism 31
perpetrators of ageism 67–71, 86–87 Media 4, 25, 27–28, 52
targets of ageism 71, 88 Medication use 51
Information provision 88, 115, 118 Mental health 23, 51–52, 53, 72, 84
Institutional ageism 5–6, 8, 22–30, 82–84, 88 Mitigating impact of ageism 145–146, 147
Insurance premiums 29 Monitoring of laws and policies 101
Interactive campaigns 144–145 Mortality 49, 53
Inter-American Convention on Protecting the
Human Rights of Older Persons 100 N
Inter-American Court of Human Rights 97 Narrative change 159–161
Intergenerational contact interventions xvii, National law 95
70, 125–137, 155 Natural disasters 29
Intergroup contact theory 69, 127 Nature of ageism xv, 1–19
Intergroup threat theory 69 Neglect 54
International Convention on the Elimination Nigeria
of All Forms of Racial Discrimination 97 films 28
International law 94–95 politics 143
Interpersonal ageism 6–7, 8, 31–36, 67–72, Not Too Young to Run campaign 143
84, 86–88
Iran, educational intervention 116 O
Israel Occupational sectors 72, 88
legal system 28 Older people, ageism against
long-term care 23 conflict-related emergencies 29
in data collection 30
J determinants xvi, 65–79
Japan economic impact 54–56
housing 29 education 30
mitigating the impact of ageism 145–146 financial institutions 29
television advertisements 28 health and social care 11, 22–26, 56
health impact 48–54
K housing 29
Knowledge about ageing 71, 73, 128 impact of xvi, 47–63
171
institutional ageism 22–30 Psychological abuse 54

interpersonal ageism 31–36, 67–72 Public awareness 102
legal system 28 Public consultation 102
media 25, 27–28, 52 Public health data 30
natural disasters 29
scale of xvi, 21–45 Q
self-directed ageism 36–37, 72–73 Quality of life 52
in statistics 30
technology 29 R
workplace 11, 26–27 Racism 11, 83
Open-Ended Working Group on Ageing Recommendations for action xvii–xviii,
(UN) 103 154–161
Organ transplantation 28 Reduction of ageism
Overgeneralizations 3 build a movement xviii, 159–161
campaigns 140–145, 146–147
P educational interventions xvii, 113–123, 128,
Panama, self-directed ageism 36 129–130, 155
Parental role 134 intergenerational contact interventions xvii,
Parkinson’s disease 23 70, 125–137, 155
Partnership working 145 policy and law xvii, 93–111, 155
Pension provision 55, 95 Research institutions, actions 156, 159, 161
Perception of ageism 34–36 Research opportunities xvii–xviii, xxii, 50,
Personality traits 67, 87 74, 89, 105, 119, 141, 157–159
Physical abuse 54 Resource availability 102
Physical appearance 11 Retirement 27, 28, 55
Physical health 49–51, 53, 72 Risky health behaviours 49–50
Policies xvii, 93–111, 155 Role-playing 119
Political Declaration and Madrid International
Plan of Action on Ageing (MIPAA) 97 S
Politics 83–84, 143 Scale of ageism xvi, 21–45, 82–84
Polypharmacy 51 School curriculum-based intervention 117
Population attributable fraction 50 Self-directed ageism 7, 8, 36–37, 72–73
Portugal, intergenerational contact Self-esteem 85–86, 128
intervention 132 Self-perceptions 37
Positive Education about Ageing and Self-stereotypes 9
Contact Experiences (PEACE) Service learning 130
programme 129–130 Sex, determinant of ageism 67, 86
Poverty 55 Sexism 10–11, 28, 29, 36, 53
Preferred Reporting Items for Systematic Sexuality 11–12, 53–54
Reviews and Meta-Analyses (PRISMA) Sexually transmitted diseases 24, 50–51
50, 74, 119 “Silicon Valley ageism” 72
Prejudice 3, 5, 8–9 Singapore, intergenerational contact
Premature mortality 30 interventions 128, 130
Prescribing practice 51 Skipped-generation households 127
Print media 27–28 Smoking 50
Private sector actions 156–157, 159, 161 Social care 4, 22–26
Professional sectors 72, 88 Social isolation 52–53, 128
172
Social media 25, 27, 144–145 health care costs of ageism 56
Social norms 95, 102 health care rationing 22
Social skills training 118–119 higher education 30
Social well-being 52–54, 85–86, 128 mitigating impact of ageism 146
Socially-determined age 3 racism and ageism 11
Spain, workplace ageism 26 television characters 27
Stakeholder actions 155–157, 158–159, workplace ageism 55–56
160–161 Uruguay, policy and laws 100–101
Statistics, ageism in 30
Stereotype embodiment theory 70 V
Stereotype threat 9, 52, 73 Video games 128, 130
Stereotypes 3–5, 8–9, 146 Violence, risk to older people 54
Subliminal stereotypes 146 Virtual reality intervention 117–118, 120
Sub-Saharan Africa, widows and witchcraft
11, 36 W
Sweden, disability policies 10 Weibo 25
Switzerland, workplace ageism 27 Well-being 52–54, 85–86, 128
WHO-CHOICE 104
T Widows 11, 36
Take a Stand Against Ageism 142 Witchcraft 11, 36
Teaching profession 88 Withholding therapy 22
Technology 29 Witness credibility 28
Television 27, 28 Women, ageism against 11, 28, 29, 36, 53, 88
Terror management theory 67, 69 Workplace 4, 11, 26–27, 52, 55–56, 82–83,
Theories of ageism 69–70 86, 99
Time-based variation in ageism 34 Workshops 116
Tobacco prevention campaigns 144 World Programme of Action for Youth to
Travel insurance 29 the Year
Twitter 25, 27 2000 and Beyond 98
U Y
UN Open-Ended Working Group on Young–Old Link and Growth Intergenerational
Ageing 103 Programme 131
United Kingdom Younger people, ageism against 81–91
educational intervention 117–118 determinants xvi, 86–88
financial institutions 29 housing 84
intergenerational contact intervention 132 impact of xvi, 84–86
loneliness 53 institutional ageism 82–84, 88
United Nations agencies, actions 156, 158, 160 intergenerational contact interventions
United Republic of Tanzania, witchcraft 36 128, 131
United States interpersonal ageism 84, 86–88
ableism 10 legal system 83
anti-discrimination laws 96 policy/law-led reduction strategies 98
combined educational and politics 83–84, 143
intergenerational contact scale of xvi, 82–84
intervention 129–130 workplace 82–83, 86
educational intervention 116–117
173
C HA PT E R 01
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MESSAGE BY THE UNITED NATIONS SECRETARY-GENERAL VII

01. THE NATURE OF AGEISM 1

06. STRATEGY 1: POLICY AND LAW 93

Tedros Adhanom Ghebreyesus Liu Zhenmin

Michelle Bachelet Natalia Kanem

• Determinants of ageism against older adults: a systematic review – Sibila Marques,

• Global reach of ageism on older persons’ health: a systematic review – E-Shien

• Scoping review on ageism towards younger populations – Vânia de la Fuente-Núñez,

GRADE Grading of Recommendations Assessment, Development and Evaluation

MIPA A Madrid International Plan of Action on Ageing

PEACE Positive Education about Ageing and Contact Experiences

PRISMA Preferred Reporting Items for Systematic Reviews and Meta-Analyses

STDs Sexually transmitted diseases

WHO World Health Organization

The nature of ageism

The impact of ageism

The determinants of ageism

Three strategies to reduce ageism

• Recommendation 3: Build a movement to change the narrative around age

Ageism refers to the stereotypes, prejudice and discrimination directed

Why a global report on ageism?

To prevent harm, reduce injustice and foster

健康老齡化⼗年：2021-2030 是老齡化與健康全球戰略和⾏動計劃以及 2030 年可

Ageism, as shown in this report, can

• a review of the global prevalence of ageism towards older people, broadly

• a series of systematic reviews of research about ageism against older people

• a scoping review on ageism directed towards younger people, which included

• targeted searches to identify other forms of published quantitative and qualitative

• a review of global, national and local campaigns to tackle ageism; and

• personal testimonies from younger and older people.

This Global report on ageism charts the

“ Discrimination a gainst older people is a serious

Fernan do, 64 , Th e Plurinational State of Bolivia

“ Youn g people based on th eir a ge are discriminated

Ageism refers to the stereotypes (how we think),

Age and stage of life are partly socially determined

Health and social care a

POSITIVE Healthy Warm

NEGATIVE Risk-takers Rigid

POSITIVE Energetic Reliable

NEGATIVE Narcissistic Incompetent and unproductive

POSITIVE Attractive Healthy

NEGATIVE Troublesome Unattractive

predominate in a given situation depend

asymmetric power structure that is based Thus, a key consideration in institutional

Examples of interpersonal ageism include:

Ageist institutional rules, norms and

Stereotype-consistent behaviour can also

men and younger women – bear the brunt

• improving our understanding of the

“ T here are c a s e s in the ho spital s w hen we have

Ageism against older people is widespread across

2.1.1 Ageism in health and

Health care rationing by age is widespread.

2.1.2 Ageism in the workplace Across a range of sectors (e.g. hospitality,

Administrative Region, vulnerability was a

2.1.4 Ageism and the legal Ageism manifests across a range of

offer in-kind or financial support to their