A life course approach to ageing

A discussion on making policy for diverse communities which takes account of life long impact

From the moment we are born, we all begin ageing. This is the start of a complex and varied life course. Each of us live through different events, we make choices, we face the consequences of policies and systems, and intersecting forms of discrimination that influence our lives. As we grow older, the impact on us of these different experiences accumulates.

As the demographic make-up of the world continues to change the need to make policies which take account of population needs across the full life course grows too. Beyond policies which deal with specific life events, policy makers need to consider the cumulative impact of their work on diverse populations. Far from being a homogeneous group, older people’s lives are impacted by the experiences and opportunities they have had through their whole lives.

Working in partnership, HelpAge International and the United Nations Development Programme developed this short animation to stimulate debate among policy makers to think about how to address these challenges. We caught up with Siôn Jones, Strategic Policy Officer at HelpAge International, to find out more about the development of this important resource and the implications this approach has for policy makers. Read on to find out how our conversation went.

Can you tell us a bit more about the brief and the development process?

We’ve been talking to our partners about the implications of a life-course perspective on our work and the sector more broadly for a while now. Alongside United Nations Development Programme (UN Development/ UNPD), we were keen to make sure the audience attending the High Level Political Forum in New York engaged with the issues of ageing, regardless of their own age. This could be achieved by exploring the life-course perspective and highlighting how we are all stakeholders in our own older age.

The brief was to communicate the concepts of the life-course in a visual way. We had different ideas about how to do this, but came up against lots of conceptual barriers. We decided on a short video and worked closely with an animator to try and communicate concepts visually. For example, the yellow line showing fluctuating well-being later in life as a result of events happening in the present.

Who was the intended audience and how did this impact on how you pitched the resource?

The target audience were policy makers attending the UNDP-led side event, ‘Making Sustainable Development Work At All Ages’. We wanted the audience to understand the concepts of the life-course, intersecting identities and cumulative disadvantage. This is because we believe it’s essential to apply these concepts when making policies and programmes that ensure that everyone benefits from development. We only had a few minutes to get these big ideas across. So we felt a short animation was a good way to approach the challenge instead of more complex ideas such as a game or microsite which would have been more complicated and difficult to engage with in an event setting.

How did you develop the characters? Were they based on real people?

We had to work to a tight schedule and so weren’t able to use real case studies. Instead we drew on our programme experience and the stories of individuals we have met through our work. We put these stories together to create characters that could illustrate the life course. Cumulative disadvantage is illustrated by the events, choices and forms of discrimination experienced by our characters and the impact they have not only in the present, but over time. The impact of intersecting forms of discrimination is illustrated by the diverse identities of each character.

The video introduces three big concepts; the life-course, cumulative disadvantage and intersectionality. Can you tell us a little about your understanding of each?

  • Understanding the life-course means realising that we all live complex and varied lives. We live through different events, make decisions and choices and face the consequences of policies, systems and forms of discrimination that impact our lives in the present and well into the future. A life-course perspective recognises that individuals face sudden changes with long term consequences. These consequences can be magnified by poverty. For example, the sudden death of a family member, losing employment, or a humanitarian disaster, are all changes and challenges that impact individuals’ present and future. In low and middle income contexts where policies and systems of support such as health services and social protection are fragmented, poorly resourced and less developed, the short and long-term consequences are even more pronounced because of lower resilience to shocks and stresses.
  • We all have intersecting identities. We all have age, gender, sexuality, physical ability, ethnic background, religion etc. Recognising this is key to understanding that discrimination manifests in complex ways. Individuals’ experiences are not defined by a single characteristic. A wealthy older woman has a very different experience of life than an older woman living in poverty and with a disability. A wealthy man living in an urban area might have worse health than a poorer man living in a village, but has better access to services. We are used to understanding people as groups — older people, young people, women, people with disabilities etc. but we need to be better at recognising the diversity within these groups to make better policy.
  • Cumulative disadvantage is particularly relevant to older age. As we live our lives and experience events, make decisions and face different forms of discrimination and marginalisation, we don’t just feel the effects in the present, but also far into the future. For example, a transgender man may face employment discrimination in his younger age and suffer from lower and insecure income at the time. Slower career progression and lower payments into his contributory pension would impact his future. A woman who develops a fistula during childbirth doesn’t just suffer at the time, but also for the rest of her life and into older age. The layers of disadvantage accumulate so that by the time we are older we face the greatest weight and complexity of cumulative disadvantage. This is a far cry from the assumption of a homogeneous experience of older age that is too often adopted when making important policy decisions.

Are there groups of older people that you think are more likely to experience cumulative disadvantage because of their intersectional identities?

Some older women face a lifetime of cumulative disadvantage that manifests in older age in the form of low and insecure incomes, a lack of assets, continued marginalisation from decision making and other disadvantages. Many are subjected to violence, abuse and neglect. A recent HelpAge report, ‘Entitled to the same rights’, found that harmful ageist attitudes were particularly strong against widowed or single older women, older women with disabilities and migrant older women.

Interestingly however, it’s also important to recognise that power dynamics change across the life course. Whilst men generally enjoy higher incomes and other forms of privilege throughout the life-course including into older age, they can also lack social connections compared to women and have less formal roles in the family which can lead to isolation and loneliness. Older men are also subject to ageism, discrimination, violence, abuse and neglect.

In the video we can see that policy interventions like health systems access and social protection have a role to play in alleviating disadvantage. Why are these important policy levers for older people?

What a life-course perspective illustrates well are the peaks and troughs of well-being that individuals experience, particularly in low and middle income contexts. It also helps identify where intersecting identities and forms of marginalisation reduce resilience to shocks and stresses experienced throughout a person’s life. Policy interventions such as Universal Health Coverage or a social pension work to smooth out the impacts of sudden life shocks and events that can often damage a person’s well-being for the rest of their lives, particularly when they live in poverty.

Perhaps an aspect the animation does not cover is that we don’t exist in isolation as individuals. The life events, choices and forms of discrimination that impact us now and in our future, also impact our families and communities. For example, universal pensions have been shown to have a positive impact on mitigating cumulative disadvantage faced in older age. However other family members also benefit, for example when grandparents help cover the cost of the education of their grandchildren.

Is there anything you would change about video or where there any concepts you would have liked to explore in more depth?

The challenge with making a 3 minute animation about the complexity of the life-course was communicating this in a simple way. With more time, some of the character stories could have been refined to better illustrate the connection between events today and their impact tomorrow. It would also be useful to explore in more depth the practical implications of a life-course perspective on policy-making and programme design. The animation could be supported with more online content, evidence, facts and figures.

We need to develop more evidence on how inequalities develop and carry across the life course, particularly for people living in poverty in low and middle income settings.

As part of this exercise we did not have time to explore how stereotypes around ageing and older people influence policy design and implementation across the life course, for example through the use of mandatory retirement ages, age categories and caps on health services or exemptions in legislation.

If you wanted policymakers to take one thing away from watching what would it be?

They key message is one of complexity and diversity across the life course, particularly in older age. Too often we see older people as a single group with homogeneous experiences, challenges and issues. Adopting a life-course perspective helps us to recognise that older age is a phase in life that is characterised by greater diversity than any other part of the life course.

Policies that adopt a life-course perspective also do not exclude or marginalise based on age, for example through age caps on data collection or eligibility exemptions based on age, and are vital for ensuring we leave no one behind.

The key ask is for policy makers to consider and analyse the impact of policies across the entire life course. We must consider the impact of a policy on a group of people today and the impact it will have on their future. But we must also think how it will interact with the complex and diverse intersecting identities and accumulated advantage and disadvantaged carried by everyone.

More about this post

  • Siôn Jones is the Strategic Policy Officer at HelpAge International. He specialises in the intersection between ageing and urbanisation and leads on new pieces of policy work. Follow Siôn on Twitter:
Post written by Fiach O’Broin-Molloy — Social Development Adviser — Inclusive Societies Department