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Holding space for minority groups in the study of ageism
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Holding Space for Minority Groups in the Study of Ageism
by
Stephanie Lowrey-Willson
Rossier School of Education
University of Southern California
A dissertation submitted to the faculty
in partial fulfillment of the requirements for the degree of
Doctor of Education
August 2021
© Copyright by Stephanie Lowrey-Willson 2021
All Rights Reserved
The Committee for Stephanie Lowrey-Willson certifies the approval of this Dissertation
Emmy Min
Susan Enguidanos
Patricia Tobey, Committee Chair
Rossier School of Education
University of Southern California
2021
iv
Abstract
According to the Pew Research Center (2020), 40% of the U.S. population comprises racial and
ethnic minorities, and as many as one in five Americans could claim a multiracial background by
2050. Despite these numbers, a review of meta and empirical data, theoretical literature, and
research within this study suggest that there is an uneven amount of research for minority groups.
For this study’s purposes, the researcher sought to understand if minority Nevadans experience
ageism differently than non-minority Nevadans. The study collected 268 responses from
LatinX/Hispanic, Black/African American, and White Nevadans 55 years of age and older. The
study’s rationale encompassed inclusive research to meet diverse populations’ needs, inclusive
research to cultivate cultural competency, and to understand ageism through diverse identity
perspectives to help end ageist attitudes at micro, meso, and macro levels. Moreover, social
services remain rooted in outmoded societal approaches that regularly preclude and marginalize
aging minority individuals’ experiences. Older Nevadans experience ageism differently
depending on their overlapping identities, which creates barriers to accessing social
services. This study recommends awareness and advocacy for individuals and influencers;
cultural competency training for social service bureaucrats; an intergenerational program for first
grade through college; an intersectionality approach for work cultures; and support at the micro-,
meso-, and macro-levels. The researcher suggests that a diversity-adjusted approach will help
provide culturally pertinent services to all social services clients. The study outcomes indicated
that there is indeed a difference in how minority Nevadans versus non-minority Nevadans
experience ageism.
Key words: ageism, intersectionality, ethnicity and aging, diverse and inclusive research,
ecological levels and ethnicity, social services, and ethnicity
v
Acknowledgements
Thank you to my dissertation chair, Dr. Patricia Tobey, and Assistant Chair, Dr. Don
Murphy, for your guidance, patience, and thorough feedback as I learned how to write a
dissertation. To my dissertation committee members, Dr. Emmy Min and Dr. Susan Enguidanos,
thank you for your expertise and for sharing my passion for equity.
Thank you to Cohort 13, especially my “ride or dies,” Dr. Suzie Burns and Dr. Becky
Bosco for their love and support. I could not have gotten through this doctoral program without
you; cheers to our lifelong friendship the OCL program has brought us. To our reading group,
Dr. Kiersten Elliot, Dr. Gohar Momjian, and our outstanding organizer Dr. Kristina Lindsey, I
am so thankful for our efficient group and, of course, our Zoom happy hours during these
COVID times.
Thank you to Tya Mathis-Coleman and Susan Bobby for helping me disseminate and
promote my survey, as well as for the love you showed me along the way. Thank you to Dana
Beckman Dose, who was always there to listen to me cry and offer backing, enthusiasm, and
reassurance. May we always boogie down at a show together. Thank you to Shan Bates Bundick
for her daily check-ins to make sure I was still sane and thank you to the feral Karen Coltin for
her help throughout our decade of friendship and hilarious texts.
To my parents Don and Paule Lowrey, it is your lifetime of inspiration and
encouragement that allowed me to believe I could complete this educational journey.
Finally, to my wonderfully supportive husband, James Willson, for never questioning my
journey, motivating me, proofing many papers, and for doing more than your fair share of
cooking and dishes. Without the sacrifices you made, I would have never had the chance to see
how far I could go.
vi
This educational journey has been a labor of love, excruciating at times but always
rewarding. I dedicate this dissertation to our baby girl Marjorie Birdie Willson. May you always
know how capable you are and dare to fulfill your dreams.
vii
Table of Contents
Abstract .......................................................................................................................................... iv
Acknowledgements ......................................................................................................................... v
List of Tables ................................................................................................................................. ix
List of Figures ................................................................................................................................. x
Chapter One: Introduction to the Problem of Practice.................................................................... 1
Background of the Problem ................................................................................................ 3
Field of Context—Social Services ...................................................................................... 5
Description of Stakeholders ................................................................................................ 6
Stakeholder Group Goals .................................................................................................... 7
Stakeholders Global Goal ................................................................................................... 7
Purpose of the Study and Research Questions .................................................................... 7
Importance of the Study ...................................................................................................... 8
Overview of Theoretical Framework and Methodology .................................................... 9
Definitions......................................................................................................................... 11
Organization of the Dissertation ....................................................................................... 13
Chapter Two: Review of the Literature ........................................................................................ 15
Background and Origins ................................................................................................... 15
Consequences of Ageism .................................................................................................. 19
Interventions ..................................................................................................................... 23
Social Services .................................................................................................................. 32
Critical Race Theory ......................................................................................................... 33
Summary ........................................................................................................................... 41
Chapter Three: Methodology ........................................................................................................ 43
Research Questions ........................................................................................................... 43
viii
Overview of Methodology ................................................................................................ 43
The Researcher.................................................................................................................. 44
Data Sources ..................................................................................................................... 45
Data Collection Procedures ............................................................................................... 48
Ethics................................................................................................................................. 52
Conclusion ........................................................................................................................ 53
Chapter Four: Results ................................................................................................................... 54
Research Question 1: How Does Ageism Manifest From the Perceptions of Older
Adults in Nevada? ............................................................................................................. 56
Research Question 2: How Do Older Nevadans Experience Ageism Differently
Depending on Their Race Structure Location (e.g., White vs. Visible Minority) ............ 63
Results ............................................................................................................................... 63
Research Question 3: What Is the Difference in Access to Social Services for
Older Minority Nevadans and Older Non-Minority Nevadans? Likert Scale .................. 68
Research Question 4: What Interventions Are Recommended to Better Serve
Marginalized Groups at the Micro-, Meso-, and Macro-Levels? ..................................... 70
Summary ........................................................................................................................... 83
Chapter Five: Recommendations and Discussion......................................................................... 84
Discussion of Findings and Results .................................................................................. 84
Recommendations for Practice ......................................................................................... 91
Limitations and Delimitations ......................................................................................... 103
Recommendations for Future Research .......................................................................... 105
Conclusion ...................................................................................................................... 105
References ................................................................................................................................... 107
Appendix A: Theoretical Framework Alignment Matrix ........................................................... 128
Appendix B: Survey Questions ................................................................................................... 129
Appendix C: Survey Protocol ..................................................................................................... 134
ix
List of Tables
Table 1: Select Participant Quotes That Illustrate the Themes: Work and Societal
Discrimination
58
Table 2: Select Participant Quotes That Illustrate the Themes: Barriers in Age
Differences, Cultural Norms, Physical Limitations
60
Table 3: Select Participant Quotes That Illustrate the Themes: Health, Mindset,
Intergenerational Contact and Policy
62
Table 4: Illustration of the Micro-Level Experience by Ethnicity 73
Table 5: Illustration of the Meso-Level Experience by Ethnicity 77
Table 6: Illustration of the Macro-Level Experience by Ethnicity 82
Appendix A: Theoretical Framework Alignment Matrix 128
x
List of Figures
Figure 1: Conceptual Framework 41
Figure 2: Survey Participants by Ethnicity 55
Figure 3: Summarizes the Themes and Frequency Rate Based on the Typicality of
How the Participants Experienced Ageism in Their Own Lives
57
Figure 4: Why Do You Think Ageism Exists? Based on Frequency Rate 59
Figure 5: What Do You Think Can Be Done to Prevent Ageism? 61
Figure 6: Ethnicity and Experience 65
Figure 7: Identity and Ageism Responses 67
Figure 8: Differences in Access to Government Services—Minority Versus Non-
Minority
69
Figure 9: Micro-Level Experiences 71
Figure 10: Differences in How Minorities and Non-Minorities Experience Ageism at
the Micro-Level
72
Figure 11: Meso-Level Experiences 75
Figure 12: Differences in How Minorities and Non-Minorities Experience Ageism at
the Meso-Level
76
Figure 13: Macro-Level Experience 79
Figure 14: Differences in How Minorities and Non-minorities Experience Ageism at
the Macro-Level
81
1
Chapter One: Introduction to the Problem of Practice
Between 2020 to 2060, the number of older Americans is estimated to increase from 62
million to 95 million, expanding the older American population’s share from 16% to 23% by
2050 (PRB, 2019). Within that same time frame, the older non-Hispanic White portion will
decline from 77% to 55%, suggesting that older Americans are becoming more ethnically and
racially diverse (PRB, 2019). Additionally, according to the Congressional Research Service
(2019), of the people aged 65, 4.7 million older adults lived in poverty in 2017. Nevertheless,
there is a shortage of research on minority groups in the study of ageism. Amongst ageism
research and interventions, 67% have focused on White individuals, demonstrating that this is a
problem (Burnes et al., 2019).
This evidence highlights that more diverse studies are needed to understand better how
minority populations experience ageism. Consider these numbers: According to the Pew
Research Center, in 2018, White Americans’ most common age was 58, though racial and ethnic
minority groups slant toward younger Americans. Although Whites’ median age in 2018 was age
44, the median age for minorities is 31, and for the overall U.S. population, 38 (Schaeffer, 2019).
In 2018, 40% of the U.S. population consisted of racial and ethnic minorities—an assessed
increase of approximately 1,271,000 people from 2017. Minority populations will likely surpass
Whites in the next several decades as minorities’ larger growth rate continue (Schaeffer, 2019).
While diversity in research has proven benefits for the culture, science, and society, it
also presents researchers, health services, and social services with challenges in meeting a
diverse population’s needs (Redwood & Gill, 2013). Even though there is a gain in diversity for
older adult populations, the fast-changing racial and ethnic configuration of the population under
age 18 has generated a diversity gap between age groups (Schaeffer, 2019). Understanding the
2
phenomena of aging for diverse populations will help cultivate useful interventions, services,
education, and research to address the needs of racial and ethnic minorities (Redwood & Gill,
2013).
In a study conducted on college students in 26 cultures, there was widespread cross-
cultural consensus concerning aging’s perceived trajectory, including declines in learning,
attractiveness, and the ability to perform everyday tasks (Löckenhoff et al., 2014). This study
suggests that harmful aging stereotypes exist globally and show that ageism is a problem.
According to the European Union Agency for Fundamental Rights Report (FRA) (2018),
older adults want age discrimination to stop and to be treated equally at work, in health care,
social services, and in the media. More than half of Europeans have experienced ageism and
believe it is detrimental (FRA, 2018). In comparison, more than 80% of older adults in the U.S.
have experienced ageism (Robbins, 2015).
According to the U.S. Census (2015), older Limited English Proficient (LEP) Americans
account for roughly 5 million of the population, and 43.8% of low-income supplemental security
income applicants are 65 and over. As noted by the National Council of Aging (n.d.), LEP
describes individuals who do not speak English as their primary language or have a partial ability
to read, speak, write, or understand English. LEP creates barriers to accessing health care and
social services available to fluent speakers. For this study’s purpose, the research will focus on
aging, race, and ethnic groups. However, due to the intersectionality in identities, the study may
uncover low-socioeconomic variants vs. working-class, gender structure, immigration status,
disability structure, and sexual orientation in the study of ageism, thus warranting the discussion
of these intersects.
3
Also, social services are not prepared to handle the increase (Jackson & Samuels, 2011).
Racial and ethnic growth poses many challenges for social workers and social service
practitioners alike in supporting services for aging racial and ethnic minority groups (Jackson &
Samuels, 2011). Understanding minority aging populations’ specific needs is vital for developing
quality services and interventions specific to minority groups experiencing ageism and will be of
use to social services (Jackson & Samuels, 2011). There is also a need for the industry to create
racially inclusive models for addressing health concerns, treatment, well-being, and service
provision among minority racial and ethnic populations, and to create a comprehensive
understanding of racial and ethnic minority populations’ experiences (Jackson & Samuels,
2011). Social services must develop a framework outlining a clear and concise definition of
critical concepts such as race, ethnicity, and culture for the community and individual older
adults experiencing ageism (Jackson & Samuels, 2011).
Background of the Problem
Since the coining of ageism in the 1960s, by gerontologist Dr. Robert Butler (Butler,
1969), numerous research studies across fields indicate ageism’s origins and work toward
informing and reducing ageist attitudes toward older adults (Levy, 2018). Popular interventions
to reduce ageism suggest intergenerational mediations, such as a mix of educational and
intergenerational targeted toward students. Indeed, positive findings note intergenerational
benefits (Christian et al., 2014). However, these interventions are recommended at an early age
and do not address mediations later in life or at the organizational level. Consider these numbers
in a 2019 meta-analysis study conducted between 1976 and 2018; the study examined 29,702
published reviews on ageism. Excluding those with weak methodology, the researchers
identified 63 studies that met the analysis criteria (Burnes et al., 2019). The study deployed three
4
programs, including a control group of students receiving interventions and those who did not.
The three programs focused on students K-12 and university students. The composition of the
participants in the cumulative study consists of (33.3%) intergenerational contact-only, (36.5%)
education-only, and (30.2%) combined intergenerational communication and education. Subjects
were White (66.7%), primarily female (67.2%) and with an average age of 22.4 years spanning
from preschool to middle school (20.7%), high-school (15.9%), undergraduate (20.6%), and
graduate (36.5%) educational age groups (Burnes et al., 2019).
The Burnes et al. (2019) study notes the need for research within groups of people with
diverse aspects of identity, and reports that their experiences differ from the shared group aged
55+ and over. A shortage of diversity is apparent when looking at sociological literature on
workplace inequality, as little is known about the consequences of age and ageism for minority
groups (Wilson & Roscigno, 2018).
Most research has studied factors at the micro and meso-levels (Ayalon & Tesch-Römer,
2018). The micro-level consists of elements such as gender and health (Palgi et al., 2012), while
the meso-level encompasses aspects of one’s societal associations, which forecast loneliness later
in life (Shiovitz-Ezra, 2013). However, there is less attention to the macro-cultural level, which
consists of how older adults are damagingly perceived and the limited social opportunities
available for older adults (Ayalon & Tesch-Römer, 2018). These levels are associated with
Bronfenbrenner’s ecological systems theory, which contends that the ecosystem one grows up in
impacts all factors of one’s life (Renn & Arnold, 2003). For the most part, ageism credits several
factors, such as fear of death, anxiety about aging, and an ever-growing siloing in a society based
on age (Hagestad & Uhlenberg, 2005).
5
Hagestad and Uhlenberg (2005) state that social norms and an increasingly age-
segregated society act as barriers that reduce the willingness of different age groups to interact
regularly (Nelson, 2004). One study surveying 2,000 English Brits, notes that less than one-third
of those under 30 years of age had friends 70 years of age or older and vice versa (Abrams et al.,
2009). Age-based biases are supported by a hierarchical system of power within society that
rewards certain groups of the population based on membership; this system of age stratification
provides benefits to the young while marginalizing the old (Calasanti, 2005). As a result, cultural
reinforcement, such as biases perpetuated in media, policies such as forced retirement, and
individual-level prejudices help maintain this system. Tackling biases can be complicated and
often relies on the interaction between intergenerational groups and education (Chonody, 2015).
These examples suggest the existence of an increasingly age‐segregated society, which
contributes to misunderstandings in ageist attitudes.
Ageism is challenging to mitigate. In a society that admires anti-aging and youth, it has
overwhelming psychological and sociological geneses that affect the way people age, further
adding to the complexity of ageism (Ayalon & Tesch-Römer, 2018). Adding to those
complexities is a shortage of research within minority populations (Burnes, 2019).
Field of Context—Social Services
This study’s field of focus examined how key populations experience ageism at different
intersects to determine whether minority groups’ experiences are the same or different from the
non-minority group to then level the predicted divide among older adults. Recognizing the
precise needs of minority aging populations is imperative for the growth of essential services and
interventions specific to racial and ethnic minority groups experiencing ageism (Jackson &
Samuels, 2011). Such an understanding is useful to social services (Jackson & Samuels, 2011).
6
Social services are an array of public services supported by nonprofit, for-profit, private, and
governmental organizations (Smith, 2017). Social services aim to promote equality and
opportunity and build healthier communities (Smith, 2017). Social services include benefits such
as education, food subsidies, health care, subsidized housing, community management, research,
and policy (Smith, 2017). The growth of racial and ethnic minority people inside the U.S.
produces challenges for social services (Jackson & Samuels, 2011). Social services need to
address diverse population concerns relating to the field by thoroughly studying and addressing
the consequences of a changing racial and ethnic society of other marginalized groups (Jackson
& Samuels, 2011). The current development and progress of racial and ethnic minorities,
including growth among other marginalized groups, stresses that social services need better
understanding and training to serve sidelined communities (Jackson & Samuels, 2011).
Description of Stakeholders
There are four key stakeholders’ groups who are impacted by this study. The primary
stakeholder group is older adults, 55 years and older, as ageism affects them directly. Older
adults can experience ageism through limited social services, being rejected for employment, or
feeling marginalized in their communities. Another stakeholder group is social service providers
as they allocate assistance, including benefits and services, to older adults. Health care providers
are also a stakeholder group who play a role in delivering health care for older populations.
Health care workers are responsible for upholding professional competencies through ongoing
education to guarantee that they are prepared to provide care to older adults. Finally, community
partners—such as public agencies, schools, nonprofit organizations, government offices, and
private businesses—are stakeholders who provide and facilitate resources to the community.
7
Community partners identify required intervention programs and provide services to older adult
populations. Overall, these stakeholders have a direct impact on aging.
Stakeholder Group Goals
According to the European Union Agency for Fundamental Rights Report (2018), older
adults want age discrimination to stop. They want to be treated equally at work, in health care,
social services, and in media. The goal is to identify and value how ageism intersects with other
identities including race and ethnicity to dismantle injustice experienced by marginalized people.
Limiting research on ageism and minority populations creates barriers to more inclusive social
services, restricting the stakeholders’ goals from being met (Yang & Levkoff, 2005).
Stakeholders Global Goal
Similar to the goals above, the stakeholders’ global goal is to address this discrimination
by age, not only for the potential benefits to an individual of this age group but also for the
societal benefits such as better research to determine the best strategies for preventing and
treating ageism and to inform policy (Cohen, 2001).
Purpose of the Study and Research Questions
This mixed-method study examined how ageism is manifested through diverse
populations’ perceptions and determines the interventions needed to improve social services
solutions to eliminate ageism. This study can help overcome age discrimination at the micro,
meso, and macro-level (better known as Bronfenbrenner’s ecological system). The research
questions that guided this study are as follows:
1. How does ageism manifest from the perceptions of older adults in Nevada?
2. How do older Nevadans experience ageism differently depending on their race
structure and location (e.g., White vs. visible minority)?
8
3. What is the difference in access to social services for older minority Nevadans
and older non-minority Nevadans?
4. What interventions are recommended to better serve marginalized groups at the
micro-, meso-, and macro-levels?
Importance of the Study
In the developed world, retirement is the mark of old age. In many developing countries,
old age begins when an active contribution to society is no longer possible (Adams et al., 2011).
In some cases, this is because of the loss of established roles due to physical decline, which is
significant in defining who is old (Adams et al., 2011). These cultural and societal constraints
limit the opportunity to continue in the workforce, learn new activities, obtain access to medical
care, and to be treated like a functioning member of society (Adams et al., 2011). Although there
are limited opportunities for older adults, Moody (1988) suggests that older adults’ new activities
lead to various positive outcomes. These benefits include protecting against cognitive decline
(Laes, 2015), learning new motor skills (Seidler, 2007), improving well-being and reducing
societal medical costs (North & Fiske, 2012).
The shortage of studies about the underrepresentation of minority groups will be better
informed by this study and will help to further understand the overlying oppression of ageism
(Burnes et al., 2019). This topic is particularly important to study as research participants should
reflect the diversity of all cultures and conditions, taking into account race, ethnicity, and age. It
is essential to study ageism as it can create improved social services strategies, and the research
benefits all of humanity, as most of us will age. Unfortunately, a limiting factor in meeting this
goal is the societal anxiety about aging (Wisdom et al., 2014), which illuminates why it is crucial
to research and understand ageist attitudes to break the cycle.
9
Overview of Theoretical Framework and Methodology
Phenomenology
Phenomenology is the first theoretical framework used for this research study. According
to Creswell (2013), phenomenology concentrates on the commonality of a particular group’s
lived experience. The approach’s central goal is to explain the phenomenon’s essence, as
phenomenology lends its view to the human experience (Creswell, 2013). This study aims to
understand diverse populations’ perceptions of how ageism manifests, thus allowing the
participants to discuss what ageism signifies in their own lives (Creswell, 2013). The
fundamental goal of phenomenology is to define experiences as they emerge in consciousness
(Maxwell, 2013).
Phenomenology looks at individuals’ lived experiences for information (Maxwell, 2013).
By gathering shared experiences of ageism from various people, this study expects to find
patterns in the human understanding of how ageism manifests, determine the core of the
problem, and decide if it varies based on different intersectionality. This approach is critical
because it describes how humans experience phenomena (Creswell, 2013).
Intersectionality Theory
Intersectionality theory is another lens used for this study. Intersectionality acknowledges
that within groups of people with shared identities, there exists an “inner” group with diverse
aspects of identity, and as such, their experiences differ from the shared group (Coleman, 2019).
Intersectionality was chosen as a framework to fully understand and consider all levels of
discrimination due to ageism. Intersectionality looks at how individuals experience social
structures differently because of their identities’ intersection so as to determine the overlaying
oppressions (Byrd, 2014). Thus, generalizations about the struggle or power of a particular social
10
group fail to recognize that individuals in the group also belong to other social groups and may
experience different forms of marginalization (Choo & Ferree, 2010). According to Coleman
(2019), intersectionality focuses on the ways that experiences of those at different socio-
demographic “intersections are differentially shaped by social power in structural and
interpersonal contexts” (Bauer & Scheim, 2019, p. 236). Determining the multiplicative effects
of ageism related to gender, race, class, and immigration status can help identify policy issues
and social problems around ageism and contribute to the development of socially relevant and
inclusive policy solutions (Clarke & McCall, 2013).
Bronfenbrenner’s Ecological Theory
The experience of ageism due to discrimination at the micro, meso, and macro levels can
influence how one thinks, feels, and acts toward age and the aging process (Backonja et al.,
2014). Bronfenbrenner’s ecological model explains how human development and behavior
impact a set of exchanges between system constructs, such as family, as well as social,
socioeconomic, psychological, and political influences, which shape human behavior, decisions,
and well-being over a lifetime. Bronfenbrenner’s ecological model’s foundation puts the
individual at the most intimate level of the environmental influences and expands outward
toward grander social systems of power (Backonja et al., 2014). Bronfenbrenner’s model is well-
matched to study ageist attitudes in Western cultures by helping to understand the multiple,
entrenched settings in which all individuals exist and the exchanges between individuals and
these other ecological systems. Understanding individual and environmental level factors,
influences, limitations, and structures can explain how key populations experience ageism at
different intersects (Backonja et al., 2014).
11
Theory of Change
Ageism can be viewed as a development of discrimination and systemized stereotyping
against older adults (Cohen, 2001). Due to ageism, younger populations see older adults as
different from themselves, which perpetuates the idea that older adults are not relatable (Cohen,
2001). Aligning with the phenomenology, intersectionality, and Bronfenbrenner’s lenses, the
researcher anticipates exploring the intersecting roles ageism has on race and ethnicity within the
ecological environments; thus leading to a critical step in understanding inequities and
overcoming ageist attitudes.
Age is a biological process, yet ageist attitudes are social constructs of social thought and
relations (Cohen, 2001). Since ageism is a social construct, the author outlines a plan detailing
how the desired change should occur. The theory of change notes three assumptions 1) that
ageism is normal, ordinary, and ingrained into society, making it challenging to recognize; 2)
that the knowledge of older adults and their “unique voice” is valid, legitimate, and critical
toward understanding the persistence of ageist inequality; and 3) awareness of bias will be the
catalyst for change. Therefore, in this view, the researcher anticipates that the theory of change
ensures that all older adults’ voices are equal, validated, and unique. Through awareness, all
individuals and social services can change damaging stereotypes. According to Tuck and Yang
(2013), change refers to a belief or perspective about adjusting situations, corrected, or
improved.
Definitions
This section defines and explains the use of key-terminology used throughout the study:
• Ageism is discrimination, bias, stereotypes, and margination based on one’s age (World
Health, n.d.).
12
• Prejudice refers to attitudes that prejudge a group. Usually negatively and not based on
facts. Prejudice usually occurs at the micro-level (Race and Ethnic Group Stratification,
2012).
• Discrimination: If prejudices become action, it then becomes discrimination, which is a
term used to describe the differential treatment of and harmful actions against minorities.
Discrimination mainly occurs at the meso and macro-levels (Sage Publications, 2012).
• A Minority Group is a group of individuals who, due to their physical or socioeconomic
status, or cultural characteristics, are singled out from other members from within the
society in which they live (Wirth, 1941). For this study’s purposes, the terms below,
when grouped together, will be described as minority groups.
o Gender is a term that highlights a spectrum of relationships that may include sex
but is not directly determined by sex or directly determines sexuality (Lindquist,
2012).
o Sexual Orientation recognizes as a person’s romantic, physical, and/or emotional
attraction to individuals of the same and/or opposite sex. It is all-encompassing of
bisexuals, gay men, lesbians, and straight women and men (Advancing Effective
Communication, 2012).
o Immigration in the United States is a many-sided policy issue that temporarily or
permanently admits foreign nationals (William & Wilson, 2018). According to the
World Health Organization, poverty, social isolation, and deteriorating health is
common among older adults due to their refugee or migrant status and older age.
o Race and ethnicity are about the process of marking differences between people
on the basis of assumptions about human physical or cultural variations and the
13
meanings of these variations; identities are about setting and maintaining
boundaries between groups (Woodward & Open University, 2000). Older adults
and racial and ethnic minority groups experience barriers to accessing certain
health care services.
o Disability, unfortunately, may be defined as a deficiency, a disease, a condition,
or a disorder, instead of just a person with a disability (Weisstub, 2015). This
incorrect lexicon gives rise to additional perceptions of people falling into this
category in the context of our social obligations (Weisstub, 2015). Combatting the
stigmatization of people with disabilities, not unlike ageism, is a topic that
continues to be a measuring point of the level of tolerance and respect given to
vulnerable populations (Weisstub, 2015).
o Class Structures represent a group of people displaying comparable
characteristics based on educational levels, income, control, and status. Each class
of individuals has different income levels and different statuses, and each
demonstrates different levels of power associated with their social rank
(Manstead, 2018).
Organization of the Dissertation
This study is comprised of five chapters. Chapter One provided an analysis of the
problem of practice and common key factors used throughout the paper. Chapter Two offers
current and existing literature supporting the study’s scope and the theoretical framework of
phenomenology, intersectionality, and Bronfenbrenner’s ecological model. Chapter Three
discusses the participant selection, data collection, analysis, and methodology. Chapter Four
consists of the data analysis and results. Finally, Chapter Five discusses the solutions, supported
14
by data and literature, for social service interventions and future curriculum recommendations to
help eliminate ageist attitudes.
15
Chapter Two: Review of the Literature
Chapter Two outlines the predominant factors of ageism identified in the literature. The
chapter highlights the assumed causes and history of ageism, consequences, interventions, and
the need for culturally and age-diverse research to fully understand the concept. The first section
focuses on an overview of ageism’s origins and the history behind ageist attitudes, highlighting
survival and dynamic shifts in society. The second section provides an overview of the term
ageism and the development of the subject area, including terminology development and the
possible root causes of ageism. The third section notes the consequences of ageism for older
adults. The fourth section illuminates commonly studied interventions as well as the need for
more mitigations through policy. The chapter continues with intersectional evidence that
supports the need for culturally and age-diverse studies to create responses in social services for
a full understanding of how minority groups experience ageism. Guided by evidence, this
chapter concludes with the theories and conceptual framework that applies to and emphasizes the
detriment of ageism, injustices inherent in current systems, and diverse research requirements.
Background and Origins
History
Researchers suggest an extensive range of theories to explain the pervasiveness of
ageism. However, according to Cuddy and Fiske (2002), two root origins are accepted as the
most plausible catalysts of aging attitudes, modernization, and medicalization. Modernization
theory explains that as a result of the change from an agrarian society to an industrial society,
views of older adults transformed into negative beliefs (Cuddy & Fiske, 2002). For example,
beginning with the nomadic age and varying from culture to culture, many tribes abandoned or
killed their older members if circumstances threatened their existence (International Longevity,
16
2006). The nomadic age describes a 190,000-year time when humans moved around to secure
food and resources, encompassing the Paleolithic and Neolithic stone ages (McCarter, 2007).
As individuals began to stay in one place, an agricultural or agrarian society began to
form. An agrarian society is a community that bases its economy on producing and maintaining
crops and farmland (Winter, 2014). In this era, older adults began to hold positions of authority
via seniority rights, which protected power, money, and land due to their knowledge of
cultivating the land (International Longevity Center, 2006).
As the transition from agrarian to industrious urban societies began to occur, many older
persons’ loss of power started to shift, resulting in more dependence and marginalization based
on age (International Longevity Center, 2006). Competition between young and old generations
began to ensue due to technological and literacy improvements and a movement toward
urbanization. This movement destabilized intergenerational connections between youth and their
families of origin. It diminished the significance of older people, bringing about the incompetent
stereotype often associated with older adults (Cuddy & Fiske, 2002).
In the developed world, retirement is the mark of old age. In many developing countries,
old age begins when an active contribution to society is no longer possible (Adams et al., 2011).
In some cases, this is due to the loss of established roles due to physical decline, which is
significant in defining who is old (Adams et al., 2011). These cultural and societal constraints
consequently lead to age discrimination, known as ageism, which is prevalent today (Cuddy &
Fiske, 2002).
Ageism
The World Health Organization describes ageism as bias or discrimination based on age.
Ageism was first coined in 1969 by gerontologist Robert Butler after he noted bigotry toward
17
aging adults. Butler (1969) said that America values youth, energy, power, and pragmatism over
the experiences and wisdom in age (Butler, 1969). However, describing older adults as wise, 30
years later, can be considered ageist as it perpetuates stereotypes (Palmer, 2000). In 1999,
positive ageism was coined (Palmer, 1999), and in 2000 sageism was coined (Minichiello et al.,
2000). Both terms describe the discrimination of people because of their age, such as when
people respect older adults because they are perceived to be revered due to their wisdom and
experience. Minichiello et al. (2002) noted that if an older adult cannot meet such expectations,
then that individual may experience negative impacts. Otherwise known as negative ageism,
these adverse effects are prejudice and discrimination based on age (Chonody, 2015).
Similarly, in the development of the field of ageism, theorists coined other terms. In 1993
the term compassionate ageism appeared to describe a belief that older adults are vulnerable and
needy. The language suggests that older adults need protection by generating appropriate policies
to help them (Friedan, 1993). Likewise, terms were built off other concepts; for instance, Katz
and Braly (1935) identified implicit bias as people’s inherent nature of stereotyping and
prejudice.
However, it was not until the study of ageism expanded that the term implicit ageism
emerged, suggesting that a person is unaware of their bias (Levy & Banaji, 2002). However, as
noted later in this chapter, Chopik and Giasson (2017) contradicted the idea of implicit bias,
highlighting the determent of old age coupled with overlying intersectional oppressions. As the
field expanded, another phrase, explicit ageism, appears and describes an internal and conscious
awareness of one’s attitudes and biases toward older adults (Chopik & Giasson, 2017).
In the last decade, institutional ageism began to surface (Fitzpatrick, 2009). Institutional
ageism builds upon the 1967 term, institutional racism, which describes entrenched practices of
18
racism within society or an organization that leads to discrimination in employment, criminal
justice, health care, employment, housing, education, and political power (Carmichael &
Hamilton, 1967). Institutional ageism characteristics encompass language depicting older people
negatively and discriminating older adults within society and organizations (Lloyd-Sherlock et
al., 2016). The origins of ageism are clear, but what about aging makes it persist in today’s
society?
Anxiety About Aging
The dominant leading theory regarding ageism’s origin links to anxiety about aging
(Wisdom et al., 2014). That fear is then perpetuated in society through internalized stereotypes,
societal stereotypes, and age discrimination, influenced by media, policy, lexicon development,
and systemic discrimination (Swift et al., 2017). Anxiety about aging supports the theory of
stereotype embodiment, which suggests that the internalization of ageist attitudes is due to a
lifetime of exposure to cultural messages of ageism (Levy, 2009). As a result, ageist attitudes
become part of implicit bias, perpetuating ideas about old age and older adults (Levy, 2009). As
individuals age, a psychological response occurs, resulting in self-fulfilling internalized
stereotypes, thus fulfilling the self-perception of being “old” (Levy, 2009). Levy (2003) noted
that individuals are more vulnerable to the ageist paradigm’s propaganda because, unlike other
discriminatory views, individuals are programmed in the belief system when it is not relevant to
their identity. For example, ageist attitudes show-up in children as young as 6 years of age
(Isaacs & Bearison, 1986). Individuals are exposed to an ageist standard before connecting to
their own experience (Levy, 2003).
Older age is associated with the decline of physical capabilities such as motor and
sensory performance (Chodzko-Zajko & Ringel, 1987). Instead of a forward-moving process
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(D’Antonio, 2020), studies examining psychological and sociological structures, such as well-
being, social power, and emotional experience, noted that these structures increase during the
first period of life, but decline from midlife on (Blanchflower & Oswald, 2004). As individuals
age into older adulthood, their negative beliefs about aging become increasingly salient and self-
directed (Levy, 2009), which leads to the discrimination of their future selves. This
discrimination embodies deterioration of age, the anxiety of age, and fear of death (Lev et al.,
2018).
To cope with this anxiety and fear, Lev et al. (2018) observed that different age groups
separate themselves from the old age by maintaining younger age identities and dividing
themselves between the third and fourth ages. The third age denotes the time between retirement
and the start of age-enforced restrictions and occurs between the ages of 65 and 80 (Barnes,
2011). At about 80, older adults cross from the third age, when they are perhaps healthy and
independent, into the fourth age (Adams et al., 2011). Related anxieties, beliefs, and stereotypes
lead to severe ramifications for older adults.
Consequences of Ageism
A person’s chronological should not attribute to the loss of capabilities associated with
aging. According to the World Health Organization, there is no “typical” older adult as older
individuals’ abilities and needs are not random but entrenched in events throughout their life.
There are many consensuses to ageism, including workers’ discrimination, health, health care,
lack of opportunities, accessibility, and loneliness, to name a few (World Health Organization).
Though most older people will eventually experience multiple health problems, older age does
not imply failing health, dependence, or inability to work (World Health Association). The
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literature below highlights the consequences of the issues separately, even though ageism’s
ramifications significantly overlap.
Ageism and Work Discrimination
Age discrimination is when a person’s age unfairly becomes an issue when deciding who
receives a job benefit, promotion, or a new job. This discrimination typically impacts older
workers but can affect younger workers (Darney & Magee, 2007). In a 2003 study conducted by
MaturityWorks, workplace ageism was examined through 150 individual interviews. The study
noted that 71% of participants were apprehensive about their future, 65% were not confident of
getting another job, 83% believed potential employers had denied them employment due to their
age. The participants’ ages ranged from 34 to 67, and the average participant was 53 years old.
Of those interviewed, 13% of participants under 40 indicated they experienced ageism, as did
61% of participants before they reached 50 (Maturity Works, 2003).
In a 2019 study looking at employees’ perceptions on workplace age discrimination, the
negative consequences of perceived age discrimination included depressive symptoms like a
decrease in employee’s job satisfaction and overall self-rated health, known as the “wear and
tear” effect (Marchiondo et al., 2019). Although ageism impacts mental well-being, health, and
employment, it also impacts perceptions.
Perceptions on Aging
In North America, negative stereotypes about aging portray later-in-life as a time of
loneliness, dependence, poor health, and physical and mental decline (Dionigi, 2015). Compared
with middle-aged adults, the perception of older adults is that of having inferior social status in
terms of wealth, respect, power, prestige, and influence (Garstka et al., 2004). As a result, these
perceptions impact older adults’ treatment in social interactions (Garstka et al., 2004).
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One study surveying 83,034 participants from 57 countries, ages 30–60, showed that
24%, 32%, and 44% had high, moderate, and low ageist perceptions, respectively (Officer et al.,
2020). The distribution of individuals with higher-level ageist attitudes was considerably higher
among those with low- and middle-incomes (Officer et al., 2020). The study highlights the
significant percentage of modern-day ageist attitudes (Officer et al., 2020).
According to Road Scholar (2010), the perception of older adults is that of passive TV
watchers, yet, in the 2010 Road Scholar report, 100,000 older adults traveled exploring
international cultures. Road Scholar is a nonprofit organization the world’s that curates
experiential traveling learning opportunities. Another view about older adults is that they
contribute little to society even though, according to SeniorCorps (2019), the perception of older
adults is that of passive TV watchers. Yet, the organization has over 500,000 members ages 55
and up, highlighting the activity of older adults. Another perception is that older adults do not
like change. According to Berk (2012), studies show excellent mental resilience levels in older
adults, including the ability to accept and rebound from adversity. Studies have also shown that
when removing older adults from decisions concerning their health care, they are less likely to
benefit from and take advantage of these services, revealing the stereotype that older adults
cannot make good decisions about important issues (Reed, 2012).
However, scientists denounce the validity of such a stereotype based on the concept
of crystallized intelligence (Zamroziewicz, 2016). The idea explains that cognitive skills built on
experiences allow older people to make decisions based on a lifetime of knowledge and
education, resulting in older adults making sound decisions by evaluating the reliability of
sources. The damaging perceptions about aging also appear in health care, perpetuating
stereotypes and affecting care.
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Health Care
Health care workers and educators perpetuate ageist attitudes. Anti-aging bias may start
early during medical training (Ouchida & Lachs, 2015). Ageism among health care providers can
be explicit or implicit (Ouchida & Lachs, 2015). According to Ouchida and Lachs (2015),
physicians-in-training consider older adults to be less rewarding, aggravating, and tiresome,
reinforcing negative views when trainees attend to ill and frail geriatric patients (Adelman et al.,
2000). Then, add in the potential for under treatment or overtreatment. Harmful over-treatment
can occur when health care providers offer erroneous health guidance based on chronological
age (Macnicol, 2006). Macnicol (2006) noted that this happens when an older adult’s assessment
does not consider conditions, preferences, and functional status. Undertreatment occurs when
health care providers stereotype older adults or apply age-based group characteristics (Macnicol,
2006). For example, in a subject group of 60-93-year-olds, 43% of individual surveys reported
that health care providers assumed ailments were due to age. Health care providers refused 9% of
the participant’s medical treatment solely due to age (Palmore, 2001). Ageism’s impact goes
beyond health care providers, with direct effects on the health of people who have or experienced
ageist attitudes.
Health Impacts
Ageist attitudes impact older adults’ quality of health (Jackson et al., 2019). Ageist
attitudes have been connected with weak recovery, reduced will to live, hearing loss, lower
engagement in preventive actions, and a lower opinion of practical health (National Institute of
Aging, 2003). In previous studies, marginalized group members displayed negative self-
stereotypes that adversely affected their cognitive abilities. However, newer research shows the
influence of ageism over a long period of life (National Institute of Aging, 2003). The Baltimore
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Longitudinal Study of Aging conducted a study that looked at ageist attitudes of 440 individuals
aged 18 to 49. This study showed that in holding negative stereotypes toward older adults, these
stereotypes amplified the risk of health conditions later in life. For example, the risk of
cardiovascular disease, a decline in memory, cognitive decline, and heart attacks increased
compared to those who experienced positive stereotypes (National Institute of Aging, 2003).
Ageism also leads to a lack of opportunities, which decreases socialization and amplifies
depression, loneliness, and severely impacts overall health (Swift et al., 2017). Despite these
statistics, there are still limited opportunities for people in the third and fourth ages to learn and
be included in society (Barns, 2011). Social engagement is considered participation in
interpersonal exchanges outside the home, including community, leisure, and social activities
(Carstensen et al., 2003). Despite being a biological process, aging is subject to the social
constraints by which each society and culture makes sense of old age, and thus interventions are
required (Fancourt et al., 2014).
Interventions
The next section reviews current and suggested interventions that examine education,
intergenerational contact, awareness campaigns, policy, health providers, health, and the
shortage of culturally diverse mitigations. Interventions designed to address ageism tend to
change people’s attitudes and knowledge toward aging (Lytle & Levy, 2019). Approaches can be
a valuable way to combat ageism (Lytle & Levy, 2019). Highlighting these approaches helps
inform the researcher and viewer about obstacles and strengthens.
Education, Intergenerational Contact, and a Mixture of the Two
Research has found a correlation between ageism and older adults’ physical and mental
health through negative stereotypes, prejudice, and discrimination based on age (Burnes et al.,
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2019). Even though interventions to reduce ageism have been around since the 1970s, Burnes et
al. (2019) found that little is known about the success of approaches to reduce ageism. To
determine the most effective response, Burnes et al. (2019) identified 29,702 articles on ageism
interventions. Researchers then excluded studies due to duplication, inaccurate records, studies
missing a comparison group, and pre- and post-assessment and ageism outcomes. The
eliminations resulted in 63 studies that qualified for meta-analysis with a total sample of 6,124
participants. The study assessed three mediations: intergenerational contact, education, and a
mixture of the two (Burnes et al., 2019). The interventions that included a combination of
intergenerational communication and educational elements validated reductions in negative
attitudes toward aging. Burnes et al. (2019) observed that a mixture of the two interventions is
critical for future testing and dissemination, in addition to exploring later-in-life mediations.
The Burnes et al. (2019) study supports Levy’s (2009) stereotype embodiment theory,
suggesting that ageist views may be transmitted culturally and internalized by older adults,
leading to significant changes to health and functioning. Knowledge and intergenerational
contact help mediate societal stereotypes passed on to individuals, as views on older age begin in
childhood (Burnes et al. 2019; Levy, 2009). However, knowledge formation cannot happen
without awareness.
Awareness Interventions
An awareness-raising campaign is an influential tool demonstrating altered attitudes and
views (Hawkes, 2013). Awareness campaigns are organized communication strategies designed
to promote awareness on issues, immediate behavioral modification among the general
population, and improve outcomes (Hawkes, 2013). Knowledge is created by identifying the
right target audience and delivering a clear call to action that makes people act (Fressman, 2016).
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Implementing the theory of change includes objectives, strategies, and assessment (Fressman,
2016). Methods for reducing ageism necessitate media campaigns and targeted education (Ory et
al., 2003). For example, AARP created an effective campaign to increase physical activity
among older adults (Ory et al., 2003). The campaign incorporated comprehensive one-on-one
interviews, three national surveys, and an intensive consumer market research plan to recognize
opportunities and obstacles to changing behaviors at the individual and community level (Ory et
al., 2003). Although awareness campaigns can lead to policy change as policy and awareness
intersect, policy changes are often hard to adopt (Burnes et al., 2019).
Shortage of Policy Interventions
In America, programs like The Older Americans Act, Medicare, and Medicaid, have
enhanced the well-being of many older adults (Blancato & Ponder, 2015). Although these
programs have been successful, reassessment is necessary as these programs were for a different
group of older adults than exist today (Blancato & Ponder, 2015). Policy interventions are
inadequate and need expansion. Topics of concern include the caregiving challenges of
grandparents raising grandchildren, better known as the “sandwich generation,” the chronic
shortage of providers trained in geriatric care, Social Security policies, elder justice, access to
benefits, the digital divide, and employment discrimination (Blancato & Ponder, 2015).
According to the Administration for Community Living (2015), the number of aging
adults will double by 2030, so more policies need to be adopted to support this growing
population. For example, policies must address the disparity of pay between men and women
who receive Social Security. According to the Social Security Administration, the average man
receives $1,500 per month, compared to the average working woman who earns $600 to $700
less in benefits per month (Caplinger, 2014). Without policy change, the current excess Social
26
Security trust fund revenue, as noted by The Social Security Administration, will be depleted by
2034. This potential depletion will lead to reduced Social Security payouts that would be less
than 76% of the promised benefits from ongoing payroll taxes. Similarly, the retirement age has
increased to 67 (Blancato & Ponder, 2015). Increased retirement mandates impact some
minorities, as this policy did not consider that minorities and those with lower average incomes
have shorter life expectancies (Guzman & Gladden, 2015). According to the Centers for Disease
Control and Prevention, the average African American man lives 5 years less than the average
White man. The average man with lower income lives almost 6 years less than the average man
with higher income (Waldron, 2007). Policies reading social services need to be adopted as well.
In 2015, The National Council of Aging reported that the number of food-insecure older
adults doubled from 2.3 million to 4.8 million. However, in the same report, the National
Council of Aging (2015) noted that as many as one-third of food-insecure older adults eligible
for the Supplemental Nutrition Assistance Program could not obtain SNAP. Food insecurities
and poverty have an impact on health. Better policies and access are needed to address these
problems, which reinforce ageism.
Another issue in need of policy adoption is long-term care. In America, 70% of older
adults age 65 and older will need some form of long-term care (Kane, 2013). As previously
mentioned, stereotype embodiment is the process through which stereotypes are self-internalized
and then self-actualized; then, they operate unconsciously (Levy, 2009), leading to a denial of
the need for care by older adults. According to Blancato and Ponder (2015), this is, in part, why
there is no funding for extended time care, which perpetuates ageism. Policies are more likely to
succeed if they attend to stereotype embodiment (Swift et al., 2017). Policies will need to focus
on end-of-life decisions and care with respect to the wishes of older adults (Blancato & Ponder,
27
2015), including the end of practices such as providing unwanted medical treatment (Blancato &
Ponder, 2015). Even though aging adults are doubling, unwelcome, inaccurate, and generalized
medical treatment persists within health care.
Shortage of Health Interventions
Even though ageism still exists in health care and among health care providers, some
mitigations help reduce ageist attitudes. One recommended intervention is to require medical
trainees to gain more exposure to older adults outside the hospital (Ouchida & Lachs, 2015b).
Only 27% of medical schools require geriatric rotations (Bragg et al., 2012). However, medical
students must complete clinical rotations in obstetrics and pediatrics, even though most will
never treat pregnant women or children after graduation (Bragg et al., 2012).
According to Ouchida and Lachs (2015), eliminating ageism within the health care
system will require more funding. Specifically, the backing is needed not only for clinical
research but also for medical fellows to pursue a second year of training. Ouchida and Lachs
(2015) suggested that improving compensation for geriatricians will help others consider
geriatrics. Physician assistants and nurse practitioners should obtain geriatrics training to tackle
the lack of qualified geriatrics providers (Ouchida & Lachs, 2015). Finally, it is vital to begin
including older adults in clinical trials that form the basis of clinical practice guidelines and
policy development (Blancato & Ponder, 2015; Ouchida & Lachs, 2015). Although there have
been extensive studies on ageist intervention since 1976, additional research using rigorous
designs and cultural diversity is needed (Burnes et al., 2019).
Shortage and Need of Diverse Studies and Interventions
Given that ageism is a global dilemma, establishing interventions is critical to adapt and
account for numerous cultural perspectives (Burnes et al., 2019). The Burnes et al. (2019) study
28
revealed two gaps in the ageism intervention literature. The first gap documented that research
was inadequate when examining the impacts of ageism interventions on older adults themselves
(Burnes et al., 2019). This highlighted the researcher’s implicit preferences for younger adults
and illuminated internalized biases toward older adults (Burnes et al., 2019). Further,
contributing to bigotry, the bulk of ageism intervention studies were from the United States
(Burnes et al., 2019). Culturally and age-diverse studies are needed to understand ageism’s
impacts and the required interventions to address cultural norms and overlying oppressions.
When examining overall ageism interventions, the Burnes et al. (2019) study noted that 67% of
the subject participants were White. Ageism plus overlying oppressions, such as the intersection
of race, disability, gender, sexuality, socioeconomic and immigration status, intertextually
complicate and nuance the experience of ageism (Bauer, 2014). Documented inequality in the
United States includes deteriorated physical health among White bisexual men and women
compared to lesbian and gay men and women (Fredriksen-Goldsen et al., 2014).
There are increasing chances of psychological distress, disability, detrimental health
behaviors among (White) LGB older people compared to cisgender heterosexual people
(Fredriksen-Goldsen et al., 2014). Older Hispanic LGBT adults are at increased risk of weaker
mental health than White peers (Fredriksen-Goldsen et al., 2014). Transgender older adults have
advanced chances of perceived stress, poor physical health, depressive symptomatology, and
disability than non-transgender LGB older adults. This stress is due to discrimination and
harassment (Howard et al., 2019). Black and Hispanic LGBT older adults report higher rates of
poverty and lower educational attainment levels compared to White older adults (Fredriksen-
Goldsen et al., 2017). The African American transgender population is worse off than all other
29
older Americans (Howard et al., 2019). Gender is a social construct (Bell, 2016) and, as noted
above, impacts aging as well.
An individual identifying as a woman diagnosed with dementia is at a higher risk of
physical neglect and abuse by family and caregivers (Racic et al., 2006). Social isolation,
poverty, and inadequate education impact elder abuse in women with dementia (Racic et al.,
2006). According to the United Nations (2013), many older women face abuse and violence,
which is an invisible occurrence. Many are in a situation of dependence and vulnerability due to
low socioeconomic status and face challenges in reporting problems and seeking protection.
There are other overlying oppressions such as economic disparities and aging. According to the
Social Security Administration (2016), socioeconomic status is a critical factor in determining
older Americans’ quality of life because socioeconomic status impacts individuals’ physical and
mental health. Studies suggest that communities with economic disparities have more polluted
and degenerated environments (Social Security, 2016). The connection between social inequality
and environmental quality and the axes of income, wealth, political power, race, and ethnicity
perhaps explain why unequal societies are regularly less healthy (Williams et al., 2016).
Low socioeconomic status results in poor health, lower educational achievement, and
poverty, which affects society (Williams et al., 2016). Imbalances in quality-of-life health and
resource distribution are growing both globally and in the United States (Williams et al., 2016).
Cuts to Social Security benefits are coming as demands on Social Security grow and as a large
percentage of the U.S. population approaches retirement. Many low-income older adults are
more likely to rely on Social Security as their primary income source, putting them at a severe
disadvantage (Williams et al., 2016). Consider these numbers: 14.6% of older Americans live
below the poverty line (DeNavas-Walt & Proctor, 2014). For 21% of older married couples and
30
about 46% of older unmarried individuals, Social Security benefits account for 90% of their
household income (Social Security Administration, 2015). For individuals 65 years and older,
approximately 61% of these older adults receive half of their income from Social Security
(Social Security Administration, 2016). Adding in the intersection of aging and race, it is
projected that by 2030, 25% of older adults will be from culturally diverse minority groups; yet
18.1% of older Latinos and 19.2% of older Black Americans live in poverty, compared to just
8.7% of older White Americans (Social Security Administration, 2016). Some older Black
Indigenous People of Color (BIPOC) adults have limited access to facilities, which increases
loneliness and social exclusion. Due to lower economic status, senior communities are often not
affordable and, therefore, inaccessible (European Network, 2017).
Overlapping oppressions such as disability and aging make it more likely that an older
person with disabilities will receive low standards of care and support (European Network,
2017). According to the Equality and Human Rights Commission (2019), ageist attitudes lead to
lower or limited quality of services, refusal or denial of treatment, and sometimes abuse when
receiving home care services. When limiting disability support services later in life, according to
Convention on the Rights of Persons with Disabilities (2020), there is a risk of diminishing an
older adult’s quality of life and capacity for independence, increasing the likelihood of poverty.
When looking at the immigration population and aging, more dual oppressions emerge as
they have limited access to social services and government services like welfare; and are
overlooked in mainstream aging and immigration policies (Dolberg et al., 2018). The U.S.
Census (2014) noted that foreign-born individuals’ growth rate will outpace natives, particularly
among those 65 and older. For example, the LatinX population is one of the fastest-growing
groups in the United States. According to the U.S Census (2014), this population will grow from
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55 million today to 119 million in 2060, making up 30% of the U.S. population (U.S. Census
Bureau, 2014). As a result, it is critical to understand how immigration and aging intersect to
affect older populations’ language inequalities (Arxer, 2017). Most data on fluency are based on
self-reports and may not account for lower proficiencies of English language fluency,
predominantly among older adults (Arxer, 2017).
Older immigrants regularly lack political and economic power, access to public,
educational, and financial resources, which further complicates their English language fluency.
Particularly for new immigrants, older adults’ age and work status sideline them from English-
speaking communities, limiting access to schooling and access to relationships in public spaces,
thus restricting older adults from interactional opportunities to become bilingual (Arxer, 2017).
The language barrier impacts older adults’ self-esteem, family relationships, and social
networking (Norton, 2000). As a result, this group is at risk of being sidelined from critical
institutions and constrained from social services that shape older immigrants’ well-being and
social integration (Arxer, 2017). Negative stereotypes about older immigrants and aging further
perpetuate ageist attitudes, impacting how an older immigrant is perceived and limit access to
English as a Second Language (ESL) classes (Arxer, 2017). Some of the problems older
immigrants face in the United States are comparable to those faced by older Americans.
According to the Center for Adult English Language Accusations (2020), many relocated, older
adults experience marginalization due to being a part of non-English speaking members of a
minority group, which leads to ostracism in society.
Given that there are many overlapping and dual oppressions, in addition to BIPOC
experiencing life differently and considering the multiple entwined social constructs that
characterize people, cultural and age-diverse research and interventions are needed. Mitigations
32
should use an intersectional approach to improve healthy longevity for all (Yuval-Davis, 2016).
Mitigations should also focus on power dynamics, structures of power, and privilege to
understand mechanisms behind health and aging inequities, and include relationships between
oppression and privilege at the individual, community, institutional, and global levels (Yuval-
Davis, 2016).
Lopez and Gadsden (2016) suggest that interventions must address health’s political and
economic factors and overlapping systemic oppressions. Marginalized groups’ experiences need
to become visible by incorporating a life development course (Yuval-Davis, 2016). Diverse
voices need representation in research, along with large sample sizes, longitudinal data on gender
identity, sexuality, ethnicity, language, to measure systems of oppression at the individual,
community, and governmental levels, including intersectional discrimination (Bauer & Scheim,
2019). Bauer and Scheim (2019) suggested that existing population-based aging and health
surveys need questions on sexual and gender identity. After all, the definitive goal is to undo
systems of oppression, eliminate inequality, and end ageism.
Social Services
For marginalized populations, social services aspire to assist individuals, families,
groups, and communities in promoting opportunity and equity, and enhancing their individual
and collective wellness (Smith, 2017). Social services programs include education, food
subsidies, health care, subsidized housing, community management, research, and policy (Smith,
2017). However, social workers are still navigating how to provide services to minority groups.
From 1960-2000, the average standpoint among social theorists concerning minority and ethnic
groups’ nature notes that ethnic groups cannot exist without other groups (Castex, 1994).
However, cultural traits such as language may be significant in developing a group (Castex,
33
1994). According to Castex (1994) no one can predict which features will prove essential or
ethnically crucial in the future. Social theorists often use this lens when grouping identities
(Castex, 1994), but according to the Pew Research Center (2017), as identities merge and grow a
need for cultural competency emerges.
The 2008 National Association of Social Workers Code of Ethics states that achieving
cultural competence requires cultural humility, self-awareness, and the obligation to
understanding and acceptance culture. The origins of the social services begin with oppressed
groups experiencing inequalities in education, housing, education, work environments, to name a
few (Byers et al., 2020). These conditions resulted in illness, death, and poverty. Social workers,
acknowledging that minority groups were the targets of these oppressions, helped lead to more
social services (Byers et al., 2020). However, despite the significance of diversity and oppression
in the social services field (Byers et al., 2020), more research is needed to understand the barriers
in access to services for minority groups. One way to understand these barriers is by looking
through the lens of Critical Race Theory.
Critical Race Theory
Positioning Critical Race Theory (CRT) within social services develops a multifaceted
dialogue on race and is a useful method to enhance racial and ethnic minorities’ services. Bell
(2002) credits CRT’s origin to Professor Derrick Bell. Bell developed a new course that looked
at American law through a racial lens (Bell, 2002). CRT observes that law and legal institutions
are intrinsically racist and that race itself is a socially constructed notion that White people use to
further their interests (Bell, 2002).
According to the UCLA School of Public Affairs, CRT acknowledges that racism is
deeply rooted in American society. CRT extends strategies for action and change while offering
34
a structure for assessing power structures that maintain racial disparities (Kolivoski et al., 2014).
Though social services recognize the role of racism and racial inequalities, the field has not
wholly embraced CRT (Kolivoski et al., 2014). CRT emphasizes the importance of examining
historical, racial, social, and institutional systems (Kolivoski et al., 2014). According to the
UCLA School of Public Health, CRT is a powerful lens in investigating existing structures. CRT
recognizes that these power structures build on White supremacy and White power, which
maintains the marginalization of Black Indigenous People Of Color (BIPOC) (Crenshaw, 1995).
CRT is essential to the conceptual framework below and helps inform the problem, especially
when looking at the origins of intersectionality theory and other conceptual frameworks.
Conceptual Framework
If the goal is to eliminate ageism, create equality, and understand aging experiences by
minority individuals, then applying the theoretical frameworks of phenomenology,
intersectionality, and Bronfenbrenner’s ecological model will help achieve the goal.
Phenomenology deals with an individual’s experience, whereas intersectionality looks at how an
individual’s unique identities intersect to create discrimination models (Creswell, 2013).
Bronfenbrenner’s ecological model looks at influences through five levels of external factors
(What is, 2019). The conceptual framework begins with understanding the phenomena of ageism
to understand a person’s viewpoint better.
Phenomenology
Phenomenology is subjective of the first-person perspective, which studies the
experienced conscious experience (Moran, 2000). Often, this framework falls under the field of
philosophy (Moran, 2000). The history of phenomenology began in the late 19th century, and the
philosophy was primarily developed by Husserl to study phenomena as they appear through
35
consciousness (Finlay, 1999). Subsequent theorists have taken phenomenology in various
directions, aspiring to discover the world as lived and experienced (Finlay, 1999). At that time,
the movement of phenomenology was considered the appropriate foundation of all philosophy
(Smith, 2013). Traditional phenomenology focused on subjective, practical, and social conditions
of experience and was limited to the characterization of sensory qualities of seeing and hearing
(Petitot et al., 1999). However, individuals’ experience is usually much richer in substance than
just sensations (Smith, 2013).
Consequently, as a result, the last couple of decades have given the field of
phenomenology a much more comprehensive range, including tackling the meaning of one’s
experience in one’s lived world, specifically, the significance of events, objects, tools, time, the
self, and others (Smith, 2013). At present, phenomenology studies the foundation of numerous
experiences ranging from thought perception, memory, emotion, imagination, desire, awareness,
social activity, and action (Moran, 2000). Husserl (1963) noted that these systems of
experience’s principles involve “intentionality,” which is a term used to describe the directness
of experiences.
Principles of Phenomenology
As noted, phenomenology seeks to describe different understandings and is therefore
utilized differently in research. According to Finlay (1999), six universal principles govern the
variants of phenomenology:
1. Phenomenology focuses on the life world (the world of living experience as it is
perceived in one’s “reality”).
2. A commitment to a description of over-explanation (describing, not explaining,
how, and why meanings arise).
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3. The use of phenomenological reduction (suspending presuppositions to
understand the unique world of the individual).
4. An attempt to retain a non-judgmental attitude (the individual’s expressions are
both accepted and valued. The participants are assumed to be rational and to
reflect their perceptions honestly).
5. Acceptance of a role for interpretation (every meeting looks to involve an
individual’s understanding based on their history and experience).
6. The concept of intentionality (views that the person and the world as inextricably
intertwined).
The principles of phenomenology help underpin and guide the current research.
Phenomenology is a potent research tool that is well-matched for exploring challenging problems
(Neubauer et al., 2019). As a research methodology, phenomenology’s positionality is
distinctively to help researchers learn from others’ experiences (Neubauer et al., 2019).
Application of Phenomenology for This Study’s Purposes
Discrimination based on age is a phenomenon that many will experience as they age
(Robbins, 2015). Even though everyone will experience ageism, most older adults’
discrimination remains prevalent in their daily lives (Robbins, 2015). A phenomenological
analysis is essential to comprehend ageism’s perceived discrimination, illuminate an older
adult’s self, and speak from the participants’ voices (Creswell, 2013). A phenomenological
approach is essential to understand the diverse population’s perception of how ageism manifests
and what ageism means in their own life (Creswell, 2013). By collecting shared experiences of
ageism from various people, this study notices patterns in the human understanding of how
37
ageism manifests, determines the foundation of the problem, and decides if it varies based on
different intersectionalities.
Intersectionality
Intersectionality is a theoretical approach that creates overlapping discrimination
structures, which lead to severe disadvantages (Byrd, 2014). Intersectionality describes the
interconnected make-up of social groupings such as race, class, and gender (Byrd, 2014). The
theory first emerged in the late 1960s during the feminist movement, when Black women began
to voice the differences in the feminist movement (Springer, 2005). Many Black women found it
difficult to identify with the White, middle-class nature of the feminist movement, including the
pressure to be a homemaker (Springer, 2005). Black women did not feel as if the mainstream
feminist movement related to their experiences as they had to work to support their families
(Springer, 2005). According to the Library of Congress, while participating in the Civil Rights
movement, many Black women experienced sexism and were denied leadership positions due to
their gender. The experience of facing racism and sexism in both campaigns led to the term
intersectionality (Springer, 2005).
However, the first to coin the term was Social Theorist and Law Professor Kimberlé
Crenshaw in her 1989 paper, “Demarginalizing the Intersection of Race and Sex: A Black
Feminist Critique of Antidiscrimination Doctrine, Feminist Theory and Antiracist Politics”
(Crenshaw, 1995). Black feminist writing on intersectionality has arisen as a widely esteemed
research and policy framework (Hancock, 2007). Several central principles summarize the
unique complexion of this theory (Hancock, 2007).
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Principles of Intersectionality
Understanding human phenomena by highlighting one element is not sufficient on its
own, nor can individuals be reduced to one solo characteristic (Hankivsky, 2014). Applying
critical reflections toward intersectionalism bases the principles on the individuals (Hankivsky,
2014).
The principles include:
1. A multifaceted mix of identities (such as race, age, gender, disability, sex, and
sexuality as a construct, immigration, and socioeconomic status).
2. Naming these complex identities (a vital action in empowering individuals to
understand better the positive and negative impact that one’s dual or many
identities have on the individual’s ability to participate).
3. Intersectionalism influences the way individuals partake (which affects the way
individuals take part based on equality at all levels of society).
Application of Phenomenology for This Study’s Purposes
As noted, intersectionality recognizes that an “inner” group exists with diverse aspects of
identity within groups of people with shared identities. As such, their experiences differ from the
shared group (Coleman, 2019). Intersectionality is critical to this study to help better understand
the diverse levels of discrimination due to ageism. Intersectionality looks at how individuals
experience overlaps differently due to their identities, and the emphasis is on the overlaying
oppressions (Byrd, 2014). Intersectionality negates generalizations about the struggle of a
particular social group and aims to illuminate the different forms of marginalization in the social
group (Choo & Ferree, 2010). Determining the various effects of ageism related to race, gender,
disability, sex, and sexuality as a construct, immigration, and socioeconomic status can identify
39
policy issues, social problems around ageism (Clarke & McCall, 2013), and confront ageist
attitudes toward minority populations (Burnes et al., 2019). Using intersectionality for the study
aims to develop socially relevant and inclusive research and solutions (Clarke & McCall, 2013).
Micro, Meso, Macro-Levels (Bronfenbrenner’s Ecological Theory)
Level of analysis is a term used in social sciences to detail the scale, location, or size of a
research study, usually denoting a set of integrated relationships (Blalock, 1979). These
relationships typically represent Bronfenbrenner’s ecological systems theory. Bronfenbrenner’s
ecological theory is the most influential in social settings on human development, which
contends that the ecosystem one grows up in impacts all factors of one’s life (Renn & Arnold,
2003). Social factors determine how people think, their likes and dislikes, and the emotions they
feel (Renn & Arnold, 2003).
Urie Bronfenbrenner, an American psychologist, is the ecological systems creator, sought
to describe how children’s intrinsic abilities and environments intermingle to impact their
development (What is, 2003). Bronfenbrenner’s theory highlights the significance of researching
children in numerous settings to understand their progress. The theory now includes individuals
of all ages (What is, 2003).
This theory suggests that if people alter their environment, they will change as their
identity changes based on how the environment impacts them (Renn & Arnold, 2003).
Bronfenbrenner’s ecological model arranges settings into five levels of outside influence (Renn
& Arnold, 2003), from the most intimate level to the most extensive level. For this study’s
purposes, the research will focus on micro-, meso-, and macro-levels. According to the American
Sociological Association (2019), sociologists value examining and understanding human
dealings and at what level they study that interaction will differ based on these three levels.
40
Micro, meso, and macro refer to the levels of examination used in research. Micro-level
research looks at contained systems, including interactions with individuals, families, and
relationships to analyze feelings, beliefs, intentions, stereotypes, and prejudices (Little, 2012).
Meso-level looks at medium systems or groups encompassing organizations, neighborhoods,
schools, communities, and teams, including negative group interactions (Sage Publications,
2012). Macro-level research looks at large systems or systemic issues, including national
systems, policies, regulations, and cultures, including institutionalized discrimination (Sage
Publications, 2012). The micro-level study’s value and explains the significance of its findings at
the meso or macro-level (Marr, 1982). Likewise, meso and macro-level studies are useful in
describing the meaning of individual behaviors (Marr, 1982). According to Marr (1982),
integration can be improved by conjointly engaging multi-level investigative methods and
utilizing research questions connected with the three analysis levels. Marr (1982) noted that, in
turn, researchers will be more effective problem solvers, thus enabling them to be better poised
to inform the problem they are seeking to solve, as an analysis at one level alone is not
satisfactory.
By determining the level of analysis and understanding the integration of ageism at the
micro-, meso-, and macro-levels, this study aims to be accountable in its recommendation for
interventions and understand cultural competency within those mediations for social services.
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Figure 1
Conceptual Framework
Summary
Considering that ageism is a global problem, a new framework for global action is
essential (Burnes et al., 2019). After reviewing the assumed causes and history associated with
ageism, consequences, interventions, and the need for culturally and age-diverse research to
understand the concept of ageism fully, new approaches will need to be created and include the
diversity of older populations and address inequities (Burnes et al., 2019). By utilizing the
42
framework of phenomenology, intersectionality, and Bronfenbrenner’s theory, innovative
mediation may appear. Thus, initiating new health care practices, health providers, and
employment rights allow for collaboration and the breakdown of silos (Bauer & Scheim, 2019).
Above all, new systems need to surpass outdated ways of thinking about aging, foster a
significant shift in how individuals view aging, and stimulate the expansion of transformative
methodologies (Bauer & Scheim, 2019).
Society will benefit from increased attention to established institutions of socioeconomic
inequities to reduce obstacles not only in the United States but globally (Williams et al., 2016).
Diverse research can transform the way policymakers and service-providers perceive the aging
population and help to identify strategies that could alleviate these disparities at the micro-,
meso-, and macro-levels and eradicate ageism (Bauer, 2016).
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Chapter Three: Methodology
This study addressed the shortage of diverse research in the field of ageism. The study
developed social service interventions informed by understanding how identity impacts ageism
and promoting a more robust understanding of how social categorizations like ethnicity within
populations experience ageism and create barriers to accessing social services. This mixed-
method study used the lens of intersectionality to examine how ageism manifests through diverse
populations’ perceptions. The research supported correlated data to enhance service development
for later-in-life interventions at the micro, meso, and macro levels. Both qualitative and
quantitative research questions were used to evaluate the survey data. The research questions
deployed in the study inform the critical tenets behind the phenomena of ageism.
Research Questions
1. How does ageism manifest from the perceptions of older adults in Nevada?
2. How do older Nevadans experience ageism differently depending on their race
structure location (e.g., White vs. visible minority)?
3. What is the difference in access to social services for older minority Nevadans
and older non-minority Nevadans?
4. What interventions are recommended to better serve marginalized groups at the
micro-, meso-, and macro-levels?
Overview of Methodology
This study utilized a quantitative and qualitative design. Quantitative research is often
used in the social sciences to study questions and investigate the relationships among variables
that the researcher seeks to know (Creswell & Creswell, 2018). The quantitative design aligns
with intersectionality. Specifically, it inspects society and culture as they interact with the
44
classifications of power, law, and race (Coleman, 2019). Qualitative research concentrates on
understanding a research problem as a human-centered approach (Cohen & Crabtree, 2006). The
qualitative design aligns with the phenomenological approach, as open-ended questions also
allow participants to disclose their personal experiences (Cohen & Crabtree, 2006). By the very
nature of Bronfenbrenner, the mixed-method approach informs the problem for the ecological
levels.
The study consists of a Likert scale survey, multi-response questions, and open-ended
survey questions, ensuring triangulation through the use of multiple data sources in this study
(Creswell & Creswell, 2018). An added option of an interview was provided to help better
understand the participants’ perceptions and experiences. Finally, based on the quantitative data,
the study revealed a correlation, supporting that barriers and differences exist for minority groups
at ecological levels and when accessing social services.
The Researcher
The researcher is a woman, who identifies with the pronouns she, her, hers, in the 35-45
age range, and current doctoral candidate at the University of Southern California. The
researcher’s paradigm is shaped by her positionality, as she works with older adults and
witnesses firsthand the marginalization of older adults due to their age. This positionality leads to
a sympathetic bias toward the population in the study. Due to the researcher’s intersectionality,
she experienced changes due to the natural process of aging and because she is starting to face
ageism as well, as institutional biases inhibit equitable environments. To mitigate biases, the
researcher was cognizant to remain objective and inquire with self-awareness, rather than
presenting an opinion and personal preference (Walden, n.d.). The researcher achieved equity
45
concerning ageism by honoring human development to include people with longer spans of life
and viewing aging adults as a fundamental part of life (Raposo & Carstensen, 2015).
Equity in this study considered:
• De-institutional practices that perpetuate stereotypes about older adults based on
perception.
• Instead of older adults being deemed incompetent and unproductive; instead, view them
as competent and productive individuals, especially in the workforce.
• Instead of an ideology or action that pits generations against each other, use positive
intergenerational contact.
Instead of treating older adults as a homogenous group; older adults were treated as individuals
with unique intersections, ideas, and interests—a view that would no longer sideline their ideas.
Most importantly, equity consists of research participants reflecting the diversity of all cultures
and conditions, taking into account race, disability, gender as a construct, socioeconomic and
immigration status, and age (Sales & Folkman, 2000).
The shortage of diversity among study participants has severe ethical and research
ramifications, including delaying stakeholders’ ability to discern research data and advancing the
social science and medical fields. The shortage of diverse research blocks some populations from
receiving the study’s benefits, such as quality of care advancements.
Data Sources
Method 1
A survey instrument was used to elicit a mixed-method description of opinions, attitudes,
and trends via Likert-scale and multiple-response questions.
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Method 2
Open-ended questions were used to obtain qualitative data, which was then coded using a
priori codes established through intersectionality and Bronfenbrenner’s ecological system
framework.
Participants
The study used a sampling approach called Purposeful Random Sampling. PRS prevents
advanced knowledge of how outcomes occur by identifying a population and developing a
methodical way of selecting samples (Cohen & Crabtree, 2006). The purpose is to increase
credibility, not to foster repetition (Cohen & Crabtree, 2006).
Sampling Criterion and Rationale
Criterion 1. The study used criteria for selecting participants based on age. Participants
must be 55 or older.
Criterion 2. The study used criteria to survey groups with different race and ethnic
identities, thus allowing the researcher to collect the data needed to answer the research
questions. The group’s different identities helped inform the problem. Subjects were recruited
from diverse organizations to include members that encompass the key concepts. The threat to
aging communities is not the average age of a given population but used age and other
oppressions such as race to construct social, political, and economic existence (Carney & Gray,
2015).
Recruitment
The study participants were recruited from groups within the intersectionality gradient
(minority vs. non-minority) to identify how diverse populations experience ageism and
understand barriers to overlapping oppressions. Due to COVID-19, the researcher could not meet
47
individuals in-person and recruited participants via historically Black sororities and Las Vegas
senior centers’ newsletters.
The study collected 268 surveys via an online link, ensuring a 5% margin of error. The
survey consisted of four sections: the first was a series of multiple-choice questions used to
gather demographic information, followed by the second section of Likert scale response sets. A
Likert scale is a rating gauge that measures how people feel about something and often comes
with a neutral midpoint (Jamieson, 2004). The third section of the survey contained multi-
response questions to understand participants’ feelings and experiences. The fourth and last
section of the survey included open-ended questions to better understand the experience of
ageism and its intersections. Ensuring all participants had access to the survey, the study was
accessible online and via phone. A phone option was made available to provide further access
and compensate for: illiteracy, limited English ability, poor eyesight, lack of access or
knowledge of computers, or other conditions that make it hard to access the survey. No
participants requested a phone interview. According to the Pew Research Center (2017), 11.2
million immigrants living in the U.S. are from Latin countries, accounting for 25% of all U.S.
immigrants. In Nevada, that number rises to more than 27%. To accommodate these individuals,
the survey was generated in two languages, English and Spanish; however, no participants
accessed the Spanish survey link. Moreover, no names or identifying information was collected,
protecting the participants’ identity.
Instrumentation
This study used a survey questionnaire, open-ended question instrumentation, and an
optional interview. For the purpose of this study, both the online and phone options are described
as surveys. The survey applies scientific practices to obtain data from participants consistently.
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The survey instrument involved a questionnaire that provided a protocol for presenting a
standard set of questions and response options. The survey instrument included questions that
aim to understand the experiences of ageism and other intersects. Another objective of the survey
was to collect demographic information to describe the study participants. The survey
instrumentation provided ample yet straightforward questions for the respondent to understand
and provide accurate answers. The survey was written with neutral language to avoid leading the
respondent to specific replies, contained only one idea per question, used language that is
understandable to the participant and avoided jargon, and a Spanish-language translation was
available. For categorical responses, the survey was mutually limited and comprehensive so that
a participant could choose only one option. For the Likert scale and the multi-response questions,
the survey guided the participant to respond in a consistent format and units (Biemer & Lyberg,
2003). For the open-ended question, results were analyzed through a priori codes derived from
the theoretical framework.
Data Collection Procedures
Data collection and analysis had a three-month duration, starting upon IRB approval. The
first month entailed reaching out to community partners to deploy the surveys; the second month
involved survey data collection, and the third month involved analysis of the data.
Surveys
An original survey questionnaire, developed by this researcher, was used in this study.
The survey encompassed three parts 1) Likert-scale questions, 2) multiple-response statements,
and 3) open-ended questions. The survey was offered in an electronic format utilizing Qualtrics
for data collection. Other various formats such as paper with in-person administration, printed on
paper and mailed or conducted via the phone were offered, all participants utilized the electronic
49
format. The University of Southern California provided the researcher with Qualtrics access. The
researcher wrote the survey in English, and Qualtrics translated the survey into Spanish to
accommodate diverse individuals. The survey was anonymous with no identifiers. The survey
consisted of 37 questions with fixed response items and opened-ended response items.
The survey, Understating Diverse Groups and Ageism, took approximately 10 minutes to
complete. Survey questions focused on the participants’ experience with ageism and the
influences of the participant’s identity. Appendix A provides a breakdown of the survey sections
related to the research questions, whereas Appendix B provides the survey questionnaire.
Data Analysis
Following the completion of the surveys, transcription and data entry took place. For the
open-ended questions, results were analyzed through a priori codes derived from the theoretical
framework. Since open-ended questions are intrinsically qualitative, the researcher used them to
inform the problem but coded them to quantify. All data from the survey were examined through
Qualtrics, a web-based survey instrument to deploy survey research and evaluations. Assuring
quality data was critical to the study (Merriam & Tisdell, 2016).
The first phase analyzed the open-ended questions to determine themes based on the
conceptual framework.
The second phase of analysis examined the multiple-response and Likert-scale answers in
Qualtrics, providing a wide range of statistical data. That data was evaluated via a cross-
tabulation, then put through a chi-squared test for statistical significance. For this study’s
purposes, two variables were compared, “ethnicity” with a “Likert Scale Question or multi-
response question.” A chi-squared test was deployed to study if older Nevadans experience
ageism differently depending on their race structure. A chi-squared test provided a p-value, and
50
the p-value indicated if test results were significant. The chi-squared test of independence can
only compare categorical variables, and this test is recommended when either variable has more
than two groups. Once a p-value was established, a Cramér’s V was determined as an effect size
measurement for the chi-squared test of independence. Cramér’s V measures how strongly two
categorical fields are associated with reporting the effect size because statistical significance
does not provide conclusions about the extent of an effect.
In the third phase of analysis, the researcher identified patterns in the data. Then the
researcher established the themes that emerged in alignment with the conceptual framework and
research questions.
Validity and Reliability
By using quantitative data of a Likert scale, the study ensured validity by using “internal
validity,” which estimates truth about implications regarding cause-effect or causal relationships
(Merriam & Tisdell, 2016). Reliable sampling and measurement procedures also ensure validity.
The Likert scale consisted of a 5-point scale. Although there is debate among researchers
regarding validity for a 7-point scale versus a 5-point scale, this study utilized a 5-point scale.
Researchers have argued that there is higher reliability for 5-point scales (Jenkins & Taber,
1977). For example, numerous studies have suggested that 5-point scales increase response
quality and response rates. A 5-point scale ensures that participants are less confused, reduce
their “frustration level,” and enable participants to express their views (Babakus & Mangold,
1992). The study also used the multiplicative approach for the quantitative survey designs as the
variables are not mutually exclusive. In this approach, demographic categories look at two-way
or more interaction terms to account for the effects of intersecting classifications on a social
outcome (Bauer, 2014). Reliability is ensured through internal consistency and evaluates the
51
connection between multiple items in a test anticipated to measure the same concept (Creswell &
Creswell, 2018).
According to Fraser and Wu (2016), for multiple-response methods, reliability is
generally an easy measure. Though, the extent to which experiences forecast behavioral
outcomes remains vague. As a result, three preferred methods emerge to help authenticate
theoretical and behavioral outcomes within service surveys 1) the fulfillment with service, 2) the
recommendation of the service, and 3) recognized change (Fraser & Wu, 2016). These three
recommendations help to determine the content validity, which can be found in the social service
block in Appendix C. Analyzing the survey through experts in the social services and via
participants helped establish face validity.
Credibility and Trustworthiness
The researcher used triangulation to ensure credibility within the study by analyzing open
responses. The purpose was to increase credibility, not to foster repetition (Cohen & Crabtree,
2006). Trustworthiness was established by comparing the results from the close-ended and open-
ended questions (Lincoln & Guba, 1985). With the sample size of 286 participants, the data were
rich enough to produce quantitative and qualitative results for triangulation (Lincoln & Guba,
1985). The sample group represented that of the target population, allowing the conclusions to be
generalized to the broader community (Pelham & Blanton, 2006). By deploying an open-ended
survey for the phenomenological method, the researcher helped build trustworthiness by
identifying patterns that emerged from the evidence itself (James, 2007).
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Ethics
Ethics Rationale for IRB
The section below explains issues that can arise with the participants during the study.
The discussion of the issues below ensured that the survey complied with IRB.
Issue one revolved around confidentiality. According to the IRB, it is the researcher’s
responsibility to protect the identity of human subjects. Identity protection is essential as many of
the questions may pertain to health and immigration status. Confidentiality must be of the utmost
importance. The researcher protected the participants by deploying an anonymous survey with
no identifying information.
Issue two resolved around anonymity. According to the IRB, investigators must protect
human subjects from liability and not damage financial standing, employment, or reputation.
This protection is critical for older adults who are still working as their candor could jeopardize
their job. The researcher protected the participants by deploying an anonymous survey with no
identifying information.
Issue three resolved around psychological triggers that IRB notes as having any potential
to cause physical or mental harm. If this survey causes any psychological triggers, there was a
list of resources provided in the survey protocol under Appendix C.
Ethics Underlying the Study
The interests of humanity and society benefit from this research. Ageism is different from
other discriminations, as it will be experienced by most, as we all age. It is in society’s interest to
create interventions for the well-being of older individuals and society’s welfare due to the cost
associated with ageism (Levy et al., 2002). The researcher assumed that ageism would affect
everyone at some point. When contemplating the harm a participant may experience in this
53
study, the researcher was cautious not to marginalize the people whom study intends to help
while conducting research. The questions were inclusive and respectful.
Conclusion
The validity of this research study was anchored in the study’s methodology. Using a
mixed-method study ensured participants’ experiences were fused by deploying quantitative and
qualitative methods of research while recognizing the limitations of both at the same time.
The mixed-methods design helped with the triangulation of this social study. Triangulation
provided the researcher with the opportunity to highlight multiple findings of the phenomenon of
ageism and ethnicity.
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Chapter Four: Results
The purpose of this mixed-method study was to provide an overview of how ageism is
manifested through diverse populations’ perceptions and if non-minorities and minorities
experience ageism differently. The findings of this study may help overcome age discrimination
at the micro-, meso-, and macro-levels and determine what interventions are needed to improve
social services solutions. The research questions that guided this study are as follows:
1. How does ageism manifest from the perceptions of older adults in Nevada?
2. How do older Nevadans experience ageism differently depending on their
ethnicity (e.g., White vs. visible minority)?
3. What is the difference in access to social services for older minority Nevadans
and older non-minority Nevadans?
4. What interventions are recommended to better serve marginalized groups at the
micro-, meso-, and macro-levels?
This researcher administered an electronic survey to adults 55 years of age and older to
address the above research questions. This chapter presents the research questions’ results and
findings based on comprehensive data analysis and organized by the conceptual framework of
phenomenology, intersectionality, and Bronfenbrenner’s ecological system. Phenomenology
aims to describe experiences; intersectionality explains how people’s different identities overlap,
negating a binary experience; and Bronfenbrenner’s ecological system looks at how the
environment impacts an individual. Based on compressive data, organized by Qualtrics, utilizing
a chi-squared test, validation of identity influences was established in the study on ageism.
Nevada residents aged 55 and older were asked to take part in this study. In total, 286
participants filled out the online survey via Qualtrics. As a result of COVID-19, the participants
55
were recruited online instead of in-person. The participants were recruited from organizations
such as African American sororities and several senior centers in southern Nevada via their
online newsletters, ensuring a purposeful random sample. Eighty-eight percent of the participants
were between the ages of 55 and 75. Twenty percent of the participants were retired, while the
majority were working full time or part time. Only 5% of the participants were unemployed and
seeking work.
The survey participants consisted of 42% or 117 Black/African American participants,
37% or 103 White participants, and 12% or 33 LatinX/Hispanic participants. Although
proportion testing was deployed via Qualtrics, which notes if the sample from the population
represents the true proportion, there were fewer than 10 participants categories representing
Native Americans and Asian American Pacific Islander (AAPI). Figure 2 describes the
breakdown of participants by ethnicity.
Figure 2
Survey Participants by Ethnicity
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Research Question 1: How Does Ageism Manifest From the Perceptions of Older Adults in
Nevada?
To address how ageism is perceived and manifested, open-ended questions were used to
provide findings to inform the problem of ageism. To look at the data findings that address
research Question 1, the data are provided below.
Open-Ended Response Results
There were three open-ended questions. Ninety-one participants responded to the three
open-ended survey questions. Traditionally, open-ended statements have lower response rates.
Participants over the age of 50 provide considerably shorter responses and are less likely to
respond (Andrews, 2004). The three open-ended questions were: “Have you ever experienced
ageism?” “Why do you think ageism exists?” and “What do you think could be to prevent
ageism?” For all three questions, coding was deployed. In the first cycle of coding, themes were
developed based on the conceptual framework. Then, the researcher captured the a priori codes
in the transcript and codebook. Next, the researcher moved to analytical coding to similar
aggregate themes based on the a priori code. The codes must connect with one another to create a
pattern, or typicality. Patterns are repetitive concepts in the data that give insight into the themes.
Themes are meanings that emerge and are presented below for each question asked.
Have You Ever Experienced Ageism? How?
Fifty-one participants answered the question, “Have you ever experienced ageism in your
own life?” Two patterns emerged from 20 responses: “work discrimination” (n=5, 25%) and
“societal discrimination” (n=15, 75%). A priori themes that were not found in the thematic
analysis included: “internalized discrimination,” “discrimination due to communication,” and
“systemic discrimination.” As seen from Figure 3, two responses emerged.
57
Figure 3
Summarizes the Themes and Frequency Rate Based on the Typicality of How the Participants
Experienced Ageism in Their Own Lives
To better illustrate the findings, the participants’ quotes, based on the two themes, are
shown in Table 1 to reveal ideas and highlight the experience. Table 1 displays the participants’
quotes.
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Table 1
Select Participant Quotes That Illustrate the Themes: Work and Societal Discrimination
Work discrimination quotes
I was fired because of my age.
Because I was too old, I was discriminated against by others when I was
looking for a job.
Because I have retired, I want to take a part-time job, I do not want to rely
on anyone, I think I can support myself, but when I went to interview a
cleaner, the boss told me that the elderly should go home. Don’t go out to
work, I am worried that you will fall at work.
When I was looking for a job after I lost my job last time, because I was too
old, no one wanted to hire me. It was hard to get a good job and the salary
was very low.
Societal discrimination quotes
When I buy clothes, if I choose younger clothes, they will laugh at me.
When I want to participate in some social activities, I get a strange look
because of my age.
When I carry heavy things, I will do it by myself, but my family will think I
am not strong enough. It’s not discrimination, it’s caring, but I still think
they think I’m old.
Many activities are restricted to older people, such as sports.
I am older and others will find me cumbersome or unsafe.
A lot of young people don’t want to communicate with me. They think I
don’t know anything when I’m old.
Two themes emerged from the research question: societal discrimination is primary,
followed by work discrimination. The participants did not report results for the other themes, or
the response rate was too low for a pattern to emerge. The theme of societal discrimination is
59
seen throughout all the research questions and supported by data from the participants’
responses. The theme is discussed more in Chapter Five.
Findings—Why Do You Think Ageism Exists?
Seventy-seven participants answered the question, “Why do you think ageism exists?”
Three patterns emerged from twenty-two responses, “barriers in age differences” (n=7, 32%),
“cultural norms and values” (n=10, 45%), and “physical limitations” (n=5 or 23%). A priori
themes that were not found in the thematic analysis of: “communication,” “media,” “fear of
aging,” and “self-perception.” As seen from Figure 4, three responses emerged.
Figure 4
Why Do You Think Ageism Exists? Based on Frequency Rate
60
Figure 4 summarizes the themes and frequency rate based on the typicality of how the
participants experienced ageism in their own lives.
To better illustrate the findings, the participants’ quotes, based on the three themes, are
shown in Table 2 to reveal ideas and highlight the experience. Table 2 displays the participants’
quotes.
Table 2
Select Participant Quotes That Illustrate the Themes: Barriers in Age Differences, Cultural
Norms, Physical Limitations
Barriers in age difference quotes
Because of the difference in age, there is a generation gap
Young people certainly do not experience the pain of older people
Young people don’t understand us
Cultural norms/values quotes
Like something new and something that’s been around for decades, people seem to choose
something new
Maybe people hate old people
It is a remnant of social norms and characterizations depicted in movies and literature
Generational values—media portrayals of old age
Physical limitations quotes
Because old people can’t do what you people can do
Physical reasons
Because the elderly have limited mobility and have many slower diseases
61
Three themes emerged from the research question: cultural discrimination is primary,
followed by barriers in age and physical limitations. The participants did not report results for the
other themes, or the response rate was too low for a pattern to emerge.
Findings—What Do You Think Can Be Done to Prevent Ageism?
Ninety participants answered the question, “what do you think can be done to prevent
ageism?” Four patterns emerged from 22 responses: “health/wellness” (n=7, 32%), “mindset”
(n=7, 32%), “intergenerational contact” (n=4, 18%) and “policy” (n=4, 18%). A priori themes
that were not found in the thematic analysis of: “respect,” “support groups: family/friends,”
“more accessible activities,” and “education/awareness.” As seen from Figure 5, five responses
emerged.
Figure 5
What Do You Think Can Be Done to Prevent Ageism?
62
Figure 5 summarizes the themes and response rates of what the participants thought can
be done to prevent ageism.
To better illustrate the findings, the participants’ quotes, based on the four themes, are
shown in Table 3 to reveal ideas and highlight the experience. Table 3 displays the participants’
quotes.
Table 3
Select Participant Quotes That Illustrate the Themes: Health, Mindset, Intergenerational
Contact and Policy
Health quotes
Stay Active and involved as much as possible. Stay connected with social groups of interest:
family, friends, spiritual support.
Sports and fitness
Keep active
Heart health
Mindset
The most important thing, of course, is to maintain their own mentality
Keep optimistic
Keep a good attitude and communicate with others
Intergenerational contact
Talk to young people, walk with them often, try to understand them, let yourself be like them
Talk to people. Get together
Inclusion on all levels
Policy
Social policies and attitude changes
Protect me with the law
Formulate relevant systems, or improve the overall quality of the elderly
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The participants were cognizant of positive solutions to combat aging, including exercise
and mindset. Three themes emerged from the research question: “nothing/ I don’t know,” is
primary, followed by “health/wellness,” “mindset,” “intergenerational contact,” and “policy
changes.” The participants did not report results for the other themes, or the response rate was
too low for a pattern to emerge. Interpretation of these findings is discussed in Chapter Five.
Research Question 2: How Do Older Nevadans Experience Ageism Differently Depending
on Their Race Structure Location (e.g., White vs. Visible Minority)
Multiple-choice and a multiple-response questions were deployed to answer Research
Question 2. Out of the 10 survey questions that answered Research Question 2, eight out of the
nine multiple choice questions were significant, as well as the 10th multiple-response question.
Results
Likert Scale Questions
The study utilized a five-point scale using the value of 1. Never, 2. Somewhat, 3. Neutral,
4. Quite Often, 5. All the Time. Out of nine Likert scale questions, eight were statistically
significant based on the chi-squared test. The five-point Likert scale was utilized in this survey to
allow individuals to express how much they agree or disagree with a particular statement,
helping to inform the problem of ageism and ethnicity.
The results are presented in column percentages of responses, not by the total count to
account for proportion distribution. Forty-four percent of Black/African American participants
and 88% of LatinX/Hispanic participants noted: “quite often” compared to 32% of White
individuals when responding to “Do you believe you have been discriminated due to age” (p <
.00007, Cramér’s V= .263). Seventy-five percent of Black/African Americans and 93% of
LatinX/Hispanic participants noted: “quite often” compared to 52% White participants when
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responding to “How often has someone talked to you loudly or slowly” (p < .00344, Cramér’s
V= .340). Eighty-two percent of LatinX/Hispanics responded: “quite often” compared to 34% of
White and 16% of Black/African American participants to the question “My doctor over treats
me due to “old age” (p < .00001, Medium Effect Size = .265). Fifty-one percent of
Black/African Americans compared to 28% of White and 12% of LatinX/Hispanic participants
noted: “quite often” to the question “My doctor or health care provider under treats me due “old
age” (p < .00001, Cramér’s V=.314). Eighty-eight percent of LatinX/Hispanics responded: “all
the time,” compared to 67% of Black/African American and 32% White participants who noted,
“quite often” to the question “My doctor or health care provider lumps my symptoms as ‘old
age’” (p < .00001, Cramér’s V= .446).
Eighty-one percent of LatinX/Hispanic participants noted: “somewhat,” compared to
38% of Black/African American, and 28% of White participants who noted, “quite often” to the
question “How often have you encountered people who didn’t expect you to do well” (p <
.00003, Cramér’s V= .268). Eighty-two percent of LatinX/Hispanic participants noted:
“somewhat,” compared to 20% of Black/African American and 30% White participants who
responded, “quite often” to the question “How often have your encountered people who are
surprised that you did something well” (p < .0001, Cramér’s V= .356). Eighty-two percent of
LatinX/Hispanics reported: “quite often,” compared to 28% of White participants and 21% of
Black/African Americans to the question “I am powerless in making my own choices” (p <
.0001, Cramér’s V= .330).
There was no significant difference by race for the variable “do you believe you have
access to health care.” Figure 6 describes the categorical response of ethnicity and the experience
of aging.
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Figure 6
Ethnicity and Experience
66
Figure 6 describes age discrimination and experience based on one’s ethnicity.
The Likert scale questions indicated that there were variances in how different identities
experienced ageism.
Multi-response Questions
Using Qualtrics, a multiple-response survey question was deployed to answer Research
Question 2. The multi-response question describes how one feels about aging based on one’s
ethnicity. All 286 participants were required to indicate at least one driver in this question. Out of
the 16 multi-response variables, seven of the questions were statistically significant, based on a
chi-squared test. A multi-response question was utilized in this survey due to the efficiency and
ease for participants. Multi-response questions are formatted succinctly and can thus take up only
a single screen.
The multi-response questions show differences in how non-minority and minority
participants experience ageism—specifically, when looking at how White individuals indicated
self-perception of aging. Fifty-four percent of White participants noted, “I can’t accomplish
anything due to age” (p < .00001, Cramér’s V= .326), compared to 6% of LatinX/Hispanic and
32% of Black/African American participants. In another response, 58% of White participants
noted “age limits me” (p < .00817, Cramér’s V= .216), compared to 3% of LatinX/Hispanic and
38% of Black/African American participants.
LatinX/Hispanics indicate a healthier outlook on aging. Seventy-five percent of
LatinX/Hispanic participants responded to “age does not define me” (p < .00001, Cramér’s V=
.450), compared to 18% White and Black/African American participants. In another response, “I
am defined by my age” (p < .00001, Cramér’s V= .367), 82% of LatinX/Hispanics responded to
this question, compared to 35% Whites and 27% of Black/African Americans. Conversely, 75%
67
of LatinX/Hispanics responded that “I do not look old” (p < .00005, Cramér’s V= .297),
compared to 9% of Black/African American and 8% White participants. Finally, 45% of White
participants responded to “I look old” (p < .00001, Cramér’s V= .512), compared to 26% of
Black/African Americans, and 6% LatinX/Hispanics. To highlight the perceptions of the
participants, Figure 7 indicates their responses regarding identity and ageism between different
ethnicities.
Figure 7
Identity and Ageism Responses
68
Figure 7 describes the difference in response regarding identity and ageism between
different ethnicities.
There was no significant difference between ethnicity and these nine variables: “I feel
beautiful or handsome,” “I do not feel beautiful due to age,” “I am wiser due to age,” “I feel alive
and well,” “Do you believe age makes you frail,” “I am interested in new things,” “I have a sense
of purpose,” “I have great self-esteem” and “systemic discrimination.”
Seven variables emerged from the research question and indicated negative self-
perceptions for White individuals: “I can’t accomplish anything due to age,” “I am defined by
my age,” “I feel old and frail,” “I look old,” and “Age limits me.” Two variables indicate
healthier outcomes for the LatinX/Hispanic population: “Age does not define me” and “I do not
look old.” For the other variables, the results were not statistically significant.
Research Question 3: What Is the Difference in Access to Social Services for Older
Minority Nevadans and Older Non-Minority Nevadans? Likert Scale
A five-point scale was utilized using the values of 1. Easy to Access, 2. Somewhat Easy
to Access, 3. Average to Access, 4. Somewhat Difficult, 5. Difficult to determine if there is a
difference in access to government services for older minority and older non-minority Nevadans.
Government services in this research question were classified as broad programs (Social
Security, Medicaid, Medicare, Supplemental Nutrition Assistance Program, Food Assistance
Programs, Bus Transportation, Unemployment assistance, Temporary Assistance for Needy
Families, and Welfare). A chi-squared test was deployed to identify the p-value and the Cramér’s
V to determine the relationship between ethnicity and access to government services.
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The findings suggest there is a strong significant relationship between the variables of
“ethnicity” and “access to government services.” Out of the five-point scale the variable
“difficult” to access was statistically significant.
On the Likert five-point scale, 76% percent of LatinX/Hispanic participants, 29% of
Black/African American participants, and 5% of White participants responded: “difficult” when
asked, “what is your difficulty or ease when accessing social services” (p < .00001, Cramér’s V=
.336). While most Black/African American participants chose the neutral response “average to
access,” there is still a significant difference in ease of access based on ethnicity, specifically, the
researcher identified disparities in how LatinX/Hispanics access social services. Figure 8
describes the breakdown of the difference in access to government services between different
ethnicities.
Figure 8
Differences in Access to Government Services—Minority Versus Non-Minority
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
70.0%
80.0%
90.0%
LatinX
Black or African American
White
70
Figure 8 describes the breakdown of difference in access to government services between
different ethnicities.
The data that emerged highlighted that it is “difficult” for LatinX/Hispanics to access
social services. White and Black/African American participants indicated various ease and
difficulty accessing social services, with no one variable standing out.
Research Question 4: What Interventions Are Recommended to Better Serve Marginalized
Groups at the Micro-, Meso-, and Macro-Levels?
Using Qualtrics, a multiple-response survey question was deployed to answer Research
Question 4. The multiple-response question describes one’s experiences at the micro, meso, and
macro-level. For all three levels, a chi-squared test was deployed to determine statistical
significance. All 286 participants were required to answer at least one driver within this question.
A multiple-response question was utilized in this survey due to the efficiency and ease for
participants. Multiple-response questions are formatted succinctly and can thus take up only a
single screen.
Micro-Level
The micro-level includes direct contact with individuals in their immediate environment
(Shelton, 2019). A response rate of 70% or higher shows strong support at the micro-level.
Overall, all ethnicities responded below a 50% rate at the micro-level. The micro survey
highlighted four positive responses that emerged. Out of 286 participants, 49% or 140
participants noted, “I have family support.” Thirty-four percent or 98 participants noted, “I have
friend support.” Thirty-four percent or 96 participants noted, “I feel satisfied in life.” Twenty-
eight percent or 93 participants noted “I go on vacation,” and 20% or 56 participants noted, “I
exercise.” Figure 9 provides a summary of the results for all ethnicities at the micro-level.
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Figure 9
Micro-Level Experiences
Figure 9 describes survey results at the micro-level for all ethnicities.
For the variable ethnicity and the micro variables, a chi-squared test was run to determine
the statistically significant relationships. Out of 11 variables, seven proved to be statistically
significant, indicating a difference in how minorities and non-minorities experience ageism. The
results are listed below.
Thirty-six percent of White participants, 55% of Black/African American participants
compared to 2% of LatinX/Hispanic participants noted, “I have my own vehicle” (p < .0214,
Cramér’s V= .264). Sixty-two percent of White participants, 31% of Black/African American
participants compared to 2% of LatinX/Hispanic noted, “I have a current driver’s license” (p <
.00660, Cramér’s V= .286). Thirty-eight percent of White participants, 36% of Black/African
American participants, compared to 15% of LatinX/Hispanic participants noted, “I am satisfied
in life” (p < .00001, Cramér’s V= .378). Forty-two percent of White, 30% of Black/African
72
American, and 14% of LatinX/Hispanic participants noted, “I go on vacation” (p < .00058,
Cramér’s V= .324). Fifty-one percent of White, 31% of Black/African American, and 11% of
LatinX/Hispanic participants noted, “I have family support” (p < .00001, Cramér’s V= .452).
Fifty percent of both White and Black/African American participants noted, “I have friend
support” compared to 2% of LatinX/Hispanic participants (p < .00144, Cramér’s V=.311).
Seventy-five percent of White participants compared to 20% of Black/African American
participants and 2% of LatinX/Hispanic noted, “I exercise” (p < .00001, Cramér’s V= .422).
There was no significance between ethnicity and these three variables: “I am no longer
dependent,” “I depend on others to survive,” “I use a wheelchair/walker/cane to get around.”
Figure 10 describes how minorities and non-minorities experience ageism at the micro-level.
Figure 10
Differences in How Minorities and Non-Minorities Experience Ageism at the Micro-Level
73
Figure 10 describes difference in how minorities and non-minorities experience ageism at
the micro-level.
The participants’ responses are shown in Table 4 to illustrate the findings at the micro-
level experience. Table 4 displays the participants’ percentage responses by ethnic group.
Table 4
Illustration of the Micro-Level Experience by Ethnicity
Variable + Chi-Squared White Black/African
American
Latinx/
Hispanic
I have my own vehicle (p < .0214,
Cramér’s V = .264)
36% 55% 2%
I have a current driver's license (p
<.00660, Cramér’s V = .286)
62% 31% 2%
I am satisfied in life (p < .00001,
Cramér’s V = .378)
38% 36% 15%
I go on vacation (p < .00058, Cramér’s V
= .324)
42% 30% 14%
I have family support (p < .00001,
Cramér’s V = .452)
51% 31% 11%
I have friend support (p < .00144,
Cramér’s V =.311)
50% 50% 2%
I exercise (p < .00001, Cramér’s V =
.422)
75% 20% 2%
74
The responses indicate disparities for LatinX/Hispanic Nevadans within the micro-level
survey. The findings indicate that all the survey participants did not experience well-being at the
micro-level. None of the survey questions generated an above 62% rating, for White,
Black/African American, and LatinX/Hispanic Nevadans.
Meso-Level
The meso-level falls between the macro and micro-levels and entails working with
smaller groups, institutions, or neighborhoods (Shelton, 2019). A response rate of 70% or higher
shows strong support at the meso-level. Forty-four percent or 126 participants noted, “I find it
easy to communicate.” Forty-three percent or 123 participants noted “I am happy,” and 31% or
89 participants reported, “I have a great quality of health.” Twenty-seven percent or 78
participants noted, “Most people speak my language.” Other responses included: “I have health
insurance” for 27% or 76 participants; “I have access to religious activities” for 22% or 64
participants; “I have access to health care” for 22% or 64 participants; “I have access to food” for
20% or 58 participants; “I have access to social activities” for 20% or 57 participants; “I have
affordable housing” for 16% or 47 participants; and “I have social trust” for 15% or 44
participants. Figure 11 provides a summary of the results for all ethnicities at the meso-level.
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Figure 11
Meso-Level Experiences
Figure 11 provides a summary of the results at the meso-level for all ethnicities.
For the variable ethnicity and the meso variables, a chi-squared test was run to determine
the statistically significant relationships. Out of 15 variables, seven proved to be statistically
significant, illuminating a difference in how minorities versus non-minorities experience the
meso-level. All but two of the survey questions fell below 50%. The results are listed as follows:
Forty percent of White and 48% of Black/African American participants, compared to
1% of LatinX/Hispanic responded, “I have health insurance” (p < .0129, Cramér’s V= .274).
Forty-seven percent of White, 28% of Black/African American, and 15% of LatinX/Hispanic
participants noted, “I have great quality of health” (p < .00013, Cramér’s V= .344). Forty-two
percent of White and 43% of Black/African American participants compared to 3% of
LatinX/Hispanic noted, “I am happy” (p < .00601, Cramér’s V= .288). Forty-seven percent of
White and 45% of Black/African American participants compared to 2% of LatinX/Hispanic
reported, “I have access to religious activities” (p < .0105, Cramér’s V= .278). Sixty-two percent
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of White participants compared to 34% of Black/African American and 2% of LatinX/Hispanic
participants noted, “I have access to food” (p < .00216, Cramér’s V= .304). Fifty-five percent of
White and 36% of Black/African American participants compared to 2% of LatinX/Hispanic
participants noted, “I have affordable housing” (p < .0313, Cramér’s V= .256). Thirty-four
percent of White and 39% of Black/African Americans, compared to 11% of LatinX/Hispanic
participants, noted, “I find it easy to communicate” (p < .00261, Cramér’s V= .301). Figure 12
describes the difference in how minorities and non-minorities experience ageism at the meso-
level.
Figure 12
Differences in How Minorities and Non-minorities Experience Ageism at the Meso-Level
77
Figure 12 describes difference in how minorities and non-minorities experience ageism at
the meso-level.
The participants’ responses are shown in Table 5 to illustrate the findings at the meso-
level experience. Table 5 displays the participants’ percentage responses by ethnic groups.
Table 5
Illustration of the Meso-Level Experience by Ethnicity
Variable + Chi-Squared White Black/African
American
Latinx/
Hispanic
I have health insurance (p < .0129,
Cramér’s V= .274) 40% 48% 1%
I have great quality of health (p < .00013,
Cramér’s V= .344) 47% 28% 15%
I am happy (p < .00601, Cramér’s V =
.288) 42% 43% 3%
I have access to religious activities (p <
.0105, Cramér’s V= .278) 47% 45% 2%
I have access to food (p < .00216, Cramér’s
V= .304) 62% 34% 2%
I have affordable housing (p < .0313,
Cramér’s V= .256) 55% 36% 2%
I find I easy to communicate (p < .00261,
Cramér’s V= .301) 34% 39% 11%
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There was no significant difference between ethnicity for these nine variables: “I find it
easy to communicate,” “Most people speak my language,” “I have access to health care,” “I have
access to social activities,” “I have social trust,” “I am lonely,” “I have been discriminated at
work due to age,” “I have been passed on training’s, promotions, etc. due to age,” and “I have
been scammed later in life.”
The findings indicate that all the survey participants did not experience support at the
meso-level, as all variables fell below a 50% response rate. The data show that there is a slight
indication in disparities between White Nevadans and LatinX/Hispanic Nevadans. However,
primarily, all ethnicities are lacking in meso-support.
Macro-Level
The macro-level describes large-scale social processes, such as social change and
stability, and impacts symptoms and policy (Shelton, 2019). A response rate of 70% or higher
shows strong support at the macro-level. Out of the 21 variables, three positive responses
emerged: Out of 286 participants, 44% or 127 participants strongly responded that “my housing
is quality.” Thirty-seven percent or 107 responded that “I find it is easy to shop and obtain
services.” Thirty-one percent or 88 participants “live on a street that is well lit.” Most of the
other responses indicated that at the macro-level Nevada is failing older adults. Twenty-eight
percent or 80 participants noted, “I have access to public facilities.” Twenty-one percent or 60
participants reported, “I feel safe in my neighborhood.” Sixteen percent or 46 participants noted,
“I have access to public transportation.” Fifteen percent or 44% stated, “services are in close
proximity to me.” Fourteen percent or 41 participants noted, “I have access to a walkable
environment.” Twelve percent or 34 participants responded to “recreation spaces like exercise,
sports are accessible.” Twelve percent or 34 participants noted, “I can get to my appointments
79
easily.” Eleven percent or 32 participants report that “my political leaders care about me.”
Eleven percent or 32 people noted, “that local policies include me.” Ten percent or 29
participants noted, “national policies help with the aging process.” Nevadans at the macro-level.
Figure 13 describes all ethnicities experiences at macro-level.
Figure 13
Macro-Level Experience
80
Figure 13 describes the macro-level experiences for all ethnicities.
For the variable of ethnicity and the macro variables, a chi-squared test was run to
determine the statistically significant relationships, indicating that there is difference in how
minorities experience the macro-level compared to non-minorities. Seven out of 21 variables
proved to be statistically significant. The results are listed as follows.
Fifty-two percent of LatinX/Hispanic participants noted that “I feel as if my worker’s
rights have been violated due to age” (p < .00001, Cramér’s V= .636), compared to 14% of
Black/African American and White participants. Sixty-three percent of White participants noted,
“I have access to a walkable environment” (p < .0489, Cramér’s V= .247) compared to 30% of
Black/African American and 5% of LatinX/Hispanic participants. Forty-three percent of White
participants noted, “I have access to transportation” (p < .00001, Cramér’s V= .425) compared to
24% of Black/African American and 26% of LatinX/Hispanic participants. Sixty-two percent of
White participants noted, “the street on which I live on is well lit” (p < .00001, Cramér’s V=
.387) compared to 32% of Black/African American and 1% of LatinX/Hispanic participants.
Fifty-four percent of White participants, compared to 37% of Black/African American and 2% of
LatinX/Hispanic participants, noted, “It is easy to shop and obtain services” (p < .00007,
Cramér’s V= .352). Forty-seven percent of White participants, compared to 27% of
Black/African American and 17% of LatinX/Hispanic participants, noted, “I have access to
public facilities” (p < .0001, Cramér’s V= .405). Fifty-four percent of White participants
compared to 27% of Black/African American and 5% of LatinX/Hispanic participants responded
to “services are in close proximity to me” (p < .00601, Cramér’s V= .288). Based on the data, it
is clear there are disparities between White and BIPOC individuals. Figure 14 describes
difference in how minorities and non-minorities experience ageism at the macro-level.
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Figure 14
Differences in How Minorities and Non-minorities Experience Ageism at the Macro-Level
Figure 14 describes difference in how minorities and non-minorities experience ageism at
the macro-level.
The participants’ responses are shown in Table 6 to illustrate the findings at the macro-
level experience. Table 6 displays the participants’ percentage responses by ethnic groups.
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Table 6
Illustration of the Macro-Level Experience by Ethnicity
Variable + Chi-Squared White Black/African
American
Latinx/
Hispanic
I feel as if my worker’s rights have been
violated due to age (p < .00001, Cramér’s
V = .636) 14% 14% 52%
I have access to a walkable environment (p
< .0489, Cramér’s V= .247) 63% 30% 5%
I have access to transportation (p < .00001,
Cramér’s V= .425) 43% 24% 26%
The street on which I live on is well lit (p <
.00001, Cramér’s V= .387) 62% 32% 1%
It is easy to shop and obtain services (p <
.00007, Cramér’s V= .352) 54% 37% 2%
I have access to public facilities (p < .0001,
Cramér’s V= .405) 47% 27% 17%
Services are in close proximity to me (p <
.00601, Cramér’s V= .288) 54% 27% 5%
There was no significant difference between ethnicity and these 14 variables: “I feel
society does not value me due to age,” “My housing is quality,” “ I live on an urban block,” “I
feel safe in my neighborhood,” “I live in an area with natural landscaped or open spaces,”
“Recreation spaces like exercise, sport are accessible,” “I can easily get to my appointments,”
“My political leaders care about older adults,” “Local policies include me,” “National policies
help with the aging process,” “I live around air and noise pollution,” “I am home-bound and have
no access to services,” “Media portrays me incorrectly,” and “I feel as if my human rights are
violated due to age.” The results indicated that all the survey participants are not experiencing
support and that there are disparities between minorities and non-minorities at the macro-level.
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Summary
The purpose of this study was to compare how different ethnicities experience ageism.
Data analysis revealed both strengths and gaps in the relationship between ageism and ethnicity.
Based on the chi-squared test, this study’s key finding documents a difference in how non-
minorities vs. minorities experience ageism. Chapter Five address the implications of the
findings and suggestions based on this study’s data by outlining recommendations and solutions.
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Chapter Five: Recommendations and Discussion
Chapter Four provided detailed findings on how ageism is manifested through diverse
populations’ perceptions, how different ethnicities experience ageism, and how there is limited
support for older adults in Nevada at the micro, meso, and macro-level. Chapter Five seeks to
provide brief explanations to the research findings and recommend solutions to: end ageism at
the micro, meso, and macro-level and address the identified gaps in disparities between
ethnicities. The New World Kirkpatrick Model (NWKP) will serve as the comprehensive
overview framework to evaluate training (Kirkpatrick & Kirkpatrick, 2016). The NWKM four-
level model is a new vision of the Kirkpatrick Model. NWKM adds new elements to evaluate the
effectiveness of continuing education recognition and the complications that arise from an
educational program.
The remainder of the chapter will discuss the research’s strengths and weaknesses and
recommendations for future research.
Discussion of Findings and Results
The findings of this study are four-fold. The first notable finding is that societal
discrimination is pronounced throughout all the findings. Within the societal discrimination
theme, adults perceive barriers in the aging process through age differences and physical
limitations but believe mindset, health, policy changes, and intergenerational contact can prevent
ageism. The second finding highlights that White populations have a negative self-perception of
aging, whereas the BIPOC community, especially the LatinX community, have a healthier
perception of aging. The third finding indicates that LatinX/Hispanics have a more challenging
time accessing social services than White or Black/African Americans. The fourth finding notes
that Latinx/Hispanic populations are being failed at the micro-, meso-, and macro-levels,
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whereas Black/African Americans lack support at the macro-level. The last finding indicates that
all older Nevadans, despite ethnicity, are not being supported at the micro-, meso-, and macro-
levels.
Finding one notes ageism stems from societal discrimination, a broad overarching theme
consistent with the literature review findings. Societal discrimination can stem from the media,
personal biases to work discrimination. Ageism’s origin links to anxiety about aging (Wisdom et
al., 2014). That fear then perpetuates in society through internalized stereotypes, societal
stereotypes, and age discrimination, influenced by media, policy, lexicon development, and
systemic discrimination (Swift et al., 2017). Societal discrimination is a prevalent response in
open-ended responses, which encompasses work discrimination. Work discrimination is listed as
a way in which the participants experienced ageism. Age discrimination allows a person’s age to
unfairly become an issue when deciding who receives a job benefit, promotion, or a new job.
This discrimination typically impacts older workers (Darney & Magee, 2007). These findings are
consistent with a study in which 61% of participants experienced workplace discrimination due
to age before they reached 50 (Maturity Works, 2003).
Moreover, adults perceive barriers in the aging process through age differences and
physical limitations, but believe that mindset, health, policy changes, and intergenerational
contact can prevent ageism. This study’s findings are consistent with the literature review’s
findings when looking at the physical limitation’s response. Older age is associated with the
decline of physical capabilities such as motor and sensory performance (Chodzko-Zajko &
Ringel, 1987). Instead of a forward-moving process (D’Antonio, 2020), studies examining
psychological and sociological structures, such as well-being, social power, and emotional
experience, noted that these structures increase during the first period of life, but decline from
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midlife on (Blanchflower & Oswald, 2004). As individuals age into older adulthood, their
negative beliefs about aging become increasingly salient and self-directed (Levy, 2009), leading
to the discrimination of their future selves. Another response within this study, age differences, is
also consistent with the literature review findings. For example, ageist attitudes show up in
children as young as 6 years of age (Isaacs & Bearison, 1986). Individuals are exposed to an
ageist standard before connecting to their own experience (Levy, 2003). Two interventions
participants of this study noted are also consistent with the literature review findings. For
example, policy change: As the number of older Americans will almost double by 2060 (PRB,
2019), older adults’ policy interventions are deficient and need augmentation to support the older
population’s growing needs (Blancato & Ponder, 2015). The other intervention, intergenerational
contact, is supported by the Burnes et al. (2019) study, which noted that interventions that
included a combination of intergenerational communication and educational elements validated
reductions in negative attitudes toward aging. The other two intervention themes—mindset and
health—were not discussed in the literature review but will be highlighted later in Chapter Five’s
recommendations section.
Finding two notes White participants’ negative perception of aging, which connects back
to the literature review and explicitly stems from anxiety about aging (another form of societal
discrimination), which supports the theory of stereotype embodiment (SET). SET suggests that
the internalization of ageist attitudes is due to a lifetime of exposure to cultural messages of
ageism (Levy, 2009). As a result, ageist attitudes become a part of implicit bias, perpetuating
ideas about old age and older adults (Levy, 2009). As individuals age, a psychological response
occurs, resulting in self-fulfilling internalized stereotypes, thus fulfilling the self-perception of
being “old” (Levy, 2009). Conversely, the BIPOC community, specifically LatinX/Hispanic
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populations, have healthier outlooks on aging. The surprising findings may be in variance with
Levy’s (2009) findings, noting that most adults internalize aging, and the idea will be expanded
upon later in Chapter Five’s recommendations section.
The third finding indicates that LatinX/Hispanics have a more challenging time accessing
social services than White or Black/African Americans. Finding three connects with the extant
literature, which stems from language barriers or accents that impact social networking (Norton,
2000). As a result, groups like LatinX/Hispanics are being sidelined from critical institutions and
constrained from social services that shape older adults’ well-being and social integration (Arxer,
2017). The sidelining from social services is a result of Critical Race Theory (CRT), which
observes that law and legal institutions are intrinsically racist and that race itself is a socially
erected notion that White people use to further their interests (Bell, 2002).
The origins of the social services begin with oppressed groups experiencing inequalities
in education, housing, education, work environments, to name a few (Byers et al., 2020). These
conditions resulted in illness, death, and poverty. Social workers, acknowledging that minority
groups were the targets of these oppressions, lead to more social services (Byers et al., 2020).
However, despite the significance of diversity and oppression in the social services field (Byers
et al., 2020), there is a lack of understanding of the barriers in access to services for minority
groups.
Critical Race Theory also plays a role in the fourth finding that Latinx/Hispanic
populations are failed at the micro, meso, and macro levels, and Black/African Americans lack
support at the macro-level. These findings are consistent with the literature review’s findings.
According to the UCLA School of Public Affairs, CRT acknowledges that racism is deep-rooted
in the system within American society. Though social services recognize the role of racism and
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racial inequalities, the field has not wholly embraced CRT (Kolivoski et al., 2014). Social
services directly impact the micro-, meso-, and macro-levels. Critical Race Theory promotes an
approach emphasizing the importance of examining historical, racial, social, and institutional
systems (Kolivoski et al., 2014).
Finding four notes all older Nevadans, despite ethnicity, are not being supported at the
micro-, meso-, and macro-levels. Consistent with the literature, the lack of support directly
results from institutional ageism characteristics that includes language depicting older people
negatively and discriminating older adults within society and organizations (Lloyd-Sherlock et
al., 2016). The deficiency in support develops from a shortage of policy interventions. Policy
interventions are inadequate and need expansion (Blancato & Ponder, 2015). According to the
Administration for Community Living (2015), the number of aging adults will double by 2030,
and, as such, more policies need to be adopted to support this growing population.
Data analysis of the survey responses revealed both strengths and gaps in the relationship
between ageism and ethnicity. Based on the chi-squared test, the researcher found a significant
difference in how non-minorities and minorities experience ageism. Ageism impacts minorities
at an institutionalized level, which is consistent with systemic racism, but affects non-minorities
in an internalized way, and is consistent with negative self-perceptions about aging. The multi-
response answers located in the micro, meso, and macro-level section of the survey noted the
LatinX/Hispanic community reported below a 3% response rate. The underreporting of responses
for the LatinX/Hispanic population at all three levels indicates the participants’ lack of
agreement with the statements, noting significant disparities for this group at all three levels.
Moreover, the results highlight that there needs to be more support for older Nevadans at
the micro-, meso-, and macro-levels. The results supported the conceptual framework and
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literature review and even gleaned insight into aging’s internalization, which the researcher did
not anticipate. The conceptual framework below illustrates the findings, describes the relevant
variables, and how results relate to the conceptual framework. The results’ discussion is grouped
by phenomenology, intersectionality, and Bronfenbrenner’s ecological model and are also found
in the Recommendations section.
Phenomenology
Understanding an individual’s lived experience generates rich data when unearthing the
participants’ opinions, thoughts, and feelings. For Research Question 1, the results align with the
conceptual framework of phenomenology. Discrimination based on age is a phenomenon that
many will experience as they age (Robbins, 2015). Phenomenological analysis is essential to
comprehend ageism’s perceived discrimination, illuminate an older adult’s self, and speak from
the participants’ voices (Creswell, 2013). Deploying a phenomenological study helped to
understand diverse population’s perception on how ageism manifests (Creswell, 2013). By
collecting the shared experiences of ageism from various people, the study documented patterns
in the human understanding of how ageism is manifested and experienced, and suggested
collective interventions. The overall theme described societal discrimination, which included
work discrimination. Other themes that became prevalent were Stereotype Embodiment Threat,
and internalized discrimination by the older individuals themselves. The gap in disparities
between culture and age was also prevalent. The results informed the problem by obtaining
opinions about the meaning of one’s experience by describing that experience to determine the
problem’s foundation.
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As the foundation of the problem was established, based on the results and on meta-data,
the next step in the research process was to understand if the ageism experience varies based on
intersectionality.
Intersectionality
Intersectionality describes the interconnected make-up of social groupings such as race,
class, and gender (Byrd, 2014). For Research Questions 2, 3, and 4; the results aligned with
intersectionality theory. Understanding human phenomena by highlighting one element is not
sufficient on its own, nor can individuals be reduced to one solo characteristic (Hankivsky,
2014); therefore, it is essential to understand dual identities. The findings from the survey
showcased how ageism impacts minorities systemically but non-minorities in an internalized
way.
Moreover, the findings note that the BIPOC community experiences ageism more than
non-minorities at the macro-level and when accessing government services. The findings connect
theory and research by naming these complex identities, which is vital to empowering
individuals’ understanding of dual identities’ positive and negative impact. The findings address
the problem of practice by understating how intersectionalism influences the way individuals
interact, which affects how individuals take part based on equality at all levels of society
(Hankivsky, 2014). Understanding the phenomena of age and identity creates socially relevant
and inclusive research and interventions. The research helps provide interventions at all
ecological levels.
Bronfenbrenner’s Ecological Theory
Bronfenbrenner’s ecological theory is the most influential in social settings on human
development, which contends that the ecosystem one grows up in impacts all factors of one’s life
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(Renn & Arnold, 2003). For Research Question 4, the results aligned with Bronfenbrenner’s
theory. Based on the survey results, it is evident that all older Nevadans are lacking support at
the micro-, meso-, and macro-levels, which perpetuates ageism.
By determining the level of analysis and understanding the integration of ageism at the
micro-, meso-, and macro-levels, the study informs the problem by highlighting more
accountability in its recommendation for interventions. Since the systems work together,
integrating the systems can be improved by conjointly engaging multi-level investigative
methods and utilizing research questions connected with the three analysis levels (Marr, 1982).
Recommendations for Practice
The recommendations below center on behavior changes to end ageist attitudes. Many of
these behavior changes focus on continuing education or learning. Continuing education is
needed for individuals to stay current with the latest skills like diversity training, development,
and new technologies (Billet et al., 2016). By understanding and enhancing the efficiency of
continuing education, evaluation is necessary to examine the design, development, application,
and effect of the training programs (Wang & Wilcox, 2006). A thorough assessment of a training
program should include a review before training, program design and development, and
following training (Goldstein & Ford, 2002). The NWKP four-level model is an accepted and
well-known program evaluation framework that highlights how quantifiable outcomes are the
ultimate level of impact that training interventions can achieve (Moreau, 2017; Sultan et al.,
2019; Yardley & Dornan, 2012). The levels include L1 (reaction), L2 (learning), L3 (behavior),
and L4 (result). Without evaluating the effectiveness of an educational program, few educational
programs can successfully improve the outcomes. Therefore, the NWKP model’s application is a
must to evaluate the effectiveness of the recommendations below.
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Recommendation 1: Awareness/Advocacy
In an era where it is unacceptable to display racism, sexism, or prejudice, why is it still
tolerable to be ageist? Based on the open-ended survey, three patterns to emerge were “barriers
in age differences,” “cultural norms and values,” and “physical limitations.” Stereotype
Embodiment Threat was one of the theories to emerge, which is anxiety about aging, and
suggests that the internalization of ageist attitudes is due to a lifetime of exposure to cultural
messages of ageism (Levy, 2009). As a result, ageist attitudes become part of implicit bias,
perpetuating ideas about old age and older adults (Levy, 2009). As individuals age, a
psychological response occurs, resulting in self-fulfilling internalized stereotypes, thus fulfilling
the self-perception of being “old” (Levy, 2009). Levy (2003) noted that individuals are more
vulnerable to the ageist paradigm’s propaganda because, unlike other discriminatory views,
individuals are programmed to the belief system when it is not relevant to their identity. For
example, ageist attitudes show up in children as young as 6 years of age (Isaacs & Bearison,
1986), noting an exposure to an ageist standard before it connects to their own experience (Levy,
2003). SET also can be seen in Research Question 2’s multi-response selections noting that
White participants reported strong negative self-perceptions about aging compared to
Black/African American and LatinX/Hispanic participants. Age is treated as a more accepted
value and respected in the BIPOC communities compared to the White communities. The
difference in perceptions stems from SET.
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The internalization of aging is linked to collectivist and individualist societies. Cross-
cultural psychologists study how different cultural factors influence individual behavior by
studying collectivist and individualist societies. Findings suggest that the BIPOC community is
more collectivist than White Americans (Acevedo, 2003). Self-descriptions from people living in
collectivist societies are more likely to note that they are “loyal friends and a good daughter”
which is in contrast with a person from an individualistic culture who might say he or she is
“young, old, athletic, and sarcastic.” The difference between these two cultural factors is how
people describe themselves (Schwartz, 1994). Culture influences how people behave, as well as
their self-concept. Those in individualistic cultures might express themselves in terms of
personality traits and characteristics. Those from collectivist cultures are more likely to describe
themselves in terms of their social relationships and roles (Schwartz, 1994). The multiple-
response survey results indicate that there is a difference between how different ethnic identities
perceive age.
Methods for reducing ageism and SET necessitate media campaigns and targeted
education (Ory et al., 2003). An awareness-raising advocacy campaign is needed, as it is an
effective tool demonstrating altered attitudes and views (Hawkes, 2013). Awareness campaigns
are organized communication strategies designed to promote awareness on issues, provide
immediate behavioral modifications among the general population, and improve outcomes
(Hawkes, 2013). Implementing the theory of change includes objectives, strategies, and
assessment (Fressman, 2016). Deploying NWKP’s “behavior” is essential to evaluate the
effectiveness of the campaign and education. According to Shih-Chieh and Shih-Yun (2019),
“behavior” is the key to evaluating training effectiveness. Since it can take years to determine the
long-term effects of a campaign causing the “result” to be a complex measure, then according to
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Shih-Chieh and Shih-Yun (2019), the “behavior” should be deployed as “behavior,” which could
directly forecast the “result.” Therefore, the recommendation is to target individuals, decision-
makers, and influencers for advocacy and awareness campaigns. Individuals are a part of all
spheres of society and can help create change at the micro-level, whereas decision-makers and
influencers generate change at the meso-level.
Although awareness campaigns can lead to a policy change, put pressure on media, and
improve individual actions, more interventions are needed at an early age to prevent ageism in
the first place.
Recommendation 2: Intergenerational Programs
Researchers have shown that through education and intergenerational contact, it is
feasible to decrease ageist prejudices, attitudes, and stereotypes (Cornell University, 2019).
Based on the open-ended survey results, three patterns emerged: “barriers in age differences,”
“cultural norms and values,” and “physical limitations.” One of the topics to emerge from the
above themes was intergenerational contact. In fact, in the open-ended responses, results
highlighted the theme of intergenerational contact, including being listed as an intervention.
In the Burnes et al. (2019) study, the mediation that produced the most significant results
in reducing ageism included a combination of intergenerational communication and educational
elements, and validated reductions in negative attitudes toward aging. Burnes et al. (2019)
observed that a mixture of the two interventions is critical for future dissemination of ageist
attitudes.
The Burnes et al. (2019) meta-study supports Levy’s (2009) stereotype embodiment
theory, suggesting that ageist views may be transmitted culturally and internalized by older
adults, leading to significant changes to health and functioning. Knowledge and intergenerational
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contact help mediate societal stereotypes passed on to the individual, as views on older age begin
in childhood (Burnes et al., 2019; Levy, 2009). According to the Pew Research Center (2019),
79% of Americans see fundamental differences between older and younger adults in the way
they look at the world. Younger groups generalize and view themselves as “not old” and
propagate their perceived power through those generalizations. According to Cornell University
(2019), curriculums that provide education about the aging process and its misconceptions
combined with intergenerational contact worked best at diminishing ageist attitudes. The
intergenerational program interventions had the most significant impact on young adults,
teenagers, and women (Cornell University, 2019). As the intergenerational method is looking to
change attitudes and actions through learning, NWKP’s “learning” should be applied along with
“behavior” because behavior involves applying “learning” the knowledge and skills learned from
continuing education to real-world practice (Kirkpatrick & Kirkpatrick, 2016). A certain amount
of time is needed to realize positive “behavior” outcomes. Kirkpatrick and Kirkpatrick (2016)
have suggested that to increase “behavior” outcomes, trainees need to have numerous
opportunities to apply their learning and time to see improved performance.
Therefore, the recommendation is for students from grade school through college to
integrate intergenerational and educational programs with older adults. In addition to
intergenerational interventions, behavior formation needs to happen through an intersectional
approach, especially for adults, as there are multiple layers to diverse identities.
Recommendation 3: Intersectional Approach
All individuals deserve to have their faces and experiences reflected in culture and media,
their voices heard, and their unique requirements addressed through appropriate policies.
However, when individuals and society fail to integrate intersectionality into everyday routines
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and policies, communities get left behind. An intersectional approach recognizes systemic
discrimination, and this systemic discrimination controls access to opportunity. Discrimination is
based on economic status, sexual orientation, identity, race, gender, identity, immigration status,
and national origin. Based on the four research questions in this study, dual identities do indeed
impact how an individual experiences ageism. The research illuminated that the BIPOC
community had a more challenging time accessing social services and experienced ageism due to
intersecting identities at the systemic level. The differences in minority responses versus non-
minority responses at times ranged up to 50% difference in response based on specific
categories. For example, almost 60% of Black/African Americans noted, “I feel society does not
value me due to age,” while no White participants agreed with this statement. In another
question, more 50% of LatinX/Hispanic participants noted, “I feel as if my works rights have
been violated due to age,” compared to 14% of White and Black/African Americans who agreed
with this statement.
An intersectional approach strengthens the knowledge that there is a nuance in how non-
minorities hold power. The approach fosters understanding of more complex identities that are
more than oppressor and oppressed constructs. An intersectional approach educates on racial
categories to understand the complexity of having multiple identities or ethnicities (Berger &
Guidroz, 2009). Still, within these groups, there are different ways individuals experience
privilege or oppression. The approach also considers the identities of different abilities, gender
identities, sexual orientations, and economic backgrounds that interweave with the racialized
experience, and present additional hurdles to significant inclusion (Berger & Guidroz, 2009).
Without an intersectional approach, society cannot define the root causes of social and racial
marginalization (Berger & Guidroz, 2009).
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NWKP assessment is necessary to support the intersectional method. Researchers argue
that most of the Kirkpatrick’s model’s implications in evaluating education programs’
effectiveness reveal the “learning” variable (Yardley & Dornan, 2012; Sultan et al., 2019).
However, Shih-Chieh and Shih-Yun (2019) note that “reaction” and “learning” will only
indirectly predict the “result.” In contrast, “behavior” can directly predict the “result” outcomes
(Shih-Chieh & Shih-Yun, 2019). This emphasizes why “behavior” is essential when evaluating
the intersectional approach due to the intricacies of diversity layers in this method.
Therefore, the recommendation is for an intersectional approach that targets adults within
the workforce and the college level to understand the complexity of having multiple identities or
ethnicities. The opportunity to explore intersectionality and diversity helps understand cultures,
but cultural competency within social services is needed to understand, interact, and effectively
communicate with people across cultures.
Recommendation 4: Cultural Competency Within Social Services
For marginalized populations, social service aspires to assist individuals, families,
groups, and communities in promoting opportunity and equity, and enhancing their individual
and collective wellness (Smith, 2017). Social services programs include education, food
subsidies, health care, subsidized housing, community management, research, and policy (Smith,
2017). Based on the survey data, 66% of LatinX/Hispanic, 29% of Black/African American, and
5% of White individuals responded that it was “difficult” to access these services, noting a
significant difference in ease of access based on ethnicity. According to Einstein and Glick
(2017), access to various social services is limited, and obtaining these services is tricky,
especially for low-income individuals. As a result, potential beneficiaries rely on entry-level
providers, producing the perfect environment to discriminate in ways consistent with meta-
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findings of discrimination against the BIPOC community (Butler & Broockman, 2011;
McClendon, 2012; White et al., 2014). Einstein and Glick (2017) identified one of the problems
in access, which stems from the differences in friendly tones over the phone and via emails,
based on the individual’s ethnicity. Marrow (2011) found that schools and social service
organizations play a critical role in including or failing the LatinX/Hispanic population,
especially new immigrants, and noted that unfriendly tones sway an already stigmatized
community from seeking services, leading to a harmful failing of incorporation. In the Einstein
and Glick (2017) study on racial disparities in email tone, prospective LatinX/Hispanic housing
applicants were 20% less likely to be greeted by name in a salutation than their Black and White
counterparts. The Einstein and Glick (2017) findings could identify why the LatinX population
responded strongly to the “difficult” value in the survey.
Despite the significance of diversity and oppression in the social services field (Byers et
al., 2020), more training is necessary to understand the barriers in access to services for minority
groups. The recommendation is that social service administration must undergo cultural
competency training. Cultural competence improves organizations and providers’ ability to
efficiently deliver services that match clients’ linguistic, cultural, and social needs. Cultural
competence training methods can improve transparency between language, beliefs, values, and
cultural differences. Based on this study’s data, deploying NWKP’s “behavior” can directly
predict the “result.” Suggesting that the evaluation of training at the “behavior” level will result
in an improved outcome and better understanding of how the program might help the trainees
and instructors achieve “results,” which is the goal of any training program (Shih-Chieh & Shih-
Yun, 2019). Therefore, due to ethnic bias in bureaucracies, this study recommends cultural
competency training within government agencies to better serve populations.
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Cultural training within government services is necessary for intervention, but more
interjoined interventions at the micro-, meso-, and macro-levels, are essential.
Recommendation 5: Support at Micro, Meso, Macro-Levels
Bronfenbrenner’s theory highlights the significance of researching individuals in
numerous settings to understand their progress. The ecological theory seeks to describe how
individuals’ abilities and environments intermingle to impact their development. Scholars and
professionals look at micro-, meso-, and macro-levels to discover and tackle familial, mental,
social, emotional, and financial difficulties that individuals face at each level (Poulin et al.,
2018). This study specifically looked at the level of analysis and understanding the integration of
ageism at the micro-, meso-, and macro-levels. Based on the results, older Nevadans lack support
in all ecological levels. A difference in support between the BIPOC community and non-
minorities is most prevalent at the macro or systemic level. The evaluation of the micro, meso,
and macro-level interventions will utilize all four of NWKP’s levels. According to Shih-Chieh
and Shih-Yun (2019), NWKP’s “reaction” and “learning” in the Kirkpatrick model should be
considered one category of continuing education, and “behavior” and “result” the other. Since
the micro-, meso-, and macro-levels interconnect, it is vital to consider all four NWKP models,
with extreme care not to emphasize “reaction” and “learning” outcome as it overstates training
effectiveness and undervalues practical training (Kirkpatrick & Kirkpatrick, 2016).
Micro
Within the micro-level survey, which looks at how ageism impacts the micro-level, the
responses seem to show a slight disparity between White and Black/African American
participants, but a greater disparity in the LatinX/Hispanic responses regarding support. Perhaps
the underreporting at the micro-level is in response to what Marrow (2011) describes as schools
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and social service organizations playing a critical role in failing the LatinX/Hispanic population,
especially new immigrants.
The findings also conclude that all survey participants did not experience well-being at
the micro-level. None of the micro-level survey responses generated an above 62% rating, all
falling below 40%. The degree to which well-being variables influence personal well-being at
the individual, micro-level is mostly substantial (Mahadea & Rawat, 2008). The survey hinges
upon the analysis of the assortment of individual well-being experiences. The variables of well-
being have been carried out at the micro-level to quantify the relationship between “ethnicity and
well-being.” As pioneered by Daniel Kahneman and Amos Tversky (2016), behavioral
economics indicates that happiness/well-being is measurable through surveys by asking people
about their life satisfaction levels. Surveys indicate that happiness is partly related to personality
attributes and life circumstances.
The survey responses indicated that the participants were cognizant of positive solutions
to combat ageism at the micro-level, including exercise and mindset. Exercise slows down the
process of brain shrinkage in older adults. Previous studies have found exercise can take 10 years
off a brain’s age, resulting in improved gray matter, brain plasticity, and improved thinking skills
such as alertness and memory (Willey, 2016). The mindset about aging will determine how one
experiences aging. A growth mindset relates to self-esteem and self-image; it is a conviction that
one can improve oneself through education and training versus believing that one’s abilities are
fixed (Luchetti et al., 2016). Essentially, mindset has an impact on one’s cognitive decline
(Luchetti et al., 2016).
Moreover, at the micro-level, there are actions one can do or avoid to enrich life-
gratification and contentment in society (Mahadea & Rawat, 2008). According to
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Bronfenbrenner (Shelton, 2019), a recommendation to improve well-being at the micro-level is
to provide more interventions, direct services, and support to individuals, families, and groups.
The recommendation is for more direct practice social work, which involves getting to know
each client and tailoring a treatment plan to the individual’s unique worldview and experience.
For individuals who do not work with social workers, maximizing environmental support is a
requirement. Goldberg (1974) first introduced the idea of maximizing the environment, and the
theory has grown from there. Environmental support entails modifying and creating structures to
meet the needs of the individual. For example, when administrators show engagement at a senior
center by redesigning programs, they work to modify a structure to meet older adults’ needs. The
program then impacts the older adult at the micro-level. Once established, these new structures
can operate in the interest of older adults without the administrator’s presence.
Meso
The findings also conclude that all the survey participants did not experience well-being
at the meso-level. All but two of the survey questions generated an above 63% rating, with most
responses falling below 40%. The meso data indicated slight disparities at the meso-level
between White Nevadans and the BIPOC Nevadans. However, all ethnicities are lacking in
meso-support. Bronfenbrenner noted that assistance needs come from organizational and
community interventions (Shelton, 2019).
The recommendation is to organize community action, like organizational functioning,
service delivery, and community well-being for vulnerable populations (Poulin et al., 2018).
Systems at the community level include community coalitions, neighborhood groups,
professional task forces, and community citizens’ groups. The intervention is often to improve
community and neighborhood circumstances by mobilizing individuals to advocate for change
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and resources, developing resources, empowering residents, and increasing community
awareness of economic and social problems (Poulin et al., 2018). Meso-level interventions stress
the importance of formal and informal collaborative partnerships, cross-training, and maintaining
a shared goal for accessibility to physiological and safety needs (Nichols, 2020).
Macro
At the macro-level, the disparities between minorities and non-minorities are most
prominent. There is a divide in how the BIPOC community experiences the macro-level
compared to non-minorities. However, the responses indicate that older Nevadans of all
ethnicities lack macro-level support, which impacts their overall human rights. At the macro-
level there were no responses above a 63%, with most of the responses falling below a 50%
response rate.
The first recommendation is improvement in systems from macro involvement, which
calls for improving the system to ensure that it is responsive to and thoughtful of human rights,
which is known as the human rights approach. According to Ife (2012), the human rights
approach looks beyond individuals and the problems they are encountering. It looks at the
culture and structure of a society to examine how it is aiding the individuals’ issues. The
approach turns personal problems into public issues (Ife, 2012). It moves away from focusing on
individual needs and supports cultural and structural changes to focus on human rights (Libal &
Harding, 2015). According to Mahadea an Rawat (2008), certain controllable elements of human
behavior can enrich one’s happiness through the path of policy issues. Policy conditions that are
beneficial to economic growth, prosperity, and human capabilities can increase happiness and
welfare within the macro symptoms (Mahadea & Rawat, 2008). Outside of the human rights
approach, another recommendation is derived from Bronfenbrenner’s system (Shelton, 2019) to
103
discover large-scale trends and patterns in society by analyzing the similarities and differences
between cultures at the national or international level through policy and government. The data
from this research study support that systematic racism is occurring at the macro-level. Direct
action to eliminate disparities requires intertwining the micro- and meso-level. Local action is
needed to influence policy to ensure macro-level systems are in place for the BIPOC community.
Local action includes individuals working with the city government, community, and
neighborhood groups to tackle age inequities, accessibility, and racial injustice. According to the
American Civil Liberties Union (2019), policy changes need to happen to ensure voting rights,
economic equality, accessibility to services and education, and the criminal justice system.
The recommendation at large is for social workers to break down their respective silos
and collaborate within all three levels. High-level governmental priorities and policies limit the
interests of professionals and scholars at the micro-level. As a result, the meso- and micro-levels
merge within the macro-level. Likewise, there is a cyclical effect, as learning at the micro- and
meso-levels informs macro-level choices about urgencies and policies (Roberts, 2019).
Limitations and Delimitations
Limitations
The individuals sampled in this study were a purposive, non-random sample, and
therefore are not representative of the Nevada population, much less the U.S. Moreover, this
sample was accessed through professional sororities and Las Vegas senior centers, thus possibly
not reflecting the broader needs of those who were not using social service programs. Due to the
three-month time frame, the results were affected by society’s controls due to COVID-19.
According to Crawford (1997), a researcher must develop an intuition constituting a “good
design” since there is no questionnaire model to guide the researcher. As such, there may be
104
limitations within the survey design. The researcher needed to remember that a dissertation’s
limitations are often not something that the researcher can solve. Other restrictions included
qualitative methods like phenomenology, which did not lend themselves well to replicability.
Finally, most of the commonly used quantitative statistical models only determine correlation,
not causation.
Delimitations
The study’s scope seeks to improve understandings, standards, and interventions in the
field of ageism. The study researches the experience of ageism via ethnicity. The delimitation of
this study is the inclusion of only participants from within those demographics. Still, exclusion of
participants from other demographics was not intended. However, many identities intersect, like
gender, sexual orientation, disability, immigration status, and social class, but too few of these
identities were represented in the survey participants to conclude statistical significance.
A further delimitation is that the study is comprised of closed-ended Likert scale
responses and open-ended replies in the survey, rather than interviews. Surveys are more easily
distributable and might make some people more willing to participate. Further, due to COVID-
19 pandemic, in-person interviews were difficult to achieve, as the pandemic limited access to
individuals. According to Geerts and Van der Tuin (2014), epistemic bias is due to the
intersectionality silo. Geerts and Van der Tuin (2014) noted that these biased origins are rooted
in intersectional scholars. When considering the epistemology of phenomenology, first-person
knowledge, at its core, informs understanding about the nature of consciousness (Moran, 2000);
however, people incorporate studies of consciousness into studies of phenomenal experience,
and they can differ (Millikan, 2014).
105
Moreover, open-ended comments have traditionally low response rates. There are also
education, language, or other demographic issues that may affect the likelihood and quality of
response (Andrews, 2004). The above delimitations are the researcher’s boundaries, thought to
be accurate based on the researcher’s knowledge.
Recommendations for Future Research
Future research on this topic points to the need to include more identities such as Asian
American, Native American, LGBTIQ, diverse abilities, immigration, and socioeconomic status.
Moreover, most of the participants were between the ages of 55-70. In the future, it would be of
great benefit to survey older adults in the fourth age. This researcher is cautious in generalizing
too much from this study’s results, as the sample size was narrow and only sampled Nevada
residents. Future research suggests expanding the research nationally, with larger population
sizes, to allow for more generalized results. Follow-up studies regarding the recommendations in
this ageism study, including expanding upon research to see if White populations have more
negative self-perceptions of aging compared to BIPOC populations, could serve as an essential
intervention and evaluation tool over time to determine more precise mediations to end ageism.
Conclusion
Enhancing the understanding of ageism in a predominantly White researcher arena will
influence social services and help inform the issue of ageism for diverse populations at the
micro-, meso-, and macro-levels. The study also adds value as it addresses the
underrepresentation of minority groups, helping to understand further the overlapping oppression
of ageism (Burnes et al., 2019). This study’s research provides the opportunity to inform
individuals, communities, and systems about ageism. The study can potentially educate the
public; influence workforce development; remove barriers, stereotypes, discrimination, and bias;
106
enhance policy; as well as engage individuals and the media to understand the role they play in
ageism. This study expands upon diverse research in ageism to understand the barriers in access
to the same service faced by different groups, and to understand ageist experiences through
minority groups’ perspectives.
This research study, Holding Space for Minority Groups in the Study of Ageism, is
relevant because it highlights how different ethnicities experience ageism. Black/African
Americans experience institutionalized discrimination compounding ageism, while White
populations are more prone to negative self-perceptions about aging, thus creating internalized
ageism. In contrast, the LatinX/Hispanic populations have more difficulty accessing social
services due to the lack of cultural competency in the bureaucrats who deploy the services.
Out of the 30,000 studies on ageism, nearly 70% of those studies only identify White
women in their sample group. This study is important as it opens the doors to more diverse
research in gender and ethnicity, helping to inform the problem of ageism for more inclusive and
diverse populations.
107
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Appendix A: Theoretical Framework Alignment Matrix
Research Question Theoretical Framework Data Instrument Questions
How does ageism manifest
from the perceptions of
older Nevadans?
Phenomenology
(Creswell, 2013)
Survey Q33-36
How do older Nevadan’s
experience ageism
differently depending on
their location in the race
structure (e.g., White vs.
visible minority).
Intersectionality
(Coleman, 2019)
Survey Q1-13
Survey Q15-29
Interview Q33
What is the difference in
access to social services for
minority older Nevadans
and to older non-minority
Nevadans? (statistical)
Intersectionality
(Coleman, 2019)
Survey Q14
What interventions are
recommended to better
serve marginalized groups
at the micro, meso and
macro-levels?
Bronfenbrenner’s Social
Ecological Theory
(Backonja et al., 2014)
Survey Q30-32
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Appendix B: Survey Questions
Understating Diverse Groups on Ageism
Demographics Block:
1. Do you consider yourself to be: Heterosexual or straight, Gay or lesbian, Bisexual,
Different identity?
2. What is your current gender identity? Male, Female, Transgender, Nonbinary/third
gender, Other?
3. What is your household income: Under $20,000, $20,001 – $40,000, $40,001 – $60,000,
$60,001 – $80,000, $80,001 – $100,000, $100,001-$120,000, $120,001-1$140,000,
$140,001-$160,000, $160,001-$180,000, $180,001-$200,000, $200,001 over
4. What is your education level? No formal education, High school diploma, College
degree, Vocational training, Bachelor’s degree, Master’s degree, Professional degree,
Doctorate degree, Other?
5. What is your age: 55-60, 61-65, 66-70, 71-75, 76-80, 81-85, 86-90, 91-95, 96-100, 101+
6. What is your work status? Employed, Self-employed/Freelance, Interning, Part-time,
Unemployed- Looking for work, Unemployed – Not looking for work, Retired, Studying,
Military/Forces, Furloughed
7. In what type of dwelling do you live? I own my home, condo, trailer, etc., I rent my
home, apartment, condo, trailer, etc., I live with friends or relatives, I live in subsidized
housing, Homeless, I live in a shelter, I live in a senior community, I live in a government
assisted senior community, Halfway house or rehab, Group home
8. What is your household size? I live alone, I live with one other person, I live with two
other people, I live with three other people, I live with four other people, I live five other
people, I live with six other people, I live with seven people or more
9. I help take care of ...check all that apply: Adult Children, Grandkids, Another adult(s),
N/A.
Racial and Ethnicity Block
10. Which language do you speak fluently? Check all that apply English, Spanish,
Portuguese, French, Mandarin, Arabic, Russian, Other.
11. What is your ethnicity? Hispanic, LatinX, Spanish, Native American Indian or Alaska
Native, Asian, Black or African American, Native Hawaiian or Other Pacific Islander,
White, Unknown, Other/Prefer to self-describe.
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12. What is your Race? Select ALL that apply: American Indian or Alaska Native, Asian,
Black or African American, Native Hawaiian or Other Pacific Islander, White.
13. Immigration status: U.S. Citizen, Naturalized, US citizen parents or grandparents, Lawful
permanent resident, Refugee or asylee, Temporary Resident (i.e. visa holder, non-
immigrant, student, etc., Undocumented immigrant.
14. Do you use a Government program? (EX: Social Security, Medicaid, Medicare,
Supplemental Nutrition Assistance Program, Food assistance programs, Bus
Transportation, Unemployment assistance, Temporary Assistance for Needy Families,
Welfare, etc.) If you Do use this service then please rate what is your difficulty or ease in
accessing the Government programs? (Likert scale)?
Aging Experience Block
15. How often has someone talked to you loudly or slowly? 1. Never, 2. Somewhat, 3.
Neutral, 4. Quite Often, 5. All the time.
16. How often have your encountered people who are surprised that you did something
well? 1. Never, 2. Somewhat, 3. Neutral, 4. Quite Often, 5. All the time.
17. How often have you encountered people who didn’t expect you to do well? 1. Never, 2.
Somewhat, 3. Neutral, 4. Quite Often, 5. All the time.
18. Do you believe you are discriminated against due to age? 1. Never, 2. Somewhat, 3.
Neutral, 4. Quite Often, 5. All the time.
19. I am powerless in making my own choices? 1. Never, 2. Somewhat, 3. Neutral, 4. Quite
Often, 5. All the time.
20. Do you believe you have access to health care? 1. Never, 2. Somewhat, 3. Neutral, 4.
Quite Often, 5. All the time.
21. My doctor or health care provider lumps my symptoms as “old age”? 1. Never, 2.
Somewhat, 3. Neutral, 4. Quite Often, 5. All the time, 0. I do not have a doctor/health
care provider.
22. My doctor or health care provider over treats me due “old age”? 1. Never, 2. Somewhat,
3. Neutral, 4. Quite Often, 5. All the time, 0. I do not have a doctor/health care provider.
23. My doctor or health care provider under treats me due “old age”? 1. Never, 2. Somewhat,
3. Neutral, 4. Quite Often, 5. All the time, 0. I do not have a doctor/health care provider.
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Identity +Age
15. Check all statements that pertain to you:
I feel beautiful or handsome.
I do not feel beautiful due to age.
I can’t accomplish anything due to age.
Do you believe age makes you frail?
I am defined by my age.
Age does not define me.
I am wiser because of age?
I feel alive and well?
I feel frail and old?
I look old.
I do not look old.
Age does not limit me.
Age limits me.
I am interested in learning new things.
Intersect Block
16. How often has some said an insult or slur to you? Please rate the frequency between 1-5.
(Likert Scale option)?
17. If you answered the above, was the insult or slur due to (check all that apply):
Age
Class structure
Race
Gender structure (trans, male, female, bigender, gender fluid, etc.)
Immigration status
Disability (including mental, learning, physical etc.),
Sexual orientation (straight vs. gay, lesbian or bi-sexual in the heterosexual–homosexual
continuum)
Does Not Apply to Me
18. How often has someone threatened to harm you physically due to age? Please rate the
frequency between 1-5.
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19. How often have you been treated unfairly due to age? Please rate the frequency between
1-5.
20. How often has someone discouraged you from trying to achieve important goals due to
age? Please rate the frequency by group structure between 1-5.
Micro Block
21. Check all statements that pertain to you:
I exercise
I have friend support
I have family support
I go on vacation
I am satisfied in life
I use a wheelchair/walker/cane to get around
I am no longer dependent
I depend on others to survive
I have a current driver’s license
I have my own a vehicle
I have access to a vehicle
Meso Block
22. Check all statements that pertain to you:
Most people speak my language
I find it easy to communicate
I am happy
I am lonely
I have great quality of health
I have health insurance
I have a pension
I have affordable housing
I have access to food
I have access to religious activities
I have access to social activities
I have access to health care
I have social trust
I am discriminated at work due to age
I have been passed on training’s, promotions, etc. due to age
I have been scammed later in life
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Macro Block
23. Check all statements that pertain to you:
Services are in close proximity to me
I have access to public facilities
It is easy to shop and obtain services
My housing is quality
The street on which I live is well lit
I live on an urban block
I live around air and noise pollution
I live in an area with natural, landscaped or open spaces
I have access to transportation
My political leaders care about older adults
Local policies include me
I have access to a walk able environment
Media portrays me incorrectly
National policies help with the aging process
I feel safe in my neighborhood
Recreation spaces like exercise, sport is accessible
I can easily get to my appointments
I am home-bound and have no access to services
I feel as if my human rights are violated due to age
I feel as if my worker’s rights have been violated due to age
I feel society does not value me due to age
Phenomenology Block
24. Have you experienced ageism in your own life? If yes, please describe (open ended
question).
25. Why do you think ageism exists? (open ended question).
26. What do you think can be done to prevent ageism? (open ended question).
27. Would you be interested in an interview to share your thoughts or expand on your
experiences? (Yes or No, Qualtrics will direct how to contact)
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Appendix C: Survey Protocol
Information and Consent to Participate in Survey
Understating Diverse Groups and Ageism
Stephanie Lowrey, University of Southern California Doctoral Student
Introduction
Thank you so much for taking the survey. Your perspective is valuable to this study. This study
is designed to gain scientific knowledge that may help older adults in the future. I am a doctoral
student at University of Southern California, and I am, trying to understand the experience of
ageism for different identities.
This is completely confidential and there will be no personal information collected to identify
who took this survey, to keep one’s anonymity/ identity confidential. You will not receive any
benefit from being part of the study. Too the researchers’ knowledge there are no risks for the
participant to take the survey, as anonymity is confidential. Your participation is voluntary.
Why Is This Study Being Done?
The purpose of this study is to understand how ageism manifests in Nevada and if identify
creates barriers in obtaining services or makes it harder to age. This study furthers expands upon
ageism research to understand minority vs. nonminority’s experiences in aging. For this purpose,
ageism will be defined as discrimination, bias or marginalization based on age.
Once the surveys are collected, the researcher will analyze the results to see if recommendations
can be made in the field of ageism and social services
How Many People Will Take Part In The Study?
About 100 people will take part in this study.
What Is Involved In This Research Study?
The study involves 1) survey 2) the analysis of results and 3) the dissemination of information
gained from this study.
How Long Will You Be In The Study?
This survey occurs one time. The time of the survey has been estimated between 10-15 minutes.
What Are The Risks Of The Study?
Since the researcher is not asking for personal identifying question, there are no risk of taking
this survey. Confidentiality and anonymity are crucial to the success of this survey. There may
be risk that the reserve cannot predict, but overall, very safe and confidential.
Are There Benefits To Taking Part In The Study?
If you agree to take part in this study, there may or may not be direct benefit to you. We hope the
information learned from this study will benefit other people in the future. The benefits of
participating in this study may be: 1) informing future research 2) helping to eliminate ageism 3)
135
understanding ageism 4) understanding how diverse groups experience ageism and 5) addressing
barriers in services due to ageism and identity.
What About Confidentiality?
Confidentially and anonymity are critical in this survey. The researcher will not know who took
the survey or ask questions about your personal information. The researcher can guarantee
absolute confidentiality. If the participant elects for a follow-up interview, the researcher will not
ask first name or last names and will delete any contact information. Federal law states that we
must keep your study records private
When the information is published, you will not be identified by name or in any other way as the
researcher never collected that information,
What Are The Costs Of Taking Part In This Study?
There are no costs to you for participating in this survey. All study costs, like postage associated
directly to the survey, will be paid for by the researcher.
Will You Be Paid For Participating?
You will receive no payment, but compensation will include a $5 gift card for taking part in this
study, received upon completion. Your gift card will be dispersed via email if taking the
electronic version or via mail, if taking the survey over the phone or submitting the survey
through the mail. If the survey is distributed and collected in person, you will get the gift card in
person. All gift cards will be paid by the researcher.
Who Is Sponsoring This Study?
No sponsor.
This study is being conducted by a USC doctoral student. The researcher does not, hold a direct
financial interest the product being studied.
What Are Your Rights As A Research Study Participant?
Taking part in this study is voluntary. You may choose not to take part or decline. The researcher
just appreciates your help.
Whom Do You Call If You Have Questions Or Problems?
For questions about the study or in the event of a research-related injury, contact the study
investigator, S. Lowrey at slowrey@usc.edu or IRB@usc.edu. You may email if:
o You have concerns or complaints about the survey.
Resources
For Nevada residents if you have experienced any psychological triggers as a result of this
survey or in need of access to services for older adults please reach out to Nevada 2-1-1 by
calling 211 or 1-866-535-5654. In addition, you can search service at
https://www.nevada211.org/senior-services/
To report suspected neglect, abuse, abandonment, isolation, or exploitation for vulnerable
adults, or complaints, please use these phone numbers:
• Las Vegas/Clark County (702) 486-6930
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• Statewide/All other areas (888) 729-0571
If a vulnerable adult is in immediate danger, please call:
• 911
If the person is not in immediate danger, the report should be made via one of the designated
phone numbers above.
Mail?
Most survey, will be conducted online. However, If given the opportunity to mail back a survey,
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Abstract (if available)
Abstract
According to the Pew Research Center (2020), 40% of the U.S. population comprises racial and ethnic minorities, and as many as one in five Americans could claim a multiracial background by 2050. Despite these numbers, a review of meta and empirical data, theoretical literature, and research within this study suggest that there is an uneven amount of research for minority groups. For this study’s purposes, the researcher sought to understand if minority Nevadans experience ageism differently than non-minority Nevadans. The study collected 268 responses from LatinX/Hispanic, Black/African American, and White Nevadans 55 years of age and older. The study’s rationale encompassed inclusive research to meet diverse populations’ needs, inclusive research to cultivate cultural competency, and to understand ageism through diverse identity perspectives to help end ageist attitudes at micro, meso, and macro levels. Moreover, social services remain rooted in outmoded societal approaches that regularly preclude and marginalize aging minority individuals’ experiences. Older Nevadans experience ageism differently depending on their overlapping identities, which creates barriers to accessing social services. This study recommends awareness and advocacy for individuals and influencers; cultural competency training for social service bureaucrats; an intergenerational program for first grade through college; an intersectionality approach for work cultures; and support at the micro-, meso-, and macro-levels. The researcher suggests that a diversity-adjusted approach will help provide culturally pertinent services to all social services clients. The study outcomes indicated that there is indeed a difference in how minority Nevadans versus non-minority Nevadans experience ageism.
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Asset Metadata
Creator
Lowrey-Willson, Stephanie
(author)
Core Title
Holding space for minority groups in the study of ageism
School
Rossier School of Education
Degree
Doctor of Education
Degree Program
Organizational Change and Leadership (On Line)
Degree Conferral Date
2021-08
Publication Date
07/31/2021
Defense Date
04/07/2021
Publisher
University of Southern California
(original),
University of Southern California. Libraries
(digital)
Tag
Ageism,diverse and inclusive research,ecological levels and ethnicity,ethnicity and aging,intersectionality,OAI-PMH Harvest,social services and ethnicity
Format
application/pdf
(imt)
Language
English
Contributor
Electronically uploaded by the author
(provenance)
Advisor
Tobey, Patricia (
committee chair
), Enguidanos, Susan (
committee member
), Min, Emmy (
committee member
)
Creator Email
slowrey@usc.edu,steph.lowrey@gmail.com
Permanent Link (DOI)
https://doi.org/10.25549/usctheses-oUC15672109
Unique identifier
UC15672109
Legacy Identifier
etd-LowreyWill-9955
Document Type
Dissertation
Format
application/pdf (imt)
Rights
Lowrey-Willson, Stephanie
Type
texts
Source
University of Southern California
(contributing entity),
University of Southern California Dissertations and Theses
(collection)
Access Conditions
The author retains rights to his/her dissertation, thesis or other graduate work according to U.S. copyright law. Electronic access is being provided by the USC Libraries in agreement with the author, as the original true and official version of the work, but does not grant the reader permission to use the work if the desired use is covered by copyright. It is the author, as rights holder, who must provide use permission if such use is covered by copyright. The original signature page accompanying the original submission of the work to the USC Libraries is retained by the USC Libraries and a copy of it may be obtained by authorized requesters contacting the repository e-mail address given.
Repository Name
University of Southern California Digital Library
Repository Location
USC Digital Library, University of Southern California, University Park Campus MC 2810, 3434 South Grand Avenue, 2nd Floor, Los Angeles, California 90089-2810, USA
Repository Email
cisadmin@lib.usc.edu
Tags
diverse and inclusive research
ecological levels and ethnicity
ethnicity and aging
intersectionality
social services and ethnicity