By Dr. Jeremy Holloway

Ageism is often left out of the national conversation on equity. Yet it is one of the most pervasive and destructive forces shaping health outcomes for a rapidly growing population: older adults.

Unlike other forms of discrimination, ageism is often subtle, socially tolerated, and embedded in both culture and policy. But its impact is anything but soft. The World Health Organization has equated the health impact of social isolation and loneliness—two key consequences of ageism—to smoking 15 cigarettes a day WHO, 2021. This is not merely a public health concern—it’s a silent epidemic, contributing to premature death, chronic disease, misdiagnosis, and widespread emotional harm.

And yet, health systems are often unprepared.

A Curriculum of Neglect

The ageist foundation in U.S. healthcare begins at the very start of medical training. According to the Association of American Medical Colleges, most medical schools offer only a week or two of geriatric-specific instruction—if any at all. The lack of geriatric content in clinical education leads to significant knowledge gaps in older adult care, including polypharmacy management, fall prevention, cognitive assessment, and end-of-life conversations.

Without proper training, healthcare professionals often overlook or misinterpret symptoms in older patients, attributing issues to “normal aging” rather than treatable conditions. The consequences are profound: delays in diagnosis, under-treatment, overtreatment, and miscommunication that can escalate to preventable hospitalizations—or worse.

From Stereotypes to Systems

Ageism thrives on assumptions: that most older adults are frail, technologically inept, or incapable of growth. These stereotypes shape not just personal biases, but policy and systems design. Hospitals may lack protocols tailored for geriatric patients. Digital health innovations often bypass usability for older populations. Insurance programs may undervalue interventions that address social isolation, even though those interventions are linked to lower healthcare costs.

Even well-meaning professionals can fall into the trap of paternalism or invisibility—speaking about the patient, not to them. This diminishes trust and contributes to the disconnect between care plans and patient adherence.

The Isolation Multiplier

Ageism also intensifies loneliness—especially for older adults who have lost spouses, live far from family, or are no longer in the workforce. The result is generational isolation. Older adults become siloed from intergenerational networks, and younger individuals lose valuable mentorship and relational wisdom.

This matters because loneliness is not just emotional—it’s physiological. Studies have found that social isolation increases the risk of heart disease by 29% and stroke by 32% (Holt-Lunstad et al., 2015). For older adults with multiple chronic conditions, this isolation can be deadly.

A Policy Blind Spot

Despite the magnitude of the issue, ageism rarely appears as a central theme in major policy discussions. While frameworks like the Affordable Care Act expanded access, and programs like Medicare Advantage have innovated around supplemental benefits, few national strategies directly confront age bias or require robust geriatric training.

If we are to build a truly equitable healthcare system, age must be part of the equity conversation.

This means…

  • Mandating geriatric training across all health professions.
  • Incentivizing intergenerational programming that reduces social isolation.
  • Embedding age-inclusive design in digital health, hospital systems, and public health outreach.
  • Promoting data transparency around age-related health disparities.

The Path Ahead

There is hope. Some programs are working to reverse the trend. Tellegacy, the intergenerational program I founded, pairs college students with older adults for weekly connection rooted in storytelling, goal setting, and emotional presence. We’ve found that both groups benefit: older adults report fewer depressive symptoms, and students become more empathic and prepared to serve diverse populations.

This is not a replacement for systemic change—but it’s a glimpse into what’s possible when we reject ageism and invest in mutual respect.

Ageism is not an afterthought. It is a frontline health threat. And unless we acknowledge it as such, our aging population—already projected to double by 2060—will continue to suffer from a system that too often sees them as invisible, inconvenient, or expendable.

We have the knowledge, the tools, and the moral responsibility to do better.

Now we need the policy—and the will—to act.