Lee Kuan Yew School of Public Policy, National University of Singapore, Singapore, Singapore.
Lloyd's Register Institute for the Public Understanding of Risk, National University of Singapore, Singapore, Singapore.
Gerontologist. 2022 Apr 20;62(4):598-606. doi: 10.1093/geront/gnab151.
While studies have researched ageism in public policy, few investigated the impact of aging policy on ageism-typically, an unintended consequence. Ageism is linked to $63 billion in health care costs, so its antecedents are of interest. We test the association between Aging Policy Agenda Setting and Societal Age Stereotypes and hypothesize a mediating pathway via Medicalization of Aging, moderated by demographics.
Scholars identified Singapore's Pioneer Generation Policy (PGP) as one of the largest policy implementations in recent years, where the agenda was set by the Prime Minister at an equivalent State of the Union address in 2013, and US$7 billion allocated to fund outpatient health care costs for aged 65 years or older. More than 400,000 older adults received a PGP card and home visits by trained volunteers who co-devised a personalized utilization plan. We leveraged a 10-billion-word data set with more than 30 million newspaper and magazine articles to dynamically track Societal Age Stereotype scores over 8 years from pre- to postpolicy implementation.
Societal Age Stereotypes followed a quadratic trend: Prior to the Aging Policy Agenda Setting from 2010 to 2014, stereotypes were trending positive; after 2014, it trended downward to become more negative. Medicalization of Aging mediated the relationship between Aging Policy Agenda Setting and Societal Age Stereotypes. Furthermore, Old-age Support Ratio moderated the mediational model, suggesting that the impact of policy on medicalization is stronger when a society is more aged.
We provided a framework for policymakers to ameliorate the unintended consequences of aging policies on societal ageism-if unaddressed, it will exert an insidious toll on older adults, even if initial policies are well-intentioned.
尽管已有研究探讨了公共政策中的年龄歧视问题，但很少有研究调查老龄化政策对年龄歧视的影响——通常是一种意料之外的后果。年龄歧视与 630 亿美元的医疗保健成本有关，因此其前因后果值得关注。我们检验了老龄化政策议程设置与社会年龄刻板印象之间的关联，并假设通过老龄化的医学化来介导这种关联，同时由人口统计学因素进行调节。
学者们将新加坡的先驱一代政策（PGP）确定为近年来最大的政策实施之一，该政策议程是由总理在 2013 年相当于国情咨文的演讲中设定的，并拨款 70 亿美元用于为 65 岁或以上的老年人提供门诊医疗保健费用。超过 40 万名老年人收到了 PGP 卡，并接受了经过培训的志愿者的家访，这些志愿者共同制定了个性化的使用计划。我们利用一个包含超过 3000 万篇报纸和杂志文章的 100 亿字数据集，在政策实施前后的 8 年时间内，动态跟踪社会年龄刻板印象分数。
社会年龄刻板印象呈二次趋势：在 2010 年至 2014 年老龄化政策议程设置之前，刻板印象呈积极趋势；2014 年之后，它呈下降趋势，变得更加消极。老龄化的医学化调节了老龄化政策议程设置与社会年龄刻板印象之间的关系。此外，老年抚养比调节了中介模型，这表明当一个社会老龄化程度更高时，政策对医学化的影响就更强。
我们为政策制定者提供了一个框架，以改善老龄化政策对社会年龄歧视的意外后果——如果不加以解决，即使最初的政策是出于好意，也会对老年人造成阴险的伤害。
