Racism and Its Intersection with Ageism

      In addition, for elder African Americans, structural or institutionalized racism is part of their life-long experience. For many, segregated schools and public places, anti-miscegenation laws, and Jim Crowe laws are part of their personal memories. World War II ostensibly integrated African-American and white soldiers, but they returned to largely segregated housing and racially-influenced employment opportunities. In many urban settings, housing-- including low-income housing for elders--remains substantially de facto race segregated. Such segregated housing is associated with a lack of community-level economic investment and health services, with both market failures and redlining in health care and pharmacy services impeding continuity of depression care. Race-based housing segregation is also associated with interpersonal experiences of unfair treatment, which are associated with psychological distress. While explicit, legislated racial discrimination has been prohibited, ostensibly race-neutral application of policies and social practices has perpetuated inequality between African Americans and Whites in rates (or levels) of income, home ownership, educational attainment, and employment.

      Interpersonal racism--discrimination and disrespect in many obvious or implicit and private, interpersonal ways--has substantial effects on individuals' daily lives, while internalized racism is inversely related to health. One recent study indicates that perception of racism, particularly in interpersonal health care interactions, is associated with increased mistrust in the health care system. Such findings suggest that mistrust is not an historically induced attribute of individuals or populations, nor even, but the result of personal experience.

      Racism and ageism may operate for African-American elders as Dorothy Roberts argues racism and sexism operate for women of color: there is not a merely additive effect, but a transformative effect with exponential impact on the lived experience of those occupying several devalued groups. An older African-American man who, because of his age, no longer seems threatening on a darkened street and no longer prompts a young white woman to cross to the other side of the street, avoids her racist fear only in virtue of being subject to ageist disregard. In viewing an older African-American woman as a matriarchal figure, one may indeed venerate her for her wisdom and life experience, but without specific knowledge of her, such regard is mere ageist, sexist, and racial stereotyping that marks her as beyond her sexual prime and valued primarily in terms of her family or community role. Ageism may cast as beyond their prime a population that because of racism never came into its own and never had access to prime opportunities. Examination of health and health care disparities at the population level affords an opportunity to both tease apart and examine the synergistic interaction of race, age, gender, and socioeconomic, cultural, and economic factors.