Old Age, Gender and Physical Activity

The biomedicalization of aging, forged over a century ago by socially constructing old age as a diseased, dependent and inactive “stage of life” has strongly influenced the way many people think about the physical and sporting possibilities of aging men and women. Such a view has fostered age-grading systems and perpetuated the tendency to view aging negatively and as a medical “problem” requiring medical assistance, despite increasing contemporary evidence of the importance of social and behavioral factors in explaining health and aging. Perceptions of old people as helpless, sick and dependent upon medical intervention “may actually teach older people to become dependent and sick, encouraging them to act the part while simultaneously affirming the power of the medical model to define what is real and important.” The belief is perpetuated that the problems of aging are biological and physiological rather than social and behavioral and hence can only be fixed by medical technology, if at all.
Furthermore, many physicians remain unclear about which changes found in elderly patients are pathological, which represent normal aging and what to advise in either case. The elderly are often insufficiently impressed with the “use it or lose it” argument in their dealings with medical personnel. Some doctors, for example, have been found to considerably underestimate the average life-expectancy of seventy-five year old women, leading them to dismiss the utility of behavioral changes that would reduce morbidity. Though sources of resistance to the biomedical construction of aging are increasingly apparent, a distinction continues to be made between providing the elderly with “just enough” assistance for modest maintenance but not “too much” for free and enjoyable living. These restrictive norms of a culture biased toward youth have operated to decrease the range of choice of the elderly as much, if not more than physiological and economic limitations. Though Laslett talks of an emerging “Third Age” of personal fulfillment begun after leaving the labor force, old people are still often viewed as “running out of program,” living out their older years inactively and devoid of purpose. This condition creates, for some, a vulnerability to and dependence upon external sources of labelling, many of which communicate a stereotyped, negative message of the elderly as in poor health, incompetent and useless.
Although there are distinct indicators of increased interest and participation in healthful physical activity and sport, fewer than twenty per cent of Americans over the age of sixty-five are as physically active as they could be for optimal functioning. Older women, particularly, are under-represented among today’s active elderly. While health limitations clearly have a direct influence on their physical activity patterns, perceived barriers to health and strongly held beliefs about the potential risks of vigorous exercise during old age seem to remain salient among many elderly women. Indeed, it is a paradox that one of the main reasons given by elderly women for not being more physically active is their declining health and the perception that they are “too old,” while at the same time scientific research increasingly demonstrates that one of the certain benefits of physical activity is health improvement. It is a further paradox that, while women have proven more durable than men from a physiological standpoint, they have done so in a culture which, until recently, has encouraged them to take on the characteristics of aging too readily. Despite their superiority in living longer than men (even in preindustrial western society female life expectancy was eight months longer than that of males), women have, especially since the late nineteenth century, often been considered old and frail earlier than men, pressed to retire sooner than men, and generally viewed as less useful and less capable of dealing with the vicissitudes of aging.
There is evidence that women continue to internalize such beliefs as they age. The substantial improvements in the health status of elderly women since the turn of the century have not necessarily been accompanied by a similar level of improvement in subjective feelings about health and well-being. Older women are reporting higher rather than lower rates of disability, symptoms and general dissatisfaction with their health. Furthermore, they consistently rate their health more poorly than do men, and they hold stronger beliefs than men in the merits of restricted physical activity. As the gap between objective health status and subjective well-being (which is an important motivation to exercise) remains wide, medical sociologists seek to explain why elderly women continue to adopt a “sick role” so readily regardless of their actual state of health. Society’s current preoccupation with physical fitness provides a partial explanation, for paying constantly increasing attention to one’s body and its health and fitness can negate real gains in health by leading people to assess their health more negatively. “Bodily awareness, self-consciousness and introspection are associated with a tendency to amplify somatic symptoms inducing worry about health where before there was none.” A more complex explanation locates a deepening or a hardening of negative attitudes toward the physical capabilities of the elderly, especially aging women, in the last decades of the nineteenth and early years of the twentieth century. During these years, American middle-class society more readily conceived of aging as a distinct period of life characterized by decline, weakness, and obsolescence, rather than accepting it as a natural process of continuous development and maturity. The professions, particularly the medical profession, played a key role in articulating the unique and generally uninviting conditions of a “stage of old age.” They assisted in promoting societal recognition and a large measure of popular acceptance for the view that old age was a disease, a perilous condition, requiring cautious age-appropriate and gender-appropriate behavior and close medical supervision.


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