Across the globe, older people face discrimination in all areas of their lives. Whether they are accessing health care, seeking employment, or protecting their right to their land, older people are likely to experience discrimination because of their age.

‘Sometimes age discrimination is subtle: lack of transportation may prevent older people from taking part in social activities, which is a right everyone shares. At the other end of the scale, there are appalling cases of neglect and violence against older people.’ (HelpAge International)

If an older person is also a member of a minority or indigenous community then they are particularly marginalized and vulnerable. They are likely to experience intersectional discrimination on the basis of their age as well as their ethnic, linguistic or religious background, or indigenous status.

Minority older people are often among the poorest members of their countries. In the US, for example, poverty rates vary significantly by ethnicity among older people (aged 65 and above): 17.1 per cent of older black people and 18.7 per cent of older Hispanic people are living in poverty, compared with 6.8 per cent of older white people.[i] This is compounded by the fact older people face discrimination at work or when seeking employment, even in countries where laws are in place to prevent this.

Older people from minority or indigenous communities are also particularly vulnerable during conflict or post-conflict situations, or when natural disasters strike. For example, after the ethnic conflict in Osh, Kyrgyzstan, in June 2010, many older people were left in financial hardship: HelpAge International research conducted in the wake of the violence found that 37 per cent of older people surveyed reported having no money. However, when disaggregated by ethnicity the findings suggested an even more acute situation among the Uzbek minority, with 55 per cent of older people from their community reporting a lack of money, compared to 20 per cent of majority older Kyrgyz people. A high percentage of older Uzbek people also said they were unable to procure essential medical supplies in the aftermath of the conflict.[ii]

At the same time, older people are a key economic resource often overlooked by governments and make substantial contributions to the well-being of their families and communities. Older people in minority and indigenous communities play an important role as respected leaders and human rights activists. They help bring communities together and provide support to younger members, who may need extra support when dealing with the sense of marginalization that can come with being part of a minority or indigenous people.

Discrimination in health care

The world’s population is ageing as people are living longer. This means access to appropriate health and social care is essential to ensure that older people can enjoy healthy, active lives.

Yet older members of minority and indigenous communities experience barriers to accessing the health care they need and are entitled to. Language barriers are one of the main issues when trying to obtain health care for minority groups. Research by the Fundamental Rights Agency of the European Union on inequalities in access to health care found that language is a key barrier, particularly for minority older persons and women, who interact less with mainstream society.

Lack of consideration among health professionals of diverse cultural practices also prevents some groups from accessing health services. Muslim women living in Europe, for example, can feel uncomfortable with male medical staff or interpreters. In Thailand, Malay Muslims encounter problems in accessing health care. These include communication problems for elderly Muslims in public hospitals and the failure of some health care centres to accommodate Muslim customs.

The UN Committee on Economic, Social and Cultural Rights has outlined minimum standards for delivering on the right to health. These stipulate that health services must be provided in a manner that is compatible with cultural and linguistic rights, for example, by providing services in local languages and sensitive to different cultural practices. Charities working on older peoples’ rights have also called for culturally responsive care for older people from ethnic minority backgrounds – such as providing interpreters or providing appropriate food according to the person’s religious background.[iii]

Some minority groups are particularly prone to depression in older age. This could be due to feelings of isolation and loneliness, because of their status as a minority as well as their age. HelpAge International has reported on the devastating effects of what it terms ‘cumulative age discrimination’ – the cumulative impact of a lifetime of discrimination for older people. Minority people may have experienced discrimination all their lives, which has serious consequences in old age.[iv]

Again, older people belonging to minority and indigenous communities are likely to face barriers to gaining help for mental health issues, for example due to stigma surrounding mental health illnesses such as dementia and depression, or because of language barriers and not knowing where to go for help.[v]

On a more positive note, older people play an important role in traditional health and the collective well-being of indigenous communities. For example, in many indigenous cultures in Latin America, an elderly indigenous woman in the community is chosen each year to become the Pachamama (or Earth Mother), advising the whole community and guiding them towards a caring relationship with the environment. In the US, it has been noted that elders play a key role in preventing health problems and improving well-being among indigenous communities. There are high suicide rates among Native American communities, particularly of young people, driven by socio-economic factors such as high unemployment rates, land dispossession, marginalization, language loss, cultural disintegration and exclusion. However, family and clan relationships, reverence for elders and a deeply held spiritual life are among the key protective factors for young people’s well-being.[vi]

Land rights and housing

The land rights of older people from minorities and indigenous communities can be particularly insecure, especially in situations of conflict or land-grabbing. For many older people from minority and indigenous communities, losing their land also means the loss of their main source of income as many are occupied in work such as agriculture that is tied to their land.

For example, in Kenya, the government evictions of indigenous Ogiek from their ancestral land in the Mau Forest and around Mount Elgon has left entire communities homeless or without proper housing. This particularly affects older people, who are forced to sleep on the bare ground and are unable to access health care.[vii] Similarly, in Europe, forced evictions of Roma communities have left older people particularly vulnerable.

Being separated from traditional lands comes with many negative impacts and complications for older minority and indigenous people. During the long conflict in northern Uganda, many Acholi people lived in IDP (internally displaced persons) camps for as long as 20 years. During this time, people were separated from their land for protracted periods. When the camps were disbanded and people began to return to their land, customary rules for land tenure meant there was confusion over who owned different areas of land. In such a context, the land rights of those with the least power – widows, the disabled, the elderly – were very insecure.[viii]

Being separated from traditional lands also affects older people’s role in passing on traditional knowledge and customs to younger generations. In addition, the process of urbanization in many parts of the world has resulted in assimilation and loss of cultural knowledge systems. In Tanzania, for example, Maasai women who practise traditional medicine have found it difficult to continue upon relocation to cities, where medical boards and city authorities demand a licence and a permanent location for their work, amounting to largely unaffordable expenses.[ix]

Conclusion

Older people from minority or indigenous communities are likely to face intersectional discrimination with regard to health, work, land and other human rights issues in many parts of the world. Some non-governmental organizations are calling for an international convention to protect older people’s rights as well as the collection of disaggregated data with regard to age. Any such actions must also take into account the situation of older people belonging to minorities and indigenous peoples, while their many positive contributions must not be forgotten.

Jasmin Qureshi

[i] See: http://www.aarp.org/content/dam/aarp/research/public_policy_institute/econ_sec/2013/income-and-poverty-of-older-americans-AARP-ppi-econ-sec.pdf

[ii] Assessment Report: The Vulnerability of Older Persons in Post-conflict Osh, Kyrgyz Republic, London, HelpAge International.

[iii] See: http://www.ageuk.org.uk/documents/en-gb/for-professionals/health-and-wellbeing/id7733_dignity_on_the_ward_working_with_older_people_from_ethnic_minorities_2008.pdf?dtrk=true

[iv] See: http://www.helpage.org/silo/files/discrimination-in-old-age-multiple-cumulative-and-on-the-increase.doc

[v] See: http://www.scie.org.uk/publications/guides/guide03/minority/

[vi] MRG, State of the World’s Minorities 2013: Events of 2012, London, MRG, 2013, p.115.

[vii] Ibid, p.61.

[viii] MRG, State of the World’s Minorities 2012: Events of 2011, London, MRG, 2012, p.54.

[ix] Ibid., pp.40-41.

Photo: Pastoralist elders in Cameroon. Credit: Emma Eastwood/MRG.