Dillaway and Byrnes Reconsidering Successful Aging

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Journal of Applied Gerontology
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DOI: 10.1177/0733464809333882
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2009 28: 702 originally published online 12 May Journal of Applied Gerontology
Heather E. Dillaway and Mary Byrnes
Academic Critiques and Conceptualizations
Reconsidering Successful Aging : A Call for Renewed and Expanded
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702
Journal of Applied
Gerontology
Volume 28 Number 6
December 2009 702-722
2009 The Author(s)
10.1177/0733464809333882
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Manuscript received: November 11, 2007; final revision received: December 31, 2008;
accepted: February 12, 2009.
Authors Note: Earlier versions of this article were presented at the American Sociological
Association meetings in August 2004 and the Southern Sociological Society meetings in April
2005. The authors thank audience members for helpful comments. The authors also thank
Peter Lichtenberg, Cathy Lysack, Jay Gubrium, Victor Marshall, and anonymous reviewers
for their comments on previous drafts. Correspondence concerning this article should be
addressed to Heather E. Dillaway, Department of Sociology, Wayne State University, 2263
Faculty Administration Building, Detroit, MI 48202; e-mail: dillaway@wayne.edu.
Reconsidering Successful
Aging
A Call for Renewed
and Expanded Academic
Critiques and Conceptualizations
Heather E. Dillaway
Mary Byrnes
Wayne State University, Detroit, MI
Many scholars now critique successful aging terminology. Nonetheless, there
is incomplete analysis of the political motivations behind the development of
and/or effects of widespread use of these terms. This article suggests that
analysis of the people who developed the terms and the settings within which
they work parallels an analysis of the terms themselves and illustrates the
continuing negative perception of aging. This study fleshes out a more thor-
ough critique of the sociopolitical contexts surrounding the successful aging
paradigm so that it can help renew and expand existing critiques. The
authors conclude that researchers need to be wary of adopting successful
aging terminology without considering and expanding their understanding
of the political motivations and results that accompanies it. New, expanded
conceptualizations of successful aging are needed so that socially minded
researchers and practitioners of gerontology do not contribute to ageism and
discrimination against older adults.
Keywords: successful aging; paradigm; critique; politics; conceptualization
Article
Dillaway, Byrnes / Reconsidering Successful Aging 703
S
uccessful aging is a concept almost ubiquitous in gerontology today. As
we enter the Institute of Gerontology on our very own university campus,
we are greeted by a large sign holding the slogan, Promoting Successful
Aging in Detroit and Beyond. A perusal of the programs for the last three
meetings of the Gerontological Society of America (GSA) demonstrates that
there were over 200 presentations that held successful aging in their titles
(http://www.geron.org). A search for successful aging on the Web site for the
American Association of Retired Persons (AARP) also garners links to hun-
dreds of articles and blogs that use this language (http://www.aarp.org). Yet,
does successful aging discourse really parallel how we think, and can it help
us do what we do as scholars and practitioners of aging issues? What are the
sociopolitical forces that surround the origins of successful aging discourse
and, ultimately, should our knowledge of its origins affect our usage of suc-
cessful aging terminology? This article represents our conceptual work to
begin to understand the answers to these questions and, in doing so, we join
many other researchers in their reconsiderations of this and other similar
terminology (e.g., Estes, 2001; Holstein & Minkler, 2003; Martinson &
Minkler, 2006; Minkler & Fadem, 2002; Rudman, 2006; Schulz, 2001).
The growth in gerontology scholarship parallels the aging and retire-
ment of baby boomer cohorts in the United States and the frequently dis-
cussed crises that older adults create for Social Security and Medicaid
programs as well as for health care systems and individuals in younger
generations (Estes, 2001; Gross, 2006; Kaufman, Shim, & Russ, 2004;
Kolata, 2006; Siegel, 2004; Wysocki, 2003; Zaslow, 2002). A set of positive
aging discourses have arisen within academic, medical, policy, and popular
literatures in the last several decades, for example, on successful aging,
productive aging, resourceful aging, independent aging, healthy aging,
active aging, aging well, positive aging, normal aging, and civic engage-
ment (Angus & Reeve, 2006; Estes, 2001; Kaufman et al., 2004; Rudman,
2006). To us, these discourses are all very similar. We have had the most
contact with successful aging discourse over time, and we believe as others
do (e.g., Angus & Reeve, 2006; Scheidt, Humpherys, & Yorgason, 1999)
that it may have more impact on academic gerontology and policy arenas
than other terminologies in the last few decades.
1
Angus and Reeve (2006)
even suggested that this terminology has become a mantra of sorts in a
society eager to find ways to reduce age-related losses (p. 137).
Recent critics of the successful aging paradigm challenge mainstream
gerontology and biomedicine to avoid the usage of successful aging termi-
nology as it is currently defined and reconceptualize it on their own (e.g.,
Estes & Binney, 1989; Holstein & Minkler, 2003; Minkler & Fadem, 2002;
Rudman, 2006; Svihula & Estes, 2007). Nonetheless, existing critiques of
704 Journal of Applied Gerontology
successful aging have had little impact on mainstream gerontology, bio-
medicine, or policy arenas so farperhaps not only because some of these
critiques are so recent and have not had time to have an effect yet but also
because these critiques are still tentative and incomplete. In addition, critics
have spent more time critiquing the basic dimensions of the existing suc-
cessful aging paradigm and less time attempting to create their own, new
conceptualizations of this terminology. In this article, we urge fellow
researchers and practitioners to renew and expand their critiques so that
these critiques can be understood and consumed more fully by mainstream
gerontology, and so that we can move on to develop our own comprehensive
ideas about what successful aging means. The goal of this article is three-
fold: (a) to describe briefly current literature about and critiques of success-
ful aging, (b) to broaden critiques of the successful aging paradigm to
highlight its complex sociopolitical origins and history, and (c) to bring
renewed and expanded attention to the fact that academic gerontologists and
practitioners must be wary of any uncritical use of successful aging termi-
nology and, ultimately, extend our conceptualizationsif, indeed, we are
going to continue using this terminology in our work. Ultimately, we aim to
expand a political critique of the successful aging paradigm because we con-
sider three things simultaneously: major authors of these terms, the political
and economic contexts for the authors works, and the terms themselves
showing how successful aging discourse arose out of a very specific time
and place context. In this way, we hint at a more comprehensive history of
the sociopolitical origins of successful aging terminology than others
before us.
2
Major Themes in the Successful Aging Literature
Existing literature promotes successful aging as adaptation to the proc-
ess of growing old and methods with which individuals can age well
(Tate, Lah, & Cuddy, 2003; Torres, 2002). According to John Rowe, MD,
and Robert Kahn, PhD, the anchoring authors of this literature, those who
age successfully will show a low probability of disease and disease-
related disability, or low risk factors for disease; a high functional level
that includes both a physical component and a cognitive component; and
active engagement with life (Kahana, Kahana, & Kercher, 2003; Kahn,
2002; Rowe & Kahn, 1987, 1997, 1998). Subsequent studies also meas-
ure self-efficacy (Strawbridge, Wallhagen, & Cohen, 2002), everyday
activities (Menec, 2003), productivity (Glass, Seeman, Herzog, Kahn, &
Berkman, 1995), value orientation (Torres, 1999, 2002), allostatic load
(Seeman et al., 2005), positive spirituality as it relates to health and
disease (Crowther, Parker, Achenbaum, Larimore, & Koenig, 2002),
and social support as separate and distinct parts of success in aging.
Rowe and Kahn (1998) argued that older adults can be seen as success-
ful or usual at different moments in time as well as in individual
activities they decide to pursue; therefore, the achievement of success-
ful aging will be ongoing. The assumption is that individuals should be
able to overcome personal barriers and work toward successful aging at
all times; indeed, this is their responsibility.
Those older adults who show an absence or low risk of disease will not
have heart disease, stroke, bronchitis, diabetes, cancer, osteoporosis,
emphysema, or asthma over time (Strawbridge et al., 2002). They also do
not smoke, are not hypertensive or obese, and have a body mass index of
less than 30% over time (Strawbridge et al., 2002). Morbidity factors (e.g.,
high blood pressure, arthritis, and stomach trouble) are also used as a
measure of disease and, therefore, individuals abilities to successfully age
(Menec, 2003). Cognitive dimensions of successful aging include, among
other things, the ability to remember things without difficulty, find the
right word when talking (Strawbridge et al., 2002), recall three of six ideas
in a recall test (Glass et al., 1995), and score an acceptable level on the
short portable mental status questionnaire (SPMSQ; Menec, 2003). Other
studies concentrate on activities of daily living (ADLs) and independent
activities of daily living (IADLs; Glass et al., 1995; Menec, 2003;
Strawbridge et al., 2002).
Due to the influence of Matilda Riley (1998),
3
further operationalization
of successful aging includes measures of active engagement or social activ-
ity. Active engagement with life includes two key components: having and
maintaining interpersonal relationships and productive activities (Rowe &
Kahn, 1998). Successful aging studies have asked about interpersonal rela-
tionships and individuals satisfaction with them as well as happiness, life
satisfaction, mortality, social activities, and solitary activities of older
adults, generally 60 and older (Glass et al., 1995; Menec, 2003; Strawbridge
et al., 2002). Many studies measure productivity by quantifying hours of
paid or unpaid employment, caregiving, active volunteering, or housework
(Garfein & Herzog, 1995; Glass et al., 1995; Rowe & Kahn, 1998;
Strawbridge et al., 2002). Rudman (2006) suggested that productivity has
been measured primarily through ones paid work, however. Conceptually,
successful aging is hierarchically structured: To engage in interpersonal
relationships and have high productivity, older adults must first take
precautions to remain disease free and work to achieve and hold their dis-
ease free status (Kahana et al., 2003; Rowe & Kahn, 1998).
In measuring successful aging this way, the literature infers a calculable
gold standard of aging. In addition, via Rowe and Kahns influence, the
successful aging paradigm seems to define success as an outcome, rather
than a process. In other words, aging is not a broad biosocial process that
involves the development of new roles, viewpoints, and many interrelated
social contexts but, rather, a game which can be won or lost on the basis of
whether individuals are diagnosed as successful or usual. Successful aging
literature also intimates that individuals can control whether they contract
disease, their risk of disease, their mental health and well being, and their
level of engagement with others. As much of the aging literature adheres to
these types of quantitative, very positivistic, person-based measurements,
we are potentially characterizing aging as undesirable and preventable
(Kaufman et al., 2004).
Existing Critiques of the Successful Aging Paradigm
Anthropologists, sociologists, occupational therapists, feminist/critical
gerontologists, some humanities scholars, and other qualitative research-
ers of age identities have critiqued the current conceptualizations and
domains of study within the successful aging paradigm. They engage in
this critique either via an adherence to continuity theory or the study of
social contexts for aging and individuals social locations (e.g., Angus &
Reeve, 2006; Bearon, 1996; Becker, 1994; Gubrium, 1992; Holstein &
Minkler, 2003; Kahana et al., 2003; Kaufman et al., 2004; Luborsky, 1994;
Lysack & Seipke, 2002; Morell, 2003; Murphy, Scheer, Murphy, & Mack,
1988; Ray, 2004; Riley, 1998; Rudman, 2006; Scheidt et al., 1999). Critics
of successful aging offer alternatives to the person-based conceptualizations
of successful aging found in existing literature and political and popular
dialogue.
Continuity theory suggests that people who age most successfully are
those who carry forward the habits, preferences, lifestyles, and relation-
ships from midlife into late life (Bearon, 1996, p. 2). Featherstone and
Hepworth (1991), for instance, proposed that the baby boomers are holding
onto youthful activities as it enters midlife and beyond, and that this conti-
nuity offers the opportunity for aging to be redefined. The ideas presented
by these critics emphasize the fact that aging individuals are more similar
to youthful individuals than originally thought, and that aging individuals
are not always overcome by decline, disease, and disability (Cahan, 1997;
Kahana et al., 2003). Even if older adults do experience decline or disabil-
ity, they may not identify as unsuccessful agers and may still engage in life
activities and maintain autonomy (Becker, 1994; Cremin, 1992; Kahana
et al., 2003; Kaufman & Elder, 2002; Luborsky, 1994; Lysack & Seipke,
2002; Minkler & Fadem, 2002; Morell, 2003). Aging, at base, is a contex-
tual process, dependent on the past and present conditions of individuals
lives. Recent critics of the successful aging paradigm pay attention to these
life course contexts for aging, thereby achieving an understanding of the
cultural meanings and experiences of aging as they relate to the specific
social contexts of individuals lives, what individuals perceive as positive
versus negative aging experiences, and the changing definitions of aging
itself (Calasanti, 2004; Calasanti, Slevin, & King, 2006; Cremin, 1992;
Kahana et al., 2003; Kaufman & Elder, 2002; Lysack & Seipke, 2002;
Luborsky, 1994; Morell, 2003; Murphy et al., 1988; Ray, 2004).
One of the most important and growing critiques of the successful aging
paradigm in recent years revolves around the fact that successful aging
terminology can only speak to privileged groups experiences of aging in
U.S. society if, indeed, it speaks to any groups experience. Thus, success-
ful aging can be an exclusionary and problematic term (Angus & Reeve,
2006; Bearon, 1996; Becker, 1994; Crosnoe & Elder, 2002; Holstein &
Minkler, 2003; Kahana et al., 2003; Kaufman et al., 2004; Martinson &
Minkler, 2006; Morell, 2003; Rudman, 2006; Scheidt et al., 1999; Wray,
2003). As even Rowe and Kahn (1998) suggested, their conceptualizations
and operationalizations of successful aging can limit the number of indi-
viduals who will be seen as good at aging, for instance, they explain: [S]
ome obvious characteristics of successful physical agers appeared [within
initial research studies]. They tended to be male, white, relatively affluent,
better educated, and healthier than those who aged less well (pp. 37, 122).
Baltes and Smith (2003) further suggested that although the successful
aging paradigm may fit the experience of the young old (i.e., younger than
age 65 or 75, depending on the study), individuals in the Fourth Age (i.e.,
over age 75) cannot meet its expectations.
The creation of successful aging terminology parallels the definition and
utilization of model minority terminology (Takaki, 2000), that is, that cer-
tain racial/ethnic minorities (i.e., Asian Americans) are more successful
than others due to traits and characteristics they hold or employ. Those who
successfully age are held up to suggest that all individuals are capable of
being healthy and productive, and that society should not have to provide
help for groups when they become economically or socially dependent
(Takaki, 2000). That is, with a person-based explanation of successful
aging intact, society does not have to provide support for those who fail at
aging (Martinson & Minkler, 2006; Rudman, 2006; Scheidt et al., 1999).
The lack of in-depth attention to individuals multiple social locations is
a considerable oversight in mainstream successful aging literature and del-
egitimizes the diversity in the aging population itself (Angus & Reeve,
2006; Calasanti, 2004; Calasanti et al., 2006; Holstein & Minkler, 2003;
Kahana et al., 2003; Minkler & Fadem, 2002; Rudman, 2006; Scheidt et al.,
1999). Ultimately, this may mean that those of us who use the successful
aging paradigm in our own work (whether we are researchers, practitioners,
or policy makers) are discriminatory toward many older adults in the proc-
ess. At the very least, we make individuals define normal aging processes
more negatively than they might have without the influence of successful
aging discourse and encourage fear about the inevitable approach of aging
(Kaufman et al., 2004).
Expanding a Political Critique
In this section, we add to the important critiques outlined above and
expand on what we see as the politically and medically motivated nature of
the successful aging paradigm and the potential results of its widespread
use. Caroll Estes (e.g., in 1979, 1983, 2001) and Estes & Binney (1989) had
completed important work on the political economy of aging, and therefore
we are simply expanding on this and other critics work in this area (see
also Holstein & Minkler, 2003; Quadagno, 1999; Rudman, 2006; Schulz,
2001). Martinson and Minkler (2006) also recently critique civic engage-
ment literature in this same way because this terminology has been used
interchangeably with successful aging and other positive aging discourses
in recent years. Following these important critiques, then, we reconsider
and renew attention to the fact that the successful aging paradigm arose
directly out of political and biomedical networks in the United States and
was defined primarily by just a few individuals (perhaps only one or two).
In addition, we believe that the development and use of successful aging as
a concept may have facilitated and bolstered increased governmental con-
cern about the burden of the aging population in the United States, even
though the authors of successful aging terminology may say the opposite
(i.e., that they write to discount political or public images of aging). The
terms themselves may have become tools for furthering negative conceptu-
alizations of aging and reducing the public burden of aging individuals,
thereby discriminating against older adults. Although critics of successful
aging literature have been discussing this fact for 10 to 15 years, we need
to be more forthright about the effects of a narrow conceptualization of
successful aging than we have been and be ready to talk more openly about
the potential need to resist the use of this terminology.
To reconsider and expand a political critique of the successful aging
paradigm and its use, a multipronged analysis of the people who developed
the paradigm and the setting within which they do/did their work (i.e.,
contexts of time and place) can be as important as any existing analysis of
the terminology or paradigm itself (essentially the tools used to garner a
specific political, economic, or popular result). By focusing on both the
people and their setting, we help extend a sociopolitical/historical critique
started by scholars such as Estes (2001), Minkler and colleagues (e.g.,
Holstein & Minkler 2003; Minkler & Fadem 2002; Martinson & Minkler
2006), Schulz (2001), Scheidt et al. (1999), and others, and understand bet-
ter why/how we are continuing to view aging negatively, think in ageist
terms, see cuts made to social welfare policy for older adults, and even
discriminate against older adults ourselves.
Who Developed the Successful Aging Paradigm?
To understand successful aging, we must start with the development of
productive aging, for the latter is a precursor to the development of the
former term. The term productive aging was developed by Robert Butler,
perhaps one of the most widely known scholars in gerontology. Dr. Butler
served as the founding director of the National Institute on Aging (NIA)
from 1975 to 1985, the founder of the first department of geriatrics at the
Mount Sinai School of Medicine, and the founder, president and CEO of
the International Longevity Center (in conjunction with Mount Sinai
Hospital; http://www.ilcusa.org/who/ceo.htm). His first article on success-
ful aging appeared in 1974 in the journal Mental Health. As an expert wit-
ness, Dr. Butler has testified before the federal government on issues of the
elderly on over 50 separate occasions testifying on issues of age discrimina-
tion, the Older Americans Act (OAA), long-term care, Alzheimers disease,
home health care, healthy aging, and successful aging to name a few. He is
the author of 16 books, one of which, Why Survive? Being Old in America
(1975), won the Pulitzer Prize. He is also the author of 124 peer-reviewed
journal articles as well as 74 chapters in books (http://www.ilcusa.org/who/
ceo.htm). Ironically, Dr. Butler is widely recognized across disciplines for
having coined the term ageism in 1968 (as cited in Butler, 1975).
When Dr. Butler developed the notion of productive aging, he was direc-
tor of Mount Sinai Hospitals Geriatrics department. In a testimony before
Congress, Dr. Butler claimed to have developed the idea of productive
aging around 1978, while at Mount Sinai hospital, but it was not until 1985
that he published Productive Aging: Enhancing Vitality in Later Life. In this
book, productive aging is defined as avoidance of disease or disease sus-
ceptibility, high cognitive capacity, and active engagement with life (Butler
& Gleason, 1985).
The model of productive aging was formally discussed at the 1982
Salzburg Seminar where the participants focused on the notion of produc-
tive aging (Butler, Oberlink, & Schechter, 1990; McFadden, 2002). The
goal of the Salzburg Seminar was to bring together a group of scholars to
characterize a new outlook of the emerging older adult (McFadden, 2002).
Within this seminar, Butler and his colleagues proposed to view older
adults as agents in the last portion of their life. Gerontology, it was sug-
gested, had not yet addressed the social aspects of those advances made in
geriatrics that allowed older adults to remain healthier for a longer portion
of their life. Because older adults now live longer and healthier lives, they
argued that gerontologists must move away from models of aging that view
the older adult as passive and dependent (e.g., dependency theory). Rather,
gerontologists must propose a new model of aging that reflects the advances
made in the medical establishment. The Salzburg Seminar resulted in a
refined definition of the older adult: The notion that we can, and must
express and facilitate our personal and social productivity as we grow
older (Butler et al., 1990, p. xxxii).
The discourse from the 1982 Salzburg Seminar resulted in the sympo-
sium The Promise of Productive Aging held in Washington, D.C., in the
spring of 1987, the result of which was the edited book, The Promise of
Productive Aging, (Butler et al., 1990). The rationale of the symposium was
to bring forth knowledge about the positive ways in which people age and
the aging process (Butler et al., 1990). That the symposium was held in the
nations capital was not coincidental, as its attendants composed of schol-
ars, public leaders, and policy makers serving in the U.S. Congress. The
idea that productive aging was indeed political was explicated during this
symposium. In fact, Senator Edward Kennedy (D-MA) provided a political
statement in the preface of The Promise of Productive Aging. Included in
this same symposium and edited volume was John Rowe, MD
The idea of successful aging is discussed in Dr. Rowes contribution to
The Promise of Productive Aging (Butler et al., 1990), in which he describes
a normal aging process as a usual aging process. Rowe set forth an argument
about physiological conditions of an older population that affect physical
performance; Rowes chapter is the opening chapter to a section of The
Promise of Productive Aging, titled Work Ability in Late Life, (Butler
et al., 1990).
The subsequent discourse of successful aging was developed by John
Rowe and Robert Kahn and, like productive aging, this discourse discussed
avoidance of disease or disease susceptibility, a high cognitive capacity,
and active engagement with life (Bearon, 1996; Menec, 2003; Rowe &
Kahn, 1998), as outlined in previous sections. The tenets of the two models
or paradigms are at times indistinguishable, and there is no clear evidence
as to why productive aging became a discourse separate from, or developed
into a subsequent discourse on, successful aging. Because ideas associated
with productive aging became popularly recognized as successful aging,
and because ideas about successful aging and usual aging were initiated
within Butlers volume on productive aging, we believe the one term derived
directly from the other. The only difference is that, perhaps, Rowe empha-
sized physical functioning more within his work than Butler did in his, but
this is our speculation.
The John D. and Catherine T. MacArthur Foundation, one of many
funders of the 1987 symposium, subsequently became the primary funder
of the MacArthur Foundation Research Network on Successful Aging and
comprised 16 scholars. Led by principal investigator, Dr. Rowe, 12 of these
individuals initiated the MacArthur Foundation Studies of Aging in
America in 1988. Using results from these studies, Dr. Rowe and Robert
Kahn, PhD, a psychologist and professor of public health at the Institute for
Social Research at the University of Michigan, published the self-help,
mass-marketed book, Successful Aging, in 1997.
4
Dr. Rowe was the founding director of Harvard Medical Schools Division
on Aging until 1988, when he joined the Mount Sinai School of Medicine in
New York City. In the mid-90s, he made President Clintons short list of Food
and Drug Administration commissioner choices (Gottleib, 2000). Dr. Rowe
served as president and chief executive officer of Mount Sinai and New
York University Medical Centers from 1998 to 2000, after merging these
two hospitals. Dr. Rowe is now chairman and CEO of Aetna Inc., one of the
United States largest health care organizations. His presence there was
crucial to the financial turnaround of Aetna, which experienced a shaky
relationship not only with investors but also between doctors and the insur-
ance company: [Before Rowes leadership] few Mount Sinai doctors
accept[ed] Aetnas insurance plan anymore (Gottleib, 2000, p. 1). Thus,
Rowe is a medical doctor and businessman by trade, both of which we
argue inevitably affect his perspectives on successful aging.
The National Political Setting
From existing political critiques, we know that the creation of positive
discourses like successful aging in gerontology, biomedicine, and popular
culture parallels efforts in political arenas to recreate the national imagery of
the older adult (Estes, 2001; Estes & Binney, 1989; Martinson & Minkler,
2006; Powell, Williamson, & Branco, 1996; Quadagno, 1999; Scheidt et al.,
1999; Schultz, 2001; Svihula & Estes, 2007). Furthermore, scholars already
note that a redefinition of older adults as productive and successful within
political arenas has been linked to the neo-conservative crisis resulting from
the decreasing power of the political right in the 1960s (Estes, 2001; Powell
et al., 1996; Quadagno, 1999; Rudman, 2006; Schultz, 2001; Svihula &
Estes, 2007, 2008). At the time when Butler and Rowe were honing the suc-
cessful aging paradigm, there was a conservative Republican majority and
growing conservatism among Democrats in Congress (Svihula & Estes,
2007, p. 585), and politicians were already beginning to blame the welfare
state, particularly entitlement programs such as Social Security and Medicare,
for the U.S. fiscal problems that dominated the 1970s. Consistent expres-
sion of values aligned with market ideologyvalues with objectives of
national savings, capital accumulation, limited government responsibility,
and wealth based on individual riskallowed a Social Security crisis to
be constructed by federal politicians, in which older adults were seen as
becoming increasingly dependent on younger workers for their fiscal well
being and quality of life, even greedy in the receipt of Social Security
handouts (Svihula & Estes, 2007, p. S85; Estes, 2001; Powell et al.,
1996; Quadagno, 1999). Absolving social security into the private market
and weaning older adults off a welfare system was viewed as the solution to
U.S. economic woes and was portrayed as such by the media (Estes, 2001;
Krugman, 2005; Powell et al., 1996; Quadagno, 1999; Schultz, 2001).
Federal efforts to raise the retirement age (as a solution to the Social Security
crisis) and encourage older adults to engage in paid work longer over the
past few decades (Quadagno, 1999; Social Security Online, 2008) also coin-
cided with operationalizations of successful aging as productivity, engage-
ment, and even paid work activity (Rudman, 2006). As mentioned earlier,
Rowes first piece on successful aging was about individuals abilities to
work for pay later in life (Butler et al., 1990).
5
Although we cannot prove in this article whether the successful aging
paradigm resulted directly from specific political climates and settings, the
coincidences outlined above cannot be ignored. We believe that, at the very
least, certain political climates and settings that espoused certain ideologies
subtly encouraged first Butler and then Rowe to conceptualize productive
and successful aging paradigms in narrow ways. Ideological concerns,
rather than the issues, are central to policymaking (Svihula & Estes, 2007,
p. S79), and we argue that the ideologies behind federal policy making
about older adults in the 1980s and 1990s also probably influenced the crea-
tion of successful aging discourse in this case. Svihula and Estes (2007),
Estes (2001), Powell et al. (1996), and Schultz (2001) have put forth similar
arguments. In turn, though, the creation of academic discourse on success-
ful aging potentially facilitates governments continued desires and abilities
to make certain types of aging policy a reality or define aging adults in nar-
row ways (Svihula & Estes, 2007). Thus, the very ideologies and political
values that encourage the creation of successful aging discourse also may
thrive on that discourse once it is created. We hint at this possibility as
much as we can so that other scholars and practitioners can think about
exploring more systematically the effects of the successful aging paradigm
on recent policy making.
Schultz (2001) also believed that successful aging discourse can affect
policy making, and that it is no accident that the origins of discourses like
successful aging coincided with a change in or reconstruction of the public
and political image of the elderly as a group of deserving poor unable to
workto a more negative image of greedy geezers who are unwilling to
work (p. 62). Successful aging discourse helps refocus the political debate
and discussion about social welfare and programs for the elderly, provide
a new perspective from which to view the elderly and their needs, and
changes the way in which we think of aging and our images of older peo-
ple (Schultz, 2001, p. 62; see also Bass & Caro, 1992; Rudman, 2006;
Svihula & Estes, 2007). A conservative political and social climate mani-
fested over the last three decades that portrayed the older adult as greedy,
dependent, and living the good life at the expense of younger workers, but
these ideologies may have taken hold because they were bolstered by the
creation of political and biomedical discourses on positive aging (Angus &
Reeve, 2006; Estes, 2001; Quadagno, 1999; Rudman, 2006; Schultz, 2001).
For instance, Rowe and Kahn (1998) suggested that the relatively large
numbers of baby boomers . . . will tend to drive up health care costs (Italics
in original, p. 186). Consequently, these authors argue that the great chal-
lenge for policymakers and leaders of organizations is how best to tap the
experience, energy, and motivation of older people (Rowe & Kahn, 1998,
p. 188) because individuals do want to fight the clock (Rowe & Kahn,
1997, p. 99).
Regardless of whether Rowe and Kahn (1998) initially developed these
ideas themselves or in conjunction with politicians, once these ideas are in
print they may facilitate subsequent federal policy decisions. Although Butler,
Rowe, and Kahn suggest that they are writing to counteract the negative
images of older adultsand may have had good intentions individually
(especially since Butler publicly denounced ageism early on)in practice
their work may be used to help facilitate cuts in welfare spending and reify
the notions of greedy older adults (Rudman, 2006; Schulz, 2001). Rowe
and Kahn do not separate themselves from the construction of the national
aging crises when making their arguments; in fact, they define themselves
as acting within political contexts by urging policymakers and leaders of
organizations to think about how to encourage older adults to be self-
sufficient and engage in society (Rowe & Kahn, 1998, p. 188). Thus, per-
haps Rowe and Kahn knew of their potential influence on politics as they
wrote out the successful aging paradigm. On the other hand, to give them
the benefit of the doubt, maybe they could not realize the extent to which
their arguments would actually reinforce negative definitions of older
adults and facilitate government efforts to reduce welfare states because
they were already too much a part of the political and biomedical settings
within which they worked. We suggest that, at the very least, the initial
authors of successful aging discourse were influenced by their career tra-
jectories and the political settings in which they resided (illustrated by the
previous section). We also propose tentatively that the successful aging
paradigm may have been written with politics in mind and, if not, then suc-
cessful aging discourse (once written) still may affect current policy mak-
ing about older adults.
What evidence can we find of the influence of successful aging dis-
course on politics? Informally perusing recent transcripts from meetings of
the Subcommittee on Aging in the U.S. Congress between 2004 and 2006
(see http://aging.senate.gov), we find that Butlers and Rowes ideas are
often brought up in conversations on Medicare Reform, and Butler fre-
quently testified in Medicare hearings during these times (appearing at the
hearings approximately 50 times). Furthermore, we found several discus-
sions of a MacArthur study or the MacArthur study (presumably
headed up by John Rowe) as well as specific references to both Rowe and
Kahns work on successful aging and Butlers work on productive aging to
ground discussions of the importance of older adults staying physically
healthy and actively engaged in society, especially in conversations about
long-term care and social security.
6
We believe that any analysis of positive discourses on aging should
include attention to the complex and multifaceted political/historical con-
texts within which the people, here Butler and Rowe, developed and pro-
moted their terms. An analysis of the national political setting also
facilitates understanding of how these terms develop directly out of yet also
perhaps reinforce a particular political context. We cannot conclude defini-
tively or empirically about the exact effects of certain political climates on
specific authors or about the precise effects of the successful aging paradigm
on current policy making, but we hopefully lay out enough coincidences
about the authors of the successful aging paradigm and the sociopolitical
forces on these authors and their ideas to coax other researchers to study these
coincidences empirically. Thinking about the coincidences outlined in this
article about the people involved in the creation of successful aging discourse
and the political settings in which they worked as well as the potential evi-
dence illustrating the usage of successful aging discourse in politics today, we
could begin to think about whether Rowe and Butler are political pawns of
sorts, no matter how powerful or important these two authors/doctors/
researchers have been in their own right. Thus, perhaps the directionality of
sociopolitical forces no longer matters because both the political climate and
successful aging discourse may now affect each other simultaneously and
there is no real separation between the ideologies about older adults found in
academic discourse versus policy conversations. All of these connections and
coincidences and potential cause and effect relationships need to be exam-
ined much more thoroughly by future research than we can examine them
here. We conclude this article with some further thoughts about how to renew
and expand our and others critiques of Rowe and Kahns (1998) conceptu-
alization of successful aging, as a way to spur on this future research.
Toward Broader Conceptualizations
This article is not empirical, in that it is not based on a new data analysis.
Rather, it is a think piece that builds on existing critiques of successful
aging and points to ways in which we can continue to think seriously about
this mainstream gerontological paradigm. In this article, we reviewed the
major themes in the successful aging literature. Second, we covered recent
academic critiques of successful aging. Third, we made efforts to extend
and expand on the political critiques started by scholars like Angus and
Reeve (2006), Estes (2001), Martinson and Minkler (2006), Minkler and
Holstein (2003), Minkler and Fadem (2002), Scheidt et al. (1999), Schulz
(2001), and Rudman (2006), among others. We have attempted to show that
studying the origins of paradigms or discourses like successful aging, both
in terms of the people who author them and the settings within which these
people work, can help us understand why we are still faced with very nar-
row definitions of what it means to age well in todays society. Thinking
simultaneously about the authors of successful aging and the places/time
contexts within which the authors developed their paradigms also helps us
understand why most successful aging research has been clinical/biomedi-
cal and negative about aging processes, even though the terminology itself
is used more broadly.
Butler, while attempting to eradicate ideas of older adults as sedentary
and unproductive, unfortunately helped create a paradigm that espoused
just the opposite dictatethat older adults must remain active and fully
productive members of society. Perhaps, Butler has had good intentions
over time but his ideas were/are shaped by a particular setting (a politically
conservative policy realm) and network of people (other policy makers and
doctors).
7
Rowe derived his ideas within medical and business realms.
Within this context, it makes sense that Rowe would have to see successful
aging first and foremost as a lack of disease and usual aging as primarily a
health care cost and economic burden.
As social scientists and practitioners of aging, we must think more about
whether and how we will utilize the successful aging paradigm in our eve-
ryday work. We must ask ourselves whether it is appropriate for us to uti-
lize the successful aging paradigm if it cannot speak to a wide range of
older adult experiences and/or our own worldviews on aging, or if its
underlying ideology helps facilitate reductions in a welfare state. Ferraro
(2006) suggested that we must foster our own paradigm (rather than rely
on others) and proposes that we develop a gerontological imagination: an
awareness of the process of human aging that enables one to understand the
scientific contributions of a variety of researchers studying aging (p. 572).
We take this to mean that Ferraro is asking us to think more clearly about
a broad process of aging, not the type of aging that successful aging dis-
course typifies. Furthermore, as womens health scholars have noted
(Koeske, 1983), we are only a simple adjunct to biomedicine unless we
make efforts to define our own perspectives on what successful aging is,
and this perspective should be able to speak to all of us who fit underneath
the umbrella of gerontological studies (p. 12; see also Martinson & Minkler,
2006). Ferraro (2006) suggested that gerontology is not yet a discipline in
and of itself because it has not yet worked out these theoretical or concep-
tual issues and has not thought enough about what its intellectual and
social/public presence is and should be.
We are not Promoting Successful Aging and Beyond (as the sign at the
front of our own Institute of Gerontology suggests) until we know what
Ferraros process of human aging is and could beboth in meaning and
experiencefor a range of older adults by age, race, gender, class, disabil-
ity, work status, and other social locations and contexts. As researchers and
practitioners, we may want to use the successful aging paradigm to under-
stand some of the unique challenges of older adults. Because of its political
and biomedical origins, however, we cannot assume the successful aging
paradigm to be inclusionary to the various perspectives, structures, and
social locations that older adults occupy. Should we continue to use current
definitions of successful aging, we risk buying into an exclusionary, ageist,
and even discriminatory perspective that does not suit or parallel our intel-
lectual or advocacy goals. We may not only contribute to ageism but also
help discriminate against the very people we are trying to serve as we
engage in our academic research or more applied endeavors.
Eventually, we as social scientists and practitioners of aging should be
able to enter into dialogue with biomedical researchers and policy makers
as equals
8
and debate the tenets of the successful aging paradigm, but, so
far, few scholars seem to be able to do this because we have not done the
conceptual and methodological work that would form the basis for this
dialogue. Hopefully, our article makes it clear that we have not completely
finished our critique of the successful aging paradigm or discourse, let
alone thought enough about what our own ideas of successful aging really
are. We have more conceptual work to do before we can fully debate and
challenge the use of successful aging terminology. For now, we do remain
Koeskes adjunct to biomedicine (1983). Angus and Reeve (2006), Rudman
(2006), Scheidt et al. (1999), and Estes (2001) intimated that we might be
the adjunct of federal politics as well, if we unthinkingly continue to adopt
a preestablished, narrowly defined paradigm or discourse in our own
research. Alongside many other critical gerontologists, we argue that the
academic use of successful aging terminology has limited the scope of
aging research, in that successful aging is defined from the outside, rather
than by aging individuals or academic researchers and practitioners (Kahana
et al., 2003; Martinson & Minkler, 2006).
Especially because we currently exist in a politically conservative climate,
researchers and practitioners need to be wary of adopting successful aging
terminology in their everyday work without understanding the sociopolitical
forces that surround their origin and should work on thinking about the
effects of our utilizations of the successful aging paradigm as it stands and
broadens our own conceptualizations. This piece is meant to provoke more
conceptual and empirical work, for we believe that social scientists in geron-
tology must reconsider, renew, and expand our ideas on this topic. Hopefully,
this article will spur practitioners of aging to second-guess their use of the
existing successful aging paradigm when dealing one-on-one with aging
individuals as well, and to look for the ideologies behind the aging policies
that they confront on a daily basis. Alongside researchers, practitioners must
begin to analyze systematically how the existing successful aging paradigm
may limit how we serve local aging populations. As Weber (2001) suggested,
we must engage in our everyday work with social justice in mind and think
about how to advocate for the populations we study. If existing positive aging
paradigms and terminology cannot help us search for social justice for the
populations we study or serve, then we have an obligation to step back and
conceptualize our own positions on aging. Eventually, we need to step out-
side of our safe, discipline- or practice-bound work spaces with a new para-
digm or discourse, based in empirical evidence, which will help explain the
lived experiences of older adults.
Notes
1. This does not refute the importance of all of these individual terminologies, as they all
serve their own purpose in specific time/place contexts. Each discourse on aging should be
examined separately.
2. In this endeavor we write about the U.S. setting only.
3. Initially Rowe and Kahn (1997, 1998) did not conceptualize engagement with life or
productivity as a dimension of successful aging, until they were critiqued by Matilda Riley
(1998) for their paradigms narrowness. Engagement is now the third precondition of success-
ful aging, coming after physical and cognitive function in importance. We thank an anony-
mous reviewer for alerting us to Rileys critique and contribution.
4. Based on our conversations with multiple colleagues, we believe that Dr. Kahn was not
as politically connected as Rowe when he helped to develop the successful aging paradigm.
We also suspect that Kahns participation in the successful aging project and his connection to
Rowe was minimal at best, although we have not been able to confirm this; thus, we confine
our analysis of people and their political connections to Rowe and Butler. Perhaps, Dr. Kahn
was added as an author to legitimate Rowes work outside of biomedicine and politics, as his
involvement could facilitate academic attention to the successful aging paradigm.
5. A parallel advocacy of private (vs. public) elder care by individuals in political sectors
is evident in the United States and Canada in the last decade or so, as government bodies attempt
to cut back on spending for formal care and release older adults care to their families (Ward-
Griffin & Marshall, 2003, p. 2). The denial of physical and emotional caregiving by public institu-
tions also corresponds to the growth of the successful aging mantra (Angus & Reeve, 2006).
6. Our brief analysis of subcommittee hearings was not systematic at all; rather, we perused
subcommittee transcripts only to see whether there was any evidence of successful aging dis-
course within political arenas. Future research is needed on exactly how often and to what extent
this and other positive aging discourses affect policy creation within these forums because this
was not our goal here. Svihula and Estes (2007) provided a good model for this activity.
7. In his current emphasis on longevity, we believe that Butler is an important advocate of
extending health in aging (Olshansky, Perry, Miller, & Butler, 2006); thus, on the surface,
Butlers work seems to advocate for older adults. Nonetheless, in the pursuit of longevity and
health in aging, Butler and his colleagues are arguing that longer, healthier life should be
pursued because it can mean greater wealth for individuals and nations (Olshansky et al.,
2006, p. 31). Indeed, [h]ealthy older individuals accumulate more savings and investments
than those beset by illness. They tend to remain productively engaged in society (Olshansky
et al., 2006, p. 31). Therefore, Butler and other authors of the newest positive aging discourses
have not stepped back from their connections to certain political climates and/or market ide-
ologies for understanding aging, and still seem to be influenced by these climates and ideolo-
gies as they write.
8. One of our colleagues refers to gerontology as the red-headed stepchild of biomedi-
cine, always seeking the approval of clinical/biomedical fields and political entities rather
than trying to be a discipline in our own right with our own paradigms and goals. We suspect
that Ferraro (2006) might agree with this analogy in part, as this comment illustrates our lack
of ability to develop our own ideas about successful aging outside of biomedicine (see also
Estes & Binney, 1989).
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Heather E. Dillaway is an associate professor and director of undergraduate studies in sociol-
ogy at Wayne State University. Her broad research interests lie within the study of womens
health and structural inequalities (age, gender, race, class, and sexuality). Her current research
project focuses on how womens experiences of menopause and midlife are shaped by their
social locations and contemporary social contexts.
Mary Byrnes is a PhD candidate in sociology at Wayne State University and an instructor at
Loyola University Chicago. She is finishing a dissertation on individuals transitions into an
urban age-segregated living facility and meanings of home. Her research agenda is focused on
inequalities in aging and the sociology of place.
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