ABSTRACT

The emergence of the new coronavirus and the indication of the elderly population as a risk group led to the emergence of speeches, jokes, memes and facts indicative of ageism in social media and mass media. This article aims to analyze the expressions and implications of ageism toward the elderly reported in newspapers in Brazil and Chile in the first year of the COVID-19 pandemic. Documentary study of news from newspapers with the greatest access in Brazil and Chile. Data collection occurred in May 2021. The selection of titles, abstracts and full text was performed by two independently and blinded researchers. The final corpus of 89 news was submitted to thematic analysis supported by the MAXQDA software, whose codification, thematization and interpretation process was based on sociological theories that explain ageism. The expressions of ageism were evidenced through images and attitudes that devalue and depreciate the life of the elderly people, positioning them as ‘the other’ of the pandemic, which has implications for the life, health and work of this population.

KEYWORDS
Ageism; COVID-19; Aged; News; Internet

Introduction

The crisis caused by the COVID-19 virus not only exposed the precariousness of health systems in Latin America, but also highlighted social inequalities in the health-disease-care process and deepened the debate around the right to health of vulnerable groups and populations, reinforcing the social character of any pandemic.

In Brazil, the period before the COVID-19 pandemic was already marked by crises in the economic sector, aggravating the historic deficit of financing of the Unified Health System (SUS), accompanied by the systematic dismantling of social and health policies^{11 Morais H, Oliveira R. Saúde é Política. A pandemia da COVID-19 é Política: apontamentos para o debate. Estudos Universitários Revista de Cultura. 2020 [acesso em 2022 jul 18]; 37(1):16-29. Disponível em: https://periodicos.ufpe.br/revistas/estudosuniversitarios/article/view/248 760.
https://periodicos.ufpe.br/revistas/estu...} . The financial restriction was also substantiated with the approval of Constitutional Amendment No. 95, which froze investments in education and health for 20 years^{22 Brasil. Presidência da República. Casa Civil. Subchefia para assuntos jurídicos. Emenda Constitucional n. 95, de 15 de dezembro de 2016. Altera o Ato das Disposições Constitucionais Transitórias, para instituir o Novo Regime Fiscal e dá outras providências. Brasília, DF: Casa Civil; 2016.}. Therefore, the pandemic has settled in a country of great social inequalities, with populations living in precarious conditions of housing and sanitation, with high unemployment rates and deep cuts in social policies^{33 Werneck GL, Carvalho MS. A pandemia de COVID-19 no Brasil: crônica de uma crise sanitária anunciada. Cad. Saúde Pública. 2020 [acesso em 2022 jul 16]; 36(5). Disponível em: https://doi.org/10.1590/0102-311X00068820.
https://doi.org/10.1590/0102-311X0006882...} .

Before the pandemic, Chile experienced a moment of intense demonstrations in the streets, triggered by the increase in the price of transport, but which also reflected dissatisfaction with the intense economic burden, inequalities and social injustices accumulated over 30 years. These manifestations made explicit a number of adversities produced in the last three decades, leading international organizations to discuss serious violations of human rights. Undoubtedly, this social crisis has deepened with the COVID-19 pandemic, exacerbating citizens’ dissatisfaction with the government, the structural problems of social security, the lack of resources for health and education, and the precarious living conditions of large cities, which revealed inequalities and inequities^{44 Flores RAR, Abagaro CP, Alves SV, et al. Impactos del COVID-19 en América Latina: políticas sanitarias disímiles, resultados dispares. La situación de Argentina, Brasil, Chile y México. In: Pereira AC, Boy M, Rosales FRA, et al., editores. La pandemia social de COVID-19 en América Latina: reflexiones desde la Salud Colectiva. 1. ed. Ciudad Autónoma de Buenos Aires: Teseo; 2021. p. 29-65.}, which signals an important impact on the most vulnerable populations, including the elderly, who have always been the target of inattention and stereotypes^{55 Bernardini D. Nueva normalidad, nueva longevidad: ser mayor en tiempos de COVID-19. In: Marín CR, editor. La vejez. Reflexiones de la post pandemic. Medellín: Opción Colombia; 2020 [acesso em 2022 jul 15]. p. 65-80. Disponível em: https://archivo.cepal.org/pdfs/ebooks/vejez_reflexiones_post_pandemia.pdf.
https://archivo.cepal.org/pdfs/ebooks/ve...} .

In both contexts, there was a growing debate in the media about the social place of older people during the pandemic and the expression of ageism by different sectors of society. The public discourse conveyed in the media, which presented COVID-19 as a dangerous disease only for the elderly, due to a greater biological risk of illness and complications, generated the ‘us’ and ‘them’ dichotomy, evidenced worldwide and that potentiated stereotypes, prejudices and age discrimination^{66 Fraser S, Lagacé M, Bongué B, et al. Ageism and COVID-19: what does our society’s response say about us? Age Ageing. 2020 [acesso em 2022 jul 18]; 49(5):692-695. Disponível em: https://doi.org/10.1093/ageing/afaa097.
https://doi.org/10.1093/ageing/afaa097...} .

First used by the gerontologist and psychiatrist Butler^{77 Butler RN. Age-ism: Another form of bigotry. The Gerontologist. 1969 [acesso em 2022 jul 17]; 9(4):243-246. Disponível em: https://academic.oup.com/gerontologist/article-abstract/9/4_Part_1/243/569551?redirectedFrom=fulltext&login=false.
https://academic.oup.com/gerontologist/a...} , the term ‘ageism’ refers to the restlessnes s, repulsion and aversion on the part of young and middle-aged people towards aging, illness, disability, in addition to the fear of impotence, uselessness and death, which is usually attached to people because of their age.

Ageism can be manifested through three dimensions: cognitive (stereotypes, images and labels), affective (prejudice) and behavioral (discrimination attitudes). And it can be originated from three levels: the microstructural, which emerges from the subject (self-directed ageism), his thoughts, emotions and actions; the mesostructural, which can come from groups, social entities, institutions; and the macrostructural, which emerges from cultural or social values as a whole^{88 Ayalon L, Tesch-Romer C. Introduction to the Section: Ageism-Concept and Origins. In: Ayalon L, Tesch-Romer C, editores. Contemporary Perspectives on Ageism. Springer One; 2018. p. 1-10.}. Its manifestation can be explicit or implicit and generate negative consequences when the subject is reduced to the category of useless, fragile and unnecessary^{99 Butler RN. Ageism: A Foreword. J. Soc. Nat. Inst. Aging. 1980 [acesso em 2022 jul 16];36(2):8-11. Disponível em: https://doi.org/10.1111/j.1540-4560.1980.tb02018.x.
https://doi.org/10.1111/j.1540-4560.1980...} , causing repercussions in different areas of the elderly people’s lives^{1010 Marques S, Mariano J, Mendonça J, et al. Determinants of Ageism against Older Adults: A Systematic Review. Int J Environ Res Public Health. 2020 [acesso em 2022 jul 15]; 17(7):2560. Disponível em: https://doi.org/10.3390%2Fijerph17072560.
https://doi.org/10.3390%2Fijerph17072560...} . Thus, in the course of the pandemic, ageism reached a new level with the indexing on social networks of the hashtag #BoomerRemover, a vulgar expression that highlights prejudiced attitudes about age in response to the COVID-19 pandemic and reveals the value that people’s lives have in contemporary society^{66 Fraser S, Lagacé M, Bongué B, et al. Ageism and COVID-19: what does our society’s response say about us? Age Ageing. 2020 [acesso em 2022 jul 18]; 49(5):692-695. Disponível em: https://doi.org/10.1093/ageing/afaa097.
https://doi.org/10.1093/ageing/afaa097... ,1111 Lichtenstein B. From “Coffin Dodger” to “Boomer Remover”: Outbreaks of ageism in three countries with divergent approaches to coronavirus control. J Gerontol B Psychol Sci Soc Sci. 2021 [acesso em 2022 jul 18]; 76(4):e206-e212. Disponível em: https://doi.org/10.1093%2Fgeronb%2Fgbaa102.
https://doi.org/10.1093%2Fgeronb%2Fgbaa1...} . The use of the hashtag allows for asynchronous and immediate communication on social networks, which goes beyond borders and time zones and has an instant global reach^{1212 Vervoort D, Luc JG. Hashtag Global Surgery: The role of social media in advancing the field of global surgery. Cureus. 2020 [acesso em 2022 jul 18]; 12(6):e8468. Disponível em: https://doi.org/10.7759%2Fcureus.8468.
https://doi.org/10.7759%2Fcureus.8468...} .

It is known that the media and, currently, social networks have an impact on collective and individual health and are essential to shape beliefs, promote values and encourage negative and positive behaviors. This impact, to some extent, serves the interests of large corporations, who see in the media the tools to achieve their goals and stimulate demand for products, often unnecessary, that can be harmful to people’s health, especially in the promotion of values and in the mediation of diverse behaviors^{1313 Feo Acevedo C, Feo Istúriz O. Impacto de los medios de comunicación en la salud pública. Saúde debate. 2013 [acesso em 2022 jul 18]; 37(96):84-95. Disponível em: https://doi.org/10.1590/S0103-11042013000100010.
https://doi.org/10.1590/S0103-1104201300...} . As information is a valuable mechanism to guide people, especially in highly complex situations, such as the one generated by the COVID-19 pandemic, the media either helps to reduce uncertainty and anxiety or, on the contrary, can increase panic and the chaos^{1414 Casero-Ripollés A. Impacto da Covid-19 nos sistemas de mídia: consequências comunicativas e democráticas do consumo de notícias durante o surto. Comunicação e Educação. 2020 [acesso em 2022 jul 19]; 25(1):109-129. Disponível em: https://doi.org/10.11606/issn.2316-9125.v25i1p109-129.
https://doi.org/10.11606/issn.2316-9125....} .

Studies concerning ageism against elderly people in the COVID-19 pandemic are still scarce. A review^{1515 Silva MF, Silva DSM, Bacurau AGM, et al. Ageismo contra idosos no contexto da pandemia da covid-19: uma revisão integrativa. Rev. Saúde Pública. 2021 [acesso em 2022 jul 18]; 55(4). Disponível em: http://dx.doi.org/10.11606/s1518-8787.2021055003082.
http://dx.doi.org/10.11606/s1518-8787.20...} analyzed 21 publications that discussed ageism during the pandemic, its origins, consequences and ethical-political implications, with only 9.5% of primary studies, which shows the need for more investigations on the subject.

That said, this analysis of newspapers becomes unprecedented and contributes to deepening knowledge and reflections about this phenomenon.

News about the portrait of ageism in Chile were considered due to actions established by the Chilean government, which prohibited elderly people from leaving their homes at the beginning of the pandemic, instituting mandatory quarantine, which is an expression of ageism^{1616 Chile. Ministerio de Salud. Resolución n. 215 exenta. Dispone medidas sanitárias que indica por brote de COVID-19. Diario Oficial de la republica de Chile. N.42.619-B. Santiago. 30 Mar 2020.,1717 Chile. Ministerio de Salud. Resolución n. 347 exenta. Dispone medidas sanitárias que indica por brote de COVID-19. Diario Oficial de la republica de Chile, N. 42.655. Santiago. 13 Mayo 2020.}. In Brazil, an aging country and the country of origin of the authors of this study, ageism was not so restrictive to the elderly, but it also brought multidimensional damage to those over 60 years of age. Furthermore, Brazil and Chile are countries that are geographically close.

Therefore, the study aims to: analyze the expressions and implications of ageism against the elderly reported in newspapers in Brazil and Chile in the first year of the COVID-19 pandemic.

Methodology

This is a qualitative research, of the documentary type, in which current materials were analyzed, in order to contextualize historical, cultural, social and economic aspects of a place or group of people, at a given moment in history^{1818 Fonseca JJS. Metodologia da pesquisa científica. Fortaleza: UEC; 2002. (Apostila).}.

The data collection sources were two of the most read newspapers in Brazil and Chile in online and digital versions and whose choice was justified by the report of the Reuters Institute/Digital News Report 2021, from the University of Oxford^{1919 Newman N, Fletcher R, Schulz A, et al. Reuters Institute Digital News Report 2021. Reut. Inst. Stud. J. 2021. [acesso em 2021 out 19]. Disponível em: https://ssrn.com/abstract=3873260.
https://ssrn.com/abstract=3873260...} , which analyzes the consumption of news by people from several countries in the world, through TV, radio and internet, and points out that 85% of Brazilians and 84% of Chileans consume news via the internet. In Brazil, the most read newspapers in 2021 were ‘O Globo’ (27%) and ‘Folha de São Paulo’ (18%), and in Chile they were ‘El Mostrador’ (21%) and ‘La Tercera’ (20%).

The data collection process began with a preliminary search in March 2021 in the information sources of the two countries, in order to identify the terms used in the retrieved articles and, thus, choose the keywords to compose the search strategy, being: edadismo; marginacion; discriminación por edad; prejuicio de la edad; estereotipos de edad; vejez; anciano; adulto maior; gerontofobia; ancianos pandémicos; envejecer; viejismo; ageísmo; idadismo; etarismo; preconceito etário; estereótipos de idade; discriminação de idosos; gerontofobia; estigma de idade.

The eligibility criteria were news about ageism against the elderly, published between January 2020 and April 30, 2021, a period demarcated due to the decree, by the World Health Organization (WHO), of the outbreak of the new coronavirus as an international public health emergency^{2020 Organização Pan-americana da Saúde, Organização Mundial da Saúde. OMS afirma que COVID-19 é agora caracterizada como pandemia; 2020. [acesso em 2021 jun 19]. Disponível em: https://www.paho.org/pt/news/11-3-2020-who-characterizes-covid-19-pandemic.
https://www.paho.org/pt/news/11-3-2020-w...} , and the end of the first quarter of 2021, when the vaccination of elderly people was achieved in the study contexts. News that contained only videos and images were excluded.

The data collection and selection stage was developed as follows: in the first stage, the keywords were inserted, one by one, in the search fields of the newspapers; and all retrieved news that met the temporal inclusion criteria were saved and organized in the Zotero reference manager (https://www.zotero.org/). This search took place in May 2021 in all sections of the newspapers and aimed to retrieve as many publications as possible. In the second phase, duplicate news items were excluded using the EndNote tool (Clarivate, PA, USA), web version. The third phase took place with the screening of titles and abstracts using the Rayyan tool (https://www.rayyan.ai/). In the fourth phase, the full reading of the news was carried out in order to identify whether they met the eligibility criteria. The third and fourth phases were performed by two researchers independently and blindly. At the end of this process, a third researcher involved in the study dedicated herself to resolving the differences between the two researchers regarding the inclusion or exclusion of the articles. The results are presented in the flowchart extension for scope reviews (PRISMA-Scr)^{2121 Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018 [acesso em 2022 jul 18]; 169(7):467-473. Disponível em: https://doi.org/10.7326/m18-0850.
https://doi.org/10.7326/m18-0850...} . The excluded articles were quantified, and the reasons justified (figure 1).

Data analysis was conducted through thematic analysis of Braun and Clarke^{2222 Braun V, Clarke V. Using thematic analysis in psychology. Qualitative Research in Psychology. 2006 [acesso em 2022 jul 17]; 3(2):77-101. Disponível em: https://www.tandfonline.com/doi/abs/10.1191/1478088706qp063oa.
https://www.tandfonline.com/doi/abs/10.1...} following the following stages:

Familiarization with the data, in which the news articles were organized in a Microsoft Word file and read in full to identify possible patterns in the terms used.

Deductive generation of codes, carried out from the theoretical framework of ageism by Butler^{99 Butler RN. Ageism: A Foreword. J. Soc. Nat. Inst. Aging. 1980 [acesso em 2022 jul 16];36(2):8-11. Disponível em: https://doi.org/10.1111/j.1540-4560.1980.tb02018.x.
https://doi.org/10.1111/j.1540-4560.1980...} , with support of the MAXQDA software, version 2020. Initially, 22 news items were coded by the first and second authors independently and blindly, and divergences were discussed and agreed on in a meeting with the last author. After this step, the Kappa Index of 0.95 was verified, which represents the level of agreement between the coders during the material encoding phase. The entire analytical process was conducted using the MAXQDA softwere, by researchers who have expertise in the area of gerontology, in studies on stigma and vulnerable populations.

The research of themes began with the generation of codes in the previous stage, and now, the organization of codes into themes was carried out, guided by the theoretical framework of ageism in the light of Buther^{99 Butler RN. Ageism: A Foreword. J. Soc. Nat. Inst. Aging. 1980 [acesso em 2022 jul 16];36(2):8-11. Disponível em: https://doi.org/10.1111/j.1540-4560.1980.tb02018.x.
https://doi.org/10.1111/j.1540-4560.1980...} , expanded by theories of micro, meso and macro levels, by Ayalon and Tesch-Römer^{88 Ayalon L, Tesch-Romer C. Introduction to the Section: Ageism-Concept and Origins. In: Ayalon L, Tesch-Romer C, editores. Contemporary Perspectives on Ageism. Springer One; 2018. p. 1-10.}, which explain the origins of ageism.

The revision of the themes took place when the authors met and validated themes and the entire analysis, to ensure: credibility, established through discussion between the authors of the study; reliability, met through independently peer-to-peer coding, with resolution of divergences by a third researcher; and confirmability, obtained through discussion of preliminary results with a group of researchers^{2323 Guba EG, Lincoln YS. Competing paradigms in qualitative research. In: Denzin NK, Lincoln YS, editores. Handbook of qualitative research. Thousand Oaks: Sage; 1994. p. 105-117.}.

For the production of the final report, extracts from the news were selected and related to the research question and the literature.

The ethical aspects of the research were observed by complying with Brazilian ethical standards, recommended in Resolution No. 510/2016, of the National Health Council of Brazil, and by Federal Law No. 9,610, of February 19, 1998. As the data is in the public domain and does not require contact with human beings or impose limitations related to privacy, security or access control, this study does not require the evaluation of the ethics committee.

Results

Of the 89 news that composed the corpus of analysis of this study, 38.2% were from the newspaper ‘Folha de São Paulo’, followed by ‘O Globo’ (23.2%), ‘La Tercera’ (21.3%) and ‘El Mostrador’ (16.9%). The evolution of the amount of news over time is shown in graph 1, and the decline in news about ageism against the elderly in Brazilian newspapers as the pandemic progresses is noteworthy; and, in Chile, the largest amount of news occurred in the months of May and September 2020.

Regarding the nature of the news published in Brazilian newspapers, 78% were of the opinion type, 15% interviews and 5% of other types. In Chile, 76% were opinion, 5% interviews and 11% other types. It is noteworthy that both the opinions and the interviews had the participation of gerontologists, judges, researchers, doctors and other specialists in the area.

Newspapers from both countries covered news that showed stereotypes, prejudice and age discrimination during the COVID-19 pandemic, originating from the microstructural levels (from the elderly person themselves, which is self-directed ageism); mesostructural, composed of managers and politicians, health and social institutions, the labor market, the media, family members of elderly people; and the macrostructural level, which involves culture, society and the State (table 1). Although this investigation sought to operationalize the levels for the analysis of the information conveyed, the intersectionality that exists in each of them is recognized, not being understood as manifestations limited to a single level.

Some of the news published analyzed how ageism was revealed in Chilean and Brazilian societies during the pandemic, based on the restrictive measures adopted by governments and health authorities to contain the spread of the disease and which resulted in the potentialization of this phenomenon in the contexts studied. The implications of this phenomenon for the elderly and for society are reported in table 2.

A representative synthesis of the findings of this study is shown in figure 2.

Discussion

The COVID-19 pandemic and the first measures to combat the new coronavirus, which targeted the elderly, aroused comments, opinions and editorials from scholars about the reality of ageism that was growing in the world and warned of the consequences of this phenomenon<sup>66 Fraser S, Lagacé M, Bongué B, et al. Ageism and COVID-19: what does our society’s response say about us? Age Ageing. 2020 [acesso em 2022 jul 18]; 49(5):692-695. Disponível em: https://doi.org/10.1093/ageing/afaa097.
https://doi.org/10.1093/ageing/afaa097... ,2424 Armitage R, Nellums LB. COVID-19 and the consequences of isolating the elderly. Lancet Public Health. 2020 [acesso em 2022 jul 18]; 5(5):e256. Disponível em: https://doi.org/10.1016/S2468-2667(20)30061-X.
https://doi.org/10.1016/S2468-2667(20)30...

25 Previtali F, Allen LD, Varlamova M. Not Only Virus Spread: The Diffusion of Ageism during the Outbreak of COVID-19. J Aging Soc Policy. 2020 [acesso em 2022 jul 17]; 32(4-5):506-514. Disponível em: https://doi.org/10.1080/08959420.2020.1772002.
https://doi.org/10.1080/08959420.2020.17...

26 Ayalon L. There is nothing new under the sun: ageism and intergenerational tension in the age of the COVID-19 outbreak. Int Psychogeriatr. 2020 [acesso em 2022 jul 16]; 32(10):1221-1224. Disponível em: https://doi.org/10.1017%2FS1041610220000575.
https://doi.org/10.1017%2FS1041610220000... -2727 Skoog I. COVID-19 and mental health among older people in Sweden. Int. Psychogeriatr. 2020 [acesso em 2022 jul 27]; 32(10):1173-1175. Disponível em: https://doi.org/10.1017/s104161022000143x.
https://doi.org/10.1017/s104161022000143...</sup> .

Protective measures were initially focused on the elderly, as the case fatality rates were alarming for this population. Among the deaths confirmed by COVID-19 in Brazil, 75% occurred in individuals over 60 years of age. In addition, 74% of them had at least one risk factor, such as heart disease, lung disease, neurological and renal disease^{2828 Brasil. Ministério da Saúde, Secretaria de Vigilância em Saúde. Boletim Epid. 2020 [acesso em 2020 set 21]; (9). Disponível em: https://portalarquivos.saude.gov.br/images/pdf/2020/April/12/2020-04-11-BE9-Boletim-do-COE.pdf.
https://portalarquivos.saude.gov.br/imag...} . In Chile, the fatality rate was 12.6% for the year 2020 (in all continents, the global lethality was 3.6%), and the mortality from COVID-19 was 433.5 x 100,000 inhabitants in people aged 60 years or older^{2929 Chile. Ministerio de Salud, Subsecretaría de Salud Pública División de Planificación Sanitaria, Departamento de Epidemiología. Informe Epidemiológico. Personas Mayores con COVID-19. Santiago: MS; 2020. [acesso em 2021 set 21]. Disponível em: http://epi.minsal.cl/wp-content/uploads/2021/06/PM_COVID_SE_24_2021.pdf.
http://epi.minsal.cl/wp-content/uploads/...} .

Given the seriousness of the situation, these people were characterized as belonging to the risk group, based on chronological age, regardless of associated health conditions. This decision was considered arbitrary by experts on aging, given that other aspects interfere with morbidity and mortality, in addition to age, such as physical conditions, prognosis of previous diseases and behaviors that imply the emergence of diseases and social determinants^{3030 Rahman A, Jahan Y. Defining a ‘Risk Group’ and Ageism in the Era of COVID-19. J Loss Trauma. 2020 [acesso em 2022 jul 17]; 25(8):631-634. Disponível em: https://doi.org/10.1080/15325024.2020.1757993.
https://doi.org/10.1080/15325024.2020.17...} . Another consideration is that the ‘risk group’ label minimizes the severity of the pandemic, as ‘only’ older people would be exposed to COVID-19, bringing a false idea that younger people were immune to infection and death from the coronavirus, which may have made it difficult for people of other age groups to adhere to compliance with the coping measures^{2626 Ayalon L. There is nothing new under the sun: ageism and intergenerational tension in the age of the COVID-19 outbreak. Int Psychogeriatr. 2020 [acesso em 2022 jul 16]; 32(10):1221-1224. Disponível em: https://doi.org/10.1017%2FS1041610220000575.
https://doi.org/10.1017%2FS1041610220000...} .

The news in Chile pointed to decrees by public authorities forbidding people over 75 years of age to leave their homes, except with authorization in strict situations^{1616 Chile. Ministerio de Salud. Resolución n. 215 exenta. Dispone medidas sanitárias que indica por brote de COVID-19. Diario Oficial de la republica de Chile. N.42.619-B. Santiago. 30 Mar 2020.,1717 Chile. Ministerio de Salud. Resolución n. 347 exenta. Dispone medidas sanitárias que indica por brote de COVID-19. Diario Oficial de la republica de Chile, N. 42.655. Santiago. 13 Mayo 2020.}. This measure may have affected not only people’s dignity, by restricting their autonomy, but may also compromise the economic subsistence of families^{3131 Torres-Marín B. El derecho a envejecer con dignidad no se confina. In: Marín CR, editor. La vejez: reflexiones de la postpandemia. Medellín: Opción Colombia; 2020. p. 225-233. [acesso em 2022 jul 19]. Disponível em: https://archivo.cepal.org/pdfs/ebooks/vejez_reflexiones_post_pandemia.pdf.
https://archivo.cepal.org/pdfs/ebooks/ve...} , in addition to exposing them to abandonment, prejudice, discrimination and the invisibility of their needs^{3232 Muñoz CM, Hidalgo FA. La sobrevivencia en la vejez en Chile: lo que muestra la pandemia sobre la protección social. In: Abagaro CP, Boy M, Flores RAR, et al., editores. La pandemia social de COVID-19 en América Latina: reflexiones desde la Salud Colectiva. Ciudad Autónoma de Buenos Aires: Teseo; 2021. p. 251-272. [acesso em 2022 jul 18]. Disponível em: https://www.teseopress.com/pandemiasocial/chapter/la-sobrevivencia-en-la-vejez-en-chile-lo-que-muestra-la/.
https://www.teseopress.com/pandemiasocia...} .

The recommendation of strict social distancing of the elderly population was necessary due to the higher severity and lethality rates of the disease, however, the measures implemented by governments should have been adapted to the local culture and expectations and accompanied by the will of the population itself to follow these indications^{3333 Ochoa-Rosales C, Gonzalez-Jaramillo N, Vera-Calzaretta A, et al. Impacto de diferentes medidas de mitigación en el curso de la pandemia de COVID-19 en Chile: proyección preliminar para el período del 14 de abril al 14 de mayo. Rev. salud pública. 2020 [acesso em 2021 out 1]; 22(2):e205. Disponível em: https://doi.org/10.15446/rsap.v22n2.86380.
https://doi.org/10.15446/rsap.v22n2.8638...} .

In general, the opinions of scholars heard by the newspapers about strategies to combat the evolution of the disease assume that, even with the intention of protecting the elderly, they were implemented without considering the specificities and heterogeneity of aging. Elderly people were seen as a problem, and the way to solve it was through social segregation, indistinctly^{1111 Lichtenstein B. From “Coffin Dodger” to “Boomer Remover”: Outbreaks of ageism in three countries with divergent approaches to coronavirus control. J Gerontol B Psychol Sci Soc Sci. 2021 [acesso em 2022 jul 18]; 76(4):e206-e212. Disponível em: https://doi.org/10.1093%2Fgeronb%2Fgbaa102.
https://doi.org/10.1093%2Fgeronb%2Fgbaa1...} .

Justifying the restrictive measures and the confinement of the elderly person only by the chronological age and the biological character of senility was configured in an inappropriate way of protecting them, since the aging process, as well as the health-disease process, is multidimensional and encompasses the social, cultural, economic, psychological, spiritual, affective and historical contexts, which at all times surround and stress people’s way of living.

The argument of immunological weakness to confine the elderly person disregards all the elements that influence the health-disease process and neglects the inequalities, inequities and exclusions to which this population group is exposed on a daily basis. Still, it is known that ageism can be more lethal than the coronavirus itself^{3131 Torres-Marín B. El derecho a envejecer con dignidad no se confina. In: Marín CR, editor. La vejez: reflexiones de la postpandemia. Medellín: Opción Colombia; 2020. p. 225-233. [acesso em 2022 jul 19]. Disponível em: https://archivo.cepal.org/pdfs/ebooks/vejez_reflexiones_post_pandemia.pdf.
https://archivo.cepal.org/pdfs/ebooks/ve...} .

Newspaper articles showed discriminatory images and attitudes towards the elderly that preceded the pandemic, but which were strengthened when the world sought to overcome the spread of the new coronavirus, and that expressions of ageism developed in social interactions, in the context of health and the economy.

In health, resources were insufficient to serve the entire Brazilian and Chilean population, generating competition between young and old. Social media highlighted older adults who sacrificed their own lives so that ventilators could be used by younger people, and when medical equipment and hospital capacity became scarce, care providers were faced with ethical decisions about who would have priority over life. Thus, age became a decisive factor, leading society to believe that the life of an older person could be less valuable than that of a younger person^{66 Fraser S, Lagacé M, Bongué B, et al. Ageism and COVID-19: what does our society’s response say about us? Age Ageing. 2020 [acesso em 2022 jul 18]; 49(5):692-695. Disponível em: https://doi.org/10.1093/ageing/afaa097.
https://doi.org/10.1093/ageing/afaa097...} .

Some countries explicitly used age as a criterion for the allocation of treatment, establishing an age limit for access to intensive care, the use of ventilators, which reinforced the perception that older people are costly to the economy and the health system^{88 Ayalon L, Tesch-Romer C. Introduction to the Section: Ageism-Concept and Origins. In: Ayalon L, Tesch-Romer C, editores. Contemporary Perspectives on Ageism. Springer One; 2018. p. 1-10.}. Age as a criterion for entry into the Intensive Care Unit (ICU), for example, should only be a reference to define the person’s health status and prognosis, and not a criterion in itself, nor the only decisive marker for the use of resources^{3434 Valera L, Carrasco MA, López R, et al. Orientaciones éticas para la toma de decisiones médicas en el contexto de la pandemia de COVID-19 en Chile. Rev. Med. Chile. 2020 [acesso em 2022 jul 18]; 148(3):393-398. Disponível em: http://dx.doi.org/10.4067/S0034-98872020000300393.
http://dx.doi.org/10.4067/S0034-98872020...} . Thus, discourses and narratives that the elderly ‘already lived their lives’ and that it was time to renounce their rights to the detriment of the younger ones disregard the lives of these people, their contribution to society and their social needs, thus reproducing a speech of prejudices with age. These assumptions and perceptions accentuate intergenerational disagreements and strengthen a vicious cycle of ageism.

At the economic level, expressions of ageism were evidenced when speeches published in the media claimed that the economy would be weakened by social isolation and the blame would fall on older people. This is perhaps another consequence of the individualistic logic of neoliberalism, in which everything becomes a commodity, and, therefore, there is no room for a social bond that is not mediated by consumption, only interested in productive bodies. This generated understandings that the COVID-19 pandemic would be responsible for a destructive way of life, both for nature and for human beings, resulting from a deadly capitalism that devastates everything in its path^{3535 Abagaro CP, Boy M, Flores RAR, et al., coordenadores. La pandemia social de COVID-19 en América Latina: reflexiones desde la Salud Colectiva. Ciudad Autónoma de Buenos Aires: Teseo; 2021. 280 p. [acesso em 2022 jul 17]. Disponível em: https://www.teseopress.com/pandemiasocial/chapter/la-sobrevivencia-en-la-vejez-en-chile-lo-que-muestra-la/.
https://www.teseopress.com/pandemiasocia...} .

A State that cares about its citizens should promote a minimum of dignity to people at older ages and more vulnerable in terms of health, social and economic conditions. However, the movement occurs in the opposite direction, since sectors of government, advertisement and market act to convince that the elderly person is close to death, that the responsibility for health care should be entirely her own, and that public resources should go to young people^{3636 Rosa CM. A velhice da morte. In: Marín CR, editor. La vejez: reflexiones de la postpandemia. Medellín: Opción Colombia; 2020. p. 151-161. [acesso em 2022 jul 17]. Disponível em: https://archivo.cepal.org/pdfs/ebooks/vejez_reflexiones_post_pandemia.pdf.
https://archivo.cepal.org/pdfs/ebooks/ve...} . This logic causes societies to strengthen the image that elderly people need assistance and charity measures, and that they are deprived of rights.

When younger adults died from complications of COVID-19 around the world, long and detailed reports were often generated in the media, while the deaths of thousands of elderly people were counted and summarized^{66 Fraser S, Lagacé M, Bongué B, et al. Ageism and COVID-19: what does our society’s response say about us? Age Ageing. 2020 [acesso em 2022 jul 18]; 49(5):692-695. Disponível em: https://doi.org/10.1093/ageing/afaa097.
https://doi.org/10.1093/ageing/afaa097...} . Paradoxically, while the elderly are victims of derogatory and inactive images and attitudes, they are sometimes the ones that contribute to the sustenance and maintenance of the domestic income of many Brazilian and Chilean households.

In Brazil, the elderly person contributes with 70.6% of household income, 62.5% of which comes from pensions or retirements, that is, from Social Security. The income from the work of the elderly person constitutes 28.5% of the family budget, since a third of the men and 15.0% of the elderly women who lived in these households were working, which shows that the elders have assumed an important role in the maintenance of family income. In addition, the length of stay of children living with their parents has increased, including in the age group from 50 to 59 years^{3737 Camarano AA. Os dependentes da renda dos idosos e o coronavírus: órfãos ou novos pobres? Ciênc. Saúde Colet. 2020 [acesso em 2022 jul 16]; 25(2):4169-4176. Disponível em: https://doi.org/10.1590/1413-812320202510.2.30042020.
https://doi.org/10.1590/1413-81232020251...} .

In Chile, more and more men and women continue to work after retirement (which occurs, on average, at age 70) on their own, as employment rates have fallen by ten percentage points in the ten years before the legal retirement age. As a result, more than 50% of the elderly continue to work after the age of 70, in the case of women, and after the age of 65, in the case of men^{3838 Vives A, Gray N, González F, et al. Gender and Ageing at Work in Chile: Employment, Working Conditions, Work-Life Balance and Health of Men and Women in an Ageing Workforce. Annals of Work Exposures and Health. 2018 [acesso em 2022 jul 18]; 62(4):475-489. Disponível em: https://doi.org/10.1093/annweh/wxy021.
https://doi.org/10.1093/annweh/wxy021...} .

The COVID-19 pandemic therefore highlighted the vulnerability of the elderly, which was enhanced by the health, economic, political and social crisis. However, such evidence does not guarantee that this population segment will be the target of effective public policies to combat the serious consequences of ageism in the post-pandemic period, which is worrisome, since it is estimated an increase in problems such as depression, feelings of social worthlessness, sadness, mental illness and even risk of suicide, as the newspapers examined in this study warn. Consequently, the demand for health services will increase.

Brazil has a universal public system that covers more than 200 million people, limited to underfunding and inequalities. At the same time, there is a dynamic private sector, which includes private providers to the Unified Health System, and a segment of health plans and insurance, to which about 50 million people, or 25% of the Brazilian population, are linked, which also use the public health system^{3939 Machado CV. Políticas de Saúde na Argentina, Brasil e México: Diferentes caminhos, muitos desafios. Ciênc. Saúde Colet. 2018 [acesso em 2022 jul 18]; 23(7):2197-2212. Disponível em: https://doi.org/10.1590/1413-81232018237.08362018.
https://doi.org/10.1590/1413-81232018237... ,} thus enhancing the challenge of ensuring universality and equity.

In Chile, there is an inability of public policies to meet social and health needs, which were potentiated by the consequences of carelessness and abandonment in the pandemic of an increasingly elderly population. In this country, the public health system is underfunded and insufficiently equipped, resulting in long waiting lists for specialized treatment and complex procedures, directly affecting the elderly, the poor and those with chronic conditions^{4040 Moreno X, Lera L, Moreno F, et al. Socioeconomic inequalities in life expectancy and disability-free life expectancy among Chilean older adults: evidence from a longitudinal study. BMC Geriatrics. 2021 [acesso em 2022 jul 14]; 21(1):176. Disponível em: https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-021-02126-9.
https://bmcgeriatr.biomedcentral.com/art...} .

The vulnerabilities to which older people are exposed lead to anti-age demonstrations on social media, which include jokes or humiliation on the elderly, minimizing the impact of COVID-19 on the general population and/or suggestions that life of the older person is less valuable than the others^{4141 Jimenez-Sotomayor MR, Gomez-Moreno C, Soto-Perez-de-Celis E. Coronavirus, Ageism, and Twitter: An Evaluation of Tweets about Older Adults and COVID-19. J Am. Geriatr. Soc. 2020 [acesso em 2022 jul 16]; 68(8):1661-1665. Disponível em: https://doi.org/10.1111/jgs.16508.
https://doi.org/10.1111/jgs.16508...} .

The newspapers examined in the present study made important denunciations about ageism in the pandemic, which gained strength through internet memes and hostile jokes that suggest annihilating people, through a hunt for ‘old offenders’, just like the cart in search of of abandoned dogs, with threats of fines, imprisonment, loss of retirement. Also, COVID-19 was called ‘old man’s disease’, and the coronavirus labeled ‘boomervirus’ or ‘baby remover’, evident manifestations of age prejudice, including within the family nucleus itself, which is expected to be the first to protect and defend the person (Tables 1 and 2. Fragments N36_FSP; N22_LT; N20_G; N12_FSP).

However, stigmatization takes place in family interactions from attitudes of discredit, contempt and the use of derogatory adjectives that are assimilated by people and shape the self-image and a deteriorated identity of the person who fails to meet social expectations. And the removal or abandonment by the family is common, especially in situations of physical difficulties that require greater attention and protective care^{4242 Carvalho ESS, Carneiro JM, Gomes AS, et al. Why does your pain never get better? Stigma and coping mechanism in people with sickle cell disease. Rev. Bras. Enferm. 2021 [acesso em 2022 jul 14]; 74(3):e20200831. Disponível em: https://doi.org/10.1590/0034-7167-2020-0831.
https://doi.org/10.1590/0034-7167-2020-0...} . The need for social isolation favored the carelessness and loneliness of the elderly, perpetrated both by family members and by social actors from the most varied public spheres, such as social and health institutions and society as a whole.

Social distancing, which had the initial intention of avoiding contamination by the virus, was followed by abandonment and vulnerability to violence, since the dependence on third parties to carry out their instrumental and/or basic activities of daily living, added to the reduced formal and informal social support, resulting from isolation, makes this group a target of different forms of violence practiced at home^{4343 Moraes CL, Marques ES, Ribeiro AP, et al. Violência contra idosos durante a pandemia de Covid-19 no Brasil: contribuições para seu enfrentamento. Ciênc. Saúde Colet. 2020 [acesso em 2022 jul 14]; 25(supl2):4177-4184. Disponível em: https://doi.org/10.1590/1413-812320202510.2.27662020.
https://doi.org/10.1590/1413-81232020251...} . Moments of social distancing should have the intention of preserving and protecting life, keeping autonomy and independence protected, since they are the foundations for healthy aging, and one cannot go back in relation to the preservation of the dignity of the elderly^{4444 Hammerschmidt KSA, Santana RF. Saúde do idoso em tempos de pandemia COVID-19. Cogitare enferm. 2020 [acesso em 2021 set 21]; (25):e72846. Disponível em: http://dx.doi.org/10.5380/ce.v25i0.72849.
http://dx.doi.org/10.5380/ce.v25i0.72849...} .

The global impact of ageism is reflected in the exclusion of the elderly from the agenda of health research agencies; in the devaluation of life; unemployment; denial of access to health care and treatments; reduced longevity; lowering of the quality of life and well-being; adherence to health risk behaviors; impoverishment of social relations; physical and mental illness and cognitive impairment, indicating that the consequences of this phenomenon reach both structural and individual levels and affect the health of the elderly in its multiple domains^{4545 Chang ES, Kannoth S, Levy S, et al. Global reach of ageism on older persons’ health: A systematic review. PLoS One. 2020 [acesso em 2022 jul 16]; 15(1):e0220857. Disponível em: https://doi.org/10.1371/journal.pone.0220857.
https://doi.org/10.1371/journal.pone.022...} .

By confirming, in this study, that the ageism expressed in the pandemic permeated the levels of macro, meso and microstructural origin, its confrontation requires actions directed at the groups that operate this phenomenon. Interventions to reduce ageism are based on educational and intergenerational actions and should be a priority, given that they have already been tested and demonstrated particularly favorable effects in combating negative attitudes related to aging^{4646 Burnes D, Sheppard C, Henderson CR Jr, et al. Interventions to Reduce Ageism Against Older Adults: A systematic review and meta-analysis. Am J Public Health. 2019 [acesso em 2022 jul 18]; 109(8):e1-e9. Disponível em: https://doi.org/10.2105/ajph.2019.305123.
https://doi.org/10.2105/ajph.2019.305123...} .

In addition, given that ageism is a global crisis, interventions adapted to different national and cultural contexts must be developed, through effective public policies, with a view to improving the health conditions and well-being of the elderly. Combating ageism is of interest not only to the aging population, but also to society as a whole, through the strengthening of intergenerational bonds, in order to re-signify the bonds with the elderly, with attitudes of respect, appreciation and consideration for the elderly with this audience^{4444 Hammerschmidt KSA, Santana RF. Saúde do idoso em tempos de pandemia COVID-19. Cogitare enferm. 2020 [acesso em 2021 set 21]; (25):e72846. Disponível em: http://dx.doi.org/10.5380/ce.v25i0.72849.
http://dx.doi.org/10.5380/ce.v25i0.72849...} .

Also, managers, policy makers, health and communication professionals must be aware of the problems of ageism, the scope of the consequences of this phenomenon and need to pay attention to the narratives they build and convey through the media^{2626 Ayalon L. There is nothing new under the sun: ageism and intergenerational tension in the age of the COVID-19 outbreak. Int Psychogeriatr. 2020 [acesso em 2022 jul 16]; 32(10):1221-1224. Disponível em: https://doi.org/10.1017%2FS1041610220000575.
https://doi.org/10.1017%2FS1041610220000...} , as ageism can be perpetuated through political channels and also through the media, in the workplace and in casual everyday interactions with the population group in question^{4747 Wister A, Speechley M. COVID-19: Pandemic Risk, Resilience and Possibilities for Aging Research. Can J Aging. 2020 [acesso em 2022 jul 17]; 39(3):344-347. Disponível em: https://doi.org/10.1017/s0714980820000215.
https://doi.org/10.1017/s071498082000021...} .

As contributions to public health, the results of this study highlight the need: to disseminate knowledge about ageism, its forms of expression and implications for the elderly with the groups that originate this phenomenon, in the media, in the public sphere and in the professional qualification; to develop and implement public policies that are capable of including the elderly, respecting their rights and autonomy. By recognizing the expressions and characteristics of ageism against this population group, health and communication workers, family members and society can adopt a self-monitoring posture in the fight against ageism.

The limitations of this study are the fact that it only provides a sample analysis of newspapers from Chile and Brazil, and that the inclusion of other countries could bring different findings, and it is not possible to generalize the results. It is possible the existence of news from newspapers that were not retrieved in the search and that could provide answers to the research question. Still, it is impossible to present empirical data on measures to combat ageism against elderly people, due to space limitations for description and analysis of results.

Final considerations

The expressions of ageism found in the newspapers involve discriminatory images and attitudes that place the elderly person in the place of the ‘other of the pandemic’, which are originated by the elderly person at the micro level; by family members, managers and politicians, social and health institutions and the labor market at the meso level; and by society and the state at the macrostructural level. These expressions generated negative implications in different areas of life and health, both in the context of Brazil and Chile, and could make the elderly population even more vulnerable to social and health inequities and inequalities. Restrictive measures to contain the advance of the pandemic have highlighted situations of prejudice and age discrimination, which implications can generate more needs and demands for public services, thus lacking investigations in this regard.

The achievements achieved from the struggle of entities, social movements and various forums that defend the rights of the elderly, and which are also actively carried out by this population group, are threatened with setbacks and losses, such are the setbacks accelerated by the health, economic, social and political crisis and by the uncertainties of the post-pandemic scenario in the medium and long term.

References

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