Perspectives of a Social Gerontologist: Aging with the Field

Abstract:

A personal reflection by noted social gerontologist, Marcia G. Ory, who provides insights on the field of gerontology and her nearly 50-year career trajectory at the intersection of aging and public health. She discusses her personal and professional journey, with callouts to mentors. Her review emphasizes stabilities and changes in the study of healthy aging, and the lifelong relevance of core principles of aging. This reflection applauds social gerontologists who have led the charge to reimagine aging.

Key Words:

healthy aging, mentors, mentoring, social gerontology, life course perspective


 

My current work and life mantra is “healthy aging is the new normal” (Ory & Smith, 2017). Imagine my delight when I saw the recent New York Times opinion piece “How 90 Became the New 60” (Collins, 2023). Aging has certainly been a journey for many of us, whether professionally or personally. One of my first aging truths, learned from the esteemed social gerontologist Matilda White Riley, was that aging was a life-course process and socially determined (Dannefer et al., 2005).

There is always an origin story for any lifelong journey. For me it was seeing family members with different life trajectories and intuitively recognizing the interacting health influence of genetics, lifestyle factors, and place. Family is for life, and I value my more than 50-year marriage to Raymond Carroll, (including a nearly 20-year commuting relationship), who has encouraged me to follow my dreams and acted as the anchor for my returning to Texas after a 30-year hiatus.

As I look back over my nearly 50 years of professional life, I can see stabilities and changes in my career path, as well as parallel paths in the field of gerontology. Like many in my generation, I did not start off as a trained gerontologist, but as a social scientist who asked questions about norms and sanctions affecting important early life decisions such as fertility and parenting (Ory, 1978). I landed my first academic job in the School of Public Health at the University of North Carolina, knowing little about public health as a field of study but quickly appreciating the importance of community as context and an agent of change.

The Value of Mentors …

Often it is hard to sustain friendships and collegial relationships over time and space. As a young academic, I benefited greatly from my association with JoAnne Earp (see UNC Gillings School of Global Public Health, 2022), who filled many roles as lifelong mentor, friend, and colleague. She instilled in me a passion for public health, and later in life a sense of appreciation and gratitude for others.

My transition to aging as an area of study was definitely influenced by my social setting and mentors. My aging origin story began with a brief postdoctoral stint at the University of Minnesota in the late 1970s, where I gained an appreciation of how policies and programs affected families and the intergenerational aspects of long-term care, working with Reuben L. Hill and Nancy N. Eustis (Ory, 1980).

It was in the early 1980s, with a freshly minted public health degree from Johns Hopkins University, that my public health and aging perspectives first began to coalesce. I feel fortunate to have had the privilege of starting my National Institute on Aging (NIA) career while Robert (Bob) N. Butler was still its first director. I can remember listening to his inspirational messages about confronting ageism stereotypes (Butler, 1969) and wishing that I could one day gain his vast knowledge about factors associated with aging well.

‘My transition to aging as an area of study was definitely influenced by my social setting and mentors.’

This wish was realized through my long association with Matilda W. Riley and Ronald Abeles, and the opportunities they gave me to grow with and shape the Social Science Research on Aging program at the NIA.

The 1980s and 1990s were exciting decades for moving the field of social gerontology forward, and establishing pillars of aging principles and solutions that hold true today. With incredible insight, Riley discussed the importance of viewing aging within a dynamic multidisciplinary approach but with a sharp lens on how social structures defined and were defined by aging (Dannefer et al., 2005). At this time, there was great lament about the confluence of two social conditions—an expanding aging population accompanied by a structural lag in roles and opportunities for older persons (Riley et al., 1994).

Her call for social change can be seen in a more age-integrated view of society that results in greater flexibility and choice of roles throughout life. While still rarer than desired, I marvel at the growing examples of life-long education, creativity, and opportunities for meaningful work and social interactions at any age.

In the health arena, it is almost axiomatic that it takes nearly 20 years to go from discovery to practice (Morris et al., 2011). Similarly, transformational social ideas take a while to become embedded. While all her projections for meaningful aging are not yet part of the social fabric, Riley’s legacy is that aspects are continually rediscovered and recycled by a younger generation of scholars and partitioners who see value in a more age-integrated society.

During my 20-year tenure at the NIA, I worked on a variety of issues setting the stage for my post-government academic life. Under Riley’s leadership, we set up a Behavioral Geriatrics Research initiative to examine the dynamic interplay among aging, health, and behavioral processes (Ory et al., 1992).

This work culminated in the coining of one of my favorite life-course lifestyle mantras, “It’s never too late to start a healthy behavior—but always too soon to quit.” And coming full circle, with nearly 20 years of immersion in the NIA’s life-course perspective, I had the pleasure of joining forces with Bob Butler to host an invitational thought leader roundtable on Maintaining Healthy Lifestyles: A Lifetime of Choices.

And, I had the distinct honor of working with the three NIA Directors, Bob Butler, T. Franklin Williams, and Richard J. Hodes. Each of them have put their own mark on the aging field—but with a common goal of furthering research to better understand the multidimensional aging processes and make a difference in the lives and roles of older people in society.

What I especially liked about my tenure at the NIA starting as a youngish 30-something professional was working with leading scholars in the behavioral and social sciences on aging and having the opportunity to learn from these giants in the field. While many early gerontologists are unfortunately no longer with us, their work lives on as a legacy to aging research and practice.

… And of New Collaborations and Ways of Viewing Aging Research and Practice

But equally rewarding was the opportunity to work with a younger generation of emergent scholars who have now come into their own as leading scholars and practitioners in the field. My favorite mechanisms were the cross-site collaborative projects around a focal topic such as Alzheimer’s disease, falls and injuries, lifestyle behavior, provider-patient interactions, or minority aging.

Not surprisingly, in my current academic research, I remain engaged in these topics, which are still highly relevant to the health and well-being of older adults. I see some of the same issues being addressed, but with a slightly different focus.

Coming to the Texas A&M School of Public Health in 2001 provided me with a new lens for my research and practice. Concurrent with a recent research shift toward translational research, I am now more likely to address questions of how evidence-based programs and practices can be scaled and sustained to benefit the maximum number of older adults, starting with my leadership in the Robert Wood Johnson Foundation Active for Life Initiative (Wilcox et al., 2008).

As a public health researcher, I have a keen appreciation for the importance of working with key community stakeholders to help define the research process from beginning to end. Working on interdisciplinary teams with academics and practitioners, I have benefitted from the sage insights my architectural and planning colleagues have about environmental supports for facilitating or impeding healthy lifestyle factors, navigating one’s environment with cognitive impairment, or designing long-term care environments to minimize infections and falls, while simultaneously enhancing social interactions (Ory et al., 2020).

The longer I spend in the field, the more I appreciate its research complexities and the ever-evolving aging population and changing social context.

Now my passion is identifying and evaluating social, behavioral, environmental, and/or technological solutions that can make healthy aging a reality for more older adults while simultaneously supporting their families and communities. Increasingly, I employ the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) translational dissemination and implementation framework, asking whom these programs are reaching, what intended and unintended consequences they have, how they are being adopted and implemented, and the extent to which benefits are sustained at the individual and organizational levels (Glasgow et al., 2019). The longer I spend in the field, the more I appreciate research complexities and the importance of recognizing that one is researching an ever-evolving aging population and changing social context (Ory, 2022).

While much of my focus revolves around new ways of looking at long-standing age-relevant topics, the past few years have highlighted new public health problems that have substantial deleterious impacts, especially on our older population. Hence, my recent involvement in promoting opioid overdose education and harm reduction strategies within an ever-evolving opioid crisis—with waves from prescription misuse to illicit drug-taking—that can have quite deadly widespread population impacts (Centers for Disease Control and Prevention [CDC], 2022).

Similarly, the recent COVID-19 pandemic underscored the vulnerabilities of older adults, who have borne a disproportionate share of morbidity and mortality, exacerbating existing fractures in healthcare and public health (Nicklett et al., 2022). Another new area for me is the recent attention to precision health, and its capacity to either accelerate or reduce existing health and healthcare inequities (Ory et al., 2023).

Takeaways from 50 Years in Gerontology

What can one say about nearly 50 years of professional experience in social gerontology interspersed with personal aging? I remain optimistic that population dynamics have brought new ways of thinking and action—whether my long-ago 1970s graduate student foray into overpopulation depicted in Ehrlich’s Population Bomb treatise (1968) or newer concerns about rapid population aging coexisting with declining life expectancies in the United States (Ory, 2020; 2022).

I have had excellent mentors along my career path—and I hope I have served as mentors to others. While my pathway to “senior” gerontologist status might appear destined and straightforward, in retrospect, the road traveled takes many turns, some planned and some fortuitous. On a personal note, I attribute my insights into healthy aging to my mother, Esther Rose Levine Ory, who provided an excellent role model for successful aging and taught me the importance of viewing aging from both a research and practice perspective. On a professional level, social gerontologists have led the charge to reimagine aging (American Society on Aging, 2023), and I am proud to be one in long standing.

My final thoughts are to stress the need to act locally but think globally. I urge us to all take to heart the WHO’s (2023) four action pillars of the Decade of Healthy Aging including combating ageism, creating age-friendly environments, integrating healthcare, and not forgetting quality and accessibility issues in long-term care. These four pillars reflect the current moment of recognition that healthy aging is possible, the movement toward reframing aging, and the momentum to make Matilda Riley’s vision of an age-integrated society a reality.

Epilogue

Many friends and colleagues ask me when I am going to retire. My first thought is “hopefully never” if retirement means “no longer doing what one loves.” I’ve set three goals for myself of what I’d like to accomplish in my professional career:

  1. To obtain one more multi-investigator grant, as I love the collaborative research process—and fortunately I have several irons in the fire;
  2. To cap my career with at least 500 peer-reviewed articles of relevance to the social gerontology field;
  3. To continue mentoring the next generation of scholars and practitioners so that the healthy aging legacy lives on.

But I think it is also important to have a post “paid” work-life plan. Toward this end, I’ve recently set up a foundation, “Healthy Across the Generations,” to have a platform to continue supporting research, education, and service to personify the perspective: “Active for Life … Everyone, Every Day, Every Age.”


Marcia G. Ory, PhD, MPH, is the Regents and Distinguished Professor at the Texas A&M School of Public Health in College Station, Texas. She may be contacted at mory@tamu.edu.

Photo credit: Shutterstock/Keri Youngs


 

References

American Society on Aging. (2023). Ageism and culture. www.asaging.org/about-asa

Butler, R. N. (1969). Age-ism: Another form of bigotry. The Gerontologist, 9(4 Part 1), 243–46.

Centers for Disease Control and Prevention. (2022). Understanding the opioid overdose epidemic. U.S. Department of Health and Human Services. www.cdc.gov/opioids/basics/epidemic.html

Collins, G. (2023, April 12). How 90 became the new 60. The New York Times. www.nytimes.com/2023/04/12/opinion/aging-politics-biden.html

Dannefer, D., Uhlenberg, P., Foner, A., & Abeles, R. P. (2005). On the shoulders of a giant: The legacy of Matilda White Riley for gerontology. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 60(6), S296–304. https://doi.org/10.1093/geronb/60.6.S296

Ehrlich, P. R. (1968). The population bomb. Ballantine Books.

Glasgow, R. E., Harden, S. M., Gaglio, B., Rabin, B., Smith, M. L., Porter, G. C., Ory, M. G., & Estabrooks, P. A. (2019). RE-AIM planning and evaluation framework: Adapting to new science and practice with a 20-year review. Frontiers in Public Health, 7. https://doi.org/10.3389/fpubh.2019.00064

Morris, Z. S., Wooding, S., & Grant, J. (2011). The answer is 17 years, what is the question: Understanding time lags in translational research. Journal of the Royal Society of Medicine, 104(12), 510–20. https://doi.org/10.1258%2Fjrsm.2011.110180

Nicklett, E. J., Ory, M. G., Johnson, K. E., & Dwolatzky, T. (2022). COVID-19, aging, and public health. Frontiers in Public Health, 10. https://doi.org/10.3389/fpubh.2022.924591

Ory, M. G. (1978). The decision to parent or not: Normative and structural components. Journal of Marriage and the Family, 531–9. https://psycnet.apa.org/doi/10.2307/350933

Ory, M. G. (1980). Family impact analysis: Concepts and methodologies. Policy Studies Journal, 8(6), 941–50.

Ory, M. G., Abeles, R. P., & Lipman, P. D. (1992). Introduction: An overview of research on aging, health, and behavior. In M. G. Ory, R. P. Abeles, & P. D. Lipman (Eds.), Aging, health, and behavior. Sage Publications.

Ory, M. G., & Smith, M. L. (2017). What If healthy aging is the ‘new normal’? International Journal of Environmental Research and Public Health, 14(11), 1389.

Ory, M. G., Lee, C., & Yoshikawa, A. (2020). Health and the built environment: Enhancing healthy aging through environmental interventions. In F. Rojo-Pérez, & G. Fernández-Moyoralas (Eds.), Handbook of active ageing and quality of life: From concepts to applications (pp. 369–94). Springer.

Ory, M. G. (2020). How will society change as the US population ages? [Video] The Conversation. https://theconversation.com/video-how-will-society-change-as-the-us-population-ages-146903

Ory, M. G. (2022). Life expectancy is declining: How to fix it? Generations Now. https://generations.asaging.org/life-expectancy-declining-how-fix-it.

Ory, M. G., Adepoju, O. E., Ramos, K. S., Silva, P. S., & Dahlke, D. V. (2023). Health equity innovation in precision medicine: Current challenges and future directions. Frontiers in Public Health, 11. https://doi.org/10.3389/fpubh.2023.1119736

Riley, M. W. E., Kahn, R. L. E., Foner, A. E., & Mack, K. A. (1994). Age and structural lag: Society's failure to provide meaningful opportunities in work, family, and leisure. John Wiley & Sons.

UNC Gillings School of Global Public Health. (2022, November 19). Gillings School honors and mourns ‘force of nature’ Dr. Jo Anne Earp. https://sph.unc.edu/sph-news/gillings-school-honors-and-mourns-force-of-nature-dr-jo-anne-earp/

Wilcox, S., Dowda, M., Leviton, L., Bartlett-Prescott, J., Bazzarre, T., Campbell-Voytal, K., Carpenter, R. A., Castro, C. M., Dowdy, D., Dunn, A. L., Griffin, S. F., Guerra, M., King, A. C., Ory, M.G., Rheaume, C., Tobnick, J., & Wegley, S. (2008). Active for life: Results from the translation of two physical activity programs. American Journal of Preventive Medicine, 35(4), 340–51. https://doi.org/10.1016/j.amepre.2008.07.001

World Health Organization. (2023, April 19). WHO’s work on the UN Decade of Healthy Ageing (2021–2030). www.who.int/initiatives/decade-of-healthy-ageing