Faculty Q&A with Ruth Finkelstein on Aging

Georgette Jasen
May 08, 2015

Ruth Finkelstein has spent her career as a researcher and advocate for groups that might otherwise be ignored. She worked in the reproductive rights movement, then moved on to HIV/AIDS with the outbreak of that epidemic as policy director for the Gay Men’s Health Crisis. As the head of a research team at the New York Academy of Medicine, she focused her attention on drug users and sex workers with HIV because “they were not considered worth saving.”

    After she became senior vice president for policy and planning at the Academy of Medicine, her research on drug policy helped lead to the 2009 repeal of New York state’s tough Rockefeller-era drug laws, eliminating mandatory minimum prison sentences and allowing judges to send some first-time offenders to treatment programs.

    At around the same time, Finkelstein realized there was another fast-growing group that needed attention. “It seemed that aging was being treated more like a disease than a stage of life,” said Finkelstein. “Older people, with so much to offer society, were missing out on options and opportunities.”

    Now she is associate director of Columbia’s Robert N. Butler Aging Center, which tackles issues ranging from life expectancy to quality of life, conducts research and makes policy recommendations. Its namesake, Butler, (CC’49, P&S’53) was a geriatrician and psychiatrist who founded the International Longevity Center, which moved to the Mailman School of Public Health and was renamed in 2011 after his death.

    Last November, the center—along with the Mortimer B. Zuckerman Mind Brain Behavior Institute—sponsored an interdisciplinary workshop that brought together Columbia researchers from many disciplines to identify ways they can collaborate on aging issues. They included biologists, sociologists, economists, neurologists, psychologists and health policy management experts. The center regularly works with schools and departments across the University, because lifespans are influenced by far more than genetics and medicine; education, social and cultural resources and even the architecture of cities can all play a role.

    “We are in the midst of a dramatic demographic shift: the extension of human life by as many as 30 years in both the developed and developing world,” said Linda Fried, a geriatrician and Mailman’s dean. “If we can live these longer lives in good health, we’ll create enormous opportunity, benefiting not only older people but their families, cities, governments and society.”

    Under the leadership of Psychology Professor Ursula Staudinger, the center focuses on the idea that human aging can be modified because biology, behavior and cultural factors play a part in how we develop across the life span. (Watch Staudinger explain the impact of exercise and stress on aging brains.)

    As one of the first generations to live in a society in which older people often outnumber younger ones, “the implications—social, financial, medical—are huge,” Finkelstein said. “We have a set of institutions that were predicated on a completely different understanding of life span.”In a recent study Staudinger and colleagues examined aging trends in the United Kingdom over 40 years, assessing how study participants managed tasks such as word recall and verbal fluency. “The results showed that the population average in cognitive functioning will not go down,” Staudinger said, “even though the average population age will increase. Because of an improvement from generation to generation, we are chronologically older, but as a society we are cognitively younger.”

    Q Why is aging such an important issue right now?

    At the beginning of the 20th century the average life expectancy was 47 years. It’s gone up 30 years in a little more than a century. If you look at a chart of average life expectancy, for 100,000 years most people lived only into their late teens or early 20s. Then life expectancy doubled in a thousand years, and in a century’s time it almost doubled again. This is a gigantic change.

    Q What are the consequences?

    Every phase of modern life is poorly organized for today’s longer life spans, to the detriment of us all. The period when people in developed countries work has been condensed into a finite time frame of a few decades, which is also when we’re raising children and caring for parents. Then there’s the notion that retirement is a long vacation. Well, it turns out that a 30-year vacation is not so good for most people. If you put people out to pasture, you lose the benefit of their skills, experience, passion, commitment and knowledge in so many arenas where they can help—not just the work arena, but also in education and civic endeavors. The leaders of the major social movements of our time are getting older, yet we rarely engage with them about today’s issues, where they could be immensely helpful. (Watch Professor Jack Rowe discuss how longer life spans pose challenges to society.)

    Q What kind of impact does this shift have on families?

    We’ve moved from multi-generational understandings of family to tiny nuclear families. That isn’t a good thing. I’m not saying everybody should move back in with each other. But there’s a family, neighborhood and community dynamic— the idea that you stay networked and connected and associated with your aunts, uncles, cousins and the people you grew up with. New York City has 1 million residents over the age of 60 right now, and number that will grow dramatically over the next 20 years. When I was doing research for Age-Friendly NYC, an effort by the Mayor’s office, City Council and the New York Academy of Medicine to respond to this demographic shift, we talked to thousands of older adults about their lives and often heard about the importance of long-term social connections.

    Q How can that work?

    I have a teenage son, and I know if someone in our neighborhood saw him doing something they knew I wouldn’t approve of, they’d let me know. He knows that too. It means that he’s in an environment of social control and expectations. That is one of the ways that behavior gets shaped, positively and negatively. People of all ages are necessary for that shaping. Making neighborhoods and communities that work for all generations is good for everybody.

    Q Does this mean retirement communities aren’t a good idea?

    While there certainly can be options for people to be in a place with others their own age, I think we should be striving to build communities that work for people of all ages. Too often retirement communities separate people from the things that are important to them. Many of the institutions geared toward one age-related set of the population do so to their detriment. Think about universities, for example. Would it be so bad if there were more older people on campuses in all sorts of capacities, not just working and doing research but also attending classes? Think what perspective they could bring.

    Q How can we make society more inclusive for older people?

    Step one is to revisit work, which means we must revise the policies and practices that we use as employers to push people out of the work place. Here at the Columbia Aging Center we have an initiative called Age Smart Employer, where we interview businesses so we can guide employers about how to design a workplace where different generations benefit from working together. We give awards to employers that hire, retain and retrain their older workers in a way that benefits their companies.

    Q Can you give me a few examples of creative employment practices to use the skills of old and young at work?

    Take a family-run business, where the father teaches the craft and the son is in charge of social media for marketing. Or a manufacturing business. There is shortage now of tailors, diamond cutters, electricians and plumbers. How do we get more apprentices into these trades? Well, industries are creating financial incentives for experienced workers to train new ones. Or restaurants—they have a huge problem with high turnover. Industry people tell us they have better retention rates with older workers, who know the recipes, have a strong work ethic and are less prone to drama, which can be a big distraction in the restaurant business.

    Q Are there other examples?

    At B&D Heating in Brooklyn, the owner pairs a younger worker with a 79-year-old technician who is valued for his experience and skills. Leah Abraham, who owns Settepani in Harlem, got eyeglasses for her longtime bartender when there started to be a problem with breakage. She restructured his job so now he’s a mixologist in charge of training young bartenders. Montefiore Hospital allows its older workers to move to part time as they transition toward retirement; after they retire, some stay on as volunteers. At Little Wolf Cabinet Shop on the Upper East Side, the owner, a fourth-generation cabinet maker, convinced his most skilled craftsman to delay retirement for a year to fully train his son.

    Q Won’t it be hard to change our notions of what retirement should be?

    This is where it gets politically complicated. For the past several generations, retiring has been viewed as a right that people have earned by working—the right to collect the pension their company has promised them, the right to collect the Social Security they’ve been paying into. For some, retiring early is also a signifier of wealth and accomplishment. My position is not that people should be made to work longer; it’s that people should be able to work longer. There are many jobs that aren’t good for people in old age; nobody would argue that the longer you’re a miner, the better it is for you. But an expected retirement age of 65 is antiquated. When Social Security was signed into law in 1935, average life expectancy was 61. If you reached that age you could expect to live about seven more years on average; now people who get to 65 can expect to live another 18 years more or more.

    Q What are the economic implications?

    You simply can’t finance 20 years of retirement on 40 years of work—especially if employers are contributing less. But I’m not just talking about money here. Work is an important dimension of our lives—it gives people a sense of identity, it is often the core of social connections, and it’s where many people get their sense of productivity, their belief that they are making a contribution. Research suggests that while people are initially happy to retire, that happiness erodes rapidly. People seek purpose and meaning and connection, and right now, that open-ended space called retirement doesn’t give it to you.