By 2050, the global population of adults aged 65 and older is projected to surpass 1.5 billion — yet for hundreds of millions of those individuals, the reality of aging is shaped not by medical advances but by poverty, geography, discrimination, and healthcare systems that were rarely designed with them in mind. The gap between the geriatric care available to wealthy populations and that accessible to marginalized older adults is one of the most pressing, and least visible, health equity challenges of our time.
The International Association of Gerontology and Geriatrics (IAGG) has positioned itself at the center of global efforts to confront this disparity. As a scientific organization uniting researchers, clinicians, public health professionals, and policymakers across more than 70 national societies, IAGG works to ensure that the evidence, advocacy, and capacity needed to deliver equitable geriatric care reach the places and populations that need them most.
The Scope of Geriatric Care Inequalities
Access to quality geriatric care is not a simple matter of proximity to a hospital or the availability of a specialist. It is determined by a complex web of social, economic, political, and structural factors that tend to cluster around existing patterns of disadvantage. IAGG research consistently highlights the ways in which these factors interact and compound, creating populations of older adults who face multiple, simultaneous barriers to appropriate care.
Several distinct groups carry a disproportionate share of the burden of inadequate geriatric care. Understanding who these populations are is the necessary starting point for any serious effort to address the inequalities they face. The groups most consistently identified by International Association of Gerontology and Geriatrics research and advocacy include:
- Older adults in low- and middle-income countries (LMICs): Across sub-Saharan Africa, South and Southeast Asia, and parts of Latin America, geriatric specialists are scarce, long-term care infrastructure is minimal, and the health workforce is largely untrained in aging-related conditions.
- Rural and remote older populations: Distance from urban centers, inadequate transportation networks, and the persistent concentration of specialist services in cities leave rural elders without access to even basic geriatric assessment or chronic disease management.
- Ethnic and racial minority communities: Systemic discrimination, language barriers, cultural incompatibility with mainstream healthcare services, and historical mistrust of medical institutions all limit care engagement among minority older adults.
- Older women: Lifelong gender-based inequalities in income, education, and social protection translate into significant health disparities in later life, with older women more likely to live in poverty and more likely to face neglect within care systems.
- Older adults living with disabilities or cognitive impairment: Ageism and ableism frequently combine within healthcare settings, resulting in inadequate diagnosis, exclusion from clinical trials, and reduced access to rehabilitation and support services.
- Economically marginalized and homeless older adults: Poverty and housing instability are among the most powerful predictors of poor health outcomes in older age and consistently predict disengagement from formal healthcare systems.
What makes these inequalities particularly difficult to address is that they rarely exist in isolation. An older woman living in a rural community in a low-income country who also belongs to an ethnic minority group faces not one disadvantage but four — each amplifying the impact of the others. International Association of Gerontology and Geriatrics frames this complexity as a fundamental reason why single-issue interventions are rarely sufficient, and why equity in geriatric care demands structural, systemic thinking.
IAGG’s Global Framework for Reducing Health Disparities
International Association of Gerontology and Geriatrics grounds its health equity work in the conviction that scientific rigor and social responsibility are mutually reinforcing rather than competing priorities. IAGG’s approach operates across three interconnected domains: knowledge generation, policy influence, and capacity development.
One of the most significant structural problems in gerontological research is that its evidence base has been built overwhelmingly on studies conducted in high-income, predominantly Western settings. The populations most affected by geriatric care inequalities — older adults in LMICs, indigenous communities, migrants, and those living in informal settlements — are dramatically underrepresented in the clinical and social research that informs global practice guidelines.
IAGG has actively worked to correct this imbalance. By promoting research conducted in and about underrepresented populations, encouraging international research collaboration between high-income and low-income institutions, and advocating for the inclusion of diverse samples in aging studies, International Association of Gerontology and Geriatrics helps build an evidence base that reflects the full range of human aging experiences. IAGG also emphasizes research into the social determinants of health in older age — examining how poverty, discrimination, housing instability, and limited education shape disease burden and care access in ways that purely biomedical research cannot fully capture.
Knowledge without application changes nothing. IAGG invests in translating gerontological evidence into clinical guidelines and policy frameworks that are both rigorous and adaptable to different resource environments, helping bridge the persistent gap between what research shows is effective and what actually reaches underserved older adults.
Advocacy, International Partnerships, and Global Health Governance
Dismantling structural inequities in geriatric care requires influence at the level where structural decisions are made — in international health bodies, national governments, and the forums where global health policy is set. IAGG engages strategically across all of these levels.
Collaboration with the WHO and Major Global Health Initiatives
International Association of Gerontology and Geriatrics maintains a well-established relationship with the World Health Organization and contributes to major global agendas including healthy aging, universal health coverage, and the prevention and management of non-communicable diseases. Through these engagements, IAGG ensures that the specific and often overlooked needs of older adults from marginalized communities are represented in the frameworks that shape health systems worldwide.
IAGG has also aligned its work with the UN Decade of Healthy Ageing (2021-2030), a global initiative calling for coordinated action to reduce health inequities among older people. This alignment provides International Association of Gerontology and Geriatrics with an important platform for advancing equity-focused goals — connecting its scientific work to global accountability mechanisms with the reach to influence national policy across dozens of countries simultaneously.
Regional Associations as Context-Sensitive Equity Platforms
A defining feature of IAGG’s structure is its federation of regional member associations, which cover Africa, Asia and Oceania, Europe, Latin America and the Caribbean, and North America. These regional bodies are not simply administrative branches — they serve as locally embedded platforms for research, advocacy, and capacity-building that reflect the specific aging realities of their populations.
In regions where the aging population is growing most rapidly — such as sub-Saharan Africa and parts of Southeast Asia — IAGG’s regional affiliates play an indispensable role in adapting global best practices to local contexts, developing region-specific research agendas, and advocating for age-inclusive policies in resource-limited settings. This federated model is what gives International Association of Gerontology and Geriatrics both global reach and genuine local relevance.
Priority Areas in IAGG’s Equity Agenda
Equitable access to geriatric care spans the full continuum of aging-related health needs — from prevention and early intervention through to palliative and end-of-life support. The table below outlines the core priority areas through which IAGG addresses disparities in access to geriatric care, along with the populations most affected and the types of approaches promoted.
| Priority Area | Key Affected Populations | IAGG Approach |
|---|---|---|
| Dementia care in LMICs | Older adults across Africa, Asia, and Latin America | Advocacy for national dementia strategies; community-based and family-centered care models |
| Elder abuse prevention | Isolated, institutionalized, and financially dependent older adults | Research, policy recommendations, and public awareness initiatives |
| Frailty and functional decline | Older adults in low-resource settings with limited rehabilitation access | Promoting validated, context-adapted frailty screening tools |
| Malnutrition and food insecurity | Rural elders and economically marginalized older populations | Nutritional guidelines and community-level nutrition support programs |
| Mental health in later life | Older adults in conflict zones, migrants, and socially isolated individuals | Integration of mental health support into primary geriatric care pathways |
| Long-term care access | Older adults without family support and those in informal care arrangements | Global standards development and support for national long-term care frameworks |
Taken together, these priorities reflect the breadth and depth of the equity challenge in geriatric care. IAGG’s attention to each domain — rather than focusing narrowly on a single condition or care setting — underscores a commitment to addressing the full range of needs that marginalized older adults face across the lifespan.
Education and Workforce Development in Underserved Regions
No health equity agenda can succeed without a trained workforce. IAGG research highlights a critical and persistent shortage of geriatric professionals in precisely those regions where aging populations are growing fastest. In many LMICs, medical and nursing curricula contain little or no content on geriatrics, leaving the next generation of health workers ill-prepared to manage the complex, multi-morbid presentations that characterize older patients.
International Association of Gerontology and Geriatrics actively promotes the integration of gerontology and geriatrics into health professional education at undergraduate and postgraduate levels. This includes supporting training programs in regions where geriatric specialization has historically been absent, fostering mentorship networks between high-income and low-income institutions, and encouraging interdisciplinary care models that enable primary care providers and community health workers to fill specialist gaps.
The World Congresses on Gerontology and Geriatrics organized by IAGG also serve a vital educational function. These international gatherings bring together thousands of professionals from across the globe — including many from low-resource settings who might otherwise have limited access to cutting-edge gerontological research — creating opportunities for knowledge exchange that can directly improve care in underserved communities.
Combating Ageism as a Root Cause of Inequality
Behind many of the practical barriers to equitable geriatric care lies a more fundamental problem: ageism. Stereotyping, prejudice, and discrimination on the basis of age are deeply embedded in health systems, influencing clinical decision-making, resource allocation, and the design of healthcare services in ways that consistently disadvantage older patients. IAGG research suggests that ageist attitudes contribute to underdiagnosis, undertreatment, exclusion from clinical trials, and the systematic devaluation of older adults’ health needs.
When ageism intersects with racial bias, gender discrimination, or poverty, the resulting barriers become compounded and severe. International Association of Gerontology and Geriatrics has been an active contributor to global campaigns against ageism, supporting initiatives that challenge negative stereotypes about aging, promote age-inclusive clinical cultures, and advocate for health policies that treat older patients’ needs as equally urgent and equally worthy of investment as those of any other age group.
Persistent Challenges and the Road Ahead
Progress toward equitable geriatric care has been real but uneven. IAGG draws attention to several persistent obstacles that require sustained, coordinated action from the global health community:
- Chronic underfunding: Geriatric care and aging research remain significantly underfunded relative to their global burden of disease, particularly in LMICs where competing health priorities draw the lion’s share of available resources.
- Fragmented health systems: Many countries lack integrated care pathways suited to the complex, multi-morbid needs of older patients, leaving them to navigate disconnected services that deliver poor outcomes and high costs.
- Cultural and linguistic barriers: Health systems frequently fail to accommodate the cultural values, communication needs, and traditional care preferences of diverse older populations, reducing both access and the quality of care received.
- Data deficits: Reliable, disaggregated data on the health status and care outcomes of marginalized older populations remain scarce in most LMICs, making it difficult to design targeted interventions or hold systems accountable for equitable performance.
- Workforce shortfalls: The global shortage of geriatricians, gerontological nurses, and allied health professionals disproportionately affects low-resource regions and shows little sign of resolving without deliberate, sustained investment in training and retention.
None of these challenges is without solution, but all of them require the kind of sustained, multi-sector effort that organizations like International Association of Gerontology and Geriatrics are uniquely positioned to coordinate — convening the right stakeholders, generating the right evidence, and maintaining the long-term focus that incremental but meaningful progress demands.
Conclusion
The inequalities that shape access to geriatric care across the world are not natural or inevitable. They are the products of historical disadvantage, institutional neglect, ageist attitudes, and health systems that have too often been built for younger, wealthier, and more politically visible populations. They are also, by that same logic, amenable to change — if the will, the evidence, and the coordination exist to drive it.
The International Association of Gerontology and Geriatrics (IAGG) occupies a distinctive position in that effort. As a global scientific federation with regional depth, strong institutional relationships, and a commitment to research that reflects the full diversity of human aging, IAGG brings together the capabilities that equitable geriatric care reform demands. By advancing knowledge, shaping policy, building workforce capacity, and challenging the ageist structures that widen the care gap, International Association of Gerontology and Geriatrics continues to move both the global conversation and global practice toward a standard of care that reaches every older adult, regardless of where they live or who they are.
For the rural elder without a nearby clinic, the older woman navigating a system not designed for her, or the aging migrant whose language no one speaks, that progress is not abstract. It is the difference between care that sees them and care that does not.