Healthy Ageing for Whom?
We are told that ageing well is a matter of lifestyle. Eat healthier. Exercise more. Stay socially connected. Across Belgium and Europe, prevention policies promote “healthy ageing” mainly as a personal responsibility: a lifelong investment in one’s future self. But what if some people are not simply ageing differently, but faster? And what if this acceleration has little to do with personal choices?
Public health scholars have increasingly highlighted the underestimated health consequences of racism, even calling it a “public health emergency of global concern” in The Lancet (2020; 2024), as I discussed in a previous op-ed. Awareness is also growing in the Belgian public debate. In 2025, two books by Birsen Taspinar and Ama Kissi fueled discussion in Flanders. Taspinar points to the impact of racism on the mental health of children, adolescents and their parents, while Kissi highlights the inadequacy of the mental health care system in responding to racism-related distress. A recent article by Apache captured these insights under the headline “Racism makes ill.” Yet the ill-making capacity of racism extends far beyond mental health.
The concept of weathering, introduced by public health scholar Arline Geronimus, describes how chronic exposure to marginalizing forces such as racism accelerates biological ageing and increases the risk of early death. Repeated exposure to racism-related stress, from before birth and across the life course, keeps the body in a constant state of physiological strain. This chronic “allostatic load” damages major systems of the body, including the cardiovascular, metabolic and immune systems, increasing the risk of diseases such as diabetes, cardiovascular disease and dementia.
Research already shows the consequences. Older non-European migrants in Europe are estimated to have dementia rates up to three to four times higher than their white counterparts, as a Dutch study found in 2016. Yet for years this disparity rarely prompted questions about structural causes; it was often simplistically attributed to “culture.” Studies also show that racism can affect the body at the cellular level, shortening telomeres: the protective ends of our DNA linked to cellular ageing. The result is not only poorer health, but earlier onset of chronic illness and faster functional decline. In other words, racism does not only shape lived experience; it shapes biology.
This fundamentally challenges the dominant healthy ageing lens. If ageing is shaped by structural forces such as racism, prevention cannot remain focused on individual behaviour alone. You cannot yoga your way out of structural inequality. You cannot diet away decades of exclusion from housing, employment or healthcare. Research from the United States shows that even highly educated and affluent members of racialized groups, those who “did everything right”, still face higher risks of early illness and mortality. As Geronimus notes, you cannot fully educate or buy yourself out of weathering.
Yet (Belgian) prevention strategies remain strikingly silent about racism as a determinant of health. It is largely absent from ageing plans and health promotion programmes. Policies promote “active ageing” without acknowledging that not all bodies have been allowed to age under equal social conditions. By ignoring structural drivers, we risk reproducing the very inequalities prevention claims to reduce.
Taking accelerated ageing seriously requires several shifts. Racism must be recognised as a fundamental determinant of health and systematically monitored across the life course. Anti-racism policy should become as integral to healthy ageing strategies as the World Health Organization argues anti-ageism should be. Prevention cannot be separated from anti-racism policies in housing, labour markets, education, migration and healthcare.
Finally, we must recognise the knowledge developed within racialized communities themselves. Generational, ancestral, and cultural practices have long sustained resilience in the face of exclusion, yet they remain overlooked in mainstream health frameworks. Migration and colonial histories have disrupted and fragmented the transmission of this knowledge within diasporic communities, but it still holds important potential for protecting health and well-being. Therefore, research, community and policy efforts are needed to bring this knowledge to the surface.
If we are serious about healthy ageing, we must move beyond the illusion that it is only a matter of lifestyle. Because some bodies are not simply ageing, they are weathering. And no prevention policy can ignore the storm.
Links:
- https://www.age-platform.eu/europes-blind-spot-racism-health-and-aging-…;
- https://apache.be/2026/02/12/onze-zorg-steunt-op-wetenschap-met-kolonia…;
This op-ed appeared in Dutch on Knack.be.