ABSTRACT
In the last chapter, I have explored how administrative and epistemic reliance on chronological age measurement has been increasingly challenged by approaches that emphasise the individualised nature of the ageing process. I have suggested that, in this regard, age measurement partakes in wider processes of transformation of the role of standards in social and economic processes in late modernity. In aiming to differentiate capacities, needs and desires, alternative age measurements have attempted to personalise the relationship between individual characteristics and work, or health and welfare services. In so doing, they have drawn on the figure of the individual as both an epistemic object and an actor – a subject of normative action. This is possible because ageing – it is generally agreed – is the process by which genetic and environmental elements, including lifestyle behaviours, combine in a highly individualised trajectory of biological and psychosocial change (e.g. Walker, 2014). Within ageing research, this consensus is encapsulated, for example, in the concept of ‘differential ageing’ to express the range of probable individualised maturing pathways in any given historical context. This concept, and similar ones, express the idea that while there are common patterns of decline and adjustment associated with ageing – sometimes called ‘normal ageing’ – there is also ‘enormous individual variation [,] age changes [being] highly specific’ (Hayflick, 1998: 141). This dynamic speaks directly to debates about the relationship between ageing and health that I have argued are at the core of the agencement/assemblage of the ‘ageing society’. Indeed, one of the key propositions in that controversy, the compression of morbidity hypothesis, is specifically reliant on assuming an inherent plasticity relating to the individualised timing and extent of age-related illness and disability (Fries, 1980). In policy circles, the individualised character of the ageing process is equally paramount. Policies, it is argued, should cater for such individual variability rather than enforce agegraded rights and responsibilities. Recognising the individual as the centre of the policy process has thus come to underpin active and healthy ageing policies (e.g. Eurostat, 2012). How did this consensus come about? How did the individual
come to be seen as the pivotal, principal entity in understanding and managing the relationship between ageing, health and illness? Answering this question entails exploring the epistemic, methodological underpinnings of this relationship, and in particular the establishment of an ‘elective affinity’ between the longitudinal method and ageing processes. The longitudinal method – sometimes labelled cohort study – is a type of observational study design that relies on the serial measurement or monitoring of individuals at different points in time. Its origins lay with the consolidation of the child development movement of the 1920s and 1930s, discussed in the last chapter, and its search for new knowledge foundations – normative standards of ‘normal development’ – to ground what Frank once labelled ‘new designs for living’. It came again into prominence around World War II, with the establishment of community studies such as the Framingham Heart Study, which are usually linked to the development of contemporary risk factor epidemiology (Rothstein, 2003; Parascandola, 2004; Amsterdamska, 2005; Berlivet, 2005; Oppenheimer, 2006; Giroux, 2008) and programmes of epidemiological surveillance and health maintenance (Armstrong, 1995). One decade later, a variety of longitudinal studies of ageing – such as Duke’s or the National Institute of Mental Health Human Aging Study – came to focus on what ‘investigators often call[ed] the “dynamics” of aging’, that is to say on ‘individual differences in the patterns of physiological decline or psychosocial change, and the dependence of such patterns on social context and past history’ (Bookstein and Achenbaum, 1993: 29). These different deployments of the longitudinal method – and of the entity of the individual within – were not historically phased, and became instead articulated as different sets of epistemic practices, devices and norms, particularly as understanding the relationship between ageing, health and life expectancy became more pressing. Nowhere is this tension more evident than in the evolution of the BLSA, a major programme of investigation into the nature of the ageing process which the US National Institute of Aging has funded from 1958 to the present day. Headed for 25 years by Nathan Shock, himself an active researcher in child development research in the 1930s, the BLSA, like other longitudinal studies of ageing, was shaped by the interplay between these different agencements of the ageing individual. On the one side, there were those who emphasised randomisation and sampling to evidence claims about, and justify policies with respect to, the aetiology of disease. These relied on age group averages and regressions to the mean to devise normative standards for policy and practice. They were Queteletian in their approach to ageing and illness, aiming to use population data to calculate a ‘true value’ (Hacking, 1990; Desrosières, 2008: 130-138). Here, individuals are seen to be formed by the combination of shared characteristics, along multiple variance curves. On the other side, most notably headed by Nathan Shock himself, there were those who evoked the technical repertoire of physiological research, especially the notion of the ‘model organism’ – a purified, simplified workable exemplar, normally
contained within laboratory-like conditions. Their practices can thus be located in the articulation between ‘biological age’ and ‘uniqueness’ described in the previous chapter, in that they viewed unusual, extraordinary cases as epistemically valuable exactly because they lacked ‘representativeness’. In this agencement, the individual who is brought to bear is a singular, unique person. In the chapter, I first describe the myriad sociotechnical strands that enabled the establishment of the BLSA, to then examine how different enactments of the relationship between knowledge making procedures and the management of ageing-related processes interacted to shape the current consensus on the individual nature of that process. In this, I am arguing that this consensus was established because, and not despite, of the unstable and contested meaning of the ‘individual’ with longitudinal studies of ageing and health. This fluidity is of consequence to our understanding of the epistemic infrastructure of pervading individualisation processes that sociologists of the life course have otherwise linked to economic globalisation, labour market deregulation and the restructuration of public services since the 1980s.
