How has the societal perception and treatment of the elderly evolved throughout American history, and what structural changes are required to improve current support systems? David Hackett Fischer, a distinguished historian, examines the shifting cultural attitudes toward aging from the colonial era through the modern industrial age. He argues that the transition from a society that venerated age to one that marginalizes it necessitates a fundamental reassessment of existing social welfare frameworks, including pensions and healthcare programs.

Historians and policy analysts frequently cite this work as a foundational text for understanding the cultural roots of American gerontology. Readers often note the academic density of the prose, which provides a comprehensive historical context for contemporary debates on social security reform.