Rachael Docking explains how factors throughout life can compound to make later life challenging, and points to how such inequalities might be tackled
There are stark inequalities in how differently people can experience later life; it is an enjoyable and healthy period for some and a time of profound challenge for others. The causes of such diversity are complex, inter-related and challenging to address.
The Centre for Ageing Better recently published a review of evidence from the past decade aiming to understand the nature of inequalities related to:
- Physical and mental health
- Social connections
- Healthy life expectancy
- Financial security
- Subjective wellbeing
- Living environment
For each outcome, researchers from Newcastle University and International Longevity Centre - UK considered inequalities relating to characteristics such as gender, race, age and socio-economic status. We found that a combination of individual circumstances and experiences throughout a person's lifetime play a role in determining their quality of life in later life.
Adverse circumstances in childhood, poor education and work opportunities, along with weak social connections, can compound to create long-term consequences for people's income, health and wellbeing in older age. This can be made worse by factors such as reduced retirement income and long-term health conditions.
We also found that multiple factors can combine and overlap to influence individual and group experiences of later life. For example, on average, women are at greatest risk of financial insecurity owing to poor retirement income. The same applies on average to people from black and minority ethnic (BME) communities, and so women from BME communities can experience even greater inequalities in this respect.
What kinds of inequalities exist in later life?
Huge disparities exist in health, financial security, social connections and housing, with negative impacts accumulating as people grow older. These inequalities are largely a product of poverty and disadvantage throughout life. Women are disproportionately disadvantaged, as are those with BME backgrounds, and some evidence suggests that those from lesbian, gay, bisexual and transgender communities may be at increased risk of inequalities in later life.
We also found:
Physical and mental health: Older people with the least wealth are more likely to have one or more health problems, including angina, diabetes, depression, osteoarthritis and cataracts. Poorer people in later life are up to 4.2 times more likely to have diabetes and up to 15.1 times more likely to have osteoarthritis. Socioeconomic status in early life continues to affect health outcomes in older age. Evidence suggests that the impact of disadvantage experienced in early life can be lessened if one's socioeconomic status improves over time.
Financial security: Only 36% of women aged 65-69 years received the full state pension in 2014, compared with 88% of men of the same age. Female part-time workers or those in low-grade jobs are at greater risk, and women who have spent most of their lives working part-time are no better off in retirement than women who have never worked. Evidence suggests that people from ethnic minority backgrounds are less likely to have adequate pension savings, with women at particular risk.
Social connections: Higher education and wealth are associated with better social connections and leisure activity in later life. Older lesbian, gay and bisexual people can experience challenges that others don't face - for some the impact of losing a partner can be worsened if their networks perceive their bereavement as loss of a 'friend'.
Home and living environment: Many older people in socially deprived areas worry about safety, security and mobility in their living environment. Older people with visual impairment experience worse housing outcomes, in terms of tenure and home condition, than people with good vision. A lack of research about housing inequalities for older people means we don't understand fully how poor housing affects those in later life.
What needs to be done?
Our research has been a stark reminder of the persistent nature of inequalities affecting people in later life. For too long we have ignored or overlooked diversity in our ageing population, through focusing primarily on the differences between young and old, rather than the differences that exist within generations.
Given that our ageing population is becoming increasingly diverse, the problems are likely to get worse without measures to tackle them.
A good later life is something we should expect for everyone. It should not be conditional on where we live or how much money we have. Our gender, race, disability or sexuality should not be barriers. This is a challenge not only for government but for society as a whole. It requires policy and practice that is tailored, flexible and responsive, and focuses on addressing the root-causes of disadvantage.
Read the full report on the Centre for Ageing Better website: www.ageing-better.org.uk
Dr Rachael Docking is senior evidence manager for the Centre for Ageing Better