Class and Health Inequality in Later Life: Patterns, Mechanisms and Implications for Policy.

James Nazroo

doi:10.3390/ijerph14121533

Abstract

The growth of the post-retirement population, which has occurred as a result of rapid growth in life expectancy coupled with the ageing of the baby boomer cohort, has led to significant concern. This concern, however, typically neglects the heterogeneity of later life experiences and how these are patterned by inequalities that reflect how process of social stratification continue to operate into later life. This paper draws on a programme of work, based on analysis of the English Longitudinal Study of Ageing, to empirically examine questions of inequality in later life. It begins by illustrating the patterning of health inequality. It then investigates the importance of later life contexts and events in shaping inequality through and after the retirement process. In doing so it examines the extent to which later life continues to reflect stable social structures that shape inequalities and, consequently, health and wellbeing in later life. The paper then illustrates how the effects of socioeconomic position on health in later life can be theorised as a product of class processes, borrowing in part from Bourdieu. Other dimensions of inequality, such as gender, ethnicity, area and sexuality, are not discussed here. The paper concludes with a discussion of the need for a close focus on inequalities in later life in research, policy and practice.

Highlights

The challenges that arise as a result of the rapid ageing of the population have been the focus of a significant body of policy and academic analysis, and of enquiries held by international and national bodies
This paper reports on research that provides clear evidence of large socioeconomic inequalities in health in later life and examines the class-related mechanisms that lead to such inequalities
It first shows that socioeconomic position, as assessed by economic wealth is strongly related to health and wellbeing outcomes

Summary

Introduction

The challenges that arise as a result of the rapid ageing of the population have been the focus of a significant body of policy and academic analysis, and of enquiries held by international and national bodies. The first International Plan of Action on Ageing was agreed in Vienna in 1982 [1], and over the last three and a half decades there has been an exponential increase in such publications. These reports have largely taken on an apocalyptic tone, even when this has been paralleled with discussion of the potential opportunities that ageing populations provide. “Among the many trends that compete for the attention of policy makers these days, none is more likely to shape economic, social, and political developments in the early twenty first century than the simultaneous aging of Japan, Europe, and the United States. We must adapt the social institutions built around it to these new realities”

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