Socioeconomic inequalities in health in later life

Abstract

Socioeconomic differences in health and life expectancy are key issues for public health and health policy. In the course of demographic change, in addition to childhood, adolescence and middle adulthood, old age is increasingly becoming the focus of attention in research on health inequalities, with aspecial emphasis on the transition from working age to retirement. How do health inequalities change in the transition from middle to older age and then to very old age? This article reviews the studies available for Germany, supplemented with new analyses based on the German Health Update study and the German Socioeconomic Panel study. In order to set the findings in the context of international research on health inequalities in old age, selected studies from other countries and international comparative studies are additionally considered. Social differences in health and remaining life-expectancy also exist in older age, although to aslightly lesser extent than in middle age. There is evidence that as age progresses, health inequalities narrow in some health domains but there is also isolated evidence that health inequalities may widen with age. The existence of health inequalities in old age indicates that older people from disadvantaged social groups have aparticular need for healthcare and support. This poses special challenges for the medical, nursing and psychosocial care system as well as for the social security systems.