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Comparing socio-economic inequalities in healthy ageing in the United States of America, England, China and Japan: evidence from four longitudinal studies of ageing
- Authors:
- LU Wentian, PIKHART Hynek, SACKER Amanda
- Journal article citation:
- Ageing and Society, 41(7), 2021, pp.1495-1520.
- Publisher:
- Cambridge University Press
Healthy ageing has become a popular topic worldwide. So far, a consensus measure of healthy ageing has not been reached; and no studies have compared the magnitude of socio-economic inequality in healthy ageing outside Europe. This study aims to create a universal measure of healthy ageing and compare socio-economic inequalities in healthy ageing in the United States of America (USA), England, China and Japan. We included 10,305 American, 6,590 English, 5,930 Chinese and 1,935 Japanese participants for longitudinal analysis. A harmonised healthy ageing index (HAI) was developed to measure healthy ageing multi-dimensionally. Educational, income and wealth rank scores were derived accounting for the entire socio-economic distribution and the sample size of each category of socio-economic indicator. Associations between socio-economic rank scores and HAIs were assessed using multi-level modelling to calculate the Slope Indices of Inequality. Healthy ageing trajectories were predicted based on the full-adjusted age-cohort models. We found that education was a universally influential socio-economic predictor of healthy ageing. Moving from the highest to the lowest educational groups was associated with a 6.7 (5.2–8.2), 8.2 (6.0–10.4), 13.9 (11.4–16.3) and 6.1 per cent (3.9–8.2%) decrease in average HAI at 60 years in the USA, England, China and Japan, respectively. After 60 years, the educational inequality in healthy ageing kept increasing in the USA and China. The educational inequality in healthy ageing in China was also greater than any other socio-economic inequality in the four countries. Wealth was more influential in predicting healthy ageing inequality among American, English and Japanese participants, while income was more influential among Chinese participants. The socio-economic inequality in healthy ageing in Japan was relatively small. Chinese and American participants had worse healthy ageing profiles than Japanese and English participants. (Edited publisher abstract)
Never-married childless women in Australia: health and social circumstances in older age
- Authors:
- CWIKEL Julie, GRAMOTNEV Helen, LEE Christina
- Journal article citation:
- Social Science and Medicine, 62(8), April 2006, pp.1991-2001.
- Publisher:
- Elsevier
A growing proportion of women reach older age without having married or having children. Assumptions that these older women are lonely, impoverished, and high users of social and health services are based on little evidence. This paper uses data from the Older cohort of the Australian Longitudinal Study on Women's Health to describe self-reported demographics, physical and emotional health, and use of services among 10,108 women aged 73–78, of whom 2.7% are never-married and childless. The most striking characteristic of this group is their high levels of education, which are associated with fewer reported financial difficulties and higher rates of private health insurance. There are few differences in self-reported physical or emotional health or use of health services between these and other groups of older women. Compared with older married women with children, they make higher use of formal services such as home maintenance and meal services, and are also more likely to provide volunteer services and belong to social groups. Overall, there is no evidence to suggest that these women are a “problem” group. Rather, it seems that their life experiences and opportunities prepare them for a successful and productive older age.
Age is just a number: views among people aged 50 and over in the English Longitudinal Study of Ageing
- Author:
- CENTRE FOR AGEING BETTER
- Publisher:
- Centre for Ageing Better
- Publication year:
- 2018
- Pagination:
- 9
- Place of publication:
- London
This analysis of data from the English Longitudinal Study of Ageing, shows that across a sample of more than 6,000 people aged 50 and over in England, most are feeling fairly good about ageing, with 60 percent saying that growing older is a positive experience. However, the evidence shows large and consistent differences in attitudes across socio-economic groups. With people in routine occupations more likely to say that age often prevents them from doing the things and expecting to get lonelier as they get older, compared to those in high-status occupations. That data also suggests that if people feel negative about getting older, they can also, have a worse experience of ageing, such as poorer health outcomes. (Edited publisher abstract)
Losing the battle: perceived status loss and contemplated or attempted suicide in older adults
- Authors:
- DOMBROVSKI Alexandre Y., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 33(7), 2018, pp.907-914.
- Publisher:
- Wiley
Objective: While loss of socioeconomic status (SES) has been linked to suicidal behaviour, it is unclear whether this experience is merely a downstream effect of psychopathology (“downward drift”), a sign of hardship, or an independent psychological contributor to suicide risk. The association between the subjective experience of status loss and suicidal behaviour and ideation in old age, while accounting for potential confounders was examined. The researchers were also interested in whether status loss was associated with mere thoughts of suicide vs. suicidal behaviour. Methods: Fifty older (55+) depressed suicide attempters, 29 depressed suicide ideators with no history of attempted suicide, 38 nonsuicidal depressed participants, and 45 nonpsychiatric controls underwent detailed clinical characterization and reported their current and highest lifetime SES. Results: Suicide attempters were more likely to report a decline in their SES compared to healthy controls and nonsuicidal depressed older adults, while not differing from suicide ideators. This difference was not explained by objective predictors of SES, including education, financial difficulties, and the presence of addiction. Interestingly, while the current SES of suicide attempters was much lower than that of comparison groups, their reported highest lifetime SES was just as high, despite the differences in education. Conclusion: In older adults, the experience of status loss is associated with contemplated and attempted suicide even after accounting for objective indicators of social status and psychopathology. It is possible that suicidal individuals retrospectively inflate their previous status, making their current standing appear even worse by comparison. (Edited publisher abstract)
Identifying frailty risk profiles of home-dwelling older people: focus on sociodemographic and socioeconomic characteristics
- Authors:
- DURY Sarah, et al
- Journal article citation:
- Aging and Mental Health, 21(10), 2017, pp.1031-1039.
- Publisher:
- Taylor and Francis
Objectives: This paper investigates risk profiles of frailty among older people, as these are essential for detecting those individuals at risk for adverse outcomes and to undertake specific preventive actions. Frailty is not only a physical problem, but also refers to emotional, social, and environmental hazards. Methods: Using data generated from the Belgian Ageing Studies, a cross-sectional study (n = 28,049), we tested a multivariate regression model that included sociodemographic and socioeconomic indicators as well as four dimensions of frailty, for men and women separately. Results: The findings indicated that for both men and women, increased age, having no partner, having moved house in the previous 10 years, having a lower educational level and having a lower household income are risk characteristics for frailty. Moreover, when looking at the different frailty domains, different risk profiles arose, and gender-specific risk characteristics were detected. Discussion: This paper elaborates on practical implications, and formulates a number of future research recommendations to tackle frailty in an ageing society. The conclusion demonstrates the necessity for a thorough knowledge of risk profiles of frailty, as this will save both time and money and permit preventive actions to be more individually tailored. (Edited publisher abstract)
Changes in vision in older people: causes and impact
- Authors:
- NAZROO James, WHILLANS Jennifer, MATTHEWS Katey
- Publisher:
- Thomas Pocklington Trust
- Publication year:
- 2015
- Pagination:
- 7
- Place of publication:
- London
Summarises findings from research using data from the English Longitudinal Study of Ageing (ELSA) to look at the links between development of visual impairment and older peoples’ social and economic position, and the impact of both deteriorating and improving sight on key aspects of their lives. Findings are presented in the following areas: the relationship between self-reports and objective measures of vision; the relationship between wealth, social status and developing visual impairment; other risk factors for developing visual impairment; uptake of cataract surgery; and consequences of change in vision. The findings showed that older people in the poorest fifth of the population had an almost 80% higher risk of developing severe visual impairment than those from the wealthiest fifth. Deterioration in vision over a two year period was also related to decreases in income, quality of life and social activity. People whose vision deteriorated from good or very good to fair or poor were found to have levels of depression that increased by 29% and a fall in income levels of 19%, compared to the changes for those whose vision remained stable. (Edited publisher abstract)
Early-life characteristics, psychiatric history, and cognition trajectories in later life
- Author:
- BROWN Maria Teresa
- Journal article citation:
- Gerontologist, 50(5), October 2010, pp.646-656.
- Publisher:
- Oxford University Press
The relationship between a history of psychiatric problems and cognitive function in later life is not very well documented. This study explores the relationship between psychiatric problems and cognitive function or decline in later life, and also attempts to identify populations more likely to be affected. The study applied a longitudinal analysis of six waves of the Health and Retirement Study data. Growth curve models were used to analyse the relationships between childhood health and disadvantage, psychiatric history, and cognitive function, controlling for demographics, health behaviour, and health status. The results indicated that a history of psychiatric problems is associated with lower cognitive function and steeper declines in cognitive function with age. The influence of childhood health is mediated by later-life health status and behaviours. A combined history of childhood disadvantage and psychiatric problems more strongly affects cognitive function, but cognitive declines remain consistent with those associated with psychiatric history. These effects are partially mediated by later-life demographic, socioeconomic, or health characteristics. The findings demonstrate that cumulative disadvantage and a history of psychiatric problems shape later-life cognition and cognitive decline.
Social inequalities in facing old-age dependency: a bi-generational perspective
- Author:
- SARACENO Chiara
- Journal article citation:
- Journal of European Social Policy, 20(1), February 2010, pp.32-44.
- Publisher:
- Sage
Population ageing implies the ageing of family and kinship networks; sometimes defined in terms of the “beanpole family” where there are few (or fewer) members in each generation. As the absolute number of the frail elderly increases, a top-heavy intergenerational chain can be expected to put stress on the middle generation as those either side compete for their support. This raises issues around financial and time resources for the middle and younger generations when frailty emerges in the older generation. The author begins by presenting a conceptual framework for the development of a bi-generational analysis of the social care package for dependent elderly and of its impact on social inequalities. She goes on to present an overview of elderly care policies in all EU countries on the basis of that framework and discusses existing knowledge about social class and cross country differences in patterns of intergenerational support. The review considers whether social inequality affects resources available to the dependent elderly and how a frail elderly person’s demands impact differently on children’s resources and life chances across gender and social classes, as well as what the impact of specific patterns of public care provision (other than healthcare) is on these inequalities.
After age 60 India: a glimpse through census and NSSO
- Authors:
- SINGH D.P., YESUDIAN Princy
- Journal article citation:
- Indian Journal of Social Work, 68(4), October 2007, pp.545-560.
- Publisher:
- Tata Institute of Social Sciences
As a means of helping the planning and policy makers to provide for the need of older people in India, this paper analyses the findings of the decennial Census of India and a National Sample Survey Organisations. The figures are discussed in relation to the ageing trend, spatial distribution of the elderly, socioeconomic and health profile.
Living status and psychological well-being: social comparison as a moderator in later life
- Authors:
- CHENG Sheung-Tak, FUNG Helene H., CHAN Alfred C. M.
- Journal article citation:
- Aging and Mental Health, 12(5), September 2008, pp.654-661.
- Publisher:
- Taylor and Francis
Older adults who live alone have been found to have lower psychological well-being than their age peers who live with someone. This study examined whether downward social comparison, i.e. perceiving oneself as better than others, would moderate this relationship. A total of 205 Chinese aged 60 years or over were recruited. They rated themselves and 'someone their age' on a list of personal descriptions. Downward social comparison was defined as the extent to which their ratings of self were better than ratings of age peers. Life satisfaction and depression were measured by the Satisfaction with Life Scale and the CES-D Scale, respectively. Participants living alone were more depressed than those living with someone; yet this difference was larger among those with lower levels than those with higher levels of downward social comparison. This interaction effect was not found for life satisfaction. Findings suggest that, although living alone is a risk factor for depression in old age, its negative effect can be reduced or even eliminated when downward social comparison is practised. These findings highlight the importance and effectiveness of psychological adaptation in the face of relatively more objective challenges in old age.