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

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.

A Bourdieusian approach to class‐related inequalities: the role of capitals and capital structure in the utilisation of healthcare services in later life

“…However, measures of socioeconomic status provide descriptive classifications of socioeconomic inequalities but offer limited insights into how and why such inequalities exist (Connell and Connell ). Moreover this may particularly be the case for older people, as traditional ways of measuring socioeconomic status via income, education and occupation are even more problematic once people retire from paid employment (Allin , Nazroo ).…”

“…By looking into the relative contribution of each of the capitals and the effects of different compositions of capitals, we aim to contribute to a broader understanding of the class-related mechanisms of healthcare access in later life. This is especially important as studies have shown that ageing populations have been rather neglected in research on class and health (Nazroo 2017). We begin by providing a more detailed summary of Bourdieusian approaches to understanding capital.…”

“…In the study of health inequalities, Bourdieu's capitals have been used to empirically unveil the class-related mechanisms producing inequality in health outcomes, such as mortality, physical health and mental health (McGovern and Nazroo 2015, Nazroo 2017, Pinxten and Lievens 2014, Veenstra 2007, Veenstra and Patterson 2012. For instance, Bourdieu's lens has proven helpful in explaining the use of mammography screening, where cultural health capital accumulated early in life was an independent predictor of attending a mammography screening in later life, even after controlling for socio-economic position (Missinne et al 2014).…”

Ageing, Health and Equity—Broad Perspectives Are Needed to Understand and Tackle Health Challenges of Ageing Societies

“…The papers of Nazroo [ 6 ], Hoebel et al [ 7 ], Schönbach et al [ 8 ], and Schoenmakers et al [ 9 ] focus on social inequality and health among the elderly, alternatively investigated under a class or ethnicity-cultural lens.…”

The Policy Development of Social Welfare for Elderly Health Care in the Community: A Case Study of Phitsanulok Municipality, Thailand

“…Nevertheless, this requires concerned organisations to cooperate with partners and stakeholders in all sectors of the community (Black & Lipscomb, 2017). It is also important that seniors take part in the process of developing the quality of life of the elderly in the community in order to achieve the goals set (Phillips, 2018;Nazroo, 2017;Dong, 2015).…”