Social exclusion of older persons: a scoping review and conceptual framework

Abstract

As a concept, social exclusion has considerable potential to explain and respond to disadvantage in later life. However, in the context of ageing populations, the construct remains ambiguous. A disjointed evidence-base, spread across disparate disciplines, compounds the challenge of developing a coherent understanding of exclusion in older age. This article addresses this research deficit by presenting the findings of a two-stage scoping review encompassing seven separate reviews of the international literature pertaining to old-age social exclusion. Stage one involved a review of conceptual frameworks on old-age exclusion, identifying conceptual understandings and key domains of later-life exclusion. Stage two involved scoping reviews on each domain (six in all). Stage one identified six conceptual frameworks on old-age exclusion and six common domains across these frameworks: neighbourhood and community; services, amenities and mobility; social relations; material and financial resources; socio-cultural aspects; and civic participation. International literature concentrated on the first four domains, but indicated a general lack of research knowledge and of theoretical development. Drawing on all seven scoping reviews and a knowledge synthesis, the article presents a new definition and conceptual framework relating to old-age exclusion.Electronic supplementary materialThe online version of this article (doi:10.1007/s10433-016-0398-8) contains supplementary material, which is available to authorized users.

Constructing and negotiating social participation in old age: experiences of older adults living in urban environments in the United Kingdom

“…Yet, urban areas in their current form do not always create viable environments in which to age. Research suggests that urban areas can be isolating and hostile environments for older people, where feelings of social isolation, insecurity and vulnerability are common (Lui et al 2009;Phillipson 2004;Syed et al 2017;Walsh, Scharf and Keating 2017). Moreover, research has challenged the notion of domestic homes and communities as consistently positive environments within which to age; such environments can rapidly assume negative associations in old age with shrinking support networks, changing mobilities, barriers to the physical environment and restricted opportunities for engagement (Means 2007;Wiles et al 2012).…”

Quality of life of the very old

“…This policy is committed to enabling old and very old citizens to live their lives in a self-determined manner, preferably in the middle of society. Not much, however, is known about the impact of social inequalities, such as social exclusion or even discrimination, on quality of life in this segment of the population [30]. The relevance of social inequalities on health and living conditions (e. g. level of accommodation and housing, activities and social support) need to be taken into account for future policy making.…”

A geographical multivariable multilevel analysis of social exclusion among older people in China: Evidence from the China Longitudinal Aging Social Survey ageing study

“…Social exclusion is a broad concept that refers to the separation of individuals or groups from mainstream society. It is a dynamic and multi‐dimensional process that deprives people of the rights, resources and services available to the majority (Kneale, ; Sacker et al., ; Walsh et al., ). The process of social exclusion can be driven by poverty, lower levels of educational attainment, ill health, limited social support, age‐based discrimination or other unequal power relationships interacting across four main dimensions: economic, political, social and cultural (Bradshaw et al., ; Phillipson & Scharf, ; Popay et al., ); and arising at different levels, including individual, household, group, community, country and global levels (Popay et al., ).…”

“…Walsh et al. (, p. 81) summarised that social exclusion among older people reflects “the combination of demographic ageing patterns, on‐going economic instability and the susceptibility of ageing cohorts to increasing inequalities.” A theoretical framework to explain the factors that may lead to social exclusion of older people includes at least four perspectives: age‐related characteristics (including loss of paid work, low income and poor health – frailty or prevalence of illness due to ageing); cumulative disadvantage (vulnerable social position over the life course that leads to inequalities being more pronounced in later life compared with earlier life); ageism; and inadequate infrastructure and planning of living environments (Jose & Cherayi, ; MacLeod et al, ; Phillips & Feng, , 2018; Van Regenmortel et al., ; Yuan & Ngai, ). All of these features may limit social contact or participation of older adults in various domains of life, which results in older people being more vulnerable to social exclusion than younger age groups (Feng, ; Scharf & Keating, ; Tong & Lai, ).…”

“…All of these features may limit social contact or participation of older adults in various domains of life, which results in older people being more vulnerable to social exclusion than younger age groups (Feng, 2011;Scharf & Keating, 2012;Tong & Lai, 2016). Nevertheless, studies of social exclusion among older people are still relatively rare and have mainly been undertaken in higher-income countries (Van Regenmortel et al, 2016;Walsh et al, 2017). International studies of critical, comparative and analytical perspectives of social exclusion are very few (Scharf, 2015; see also Walsh et al, 2017).…”