This paper aims to look at how factors like inequality in health outcomes may be created by social responses and economics, and the policies created to contend with these changes. These factors also present challenges to older people's dignity, independence, and choice in determining their levels of adaptation to their personal health expectations. A literature 'review took place in response to a question that was raised in discussion following an academic seminar on older people and pain. This question asked, "whether older people's socioeconomic and health status had a relationship with their ability to maintain independence, dignity when accessing health services and choice when pain is a marker for loss of these factors." The review includes published papers linking socioeconomic issues in understanding the debilitating effects of older age. It includes publications on the perception of pain in complex conditions that affect staff and older people's expectations of choice in care, dignity when receiving care, and maintenance of independence. The literature reviewed draws upon information about the older population in Britain, and reflects similar problems with people in the same age group, encountered in other cultures. The results are presented here as a discussion of the findings.A search of the health journals online was conducted using AHMED, CINAHL, MEDLINE, EMBASE, Science Citation Index, and ageinfo. These databases include access to economics journals. Where policy, economic, and actuarial reports were known to exist, the specific sources were hand-searched. This paper is made up of three main sections. In the 259 Brought to you by | University of Arizona Authenticated Download Date | 6/7/15 5:36 PM SHORT GLOSSARY OF TERMS GDP=Gross Domestic Product. This is a way of measuring the size of the total economy during a given year. This is what a country produces. Gross Domestic Product has a monetary value and the expenditure is calculated from this GDP for all public services and Government spending. This would include for example; defense, health and social services, education, the legal system, and Government administrative activity.GNP=Gross National Product. This is the sum in any given year that can be calculated by Governments that it can receive from all taxation. This money is used by Government to spend on GDP.