Inequalities in health in an ageing population

In collaboration with the Institute for Fiscal Studies (IFS)
Funded by the Economic and Social Research Council (ESRC)

Principal researchers:

The nature and extent of health inequalities within the older population is little understood, but has important implications for a range of policy issues as life expectancy increases and our population continues to age. By 2020 the over-50s will constitute over 40% of the British population and by 2040 30% will be aged 60 or over. However, these overall trends mask considerable diversity in longevity and health within the older population. For example, life expectancy at age 65 differs markedly by socio14 September, 2012lass I can expect to live an additional 17.5 years once they reach the age of 65, while those in social class V can expect to live only another 13.4 years.

In addition, despite lengthened life expectancies, many individuals now effectively retire before the state retirement age – less than 50% of men aged between 60 and 64 are currently in paid employment, with a large proportion in this age group dependent on disability benefit income. In contrast, the contribution by retirees to informal care and voluntary activities provides a potentially important input into both the economy and their own well-being.

A crucial policy question, therefore, is, which sections of the older population will live healthy, active lives and which will be dependent on formal and informal sources of support.

The proposed project, drawing together a multi-disciplinary team, aims to understand how health, disability and well-being are distributed in the older population and the factors that drive the observed patterning of inequality in health. To do this we will address the following questions:
1. What is the extent of inequalities in health in older groups and how does this vary by age, gender and health outcome?
2. Are inequalities in health at older ages related to material well-being and how does this differ across income and type of wealth?
3. How far are material effects on health mediated by psychosocial factors, in particular the changes in roles and status that may accompany growing older and retirement from paid work? And how does this vary by gender?
4. Does the relationship between health and economic position vary with age, and do the factors that protect against health-related downward social mobility vary across socioeconomic, gender and age groups?
5. How do health inequalities relate to social participation and social productivity?

To answer these research questions we will examine two waves of data collected as part of the English Longitudinal Study of Ageing (ELSA), together with baseline data obtained when ELSA sample members participated in the Health Survey for England. The analytical approach adopted in this study will be to start with simple descriptive statistical tools to map the extent of health inequalities among the ELSA sample. We will then build regression models of the relationship between health status and a range of social, economic, and psychosocial determinants using data from a single point in time. These will be used to test a number of hypotheses set out in the research aims. Our research will then make use of the panel element of ELSA data to examine the dynamic inter-relationships between health status and its determinants over time.

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