1. Inequalities in Old Age
Thomas Scharf
Newcastle University Institute for Ageing
@NCLAgeing
The Future of Ageing
ILC-UK Conference 2017
2. Outline
• Inequalities in later life
- What do we know?
- Where do we need more evidence?
• Responding to inequalities in later life
- Why is a response needed?
- Who needs to respond?
• Towards a more joined-up approach
- Transforming ageing policy and practice
• Five key messages
3. Inequalities in later life
What do we know?
• Scoping review by Newcastle University and ILC-UK
for Centre for Ageing Better
- Robust but non-exhaustive review of inequalities
affecting people aged 50+ in England
- Outcomes: physical and mental health; (healthy)
life expectancy; subjective wellbeing; social
connections; financial security; living environment
- Inequalities associated with: gender, race, age,
disability, sexual orientation; socioeconomic
status; geography; being a carer
4. • Six separate reviews of empirical evidence relating
to each of the selected outcomes:
- What is the scale and nature of inequalities in
terms of specific outcomes in later life?
- What is the quality and strength of the evidence,
and where are there gaps or limitations in the
evidence base?
• Findings to be launched at event hosted by Centre
for Ageing Better on 6 December 2017
Inequalities in later life
What do we know?
5. • Deep-seated and persisting nature of inequalities
based on such factors as age, gender,
socioeconomic status, place of residence, care
relations
• Later life unnecessarily diminished in quality and
quantity for key groups in society
• Evidence strongest in relation to inequalities in
physical and mental health, life expectancy and
healthy life expectancy, financial security
• More work to be done in other areas, especially to
reflect better the diversity of ageing
Inequalities in later life
Where do we need more evidence?
6. “We hold out this hope for those of us committed to
critical gerontology … that we do whatever we do
with passion and a belief that our scholarship can
make a difference: that is move people to action.”
(Holstein and Minkler, 2007, p 26).
Responding to inequalities
Engaging in “passionate scholarship”
7. Responding to inequalities
Why is a response needed?
• Powerful social justice arguments
- Equity within and between social groups
• Powerful political arguments
- Social cohesion in a post-Brexit UK
- Solidarity between and across the generations
• Powerful economic arguments
- Loss of productivity, increased costs
- Changing labour markets
- Changing patterns of consumption
8. Responding to inequalities
Who needs to respond?
• A task that no single sector can tackle on its own
• Need for a ‘whole-system’ response that draws on
‘Quadruple Helix’ model:
- Government
- Industry/business
- Academia
- Civil society
• Requires political leadership but also involves all
organisations present at ILC-UK conference (e.g.
Centre for Ageing Better, National Innovation Centre
for Ageing, Legal & General, DWP, Campaign to End
Loneliness, Anchor, Newcastle University Institute for
Ageing, Age-friendly Manchester, ILC-UK…)
9. Towards a more joined-up approach?
Case study
The inequalities challenge for ‘age-friendly’ cities
and communities
• How should age-friendly cities and communities
respond to robust evidence of socio-spatial
inequalities in later life?
• Loss of capacity of local authorities to address
causes and consequences of inequality:
- Limited opportunity or support for redistribution of
resources (through taxation)
- Centralisation of decision-making processes
- Loss of supportive infrastructures
10. Unequal life expectancies
City Average male life
expectancy in years
City Average male life
expectancy in years
Glasgow City 72.6 Leeds 78.0
Manchester 74.8 London Borough
of Southwark
78.0
Belfast 75.2 Coventry 78.1
Liverpool 76.1 London Borough
of Lewisham
78.2
Salford 76.1 Bristol 78.3
Derry City (and
Strabane)
76.4 Brighton & Hove 78.7
Stoke-on-Trent 76.7 Sheffield 78.7
Nottingham 76.9 United Kingdom 78.9
Sunderland 77.0 Stockport 79.8
Newcastle 77.5 Isle of Wight 80.0
Source: Office for National Statistics, 2015
11. Transforming ageing policy and
practice
• Age-friendliness has the potential to address
unequal ageing. For example, by:
− Promoting decent employment opportunities
− Enhancing service/support access
− Improving social connections
− Creating opportunities for civic engagement
− Improving the physical environment
• Since this won’t happen spontaneously, addressing
causes and consequences of unequal ageing should
become embedded within age-friendly policies and
programmes
12. • Age-friendliness also implies challenging policies,
programmes and practices associated with widening
inequalities in later life
• Value of aligning age-friendly initiatives with related
programmes orientated towards tackling (health)
inequalities (e.g. Marmot, 2010)
• Implies a much stronger focus of age-friendly
initiatives on disadvantaged persons and
communities
Transforming ageing policy and
practice
13. 1. We already know a lot about inequalities in later
life
2. There are compelling arguments that justify
taking action to reduce inequalities
3. The key challenge is political: how do we move
people to action around unequal ageing?
4. Action on reducing inequalities involves everyone
5. Interventions required across entire life course
Key messages