Population Change and Lifecourse

Policy Brief #23 - May 2015

Health Inequalities Among Older Adults: Reconciling Theories and Policy Approaches

Summary

Despite universal access to healthcare, there are disparities in older people’s health status in developed countries. These inequalities are rooted in lifelong differences in social and economic status. Government policies to assist older people may end up reinforcing these inequalities if they fail to create a buffer against their effects. However, best case practices and WHO guidance show that policies can also mitigate against the effects of lifelong disadvantage in older age. There is opportunity to design initiatives for older people in Canada that lessen the disparities in health outcomes that we currently see.

Key Findings

Sociological Theories on Health Disparities

Figure1_SociologicalTheories

While we all might start our lives at an equal status, socio-economic (SES) (dis)advantage can cause us to follow different trajectories to end up where we are today. Theories in sociology have attempted to explain disparities in people’s social/health status:

Linking Theories to Policies for Older People

Figure2 - Theories to Policies

Government policies such as welfare state initiatives can mitigate against the effects of lifelong inequalities (Briggs 2000). But government policies can also reinforce the effects of lifelong disparities if access to schemes they promote, such as tax-free savings plans, depend on pre-existing means. For example:

WHO Guidance and Case Examples of Policies

The World Health Organization (WHO) has two key approaches to policies (‘Health in All Policies’ and ‘Age-Friendly Environments Program’) that support reducing disparities and providing targeted services to older people. The Advantage Initiative Model was adopted in an area of Washington state and experienced success by focusing on outreach to isolated seniors.

PolicyBrief23_Table1

Sociological Research to Support Policy

Figure 3

Further sociological research can help to support policymakers by providing evidence on the most effective approaches to supporting older people. Two key areas to develop are:

Policy Implications

Policies designed to support older people might worsen disparities in health if they do not consider cumulative social disadvantage. In particular, policies that rely on individuals’ means to contribute can further inequalities in old age.

Government policies can embed means to lessen these inequalities. Such policies and programs could revolve around cross-working between government departments and local agencies, incorporating age-friendly design into communities, and/or creating targeted outreach programs for vulnerable older people.

References

About this Brief

This brief is based on Amélie Quesnel-Vallée, Andrea Willson, and Sandra Reiter-Campeau (2015) Health Inequalities among Older Adults in Developed Countries: Reconciling Theories and Policy Approaches, PCLC Discussion Paper 3(1):6.

This brief summarizes policy options that can reduce health inequalities in older adults and sociological theories explaining health disparities in older people. This also highlights implications for further sociological research.

For more information, please contact Amélie Quesnel-Vallée, McGill University.