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Living conditions in old age: Coexisting disadvantages across life domains
Stockholm University, Faculty of Social Sciences, Department of Social Work.
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The aim of this thesis was to analyse coexisting disadvantages in the older Swedish population. Coexisting disadvantages are those that occur simultaneously in various life domains. A person who simultaneously experiences several disadvantages may be particularly vulnerable and less well-equipped to manage daily life and may also need support from several different welfare service providers. Concerted actions may be needed for older people who experience not only physical health problems and functional limitations, but also other problems. Research that encompasses a wide range of living conditions provides a basis for setting political priorities and making political decisions.

The studies in this thesis used data from two Swedish nationally representative surveys: the Level of Living Survey, which includes people aged 18 through 75, and the Swedish Panel Study of Living Conditions of the Oldest Old, which includes people aged 77 and older.

Study I showed that the probability of experiencing coexisting disadvantages was higher in people 77 and older than in those aged 18 through 76. These age differences were partly driven by a high prevalence of physical health problems in older people. In all age groups, coexisting disadvantages were more common in women than men.

The longitudinal analyses in Study II indicated that coexisting disadvantages in old age persist in some people but are temporary in others. Moreover, the results suggested a pattern of accumulating disadvantages: reporting one disadvantage in young old age (in particular, psychological health problems) increased the probability of reporting coexisting disadvantages in late old age.  

Study III showed that physical health problems were a central component of coexisting disadvantages. The results also showed that being older; female; previously employed as a manual labourer; and divorced/separated, widowed or never married were associated with an increased probability of experiencing coexisting disadvantages. However, the experience of coexisting disadvantages differed: the groups associated with coexisting disadvantages tended to report different combinations of disadvantage.

Study IV showed that the prevalence of coexisting disadvantages in those 77 and older increased slightly between 1992 and 2011. Physical health problems became more common over time, whereas limited ability to manage daily activities (ADL limitations), limited financial resources and limited political resources became less common. Associations between different disadvantages were found in all survey years, but certain associations changed over time. The results suggest that in general, the composition of coexisting disadvantages in the older population may have altered over time.

In sum, results showed that coexisting disadvantages were associated with specific demographic and socio-economic groups. Physical health problems and psychological health problems were of particular importance to the accumulation and coexistence of disadvantages in old age.

Place, publisher, year, edition, pages
Stockholm: Department of Social Work, Stockholm University , 2016.
Series
Stockholm studies in social work, ISSN 0281-2851 ; 34
Keyword [en]
Old age, Living conditions, Welfare, Deprivation, Coexisting disadvantages, Inequality, Longitudinal analysis, Trends, Sweden
National Category
Social Work
Research subject
Social Work
Identifiers
URN: urn:nbn:se:su:diva-132238ISBN: 978-91-7649-472-1OAI: oai:DiVA.org:su-132238DiVA: diva2:950787
Public defence
2016-09-29, De Geersalen, Geovetenskapens hus, Svante Arrhenius väg 14, Stockholm, 10:00 (Swedish)
Opponent
Supervisors
Note

At the time of the doctoral defense, the following papers were unpublished and had a status as follows: Paper 3: Manuscript. Paper 4: Manuscript.

 

Available from: 2016-09-06 Created: 2016-08-01 Last updated: 2016-08-25Bibliographically approved
List of papers
1. Coexisting disadvantages across the adult age span: A comparison of older and younger age groups in the Swedish welfare state
Open this publication in new window or tab >>Coexisting disadvantages across the adult age span: A comparison of older and younger age groups in the Swedish welfare state
2013 (English)In: International Journal of Social Welfare, ISSN 1369-6866, E-ISSN 1468-2397, Vol. 22, no 2, 130-140 p.Article in journal (Refereed) Published
Abstract [en]

Heap J, Lennartsson C, Thorslund M. Coexisting disadvantages across the adult age span: a comparison of older and younger age groups in the Swedish welfare state To experience coexisting disadvantages the simultaneous lack of several different welfare resources implies a hampered ability to manage one's living conditions. Here, we study coexisting disadvantages in the oldest population compared with younger age groups in Sweden, by drawing on two linked, nationally representative surveys (n = 5,392). The measurement of coexisting disadvantages included physical health, psychological health, frequency of social contact, cash margin and political resources. The highest odds of coexisting disadvantages were found after age 75 age groups that are frequently excluded from studies of coexisting disadvantages. This pattern persisted when controlling for socio-demographic and socio-economic characteristics. The age pattern was partly driven by the high prevalence of physical health problems in the older population. However, even when excluding physical health problems, the odds of coexisting disadvantages were highest among people older than 85 the fastest-growing segment of the population in many Western countries.

Keyword
coexisting disadvantages, deprivation, welfare resources, oldest old, age span, age differences, Sweden
National Category
Social Work
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-88999 (URN)10.1111/j.1468-2397.2012.00886.x (DOI)000315692800003 ()
Note

AuthorCount:3;

Available from: 2013-04-09 Created: 2013-04-08 Last updated: 2016-08-11Bibliographically approved
2. Duration and accumulation of disadvantages in old age
Open this publication in new window or tab >>Duration and accumulation of disadvantages in old age
2015 (English)In: Social Indicators Research, ISSN 0303-8300, E-ISSN 1573-0921, Vol. 123, no 2, 411-429 p.Article in journal (Refereed) Published
Abstract [en]

The probability of experiencing simultaneous disadvantages in more than one life domain seems to be higher for the oldest old people than younger age groups. However, the experience of coexisting disadvantages among older adults is relatively underexplored. We set out to analyse whether coexisting disadvantages among older people are long-lasting or temporary, and whether there are patterns of an accumulation of disadvantages in old age or not. We used nationally representative, longitudinal data between 1991 and 2011. Respondents were born between 1916 and 1934. The following disadvantages were included: lack of social resources, lack of political resources, lack of financial resources, psychological health problems, physical health problems and mobility limitations. Results suggest differing experiences of disadvantage in old age. We found that reporting coexisting disadvantages in 1991 increased the probability of reporting coexisting disadvantages in 2011, but the correlation was moderate. This indicates that for some people, coexisting disadvantages in old age is relatively stable, while for others it is a temporary experience. Reporting one disadvantage in 1991 also increased the probability of reporting coexisting disadvantages in 2011, suggesting a pattern of accumulation of disadvantages. Again, this pattern may not be generalised to all people. To a large extent the observed accumulation of disadvantages in old age seemed to be driven by physical health deterioration and mobility limitations.

Keyword
Oldest old, Ageing, Disadvantage, Health, Longitudinal analysis
National Category
Public Health, Global Health, Social Medicine and Epidemiology Social Work
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-112578 (URN)10.1007/s11205-014-0744-1 (DOI)000360006900006 ()
Available from: 2015-01-12 Created: 2015-01-12 Last updated: 2016-08-11Bibliographically approved
3. Coexisting disadvantages in later life: Demographic and socio-economic inequalities
Open this publication in new window or tab >>Coexisting disadvantages in later life: Demographic and socio-economic inequalities
(English)Manuscript (preprint) (Other academic)
National Category
Social Work
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-132233 (URN)
Available from: 2016-08-01 Created: 2016-08-01 Last updated: 2016-08-11Bibliographically approved
4. Associations between and coexistence of disadvantages in the oldest old people in Sweden: Patterns of change between 1992 and 2011
Open this publication in new window or tab >>Associations between and coexistence of disadvantages in the oldest old people in Sweden: Patterns of change between 1992 and 2011
(English)Manuscript (preprint) (Other academic)
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Research subject
Social Work
Identifiers
urn:nbn:se:su:diva-132234 (URN)
Available from: 2016-08-01 Created: 2016-08-01 Last updated: 2016-08-11Bibliographically approved

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