A Bourdieusian approach to class‐related inequalities: the role of capitals and capital structure in the utilisation of healthcare services in later life

in Sociology of Health and Illness (2019)

This paper draws on Bourdieu's theory of economic, social and cultural capital to understand the relative effect of the volume and the composition of these capitals on healthcare service use in later life ... [more ▼]

This paper draws on Bourdieu's theory of economic, social and cultural capital to understand the relative effect of the volume and the composition of these capitals on healthcare service use in later life. Based on data from the fifth wave of the Survey of Health, Aging, and Retirement in Europe (n = 64,840), we first look at the contribution of each capital in the use of three healthcare services (general practitioner, dentist and hospital). Using cluster analysis, we then mobilise Bourdieu's concept of habitus to explain how the unequal distribution of material and non‐material capitals acquired in childhood lead to different levels of health and hospital care utilisation in later life. After controlling for demographic and health insurance variables, our results show that economic capital has the strongest individual association among the three capitals. However, the results of a cluster analysis used to distinguish between capital structures show that those with high non‐material capital and low material capital have higher levels of primary healthcare utilisation, and in turn lower levels of hospital use. Bourdieu's approach sheds light on the importance of capitals in all forms and structures to understand the class‐related mechanisms that contribute to different levels of healthcare use. [less ▲]

Wealth inequality, frailty, and memory impairment: Is wealthier = healthier true at all older ages?

Scientific Conference (2018, December)

Determinants of cognitive decline in a large cross-national study using machine learning

in Innovation in Aging (2018, November), 2(S1), 244

Cognitive functioning and decline in relation to urban environmental characteristics

Scientific Conference (2018, November)

Overweight and obesity of mid-aged cohorts: Increasing burden, increasing educational inequalities

in Innovation in Aging (2018, November)

Global inequalities 1980-2050: a microdata oriented simulation – Worldsim

Scientific Conference (2018, July 13)

Former global inequality models lack realistic features of the population (age, gender, education, behavior). Worldsim develops a panel sample based simulation of the world population until 2050, relying ... [more ▼]

Former global inequality models lack realistic features of the population (age, gender, education, behavior). Worldsim develops a panel sample based simulation of the world population until 2050, relying on UN, Cepii, etc, big data aggregated forecasts, that we individually disaggregate. The simulation confirms the decline of the world's Gini index, but underlines several paradoxes in the socioecodemography of the world, with increasing gaps between resources and needs. Compared to more standard socioeconomic simulations of inequalities, we provide more substantial characterization of the population, and compared to other global simulations, we capture the dimensions of social divergences between social groups and geographic regions. [less ▲]

Detecting Public Health crises: APC-Detrended methodology and residuals in a 25-country, 35-year mortality matrix

Scientific Conference (2018, June 09)

Background. Mortality-by-cause analyses as done in the Global Burden of Disease 2016 update are helpful to monitor progress of public health improvements within and across countries. However, separate ... [more ▼]

Background. Mortality-by-cause analyses as done in the Global Burden of Disease 2016 update are helpful to monitor progress of public health improvements within and across countries. However, separate analyses by cause and country miss larger patterns of public health crises that are restricted to certain cohorts and periods. Those public health crises may go unnoticed even if they affect several countries and thus come with some threat potential. We propose a new method to detect cohorts with increased mortality at certain ages and periods. Method. We develop an analytical and visualizing technique based on established Age-Period-Cohort-Detrended (APCD) methodology (Chauvel and Schröder 2014). After detecting all-cause mortality increases, plotting the resulting age-period coefficients and APCD residuals in equilateral Lexis diagrams, mortality patterns can be distinguished as age, period, or cohort trends and fluctuations. Age-period interactions are plotted as ‘big red spots’. We employ the new technique in data from the Human Mortality Database, spanning 25-60 years of age, calendar years 1975-2010, and 25 countries. Results. We detect age-period interactions of young-adult cohorts in the early 1990s in Spain, other southern European countries and the U.S. Additional analyses with WHO mortality data show that mortality increases are mostly due to increased HIV/AIDS mortality. Discussion. Country-specific explanations, such as political frustrations in Spain, have been proposed to explain the 1990s increases in HIV/AIDS mortality. However, the new technique suggests that increases in HIV/AIDS mortality were more likely to be due to specific behaviors of cohorts of certain ages in a certain period. We discuss limitations of the method, such as detecting social class mortality differences of affected cohorts. Altogether, the new technique offers intuitive and efficient handling of large amounts of age-country-year mortality information. The method can further be applied in the fields of education, longevity, and demography at large. [less ▲]

Inequality in old age cognition across the world

in Economics and Human Biology (2018), 29

Although cohort and country differences in average cognitive levels are well established, identifying the degree and determinants of inequalities in old age cognitive functioning could guide public health ... [more ▼]

Although cohort and country differences in average cognitive levels are well established, identifying the degree and determinants of inequalities in old age cognitive functioning could guide public health and policymaking efforts. We use all publicly available and representative old age surveys with comparable information to assess inequalities of cognitive functioning in six distinctive age groups of 29 countries. We document that cognitive inequalities in old age are largely determined by earlier educational inequalities as well as gender differential survival rates. For example, a one percentage point increase in the Gini index of past education is associated with an increase of 0.45 percentage points in the Gini index of delayed recall and 0.23 percentage points in the Gini of immediate recall. Results are robust to a variety of alternative explanations and persist even after controlling for gender-related biases in survival rates. Furthermore, we find evidence that unequal opportunities for education -captured by differences in parental background and gender- also have significant effects on inequality of old age cognition. [less ▲]

Population aging, demographic trends and consequences for long-term care

in Boll, Thomas; Ferring, Dieter; Valsiner, Jaan (Eds.) Cultures of care in aging (2018)

This chapter reviews recent projections related to the aging of populations, developments in health expectancy and disability, and associated trends in need for and provision of long-term care, focusing ... [more ▼]

This chapter reviews recent projections related to the aging of populations, developments in health expectancy and disability, and associated trends in need for and provision of long-term care, focusing on the developments in Europe but mentioning worldwide trends where possible. First, I present demographic trends in changing age structure of populations, expected costs of those changes, and discuss how innovative measures such as the ‘real elderly dependency ratio’ could offer a more balanced view on those trends. Second, projections of healthy life expectancy and time spent with morbidity and disability are presented. Then possible limitations of those projections are discussed, especially regarding recent evidence on changing incidence of dementia, and the possible further reductions in incidence if unfavorable lifestyle and health behaviours were reduced. After that, I will delineate demographic trends in need for assistance with care, and their implications for both formal and informal long-term care provision and costs. Specifically, a ‘care gap’ both in the provision of formal and informal care has been foreseen for several countries. Lastly, I discuss some trends and phenomena in long-term care provision which may influence the trends in long-term care needs and provision. In particular, estimated care gaps could become less threatening if the trend of migration of trained and untrained caregivers to provide live-in and institutional care in understaffed countries will continue, and if technological innovations will reduce care needs by enabling persons with disabilities to carry out activities of daily living autonomously. [less ▲]

Increases in well-being in the transition to retirement for unemployed. Catching up with formerly employed persons

in Ageing & Society (2017), online

This paper examines the extent to which well-being levels change in the transition to retirement depending on transitioning from being employed, unemployed, or economically inactive. Whereas transitioning ... [more ▼]

This paper examines the extent to which well-being levels change in the transition to retirement depending on transitioning from being employed, unemployed, or economically inactive. Whereas transitioning from employment to unemployment has been found to cause a decrease of subjective well-being with more time spent in unemployment, it is not clear how transitioning from unemployment to retirement affects well-being levels. We use the Survey of Health, Ageing and Retirement in Europe to monitor life satisfaction of respondents who retire in between two waves. We portray well-being scores before and after retirement and then identify the change in life satisfaction during the retirement transition using a First Difference model. Results indicate that being unemployed before retirement is associated with an increase in life satisfaction, but presents mainly a catching-up effect compared to employed persons transitioning to retirement. Retirement from labour market inactivity does not lead to significant changes in well-being. Findings are robust to selection into unemployment and country differences. As well-being of unemployed persons recovers after transitioning to retirement, especially the currently unemployed population should be supported to prevent detrimental consequences of economically unfavourable conditions and lower well-being. [less ▲]