Income Disparities for the Elderly Affect their Health and Quality of Life

Economic conditions and income inequality in the United States have been a heavily debated topic over the past several decades, especially since the post-recession economy has further made the most wealthy in the U.S. more wealthy, and has drastically decimated the wealth of the middle class and the poor. Perhaps no other population has been affected more than the elderly, who have seen significant increases in financial inequality. It’s a problem that’s only likely to get worse.

A study published in 2016 by Rutgers University’s School of Social Work program indicates that inequality is much higher after age 64, and becomes even more apparent after age 74.

“Increasingly, life after age 65 in the US is a ‘two worlds of aging’ experience, with the well-off older adults doing better and the less well-off part of the income distribution doing worse,” says Stephen Crystal, a professor in the Institute for Health, Health Care Policy and Aging Research at Rutgers. “Based on the economic experience to date of people who are now in their middle years and will make up the future elderly, we can expect this problem to become worse, not better.”

Known commonly as a cumulative advantage and cumulative disadvantage, researchers argue that early economic, educational, and other privileges and advantages increase over a lifetime, and can cause drastic financial inequities that really come to a head in their elder years.

adult-aged-aging-1389104This inequality in wealth translates into other areas of life, including life expectancy, healthy lifestyles, and perhaps most starkly access to quality healthcare. But it’s not just education and class status that causes the income gap. There are a number of intersecting factors that give people advantages and disadvantages in regards to their health and quality of life as they age.

The good news? According to research by the U.S. Department of Health and Human Services, seniors in 2014 were 14 percent more likely to report that they were in good or excellent health. Lifespans overall are rising each year. But a closer look at the data reveals a more troubling reality. Gains in good health went to more economically advantaged groups, meaning that the socioeconomic gap has only continued to widen.

It’s certainly not the first time in our country’s history that this has been the case, but decades later, the problem has become more exacerbated. In 1980, a wealthy 50-year-old man could expect to live 5.1 years longer than a poor man of the same age. Today, the life expectancy of these two men differs by more than 12 years.

This is further compounded when you add other social dynamics into the mix. As an example, although Black Americans have much longer life expectancies than they have in past decades, they still don’t live as long as white people. Furthermore, your life expectancy varies drastically based on where you live. Counties that are affluent and counties that are impoverished have a life expectancy gap of over 20 years, according to a recent study. Those more likely to live in affluent counties consist of mostly white individuals.

Beyond life expectancies, there are a number of ways in which your intersecting identities play a role in your quality of life as you become older. Senior care is another way in which the elderly’s intersecting identities matter. Race and class matter more in senior-care decisions than most tend to realize. Care options for economically and otherwise disadvantaged individuals may be more complicated than most realize.

“Research has documented a number of racial differences [when it comes to senior care],” writes Paula Span for The New York Times. “We know that Black seniors have poorer health and greater disability than whites, on average, and shorter life spans. We know that Black families are more likely than whites to share residences with elderly parents, which may be a decision driven in part by economic factors. We know that in nursing homes and assisted living facilities, a combination of heavily minority staffs caring for mostly white residents can lead to tensions.”

Furthermore, nursing homes that predominantly serve minority residence tend to experience financial struggles and ultimately provide a lower quality of care to their patients. In fact, according to The Center for Public Integrity, nursing homes that serve minorities tend to offer less care when compared to those housing white residents. In some cases, minorities in nursing homes suffer from elder abuse.

Again, this is due to a number of factors, including access to care in the communities they live in, socioeconomic disparities, health insurance and access to Medicaid, Social Security, and other social safety nets. But it’s an issue that has still yet to be addressed.

It’s also an issue that shouldn’t be thought of as inevitable. Often policy decisions can make a significant difference.

“The current and projected levels of inequality in later life are not inevitable–they are strongly affected by policy choices, in areas ranging from Social Security to taxation to health care financing,” Crystal notes. When it comes to the funding Social Security, increasing access to Medicare and Medicaid, and providing resources to communities that need it most, it’s important for policymakers to think of those seniors who would be most affected — those with the least amount of economic advantage. Crystal continues, “The implications for the less-advantaged in America’s high-inequality retirement future need to be carefully considered [moving forward].”

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Avery PhillipsAvery T. Phillips is a freelance human being with too much to say. She loves nature and examining human interactions with the world. Comment or tweet her @a_taylorian with any questions or suggestions.