Thematic Panel 19

Inequalities and care needs in old age

Conveners and Discussants:

Lina Van Aerschot, Post doctoral researcher, and Teppo Kröger, Professor of Faculty of Social Sciences and Humanities, University of Jyväskylä, Finland

Living independently and ageing in place are key objectives of care policies in most countries. Older people are expected to live at home with the help of their families and other informal carers and, in addition, use home care services that may either be publicly provided or privately purchased. However, people’s care needs vary as older people may have needs for personal care and assistance in household tasks as well as social needs. The level and severity of care needs vary significantly and therefore older people as well as their informal carers need to deal with very different situations when organizing care. Sometimes the needed care and support are not available.

Older people have very different and unequal resources both in terms of informal care, financial assets, and capabilities of acquiring services. Formal care services may not be universally available to all or they may not cover all kinds of care needs. As a result, not everybody receives adequate and sufficient help or services to meet their care needs. These unmet needs reflect inequalities in the coverage of care needs in old age.

Unmet care needs or difficulties in accessing the needed help may be related to not having next-in-kin who could provide informal care, not being aware of suitable services, not having anyone to help in acquiring information or contacting possible service providers, not being able to access services due to long distances, high prices or other obstacles. Furthermore, care needs may remain unmet when help and assistance is received but they are not extensive enough, the quality is inadequate or they are not provided at the right time. It has been shown that both socioeconomic background and health status are related to disadvantaged positions regarding care.

Even though a rather broad range of research on poverty and social inequality exists, much less research has been done on inequality concerning care in old age. On the other hand, there is already quite a lot of research on unmet health care needs and health inequalities but much less research on inequalities regarding social care.

Tackling social inequality is stated as one of the main priorities of welfare policies in many European countries and especially in the Nordic countries. However, social and economic inequality has increased significantly throughout the last two decades, and older people are facing this especially in terms of unequal access, availability and affordability of care. Equality is often put aside and economic interests are prioritized when care services, benefits or support for informal care are designed and organized. The institutional settings and priorities of care systems and care policies are very relevant to this panel as well as the practical level of care arrangements. How equal rights to care are enhanced – or are they? How do the policies and service arrangements promote equality? How has the marketization of care services and other changes in policy priorities affected inequality? What is the role of informal and unpaid care in decreasing or, on the contrary, creating or maintaining inequality?

This thematic panel calls for presentations dealing with inequalities in care for older people. We welcome especially papers that connect inequalities related to care with wider questions and priorities of social policy. The topics may be related to social inequalities among older people or between different age groups, unmet needs, vulnerable positions, inadequate care and different mechanisms that lead to a disadvantaged position in old age. Also papers with other kinds of approaches to inequality in old age are welcome.