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Chapter 17

SOC101 - CHAPTER 17.doc

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Dan Dolderman

CHAPTER 17: HEALTH AND AGING INDIVIDUAL AND POPULATION AGING - Life Expectancy: Number of years the average person can expect to live. - Has increased steadily in Canada during the 20th century. - Canadians can also expect to live longer after age 65 than generations before them. - Increased life expectancy into old age is distinguished from previous historical period: - Never before in history did vast majority of people in a particular country expect to live to old age. LIFE EXPECTANCY IN CANDA, 1920-2005 POPULATION AGING: FACTORS - Main reason for increasing proportion of seniors is due to decreases in fertility” - With declines in number and proportion of children in population, proportion of older persons necessarily increases. - Fertility was major predictor of population aging until population reached life expectancy at birth of 70 years, at which point almost all young persons survive: - Further declines in mortality now concentrated at older ages, resulting in relatively larger older age groups. CANADIAN POPULATION AGE STRUCTURE, 1851-2006 AGING AND AGEISM - How the lives of elderly people are experienced is influenced by social construction of old age (i.e., how society views elderly people). - In contemporary Western societies, we tend to stereotype older persons, a tendency referred to as ageism - Elderly people stereotyped as poor, frail, having no interest in - or capacity for - sexual relations, being socially isolated and lonely, and lacking a full range of abilities in the workplace. - Factors in ageism: - Lack of knowledge about aging. - Lack of interaction among cohorts. - Younger people’s fears of their own future. - Equation of old age with poor health of disease. - Result of increasing medicalization of old age = Medicalization refers to social and political process whereby increasing areas of life come under authority and control of medicine. DIVERSITY IN AGING 1. Socioeconomic and class differences: - People who enjoy socioeconomic advantages tend to experience better health and live longer than others do. - Economic disadvantage follows many people into old age. - Having few economic resources affects one’s everyday life in profound ways. 2. Gender: - Is gender difference in mortality rates = Elderly women have lower mortality rates than elderly men for all causes of death. - Factors in women’s lower mortality = Possibly biological/genetic component, but also determined by social and economic factors. - Implications of gender differential: - Women more likely than men to be widowed, not remarry, live alone, and be poorer; but also more likely to maintain social support networks into old age. 3. Ethnicity and race: - Among Canadian seniors, are more foreign-born individuals than in the younger population. - Aboriginal seniors comprise less than 5% of Canada’s total Aboriginal population because of high fertility rates and high mortality rates. - Although is expected that number of seniors in Aboriginal population will more than double by 2017 and will represent about 6.5% of population at the time. APOCALYPTIC - Demography: Study of characteristics of populations and dynamics of population change. - Apocalyptic demography: Belief that demographic trend (e.g., population aging) has drastic negative consequences for society, including the following: - Inability to afford growing percentage of elderly people. - Tremendous strain on state-financed services. - Rise to dangerous levels in government debt deficits. - Claim that most elderly sufficiently well off to pay for services themselves by expect subsidization. APOCALYPTIC DEMOGRAPHY - Apocalyptic demography is faulty, and ignores the following: - We actually can afford better social services for the elderly because of economic activity, which continues to increase over time. - Nearly half of elderly women without a spouse live in poverty. - Population aging accounts for only small part of future health-care costs and will require little increase in public expenditures. HEALTH AND OLD AGE - Although equation of old age with declining health is valid with regard to physical health, is less true of psychological and emotional health and social wellbeing. - With advancing age, about 77% of men and 85% of women aged 65+ suffer from at least one chronic condition: i.e., persistent physical or mental health problem. - Chronic conditions do not necessarily interfere with day-to-day functioning. - A functional disability exists when a health problem interferes with day-today functioning. - About one-third of adults age 65+ (25% of men and 34% of women) experience restrictions in their daily activities because of health problems (figure rises to 40% among those aged 75+) - Pain is problem for many but not all elderly adults. - Elderly adults also subject to mental or brain disorders (e.g., dementia - most prevalent form: Alzheimer’s disease). - Elderly adults do not have poorer mental health or poorer sense of psychological well-being than younger age cohorts. - Self-esteem and feelings of mastery or control also seem to improve with age, peaking in middle age, followed by modest declines in later life. - Seniors’ social lives tend to be healthy and characterized social integration, not social isolation. - Most seniors are embedded in modified extended family networks, characterized by mutual and close intergenerational ties, responsible filial behavior, and contact between the generations. - According to compression of morbidity hypothesis, Western industrialized nations are successfully postponing age of onset of chronic disability. - Many analysts think that eventually we will all be able to live relatively healthy lives until very shortly before death, when our bodies will deteriorate rapidly. - Until recently, evidence on this subject was contradictory. INEQUALITY, HEALTH, AND AGING - Inequalities in health and longevity are reflected in stratification within our society based on factors, such as: - Education - Income - Gender - Race, ethnicity, and immigration status. 1. Education - People with more education are able to avoid or postpone disability to a greater extent than those with less education. - But education may be of less benefit once disability is present. - People with a university degree often feel healthy and function well late into their 60s, 70s, and 80s, whereas those with less education do not. 2. Income: - Is estimated that 23% of premature mortality (i.e., years of potential life lost) among Canadians is linked to income differences. - High-income earners (using various definitions) experience considerably more years of good health than those with lower incomes (also defined variously). - Low-income elderly adults with disabilities tend to be more functionally disabled than their high-income counterparts. 3. Gender... In comparison to men: - Women, who tend to live longer, are generally found to be less healthy and report more severe disability. - Women report more multiple health problems associated with chronic conditions (e.g., arthritis, rheumatism, high blood pressure, back problems, and allergies). - Women are more likely to report limitations in activities of daily living or disability in later life (although likelihood of disability increases with age of both sexes). 4. Race, ethnicity and immigration status - In comparison to non-Aboriginal adults, Aboriginal Canadians. - Have life expectancy six years shorter. - Suffer from more chronic illnesses and disabilities, including heart disease and diabetes. - Do not generally rate their health as excellent or very good. - Fewer than one-half of non-reserve Aboriginal adults over age 64 report having excellent for very good health. ABORIGINAL AND NON-ABORIGINAL POPULATION, 2006 ABORIGINAL AND NON-ABORIGINAL CANADIANS’ LIFE EXPECTANCY AT BIRTH BY SEX, 1991 AND 2001. - In Aboriginal populations. - Have death from infectious and parasitic disease, which is associated with inadequate housing and unsanitary conditions. - Have (i) high suicide rates; and (ii) high death rates from drowning, fire, homicide, and motor vehicle accidents. - Are affected by racism and discrimination, which increases risks of psychological distress, depression, and unemployment. - Often faced with lack of access to opportunities and resources. - Health inequities are also evident when comparing other ethnic and racial groups. - Less than 25% of Canadians aged 65+ born in Canada or U.S>, Europe, Australia, and Asia tend to report fair or poor health. - Contrasts with roughly 33% among those born in Central and South America and Africa. - Health and longevity also vary widely from one country to the next. LIFE EXPECTANCY AT BIRTH AND AT AGE 60 FOR SELECTED COUNTRIES WITH HIGH AND LOW LIFE EXPECTANCY, 2002-2006 - Immigrants, especially recent arrivals, generally enjoy better health than their Canadian-born counterparts. - Healthy immigrant effect reflects Canadian government requirement that potential immigrants meet minimum standard of health before they are admitted to the country. - However, immigrants’ health tends to decline after immigration. - Factors: Negative health implications of changes in diet and activity levels, discrimination, declines in income and other resources, and difficulties in accessing health-care services in years followin
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