Inequalities in ageing are an issue that is vitally important to us all but does not get the attention it deserves. Inequality has a significant impact on vulnerable groups of older people in Wales, and this impact often gets worse over time. For example, poverty and poor health may get worse as a person ages.
Inequalities in ageing affect us in many ways, including health, income, and social inclusion. This inequality is often referred to as the “deprivation gap” in life expectancy. There is a large income and wealth gap between the richest and poorest older people in Wales, with those in the lowest income brackets more likely to experience inequality. For example, there is a 7.1-year difference in life expectancy at birth between the most and least deprived areas of Wales. In addition, there are also significant differences in life expectancy between different regions across Wales.
According to the Welsh Government’s National Survey for Wales, 2019-20, 21% of people aged 65 and over in Wales were living in relative poverty, as they have an income below 60% of the median income in Wales. According to the 2019-20 survey, 36% of people aged 65 and over in Wales were living on a low income, as they have an income below 70% of the median income in Wales. That amounts to over one in three of all people over 65 in Wales.
Research has shown that older adults living in the most deprived areas are more likely to experience chronic health conditions such as diabetes, heart disease, and respiratory conditions. The Centre for Ageing Better wrote that “People from less advantaged groups live shorter lives in worse health and with more functional impairments.”
Older people living in poverty are more likely to have a disability, experience mental health problems, or have a chronic health condition. We could improve the lives of older people by addressing poverty and helping people be more financially stable, as well as by making it easier to access healthcare services.
There is growing evidence that suggests there are inequalities relating to the care people receive in Wales. There are issues with people being able to access the care they need, and unequal access to good quality care.
There are also inequalities relating to who provides care to their loved ones. Women and people from low-income backgrounds are more likely to provide unpaid, informal care to their family members.
Professional carers often endure low pay and difficult working conditions, with limited opportunities for career development and progression. One of the key challenges facing the social care sector in Wales is a lack of funding. Increasing funding for social care could enable providers to deliver high-quality, person-centred care and support for older people.
Housing inequalities in Wales have significant implications for the health and well-being of older people. Research has shown that poor housing conditions, such as damp and cold homes, can increase the risk of respiratory illnesses, cardiovascular disease, and mental health problems among older people. Research has also found that older people on low incomes are more likely to experience housing-related poverty, such as being unable to afford essential repairs and maintenance. Falling behind with repairs and maintenance may also worsen the physical and mental health of older people and increase the risk of accidents such as trips and falls.
Older people in Wales are at greater risk of experiencing fuel poverty, as they are unable to afford to heat their homes adequately.
With such a wide range of issues, we need a variety of solutions. These should include investment in affordable, high-quality housing for older people, improvements to the quality and energy efficiency of existing housing stock, and initiatives to address poverty.
Loneliness and social isolation are significant issues affecting older people in Wales. Over 50,000 older people in Wales are lonely. By 2030 it is estimated that there will be a 50% increase in people aged 50 and up experiencing loneliness.
Data from the Cognitive Function and Ageing Study found that 25.3% of people over 65 in Wales reported being lonely, and 26.9% said they were socially isolated. Evidence suggests that loneliness can have the same impact on the body as smoking 15 cigarettes a day.
Whilst there is some evidence available on inequalities in ageing in Wales, it tends to be focussed on very specific areas. We are calling for research which looks at the big picture and investigates the cumulative impact of inequality on older people – how things stack up over time. We need further research to identify the gaps in our understanding of how inequality affects older people. We also need to raise awareness of the impact of inequality and promote debate about the possible opportunities to improve the quality of life for older people who are in the most difficult circumstances.