Old-age exclusion is persistent and dynamic, and influenced by risk factors experienced earlier in life

• •Social exclusion is both persistent and dynamic among older adults.
• •Risk factors influenced late-life exclusion through early late-life exclusion.
• •Social exclusion is multidimensional, with associations between life domains.
• •There was a stronger effect of non-employment on exclusion in women.
• •There was a stronger effect of psychological health problems on exclusion in men.

https://www.sciencedirect.com/science/article/pii/S0167494322001418?fbclid=IwAR0O2DfhsQXLg9cebTgaiFfj-fh9ijOuPO1IcEjnIJh1bmWLDwiflo-4gDk

Purpose of the research

Social exclusion threatens quality of life in older age. However, there is a lack of research on social exclusion from life-course and gender perspectives. We investigated early- and midlife risk factors for old-age social exclusion among women and men.

Materials and methods

Two individually linked studies of Swedish nationally representative samples provided longitudinal data over a 30-year period on 1,819 people at baseline. Indicators of economic exclusion, leisure/social exclusion, and civic exclusion were assessed at early late life (M=70 years) and late life (M=81). Educational attainment, non-employment, psychological health problems and mobility problems were measured as risk factors at midlife (M=54) and late midlife (M=61). Path analysis derived a model of old-age social exclusion.

Results

Exclusion on a domain in early late life led to exclusion on the same domain in late life, except for the economic domain. Leisure/social exclusion in early late life also led to civic exclusion in late life. Midlife risk factors influenced late-life exclusion almost exclusively through early late-life exclusion. While model fit could not be significantly improved by allowing coefficients to vary freely by gender, there was a stronger effect of non-employment on exclusion in women and a stronger effect of psychological health problems on exclusion in men.

Conclusions

This study confirms that old-age exclusion is persistent and dynamic, and influenced by risk factors experienced earlier in life. A holistic approach with integrated efforts across different policy areas is needed to efficiently reduce old-age social exclusion.