Social, Economic Inequities Grow with Age

Retirement, as portrayed in TV commercials, is for indulging a passion, whether tennis, enjoying more time with a spouse, frequent socializing, or civic engagement. Boston University sociologist Deborah Carr isn’t buying this idealized picture of aging.

“This gilded existence is not within the grasp of all older adults,” she argues in “Golden Years? Social Inequality in Later Life.” “For those on the lower rungs of the ladder,” she writes, retirement is “marked by daily struggle, physical health challenges and economic scarcity.”

Her book, which mines multidisciplinary research on aging, reaches the distressing conclusion that economic inequality not only exists but that it becomes more pronounced as people age and become vulnerable. And this problem will grow and affect more people as the population gets older.

Poverty has actually declined among retirees since the 1960s. But by every measure – health, money, social and family relationships, mental well-being – seniors who have a lower socioeconomic status are at a big disadvantage. They have more financial problems, which creates stress, and they are more isolated and die younger.

Throughout the book, Carr documents the myriad ways the disparities, which begin at birth, reinforce each other as people grow up and grow old.

“Advantage begets further advantage, and disadvantage begets further disadvantage,” Carr concludes. For the less fortunate, “old age can be the worst of times,” she said.

A college degree puts young adults on a path to higher earnings, which will one day translate to living more comfortably in retirement. Thanks to generous employer health insurance and advances in medical care, college-educated Americans’ rates of disability and disease in old age have declined sharply. This group has also enjoyed significant improvements in their ability to perform so-called Activities of Daily Living, such as cooking, cleaning, and taking medications.

Retirees who dropped out of high school, on the other hand, are at risk of premature death for multiple reasons that compound over a lifetime. Their health might’ve suffered during their working years, if they were forced to cut corners on medical care because a low-paying job either didn’t have health insurance or had minimal coverage. Low-income people are also more likely to engage in unhealthy behaviors like smoking and drinking or to live in unsafe, dilapidated housing or more polluted neighborhoods. The author cites research showing that social factors like these explain 60 percent of premature deaths in the United States.

Marriage, like a college degree, is another path to economic security, because couples can pool their resources. Both the financial and emotional support in marriage become more important when couples are no longer engaged with work. Race comes into play here: 44 percent of white women over age 65 are married, compared with 23 percent of black women their age. Minorities also have lower odds of remarrying after a divorce or widowhood.

Loss is the one thing the elderly share equally. Social isolation often follows the end of meaningful employment, or a spouse, friends, and loved ones die. But the impact of loss is deeper when people lack the resources required to get involved in other fulfilling activities or if family members with their own financial constraints are unable to fill the void in the older loved one’s life.

Financially secure retirees even die better. Most elderly people have a strong preference for dying in their own homes. Being able to do this depends in part on one’s socioeconomic status.  Carr points to a study of terminally ill cancer patients, which found that when a relative of the patients took at least two weeks off before death to care for their loved ones, the patients were more likely to die at home. But taking time off is an unaffordable luxury in low-income families if it means the caregiver would have to forgo a paycheck.

Carr’s job here is to point out the inequities of old age. In reality, seniors’ coping skills are well honed, and retirement isn’t always this bleak. And as she points out, money doesn’t buy happiness. But it sure helps.

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