Social inequalities in health in an ageing population

Abstract

In the 20th century, European countries had marked declines in mortality rates, initially at younger ages, and subsequently at older ages. This resulted in ‘rectangularization’ of the survival curve: large proportions of the population surviving to older ages, at which point mortality rates increase sharply. The extent to which this will be accompanied by increases in the proportions of older people suffering morbidity has been debated. There are marked differences in life expectancy at older ages among European countries. France, Italy, Spain, and Sweden have better than average life expectancy at age 65. Denmark, Germany, the UK and the Netherlands have lower. Within countries, there are marked socio-economic differences in morbidity and mortality at older ages. The impact of illness is also likely to differ according to an individual's social circumstances. It is essential to have longitudinal studies examining the determinants and impact of health and well-being in ageing populations. Ideally, these should be carried out in a way that facilitates international comparisons