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Long-term risk factors for old-age social exclusion in Sweden: a 30-year longitudinal study
Jönköping University, School of Health and Welfare, HHJ, Institute of Gerontology. Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Stress Research Institute, Stockholm University, Stockholm, Sweden.ORCID iD: 0000-0003-3662-5486
Department of Preventive and Social Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden.
School of Health and Welfare, Dalarna University, Falun, Sweden.
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2022 (English)In: Archives of gerontology and geriatrics (Print), ISSN 0167-4943, E-ISSN 1872-6976, Vol. 103, article id 104760Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
Elsevier, 2022. Vol. 103, article id 104760
Keywords [en]
Life course, Midlife, Late life, Social exclusion, Sweden, Path analysis
National Category
Geriatrics Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:hj:diva-58153DOI: 10.1016/j.archger.2022.104760ISI: 000830297700001PubMedID: 35797759Local ID: HOA;intsam;824513OAI: oai:DiVA.org:hj-58153DiVA, id: diva2:1686493
Funder
Swedish Research Council, 2017-00668Forte, Swedish Research Council for Health, Working Life and Welfare, 2019-01141Available from: 2022-08-10 Created: 2022-08-10 Last updated: 2022-08-16Bibliographically approved

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Nilsen, Charlotta

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