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Social Inequalities in Later Life: Care Services in the Future
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Social Inequalities in Later Life: Care Services in the Future

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Care Sciences".

Deadline for manuscript submissions: 30 April 2025 | Viewed by 6036

Special Issue Editor

Dr. Ann Liljas

E-Mail Website
Guest Editor
Department of Global Public Health, Karolinska Institutet, 171 77 Solna, Sweden
Interests: social inequalities in ageing; health services research; social medicine

Special Issue Information

Dear Colleagues,

Worldwide, populations are ageing. This is a fantastic achievement and opportunity for the individual as well as society. Living longer lives might allow for more time for further education, career opportunities, and time to connect with family and friends. However, it also involves challenges as advanced age increases the risk of multimorbidity, influenced by the individual’s physical and social environments. Opportunities for living a long and healthy life also vary substantially between socioeconomic groups and regions. Furthermore, people’s physical, mental and cognitive capacities at a certain age vary substantially. A comprehensive public health response including responsive care systems are required to address such wide ranges of older adults’ needs. However, as targeting diversity in later life is complex, it raises concern of social inequalities in advanced age. Insight into potential inequalities in later life is important to successfully target older adults in greatest need of care services. Papers addressing social inequalities in later life, particularly in relation to healthcare and long-term care systems, are therefore invited for this Special Issue.

Dr. Ann Liljas
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2500 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • ageing
  • advanced age
  • older adults
  • social inequalities
  • inequity
  • healthcare service
  • healthcare
  • social care
  • long-term care
  • care homes

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Published Papers (3 papers)

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Research

21 pages, 1352 KiB  
Article
Mapping the Vulnerability of Older-Adult Neighborhoods: An Ecological Study of New York State
by Samantha Friedman, Chunxu Fang, Tse-Chuan Yang, Rui Li, Imran Hossain Mithu, Jennifer A. Manganello, Xiaobo Romeiko and Shao Lin
Int. J. Environ. Res. Public Health 2025, 22(3), 332; https://doi.org/10.3390/ijerph22030332 - 24 Feb 2025
Viewed by 868
Abstract
We examined neighborhood-level demographic, economic, and social characteristics and food and health-services access to gauge the vulnerability of older-adult neighborhoods in New York State (NYS), which is understudied and is significant given the rapid aging of populations worldwide. We conducted descriptive ecological analyses [...] Read more.
We examined neighborhood-level demographic, economic, and social characteristics and food and health-services access to gauge the vulnerability of older-adult neighborhoods in New York State (NYS), which is understudied and is significant given the rapid aging of populations worldwide. We conducted descriptive ecological analyses using data from the American Community Survey, historical redlining maps, Social Capital Instruments, U.S. Department of Agriculture food access atlas, ESRI businesses, and Social Determinants of Health. We compared census tracts classified as having high and low levels of older-adult population; among those identified as high-older-adult neighborhoods, we then examined tracts with high and low levels of adult population living alone and in poverty. Our results showed that NYS neighborhoods with large shares of the older adult population are generally faring well in terms of their socioeconomic status, social capital, lack of social isolation, and health services access. However, the older-adult neighborhoods with larger shares of the population living alone and in poverty fare worse, living in areas with poorer socioeconomic status, lower social capital, and considered medically underserved. NYS older adult communities are projected to increase by 2030. Resources should be invested in such areas with vulnerable groups so populations may age in equitable and accessible communities. Full article
(This article belongs to the Special Issue Social Inequalities in Later Life: Care Services in the Future)
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24 pages, 428 KiB  
Article
Unlocking the WHO’s Age-Friendly Healthcare Principles: Portugal’s Quest and Recommendations
by Jéssica Tavares, Gonçalo Santinha and Nelson Pacheco Rocha
Int. J. Environ. Res. Public Health 2023, 20(22), 7039; https://doi.org/10.3390/ijerph20227039 - 9 Nov 2023
Cited by 2 | Viewed by 2660
Abstract
Countries worldwide are grappling with a pressing demographic challenge characterized by a growing older population. This poses a significant healthcare dilemma, presenting challenges for healthcare systems and providers. To address these challenges, the World Health Organization (WHO) has devised a set of Age-Friendly [...] Read more.
Countries worldwide are grappling with a pressing demographic challenge characterized by a growing older population. This poses a significant healthcare dilemma, presenting challenges for healthcare systems and providers. To address these challenges, the World Health Organization (WHO) has devised a set of Age-Friendly Principles, aimed at optimizing healthcare provision for older people. This article delves into the current state of healthcare adaptation for older adults in Portugal and assesses the implementation of the WHO Principles. Case studies were conducted in three distinct regions of Portugal, involving semistructured interviews with key decision makers from both the healthcare sector and organizations wielding direct influence over health policies (n = 11). A comprehensive content analysis was conducted employing the webQDA software. The findings unveiled a noteworthy trend in which most interviewees displayed limited familiarity with the WHO Principles. Nevertheless, all interviewees acknowledged the need to adapt the healthcare system accordingly. Strengths were identified, primarily within the healthcare management system, but noteworthy gaps were also revealed, particularly in terms of facility preparedness and professional training. Interviewees proposed various interventions to enhance age-friendly healthcare provision; however, they concurrently pinpointed challenges related to human resources, infrastructure, and financial management. In their concluding recommendations, interviewees underscored the development of tools to facilitate the application and evaluation of the WHO Principles, as well as the development by the WHO of an accreditation system to encourage the application of the principles in healthcare providers across the world. Full article
(This article belongs to the Special Issue Social Inequalities in Later Life: Care Services in the Future)
14 pages, 320 KiB  
Article
Nurses’ Roles, Responsibilities and Actions in the Hospital Discharge Process of Older Adults with Health and Social Care Needs in Three Nordic Cities: A Vignette Study
by Ann E. M. Liljas, Natasja K. Jensen, Jutta Pulkki and Janne Agerholm
Int. J. Environ. Res. Public Health 2023, 20(19), 6809; https://doi.org/10.3390/ijerph20196809 - 22 Sep 2023
Viewed by 1670
Abstract
The hospital discharge process of older adults in need of both medical and social care post hospitalisation requires the involvement of nurses at multiple levels across the different phases. This study aims to examine and compare what roles, responsibilities and actions nurses take [...] Read more.
The hospital discharge process of older adults in need of both medical and social care post hospitalisation requires the involvement of nurses at multiple levels across the different phases. This study aims to examine and compare what roles, responsibilities and actions nurses take in the hospital discharge process of older adults with complex care needs in three Nordic cities: Copenhagen (Denmark), Stockholm (Sweden) and Tampere (Finland). A vignette-based interview study consisting of three cases was conducted face-to-face with nurses in Copenhagen (n = 11), Stockholm (n = 16) and Tampere (n = 8). The vignettes represented older patients with medical conditions, cognitive loss and various home situations. The interviews were conducted in the local language, recorded, transcribed and analysed thematically. The findings show that nurses exchanged information with both healthcare (all cities) and social care services (Copenhagen, Tampere). Nurses in all cities, particularly Stockholm, reported to inform, and also convince patients to make use of home care. Nurses in Stockholm and Tampere reported that some patients refuse care due to co-payment. Nurses in these two cities were more likely to involve close relatives, possibly due to such costs. Not accepting care, due to costs, poses inequity in later life. Additionally, organisational changes towards a shift in location of care, i.e., from hospital to home, and from professional to informal caregivers, might be reflected in the work of the nurses through their initiatives to convince older patients to accept home care and to involve close relatives. Full article
(This article belongs to the Special Issue Social Inequalities in Later Life: Care Services in the Future)
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