News Release

Past socio-economic factors influence present quality of life for the old

Peer-Reviewed Publication

Economic & Social Research Council

The odds of poor quality of life in old age increase by 50 - 70 per cent for people who live in rented housing compared to those who own their home, says new, independent research from the Economic & Social Research Council's 'Growing Older' Programme. This finding is backed up by evidence that social and economic status in middle age as well as in old age continues to be a factor in the quality of life experienced by over 75 year olds. The researchers say this evidence is sufficient "to warrant concern" over the extent of inequality.

The association between social class and housing tenure and the quality of life is shown to be cumulative. People who live in rented housing in middle age and also in old age are most consistently prone to poor quality of life relative to owner-occupiers. These differences continue where there have been changes in individuals’ housing tenure. People who go into social housing (predominantly local authority) from owner-occupation are worse off in terms of quality of life than those who remain in owner-occupation. The quality of life advantages of moving from local authority housing to owner-occupation are less consistent and strong than the disadvantages of a move in the reverse direction. These findings allow for different distributions by gender, age and marital status across tenures. They refer to people who were living on their own or with their spouse in old age; analyses were confined to this group because they were considered to be least likely to change housing tenure as the result of ill health.

Quality of life differs by tenure partly because people in the rented sector have worse health and more adverse lifestyles such as smoking.

Other factors that affect quality of life include:

 The more deprived the neighbourhood, the more likely that old people will score poorly on quality of life, but people’s own housing tenure appears to be more important than the neighbourhood. Older people living in areas with a high population density are more prone to suffer ‘poor morale’.

 Dependent people - defined as living with someone who is not a spouse - score more poorly on quality of life measurements relating to physical functioning than independent people ie living alone or with their spouse, and not in sheltered housing or a residential home. They were not more likely to have poor social interaction score or poor morale.

 The chances of being in the worst 20 per cent of 'quality of life' increase with age among the over 75 year olds for all problems except the 'morale' measurement.

 Women tend to have poorer quality of life than men. The difference between men and women is most pronounced for 'morale', with women holding up less well.

 Single men are poorer on social interaction, and home management if aged less than 80.  Older widowed people have greater odds of poor home management, and younger ones of poor morale, than others of their age group and gender.

The findings about inequalities in the quality of life of people aged 75 years and over used data from 8734 interviewees, from 23 general practices, taking part in a large-scale trial of the Assessment and Management of Elderly of Older people in the Community funded by the Medical Research Council and led by researchers at the London School of Hygiene and Tropical Medicine (LSHTM) (Professor Astrid Fletcher), University of Wales College of Medicine (Dr Dee Jones), Imperial College (Professor Chris Bulpittand, Oxford University (Dr Alistair Tulloch). Quality of life, which is one of the trial outcomes, was assessed at baseline and during a 36 month follow up period by trained interviewers supervised by Dr Dee Jones’ team at the University of Wales. The analyses for the GO programme were co-ordinated by Elizabeth Breeze at LSHTM.

Quality of life was measured by four sets of questions from the Sickness Impact Profile (home management, mobility, body care and movement, social interaction) and the Philadelphia Geriatric Morale Scale that specifies feelings, negative and positive.

The paper reports on relative chances of being in the worst fifth of scores for the five indicators according to demographic and socio-economic position. The extent to which differentials could be explained by health, social contacts and lifestyle factors are recorded as well as some of the characteristics of the area in which people lived. The largest group comprised owner-occupiers (53 per cent) who were alone or with their spouse (considered ‘independent’), similarly independent people in rented accommodation accounted for 21 per cent. Seven per cent were living in owner occupied homes with someone other than their spouse (‘dependent’), three per cent ‘dependent’ renters, while 13 per cent lived in sheltered housing and three per cent in residential homes. Their media age was 80.3 years.

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