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Socioeconomic inequality of long-term care for older people with and without dementia in England

Hu, Bo, Read, Sanna, Wittenberg, Raphael ORCID: 0000-0003-3096-2721, Brimblecombe, Nicola ORCID: 0000-0002-6147-5726, Rodrigues, Ricardo, Banerjee, Sube, Dixon, Josie ORCID: 0000-0003-4772-6450, Robinson, Louise, Rehill, Amritpal and Fernández, José-Luis ORCID: 0000-0002-4190-7341 (2022) Socioeconomic inequality of long-term care for older people with and without dementia in England. Ageing and Society. ISSN 0144-686X

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Identification Number: 10.1017/S0144686X22000885


Ensuring distributive fairness in the long-term care sector is vitally important in the context of global population ageing and rising care needs. This study, part of the DETERMIND (DETERMinants of quality of life, care and costs, and consequences of INequalities in people with Dementia and their carers) programme, investigates socioeconomic inequality and inequity in the utilisation of long-term care for older people with and without dementia in England. The data come from three waves of the English Longitudinal Study of Ageing (ELSA, Waves 6–8, N = 16,458). We find that older people with dementia have higher levels of care needs and a lower socioeconomic status than those without dementia. The distribution of formal and informal care is strongly pro-poor. When care needs are controlled for, there is no significant inequality of formal or informal care among people with dementia, nor of informal care among people without dementia, but there is a significant pro-rich distribution of formal care among people without dementia. Unmet care needs are significantly concentrated among poorer people, both with and without dementia. We argue that the long-term care system in England plays a constructive role in promoting socioeconomic equality of long-term care for people with dementia, but support for older people with lower financial means and substantial care needs remains insufficient. Increased government support for older people is needed to break the circle between care inequality and health inequality.

Item Type: Article
Official URL:
Additional Information: © 2022 The Authors
Divisions: Personal Social Services Research Unit
Subjects: R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
H Social Sciences > HN Social history and conditions. Social problems. Social reform
H Social Sciences > HQ The family. Marriage. Woman
Date Deposited: 29 Jun 2022 09:42
Last Modified: 16 May 2024 03:47

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