Thanks to advances in technology, medicine, Social Security, and Medicare, old age for many Americans is characterized by comfortable retirement, good health, and fulfilling relationships. But there are also millions of people over 65 who struggle with poverty, chronic illness, unsafe housing, social isolation, and mistreatment by their caretakers. What accounts for these disparities among older adults? Sociologist Deborah Carr’s new book, Golden Years?: Social Inequality in Later Life draws insights from multiple disciplines to illuminate the complex ways that socioeconomic status, race, and gender shape nearly every aspect of older adults’ lives. By focusing on an often-invisible group of vulnerable elders, Golden Years? reveals that disadvantages accumulate across the life course and can diminish the well-being of many.
Carr shows that on many indicators of physical health, such as propensity for heart disease or cancer, black seniors fare worse than whites due to lifetimes of exposure to stressors such as economic hardships and racial discrimination and diminished access to health care. In terms of mental health, she finds that older women are at higher risk of depression and anxiety than men, yet older men are especially vulnerable to suicide, a result of complex factors including the rigid masculinity expectations placed on this generation of men. Social inequalities even affect the process of dying itself, with white and affluent seniors in a better position to convey their end-of-life preferences and use hospice or palliative care than their disadvantaged peers. Because rising economic inequality may contribute to even greater disparities between the haves and the have-nots in future cohorts of older adults, Golden Years? demonstrates the importance of increased awareness, strong public initiatives, and creative community- based programs in ensuring that all Americans have an opportunity to age well.