Inclusion or exclusion? Exploring barriers to employment for low-income older adults

"What If I Die and No One Notices?" A Qualitative Study Exploring How Living Alone and in Poverty Impacts the Health and Well-Being of Older People in Hong Kong

Despite the growing number of older people who live alone and in poverty, the intersection of these two social risk factors and the impacts on older adults' health and well-being have not been widely examined. This qualitative study explores the challenges and strengths of 47 older people who live alone and in poverty in Hong Kong. Thematic analysis was used to identify eight themes related to challenges: (i) social isolation and loneliness, (ii) self-esteem and self-efficacy, (iii) declining mobility, health and activity levels, (iv) high medical expenses, (v) age discrimination and long wait times for medical health services, (vi) age discrimination, retirement, and wanting part-time employment, (vii) not enough gender-specific social participation activities, and (viii) housing insecurity. Four themes related to strengths were identified: (i) An "I have enough" mindset, (ii) strong formal social support, (iii) contributing to the community and others, and (v) "Most of us like to be alone." Successfully addressing poverty in old age and tackling the challenges associated with living alone will require focusing on and activating not only external and systemic resources but also the intrinsic capacities and strengths of older adults themselves. Five discussion points are raised addressing the implications for future gerontological research and practice.

Prevalence, types, and combinations of multiple problems among recipients of work disability benefits

PURPOSE

For persons on disability benefits who are facing multiple problems, active labour market policies seem less successful. Besides health problems, these people perceive personal, social, and environmental problems. Since very little is known about these "non-medical" problems our aim was to explore the prevalence of clients experiencing multiple problems, the types and number of perceived problems, combinations of perceived problems, and associated characteristics in a group of work disability benefit recipients.

METHODS

We performed a cross-sectional study, using self-reported data on perceived problems and socio-demographics, and register data from the Dutch Social Security Institute on diagnosed diseases and employment status. A convenient group of labour experts recruited eligible clients on work disability benefit.

RESULTS

Of the 207 persons on work disability benefit, 87% perceived having multiple problems. Most reported problems were related to physical (76%) or mental (76%) health. Health problems most frequently occurred together with a mismatch in education, financial problems, or care for family members. Clients with lower education experienced significantly more problems than clients with an intermediate or high educational level.

CONCLUSIONS

Clients with multiple problems face severe and intertwined problems in different domains of life, and need tailored multi-actor work disability management.Implications for rehabilitationClients with multiple problems face severe and intertwined problems in different domains of life; therefore, interventions tailored to deal with needs related to specific problems might be more effective than traditional programs.Interventions should match experienced barriers, and involve multi-actor work disability management with all the challenges of mutual cooperation.For persons with multiple problems a focus on pure medical barriers is too narrow, because personal, social, and environmental factors might also obstruct participation in work.

Institutional and Individual Factors Affecting Health and Employment for Low-Income Women With Chronic Health Conditions

OBJECTIVES

This qualitative study explored risk and protective factors affecting employment and health among low-income older women with chronic health conditions or physical disabilities.

METHODS

The authors conducted a secondary data analysis of 14 intensive interviews with low-income older women with chronic health conditions who had participated in a federally funded training and employment program for workers aged 55 and older. Qualitative data were analyzed using thematic analysis.

RESULTS

The physical nature of the work and discrimination were risk factors, with unaccommodating work environments, ageism, and/or ableism, and internalized ageism identified as subthemes of discrimination. Protective factors, namely institutional supports (e.g., access to retraining, time management flexibility) enhanced health and self-confidence. Occupational demands matched with the capacity of the individual resulted in continued employment and improved health.

DISCUSSION

Working conditions can degrade health through exposure to mental and physical health risks, or support health through access to financial and interpersonal resources. Institutional supports such as workplace flexibility and retraining are crucial to obtaining a good fit between occupational demands and the capacity of individuals, enabling a positive relationship between employment and health. Legislation designed to prevent discrimination, enhance opportunities for lifelong learning, and encourage flexible work arrangements among low-income women with chronic health conditions may facilitate healthier working lives.

Ageism and the Older Worker: A Scoping Review

Purpose of the Study

Given the policy shifts toward extended work lives, it is critically important to address barriers that older workers may face in attaining and maintaining satisfactory work. This article presents a scoping review of research addressing ageism and its implications for the employment experiences and opportunities of older workers.

Design and Methods

The five-step scoping review process outlined by Arksey and O'Malley was followed. The data set included 43 research articles.

Results

The majority of articles were cross-sectional quantitative surveys, and various types of study participants (older workers, human resource personnel/manager, employers, younger workers, undergraduate students) were included. Four main themes, representing key research emphases, were identified: stereotypes and perceptions of older workers; intended behavior toward older workers; reported behavior toward older workers; and older workers' negotiation of ageism.

Implications

Existing research provides a foundational evidence base for the existence of ageist stereotypes and perceptions about older workers and has begun to demonstrate implications in relation to intended behaviors and, to a lesser extent, actual behaviors toward older workers. A few studies have explored how aging workers attempt to negotiate ageism. Further research that extends beyond cross-sectional surveys is required to achieve more complex understandings of the implications of ageism and inform policies and practices that work against ageism.

Understanding the Financial Knowledge Gap: A New Dimension of Inequality in Later Life

To understand individuals' financial behaviors, it is important to understand the financial knowledge gap - the distance between one's objective and subjective financial knowledge. Overestimating one's financial knowledge can lead to risky financial behaviors. To date, limited empirical work has examined how financial knowledge gap varies across age groups. We analyze the size and nature of the financial knowledge gap and its variation across age groups. Using nationally representative data, we find robust evidence that older adults overestimate their financial knowledge. Social workers can assess the financial knowledge gap and educate their clients to protect from financial fraud, exploitation, and abuse.

Ageism: we are our own worst enemy

In 1969, Butler (1969) first coined the term "ageism" to confront "prejudice by one age group toward other age groups" (pp. 243). As with other "isms," such as racism and sexism, ageism leads to bigotry and discrimination, though it is a very distinct beast in that, for the most part, other "isms" refer to those different from ourselves: distinct, mutually exclusive, and impervious groups. Conversely, age is a fluid social construct in which we are all intimately bound as we move through the lifespan, transitioning in and out of different age-groups. Unlike other "isms," individuals negotiate shifts from the "in-group" of youth to the "out-group" of old age. Yet we are all immersed, largely unconsciously, in this ubiquitous but too often unrecognized "ism" that needs to be named and challenged.

Who Works Among Older Black and White, Well-Functioning Adults in the Health, Aging, and Body Composition Study?

Objective: The aim of this study is to examine social, economic, and health factors related to paid work in well-functioning older adults and if and how these factors vary by race. Method: We used sex-stratified logistic and multinomial logistic regression to examine cross-sectional data in the Health, Aging, and Body Composition cohort study. The sample included 3,075 community-dwelling Black (42%) and White adults aged 70 to 79 at baseline. Results: Multinomial logistic regression analyses show Black men were more likely to work full-time, and Black women were more likely to work part-time. Men with ≥US$50,000 family income were more likely to work full-time. Men with better physical functioning were more likely to work full- and part-time. Women with ≥US$50,000 family income and fewer chronic diseases were more likely to work full-time. Women who were overweight and had fewer chronic diseases were more likely to work part-time. Discussion: Results suggest that well-functioning, older Black adults were more likely to work than their White counterparts, and working relates to better health and higher income, providing support for a productive or successful aging perspective.