Abstract
As concentration of income and wealth at the top of the income distribution attracts increasing concern, this symposium focuses on income and health inequalities among current and future older adults in the US. Late-life well-being reflects the cumulative effects of life chances and choices as they interact with institutional structures. Outcomes evolve from health and economic status at birth through educational attainment, marital trajectory, labor market outcomes, and own/family health. Social insurance programs buffer cumulative disadvantage but leave substantial disparities, especially because those with lower lifetime incomes face poorer health and survival.
The first presentation examines the changing profile of economic inequality by age and cohort over three decades using a comprehensive measure of economic well-being. Results demonstrate rising old-age inequality and presage even higher future rates of inequality as high-inequality cohorts now at midlife reach old age.
The second presentation draws attention to financial factors, including access to pensions and escalating personal debt, that combine to widen income disparities for older adults. Differential longevity magnifies the impact of these trends.
The third presentation estimates the impact on health disparities at older ages of disparate access to opportunity in young adulthood and of childhood disadvantage, stressing changes for successive cohorts of Americans.
The final presentation projects future late-life inequality, highlighting the impact of out-of-pocket spending for medical and long-term services and supports on economic well-being. Social insurance reforms, including changes to Social Security and Medicare and new insurance programs for older adults with disabilities, could improve outcomes for low-income seniors.