Health inequalities in old age based on socio and economic disparities have become crucial for targeting health and social provision. Cross-sectional research has underlined that health inequalities diminish with age and, consequently, inequalities in older adults are smaller than those in middle-aged individuals. By contrast, longitudinal studies developed in the past decade have found mixed results on this relationship. They have shown a convergence, continuation, or even increase of health inequalities throughout early to late old age. These conflicting results may be due to several causes, such as the selection of specific health indicators or methodological choices in treating attrition and selection effects.
In our opinion, a clearer picture of health inequality can be obtained by using a multidimensional concept of health: frailty. ‘Frailty’ denotes a state of increased vulnerability that leads to morbidity, functional limitations and disabilities. It has been recognised as a valid measure of physiological decline, and it has been successfully applied in recent studies in order to assess health inequality among older adults.
Using a life course perspective, we investigate the association between frailty and socio-economic conditions. Although considerable research has been devoted to this topic, rather less attention has been paid to the role of national contexts. We aim to fill this gap by analysing four countries with different welfare systems and scores in ageing indexes: Denmark, Italy, Czech Republic and Poland.