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Social exclusion can become a downward spiral for older people

Walsh K, Scharf T, Keating.  Social exclusion of older persons: A scoping review and conceptual framework  European Journal of Aging. 2016; 24(1): 1-11.

Review question

How is social exclusion of older people conceptually constructed? What are the main themes or dimensions documented in the international literature in relation to each domain?

Background

Social exclusion, often experienced by the older population, is defined by the separation of individuals and groups from mainstream society. The existing evidence on the topic of exclusion in older age is disjointed. More specifically, it can be defined as a relative, dynamic and multi-dimensional concept. Older individuals may be excluded against their will, lack the capacity to achieve integration for themselves, or choose to exclude themselves from mainstream society.

Little is known about the ways in which aging and exclusion intersect across the life course, but rather, the focus is often on the exclusion one experiences when they leave the work force. Nevertheless, understanding the relationship between aging and exclusion may reveal key disadvantages faced by the aging population.

This review aims to develop a new definition and conceptual framework relating to old-age exclusion.

How the review was done

A detailed search of a number of electronic databases for studies published from 1997 to 2016 was conducted. Studies that focused on older people (aged 50 and over) and the concept of exclusion were included in the review.

A total of 1,000 studies were identified in searches, and 444 were included in the review after assessments for eligibility.

This review was partially funded by the Atlantic Philanthropies.

What the researchers found

The studies included in this review identify several interconnected domains that have an impact on the relationship between aging and exclusion. These are civic participation, neighbourhood community, socio-cultural aspects, services, amenities and mobility, material and financial resources, as well as social relations.

In addition, three key features of exclusion and old age were identified from the studies: the idea that exclusion can be accumulated over the course of an individual’s life and is not isolated to the old age population; the process of exclusion can involve a downward spiral in the sense that once an individual feels secluded they are less likely to be willing to participate in future social engagements; and older adults face challenges associated with aging, such as limited mobility, which increases the likelihood for exclusion to occur.

Conclusion

As a result of the literature review, the authors redefined the concept of old-age exclusion to include the identified features from the included studies. For example, the notion of exclusion as a process which can occur over the course of one’s lifetime was added to the definition for further research practice.

The limitations of this study include the focus on English-language studies only, difficulties in capturing all material outside of the exclusion discourse, and the limited space that prevents a detailed presentation of knowledge synthesis for each domain.