Social exclusion of older persons: a scoping review and conceptual framework

As a concept, social exclusion has considerable potential to explain and respond to disadvantage in later life. However, in the context of ageing populations, the construct remains ambiguous. A disjointed evidence-base, spread across disparate disciplines, compounds the challenge of developing a coherent understanding of exclusion in older age. This article addresses this research deficit by presenting the findings of a two-stage scoping review encompassing seven separate reviews of the international literature pertaining to old-age social exclusion. Stage one involved a review of conceptual frameworks on old-age exclusion, identifying conceptual understandings and key domains of later-life exclusion. Stage two involved scoping reviews on each domain (six in all). Stage one identified six conceptual frameworks on old-age exclusion and six common domains across these frameworks: neighbourhood and community; services, amenities and mobility; social relations; material and financial resources; socio-cultural aspects; and civic participation. International literature concentrated on the first four domains, but indicated a general lack of research knowledge and of theoretical development. Drawing on all seven scoping reviews and a knowledge synthesis, the article presents a new definition and conceptual framework relating to old-age exclusion

Does Social Isolation Affect Medical Doctor Visits? New Evidence Among European Older Adults

We aimed to determine whether social isolation is associated with higher health-care utilization among European older adults. We have used panel data (2004-2015) from the Survey of Health, Ageing and Retirement in Europe (SHARE) to examine the impact of social isolation on general practitioner health-care use. More precisely, we have considered negative binomial panel count data models to study the main driving factors. Socio-demographic, health, and social isolation measures are analyzed. Differences by Welfare Regimes have been also considered. Using two definitions of social isolation (Alone and Help), we have found that a sizeable proportion of those aged 50 years and older in Europe reported social isolation. Our results showed that while nonpartnership was significantly and positively correlated with health-care utilization (B = 0.03), providing help was significantly and negatively related with physician visits considering the full sample of European countries (B = -0.09). Differences by Welfare Regimes are highlighted. Also, Mediterranean countries consume more health-care services than other European ones. Targeting interventions for social isolated elders may significantly decrease general practitioner consultations and so health-care costs. Our findings provide several implications in current debates on the sustainability of welfare states