Social inequalities in aging in place and access to health and social care

The Canadian population is aging rapidly, and more than 17% of Canadians are now aged 65 or older. Although many older adults live with functional limitations and chronic diseases, most prefer to remain in their homes as they age rather than transition to long-term care facilities ("aging in place"). In this context, timely access to health and social services is critical for older adults who are facing challenges maintaining their autonomy at home. Without these resources, older adults are more dependent on emergency care and are more likely to be hospitalized and subsequently admitted to long-term care. Despite universal healthcare coverage in Canada, social inequalities in access to healthcare and social support remain prevalent, creating disparities in the ability to age in place among certain populations and leading to health inequity in older age. The objectives of my doctoral research are to evaluate how inequalities in admissions to long-term care, hospitalizations and emergency care use in older age are influenced by gender, socioeconomic position and rurality, and to examine the mediating impact of having access to health services and social support in reducing or perpetuating these inequalities. The results of my research will contribute to a better understanding of the social inequalities of aging in place and inform public health action and policy decisions aiming to reduce inequalities in healthy aging. The importance of such policies and practices is increasingly relevant with the growing population of older adults. Furthermore, the urgent need to improve care infrastructures for older adults has been highlighted by the disproportionate effect of the COVID-19 pandemic on older adults living in long-term care settings in Canada. As we enter the UN Decade of Healthy Aging (2021-2030), strategies to foster the autonomy and dignity of older adults are essential determinants of equitable health in older age.