Frailty and Precarious Ageing: Intersecting Biological and Social Risks in Later Life

In the United Kingdom, population health worsened significantly during the period of austerity that was implemented following the 2008 Financial Crash. When analysing these trends in older adults, the field of social gerontology has increasingly used the concept of Later Life Precarity to understand the exposure to numerous, intersecting risks that individuals face when ageing in this social and political environment. However, there has been limited quantitative analysis of Later Life Precarity and its effects on health. Accordingly, this study uses data on 8553 adults aged 50 + from the English Longitudinal Study of Ageing to examine the forms that precarity takes in later life and its associations with health. We firstly describe configurations of risk that make up precarity experienced by older adults across the domains of finances, pensions, employment, housing, relationships and caregiving. We then use Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (MAIHDA) to identify precarious intersections of risk associated with especially elevated frailty levels. The MAIHDA model identified a number of forms of precarity that were associated with particularly high frailty, with the strongest random effect being observed for women who are divorced, widowed and/or living alone and who lack financial and pensions security. In the context of the ongoing cost-of-living crisis, these findings demonstrate how frailty emerges at the intersection of numerous social risks and, furthermore, highlight the cost (both to the individual and to healthcare systems) of policies that fail to provide a secure and equitable environment for our ageing population.