[Unequal chances for reaching 'a good old age'. Socio-economic health differences among older adults from a life course perspective].

This article provides an overview of the socioeconomic inequality in physical and psychological health of older adults between 55 and 85 years of age, with a focus on the older adults whose socioeconomic status (SES) remains at a low level all their life. Data are derived from 1471 men and 1568 women, participating in the Longitudinal Aging Study Amsterdam (LASA) in 1992/1993. Based on the parental and own level of education, respondents are divided in four categories: those with a life time low level of SES, those with downward or upward mobility in SES, and those with a life time high level of SES. Logistic regression analyses showed that older adults with upward SES mobility and life time high SES, had a lower risk for functional limitations, chronic diseases (men only), 6-year mortality, depression and loneliness, compared with the older adults with life time low SES. The disadvantaged position of the low SES persons with regard to age, health and psychosocial conditions explained the SES differences in depression, but SES differences in mortality (for men) and in functional disability (for men and women) are not explained by the risk factors under study. SES differences in loneliness were attributed to differences in psychosocial conditions. Lifestyle did not add to the explanation of any of the SES differences. There were only small differences between those with a life time low SES and those with downward mobility in SES. It is concluded that a low level of education (regardless of the parental level) contributes to restricted psychosocial conditions, health problems and low well-being in old age, thereby decreasing the chances for a 'good old age' considerably.