Gender differences in well-being in older age James Nazroo and Anne McMunn UCL

Gender inequalities in depression Women have between 1.5 and twice the rate of men Differences appear to develop around puberty and be greatest during the reproductive years At their peak in the early 30s and greatest among the married? This has led to a focus on: Biological differences, related to childbearing and reproductive hormones Gendered roles, which become more concrete around puberty, and the experiences, stresses and expectations that surround them Need to consider more than role occupation, also gender differences in role quality – role strain, the cost of caring, and the identity-salience of stressful events Little data on gender differences in depression for the period post menopause/child rearing (ONS surveys)

Gender inequalities at older ages Financial resources: pensions and housing wealth (legacy of roles earlier in life) Paid and unpaid labour Paid work in years leading up to state pension age Responsibilities for providing informal care Marriage and widowhood Gendered roles in the household All leading to gender differences in the opportunity to be a Third ager

The English Longitudinal Study of Ageing A panel study of 11,500 people aged 50 and older, drawn from the Health Survey for England and interviewed every two years (since 2002) Health trajectories, disability and healthy life expectancy The relationship between economic position and health The determinants of economic position in later life Timing of retirement and post retirement labour market activity Social participation, productivity, networks and support Economic, social and health inequalities

Questionnaire coverage and outcomes Demographics Health and disability Cognitive function Psychosocial factors and well-being Social and civic participation Housing Employment and earnings Pensions and retirement Income, assets and consumption Expectations for the future Performance and biomedical measures Links to administrative data Depression symptoms (Center for Epidemiological Studies Depression scale (CESD8)) Psychological well-being (General Health Questionnaire (GHQ12)) Quality of Life (Control, Autonomy, Self- realisation and Pleasure scale (CASP-19))

Gender differences in depression (CES-D)

Gender differences in psychological distress (GHQ12)

Gender differences in quality of life (CASP19)

Gender differences in employment status

Gender differences in providing informal care Women

Gender differences in recipients of care

Gender differences in household income

Gender differences in marital status by age

Gender differences in social participation Per cent who want to go but cannot

Factors associated with depression – women (1)

Factors associated with depression – men (1)

Factors associated with depression – women (2)

Factors associated with depression – men (2)

The influence of role occupation on gender inequality in depression in older age

The influence of role occupation on gender inequality in quality of life in older age

Conclusions (1) Gender inequality in depression persists into older age, but not for a measure of quality of life Material circumstances, role occupation and role quality relate to depression for both men and women Income/wealth and economic activity Marital status (widowhood) and quality of marriage Control and demands, and social participation Gender differences in marital status and quality, and social participation contribute to higher rates of depression for women, and when accounted for suggest that older women have better quality of life than older men But we need better measures of role occupation and quality if we are to understand this better

Conclusions (2) And we need to be very aware of cohort and period effects ELSA is a study of people born before (and around) the second world war (gender roles, welfare state and economic depression) 1960s, 1970s and onwards presented significant opportunities (education, birth control, divorce, anti-discrimination legislation etc.), which may change gender inequalities in material outcomes Associated cultural changes may also influence how gendered identities are taken up However, there remain differentials in career progression, economic rewards, and gendered roles (for example, part-time work) – institutional lag? And younger womens participation in paid work may create gendered grand-parenting responsibilities