This report aims to answer the following key research questions:
How can intersectional analysis be used to explore possible social differences, inequalities in health, and differences in living conditions for different groups of older adults?
What are the future challenges for this field?
The WHO framework for active ageing acknowledges a diverse approach to perceiving that an active and healthy lifestyle in older age is determined by a wide range of determinants (WHO, 2002). An intersectional perspective involves looking at an individual from different perspectives and noting, for example, the power relations in society that affect individuals' opportunities to actively participate in society on equal terms.
This report suggests three domains of indicators that can help characterise active and healthy ageing in the Nordic countries at present, namely Healthy ageing and well-being, Socio-economic status, and Social activity, engagement, and participation. Indicators are based on the findings from the closely connected study Indicators for Active and Healthy Ageing in the Nordic Region. Possibilities and Challenges (Cuadrado et al, 2022).
Life expectancies have increased in all of the Nordic countries, and analyses of indicators for self-perceived health have been used to show how older adults in the Nordic countries rate their own health. Older men rate their health slightly higher than older women, while statistics show that women generally live two to three years longer than men in all of the Nordic countries. There is a clear pattern in health and socio-economic status in the Nordic countries, where older adults with a higher socio-economic standing generally feel healthier, but no clear distinction can be made between urban and rural areas. A consequence of poor health can be self-perceived long-standing limitations in usual activities due to health problems, and such limitations have decreased in the Nordics, except for Denmark, which has seen increasing numbers since 2003. Finland has the highest levels in total, while Norway is the only country that shows notable differences between men and women.
Another indicator in the context of health and well-being is that reflecting physical activity according to educational attainment level and according to different genders and age groups. Denmark and Sweden report the highest levels of physical activity per week, while Norway has the lowest percentage of the older population reporting weekly physical activity in the Nordic countries in 2017.
Educational attainment levels among older adults in the Nordic countries show noticeable differences. Norway, Sweden, and Finland have the highest proportions of older adults who have completed a tertiary degree. A common trend in the Nordic countries is that women generally have higher educational levels than men. Another general pattern that can be observed is that educational levels are higher in urban than in rural areas. This difference is most evident in Iceland where the proportion of older adults who have completed tertiary education is more than twice as high in urban areas than in rural areas. Another indicator used for examining socio-economic status is at-risk-of-poverty rate. This measure shows noticeable gender differences that can be observed throughout the Nordics, where women in all five countries face a greater risk of poverty than men. Related to this, housing and living conditions show that older adults who live alone generally also face a heightened risk of poverty and social exclusion (Eurostat, 2020). While there are country-specific differences between the Nordic countries, the general trend shows that in most cases those older adults who live alone generally have lower incomes.
Different indicators measuring social activity, engagement and participation were also analysed in this study. The primary intention here was to examine digital literacy in different ways. While the Nordic countries are generally among the top-ranked countries in Europe and the world on several measures of digital literacy in older age groups, cross-Nordic comparisons show great variation among older adults in this regard. One of the aspects influencing digital capabilities is socio-economic status. For instance, the general trend in all the Nordic countries is that older adults with higher educational levels are more frequent internet users than those with lower formal education. Gender differences are also apparent here as women are generally more active internet users than men in the five Nordic countries.
Indicators studying formal or informal voluntary activities as well as involvement in cultural and/or sporting events were also examined. Here, men engage more actively than women in all types of voluntary activities in each of the Nordic countries, while women are more active in cultural and/or sporting events. Engagement in all types of voluntary and cultural and/or sporting activities decreases with age in all Nordic countries. Educational attainment level is an important determinant influencing how actively one participates in voluntary activities, highlighting the importance of socio-economic factors in understanding the preconditions for active and healthy ageing.
One of the challenges in using intersectional analysis as a tool in this context is that applying understandings and perspectives with regard to active and healthy ageing is a relatively new concept in the field. Further intersectional analysis based on cross comparing the data might therefore be a useful point of focus in future studies in the field. There is a need for more detailed classifications of sex and other identity variables to create an intersectional identity matrix that covers each variable, so that each subgroup is uniquely classified. Unfortunately, the data required to examine these intersections is rarely available at the macro level. Further analysis also requires survey data and more detailed classifications of not just age and gender, but also other identity variables, relating to socio-economic standing, for instance. In the case of active and healthy ageing, the indicators observed in this report suggest highly correlated variables, which makes it difficult to separate the effects of certain variables, which is to say the true effect of a single measure.
The lack of country and time coverage for the Nordic data poses a great challenge to studying changes over time, and for making comparisons between countries. Closer Nordic collaboration and coordination of relevant data at least at the national level will be needed, while also underscoring that much data rapidly become obsolete. This report adds recommendations on how the analysis of present and future data can provide a more diverse interpretation of what constitutes active and healthy ageing in the Nordic region, and a broader understanding of who lack access to ageing well and why.