Socioeconomic and Psychosocial Determinants of Well-being in Early Old Age

Abstract

Many actions and decisions taken by welfare institutions and healthcare organisations in modern societies are contingent on a medically defined condition of disease or disability. Medical knowledge on the development and course of diseases and disabilities, and their diagnosis, treatment and prevention, serves to legitimise access to scarce resources. This access may take the form of a disability pension or some form of early retirement, use of hospitals or rehabilitation centres, or allocation of specific benefits provided by health insurance organisations (disease management programmes, for instance). While convincing reasons back this approach, positive notions of health and wellbeing as phenomena that deserve an analysis on their own are rare – perhaps with the exception of the International Classification of Function (WHO, 2001). Rather, health and well-being are defined as states that are characterised by the absence of signs of disease or disability. More elaborate positive notions of health and well-being might be instrumental, however, in supporting attempts of welfare- and healthcare organisations to act pro-actively rather than reactively to needs (for example, to develop incentives to maintain or promote good health and well-being over the life course). Developing incentives towards maintaining and promoting good health seems particularly relevant in view of rapidly ageing populations in modern societies, including most European countries. Given the economic, social and healthcare burden of ageing societies, such attempts to promote ‘healthy ageing’ (Rowe and Kahn, 1997) must be considered a policy challenge of high priority.