Socio-economic inequalities in physical and mental health persist at older ages and previous studies have shown that partnership and parenthood histories are also associated with differentials in later-life health. These domains of adult life interact, and both may be influenced by earlier life circumstances, indicating a need for a holistic approach to understanding lifecourse influences on health at older ages. In this paper, we identify classes of lifecourse types for a United Kingdom (UK) cohort born 1933–1945 and investigate differences between the latent classes identified in physical and mental health, and changes in health over a five-year follow-up period. Data were drawn from Waves 1–5 (2009–2013) of the nationally representative UK Household Longitudinal Study. Multi-level models were used to analyse associations with summary indicators of physical and mental health measured using the SF-12, and changes in health, controlling for childhood circumstances and taking account of support from family and friends in later life. Lifecourses characterised by lower socio-economic position, early parenthood and large family size were associated with worse physical and mental health in later life, with respondents who had combined a high socio-economic position and two children being the most advantaged. The study indicates that socio-economic disparities in later-life health vary depending on the way in which individuals combine work and family life.

The impact that providing care to ageing parents has on adult children's lives may depend on the long-term care (LTC) context. A common approach to test this is to compare whether the impact of care-giving varies between countries with different LTC coverage. However, this approach leaves considerable room for omitted variable bias. We use individual fixed-effects analyses to reduce bias in the estimates of the effects of informal care-giving on quality of life, and combine this with a difference-in-difference approach to reduce bias in the estimated moderating impact of LTC coverage on these effects. We draw on longitudinal data for Sweden and Denmark from the Survey of Health, Ageing and Retirement in Europe (SHARE) collected between 2004 and 2015. Both countries traditionally had generous LTC coverage, but cutbacks were implemented at the end of the 20th century in Sweden and more recently in Denmark. We use this country difference in the timing of the cutbacks to shed light on effects of LTC coverage on the impact care-giving has on quality of life. Our analyses show that care-giving was more detrimental for quality of life in Sweden than in Denmark, and this difference weakened significantly when LTC coverage was reduced in Denmark, but not in Sweden. This suggests that LTC coverage shapes the impact of care-giving on quality of life.

In this comparative study focusing on the population aged 50 and over in three European countries, we investigate the association between household debt and depressive symptoms, and possible country differences in this association, using data from Waves 1, 2, 4, 5 and 6 of the Surveys of Health, Ageing and Retirement in Europe (SHARE) for Belgium, France and Germany. Multi-level regression models with random intercepts for individuals were used to analyse the association between household debt status and number of depressive symptoms (EURO-D score). Country differences in the household debt–depression nexus were tested using country interaction models. After controlling for other measures of socio-economic position and physical health, low or substantial financial debt was associated with a higher number of depressive symptoms in all countries. Housing debt was strongly linked to depressive symptoms for women while the association was weaker for men. The only country difference was that for both sexes substantial financial debt (more than €5,000) was strongly associated with depressive symptoms in Belgium and Germany, but the association was weak or non-significant in France. Associations between financial debt and depression were also evident in analyses of within-individual changes in depressive symptoms for a longitudinal sub-group, and in analyses using a dichotomised, rather than a continuous, measure of depression. The findings indicate that measures of household indebtedness should be taken into consideration in investigations of social inequalities in depression and suggest a need for mental health services targeted at indebted older people.

The rapid increase in twinning rates in developed countries has increased interest in the question as to whether twin mothers have higher mortality and more health problems than mothers of singletons. Here we use a national survey, the Office for National Statistics Longitudinal Study of England & Wales, and a linkage between the Danish Twin Registry and the Danish population register to examine mortality patterns after age 45 (50 for fathers) for twin parents and the whole population born from 1911 to 1950. For England and Wales, presence of limiting long-term illnesses and self-rated health status was also investigated. Overall similar health and mortality was found for twin parents and the whole population although both life table methods and survival analysis suggested a slight excess mortality among older cohorts of twin mothers in England and Wales.

In this paper we examine associations between the fertility histories of older British women and men and their quality of life using data on a sample of 6,374 men and women born between 1923 and 1949 drawn from the British Household Panel Survey (BHPS). Quality of life in 2001 was measured using scores from the four subscales of the CASP-19 questionnaire: control, autonomy, pleasure and self-realisation. Fertility histories were derived using information on the births of children collected in all waves of the BHPS. The aspects of fertility history investigated were number of children born and parents' ages at birth of first and last child. Age, education, marital status, tenure status, smoking, co-residence with one or more children, perceived social support and health limitations were included as covariates. The results suggested that early entry to parenthood and to some extent high parity were related to poorer quality of life. These associations were mostly mediated by socio-economic, social support and health factors. Compared to women with two children, nulliparous women expressed a higher level of autonomy, and both nulliparous women and those with four or more children a higher level of self-realisation. Low parity was related to a lower level of pleasure, especially among men, but this relationship appeared weaker and among women was not significant when background factors were controlled.

Recent follow-up studies of depression in old age have highlighted the high relapse rate in older patients compared with younger patients. The consequences for the provision of acute psychiatric beds for elderly patients has been investigated by comparing the usage of beds by younger and older patients with depression over a 4-year period. Overall, elderly depressed patients consumed one and a half times as many bed days as younger depressed patients and a quarter of all acute bed days available in the hospital were used by elderly depressed patients.

Relationships between migration and fertility are examined, using data from the OPCS Longitudinal Study of England and Wales, including linked information from the 1971 and 1981 Censuses and birth registration data for the period 1971–80. The results showed that the proportion moving between the 1971 Census and the first subsequent birth was higher among tenants than owner occupiers, particularly for women in shared accommodation in 1971. The association between tenure and moving was more consistent than the relationship between moving and the husband's social class. Differences in the proportions moving between the censuses were positively associated with fertility in the same period particularly for women in potentially crowded accommodation in 1971. Moving in 1970–71 was not associated with differences in parity progression ratios 1971–81. There were, however, differences in the timing of births, suggesting that long distance migration was associated with a postponement of the first or second child, probably because both longer distance migration and fertility behaviour are associated with other characteristics such as education.

Data from the 1971 Census records included in the OPCS Longitudinal Study were used to examine the relationship between geographic mobility and marriage termination and remarriage. Remarried women had high rates of mobility and there seemed to be a clear ‘excess’ of moves made around the time of remarriage, shortly after the end of the first marriage. There was a suggestion too of a peak in movements following widowhood but no indication of excess movement at the time of de jure divorce. The data were not adequate to allow examination of moves made at the the time of separation. Additional data from linked 1971–81 Census information showed that changes of marital status were strongly associated with changes of tenure. Other characteristics of divorced, widowed and remarried women were also examined to see how they might affect their patterns of geographic movement.

The ‘sandwich generation’ has been conceptualised as those mid-life adults who simultaneously raise dependent children and care for frail elderly parents. Such a combination of dependants is in fact very unusual, and the more common situation is when adults in late mid-life or early old age have one or more surviving parents and adult but still partly dependent children. It can be hypothesised that for parents in this pivotal position, the demands from adult children and from elderly parents compete, with the result that those who provide help to one are less likely to provide help to the other. An alternative hypothesis, however, is that family solidarity has an important influence but is not universal, so that some pivotal-generation parents engage in intergenerational exchange in both directions, and there is a positive association between helping parents and helping children. To investigate this question, the paper presents an analysis of data from two broadly comparable national surveys, in Great Britain and the United States, on the care provided by women aged 55–69 years to their descendent and ascendent relatives. The results show that around one-third of the women reported providing help to members of both generations, and that around one-fifth provided support to neither. They broadly support the solidarity hypothesis, but provide some evidence that having three or more children is associated with a reduced likelihood of providing help to a parent.

This paper considers the processes and circumstances that create vulnerability among older people, specifically to a very poor quality of life or an untimely or degrading death. Models of ageing processes are used to define vulnerable older people as those whose reserve capacity falls below the threshold needed to cope successfully with the challenges they face. Compensatory supports may intervene to mitigate the effects of challenges and to rebuild reserve. The dimensions of reserve, challenges and compensation are discussed, with emphasis on demographic and other influences on the availability of family and social support. Policy initiatives to reduce vulnerability can focus on each part of the dynamic process that creates vulnerability, namely, ensuring that people reach later life with ‘reserve’, reducing the challenges they face in later life, and providing adequate compensatory supports. The promotion through the lifecourse of healthy lifestyles and the acquisition of coping skills, strong family and social ties, active interests, and savings and assets, will develop reserves and ensure that they are strong in later life. Some of the physical and psychological challenges that people may face as they age cannot be modified, but others can. Interventions to develop compensatory supports include access to good acute care and rehabilitation when needed, substitute professional social and psychological help in times of crisis, long-term help and income support. Our knowledge of which interventions are most effective is however limited by the paucity of rigorous evaluation studies.

Transfers of assistance from older to younger family members are an important, though often ignored, component of intergenerational exchanges. The ability to help younger family members, either financially or practically, may be influenced by the health and socio-economic status of older parents, but very little is known about these patterns. This article examines the effects of socio-economic and health status on the help that late mid-life parents in Britain and the United States give their children with money, domestic tasks, and grandchild care. Results for the different types of family support yield three main findings. First, there are relatively few differences between Britain and the USA in the factors affecting the provision of support. Secondly, socio-economic factors appear to be more important among married respondents while health is more important among the unmarried. Thirdly, children's co-residence has greater effects on the provision of domestic task help in Britain than in the United States.

There has been an increasing interest in the caring responsibilities of middle generation individuals as numerous studies have noted the continuing family obligations of people in later life. Employing data from the United Kingdom Office of National Statistics Retirement Survey of 1988/89, we examined social class differentials in the provision of care by 55–69 year olds. Our results show few social class differences in the provision of co-resident care to a parent (among those aged 55–69 in 1988/89 with at least one living parent), but significant social class differences in the provision of care to a spouse. Working class individuals were more likely to be caring for a spouse than their middle class counterparts because of the higher prevalence of disability among this group.

This paper provides a brief introduction to demography and population science and the newly emerged subfield of the demography of ageing. Links with gerontology are explored. Recent work on mortality at very high ages and on the black-white mortality ‘cross-over’ reported from the United States is then reviewed. These topics are important substantively and theoretically and also serve to illustrate demographic approaches to data and data analysis. Analytic approaches to the topics reviewed have had to be imaginative as there are major problems with data on very old people. Recent work indicates that the mortality of very old people, including centenarians, has fallen considerably, at least in those countries where good data exist. The mortality ‘cross-over’, however, appears to be artefactual, at least at ages under 95 years.

The aim of the study reported here was to investigate the relationship between health and household composition among older people. The 1 per cent and 2 per cent SARs (Samples of Anonymised Records) drawn from 1991 British Census data were used to examine the frequency of a limiting long-term illness among older people according to different types of living arrangements. These data include the population in institutions and our results show that previous studies based only on the private household population have underestimated the prevalence of illness among older people. Long-term illness rates vary across family and household types, with higher frequencies found for those individuals not living in families (either alone or with others) or in lone parent families, compared with those living as part of a couple. Importantly, our results show a previously unreported clustering of long-term illness in households. Those over 45 suffering from a limiting long-term illness were more likely than those without such an illness, to live in households including others with long-term illness. These results indicate that health should be considered from a household, rather than just an individual, perspective. Our findings support those who have argued that families including an older ill member need more help from formal services. However, it is unlikely that this can be achieved solely by redeploying services from those living alone as long-term illness rates were also high in this group.