Introduction

As we have seen in Chapters One and Two, the closing decades of the 20th century saw significant social changes in the nature of later life, some of which reflect the emergence of ‘consumer societies’ in the UK and elsewhere. The uneven nature of retirement, as well as the relative affluence of many retired people and the poverty of others, influence the experience and patterns of consumption in later life. Several key writers have pointed out how social identities are increasingly formed around processes of consumption rather than those of production and reproduction (Beck, 1991; Bauman, 1998; Zukin and Maguire, 2004). While research on the link between consumption and identity has been carried out on young or working-age groups (Hebdidge, 1979; Nixon, 1996), gerontological researchers have often presumed that older people are outside the cultural dynamics of consumption or implicitly assumed that such dynamics play little part in the day-to-day lives of older people (Gilleard, 1996; Gilleard and Higgs, 2000). However, as several commentators are aware (Dychtwald, 1999; Freedman, 1999; Metz and Underwood, 2005), the cohorts of people retiring today are those who pioneered the creation of the post-war consumer culture. The decades of the 1950s, 1960s and 1970s saw the emergence of new, youth-orientated consumer markets directed at cohort located sub-cultures. While the absolute numbers of people making up the ‘baby-boomer’ or ‘baby-bulge’ cohorts was certainly important, this was not the main reason for their significance. Young people during this period had money and they also had an increasing range of non-essential items to spend it on (Bocock, 1993). These new consumer opportunities went further than just providing outlets for fashion and conspicuous expenditure; they provided the basis for generational identities that continue to be played out decades later. The post-war cohorts both lived through the emergence of the ‘affluent society’ and participated in creating contemporary consumer society. The emphasis on choice in what they wore, as well as in the entertainment they consumed, and the goods they owned, provided the stimulus for a mass consumer culture that was different from what had gone before (Kammen, 1999).

Introduction

In Chapter One we noted that the UK experienced considerable income growth from the 1960s onwards despite prolonged periods of economic crisis and high unemployment (Atkinson, 2000). Many older people benefited from these increases in income so that the economic position of older people has improved markedly over the past few decades in Britain as it has in most of the advanced industrialised world (Disney and Whitehouse, 2001; Casey and Yamada, 2002). This improvement creates winners and losers, with retirement age couples doing considerably better than single pensioners and women, particularly women who become widows, benefiting less (DWP, 2007). The overall rise in living standards was accompanied by growing inequalities in income from the 1960s onwards, particularly during the period between 1979 and 1997. The growth in income inequality among the working age population in Britain during the 1980s was exceptionally high (Atkinson, 1999) and rising income inequality continued through to the end of the century, but changes since 2000 are less clear (Dorling et al, 2007). Income mobility among the retired population increased with marked reductions in poverty rates, and the overall variability in pensioner incomes increased rather less than within the working age population during these last two decades (Forster, 2000; Brown and Prus, 2006). Zaidi and colleagues (2005) account for the decline in the incidence of poverty among the elderly by referring to the fact that later (younger) cohorts were more likely to have had occupational pensions. Furthermore, their findings show that ‘as measured by the Gini coefficient, income inequality has increased amongst older people in Great Britain’ (Zaidi et al, 2005, p 551). Thus, while there has been a marked growth in real net pensioner income since the early 1980s and a fall in the number of pensioners below the poverty line (Hills and Stewart 2005), there remain substantial inequalities among the retirement age population (Hills, 2004; ONS/DWP, 2005). To quote Hills:

Introduction

In this book we have traced a growing engagement with consumer society among the older age groups over the last 40 years of the 20th century. While this engagement has been both varied and uneven, the overall trend has been one of increasing ownership of and expenditure on key consumer goods during this period (from a low baseline). These changes in the consumption patterns of the older population reflect other deep and lasting transformations in British society that have left their mark on the landscape of British social, economic and political life. These include the long-term decline of mass employment in manufacturing industries, changes in educational achievement and occupational mobility patterns, changes in gender relations and a freeing up of the public and private spheres. We have suggested that it is in the context of a shift towards late modernity that we are best able to understand the implications of these transformations for later life. The trends of increasing heterogeneity within the older population and the latter's increasing similarity with the general population have profound consequences for the experience of ageing in late modern society. In particular, the conditions of late modernity have given rise to increasing individualisation and a late modern sensibility based around the construction of individual identities through the pursuit and maintenance of lifestyles. These lifestyles are themselves increasingly commodified and framed by a consumer culture. In terms of levels of income and expenditure, therefore, it would appear that older people in Britain are not dissimilar in their profiles and habits to the rest of the population. Hence, these trends have a wider resonance within the study of ageing and later life. In this concluding chapter, we focus on the connections between lifestyles and consumption in later life in three important respects: first, a third age based on generational habitus; second, the contradictions of later life in consumer capitalism; and third, worlds of welfare and the ‘consumer citizen’.

The third age and generational habitus

In the opening chapters of the book, we chartered the social and economic changes that occurred in the latter decades of the 20th century. In so doing, we highlighted the importance of period, cohort and generation for understanding later life. Previous work on generations has been hampered by confusion surrounding the term.

The findings presented in this book are based on a cross-sectional historical comparison of people at different ages, household types and income levels through a secondary analysis of Family Expenditure Survey of Great Britain (FES) data. (The Office for National Statistics (ONS) conducts the Northern Ireland Family Expenditure Survey, which is very similar to the FES. However, we did not include these data in our analyses). The data were taken from eight years of the FES at five-year intervals over the period 1968-2001. These data were accessed through the Economic and Social Data Service. The FES is a voluntary survey of a random sample of private households in the United Kingdom carried out by the ONS. The FES is primarily a survey of household expenditure on goods and services, as well as household income. The original purpose of the survey was to provide information on spending patterns for the purpose of calculating the Retail Price Index. The survey has been conducted annually since 1957, although since 1994, the survey reference period has changed from the calendar year to the financial year. Data collection is carried out throughout the year to avoid potential bias arising from seasonal variations in expenditures. Respondents maintain a detailed expenditure diary over 14 days to give indicators of their consumption patterns. In addition to expenditure and income data, the FES includes information on a range of socio-economic characteristics of the households (for example, composition, size, social class, occupation and age of the head of household).

The basic unit of the survey is the household, although data are collected at both household and individual level. The FES sample for Great Britain is drawn from the Small Users File of the Postcode Address File. From this, 672 postal sectors in Great Britain are randomly selected during the year after being arranged in strata defined by government office regions (sub-divided into metropolitan and non-metropolitan areas) and two 1991 Census variables – socio-economic group and ownership of cars. The sample size and response rates for each of the years included in these analyses are presented in Table A.1. On average, about 7,000 households are surveyed each year, representing an average response rate of 60%, although this has declined over the period covered in this book.

Introduction

The horizontal divisions within society, such as cohort, age group and generation, have had considerably less attention paid to them than the vertical divisions of class, gender and ethnicity. This may reflect the starker social polarisation that emerged during the course of industrialisation, a polarisation that preoccupied the founders of the emergent social sciences. Horizontal divisions within society may have been recognised but they were not seen as so significant, or as key sites of social conflict. While there is still continued debate regarding the nature and significance of many of the vertical divisions in society, the importance of horizontal divisions has become more prominent. Indeed, some writers now argue that in contemporary society, generation is replacing class as the key site of contemporary social conflict (Turner, 1989; Becker, 1991). All of this makes it important to clarify the different but related horizontal divisions reflected in terms such as ‘age group’, ‘stage of life’, ‘cohort’, ‘period’ and ‘generation’.

Erdman Palmore (1978) pointed out that in most social science research, the need to separate age effects from period and cohort effects is inescapable. Not only are there ageing processes and issues of human development to deal with, but differences between generations and trends over time potentially confound any interpretation based on chronological age. While Palmore argued that it is always important to measure all three types of difference, doing so has always been a problem. Chronological age at least has the virtue of being an ordinal value, even though what a particular age may mean is historically contingent. Period, as has been seen in Chapter Two, is more contentious, as is the idea of generation, since both rely on interpretation. Even the idea of cohort, which seems straightforward, depends for much of its meaning on its conflation with generational effects.

These issues are highlighted in any consideration of the use of the term ‘generation’. Two approaches dominate the conceptualisation of this problem. The first is associated with the demographer Norman Ryder, who argued that ‘cohort’ was a more ‘neutral’ concept for understanding the interplay between history and biography than terms such as generation. He defined cohort as ‘that aggregate of individuals who experienced the same event within the same time interval … [where typically] the defining event has been birth’ (Ryder, 1997, p 68).

Introduction

Since antiquity, the household has been the basic organisational unit of western society. In ancient Greece, it was termed the oikos (from which is derived the term ‘economy’), while in Rome, it was termed the familia (from which is derived the term ‘family’). For the Greeks and Romans, as for most settled societies, the household was the central unit of production, consumption, enumeration and taxation. Besides being a site where goods and services were produced and consumed, the household was also the site of social reproduction where age, generation, gender and sexuality were enacted and personal identities formed and sustained. As times have changed, the nature of the household has changed, both in its size and in its composition, as well as its role in the economy. This chapter addresses aspects of continuity and change within the household during the second half of the 20th century, particularly as these changes have affected older people. Specifically, it examines the household as a unit of consumption and how this reflects on the lives and lifestyles of older adults.

Prior to the introduction of old-age pensions, the viability of maintaining an independent household for an older person was limited. It depended on some combination of accessible family support, an independent income, continuing wage labour and/or self-employment. In countries such as Britain that had a fairly comprehensive poor law system, some older people did manage to maintain a separate own household even when they could not work, through the provision of outdoor relief. The solution for surviving in their later life, for the majority of people, was to share a household with other, younger people. Failure meant institutionalisation and the poorhouse. In 1892, 21% of the population aged 65 and over in England and Wales received outdoor relief, while 8.3% (114,000 people) lived in the poorhouse (Nield, 1898).

As pensions replaced poor relief as a more reliable source of later life income, fewer people needed to labour on in later life. Pension income remained limited, however, and up until the Second World War the majority of old-age pensioners in Britain, as in most of Europe, lived with younger adults, usually their children. After the war, as regular retirement income became the norm, the numbers of older people able to live alone increased. Even so, during the 1940s and 1950s, the majority of people of pensionable age still lived with younger adults.

Introduction

The idea that later life could be represented as a third age of individual engagement and relative autonomy is one that has been contentious among social gerontologists since it started to gain widespread use in the 1990s; see Bury (1995) for a critique and Freedman (1999) for an exhortation. Part of the reason for the controversy lies not in the sentiment for a better later life but in the challenge that the idea of a third age represents for existing social gerontological theories of old age. The orthodoxy that had settled around the ‘structured dependency’ and political economy schools of thought focused around the idea of older people as poorly treated subjects of social policy rather than as agents enacting choices (Estes, 1979; Townsend, 1981). This view of later life was further challenged by the connections that were made, particularly in the US, between relative affluence, consumption, the pursuit of the third age and the search for ‘productive aging’ (Weiss and Bass, 2002). Such an approach appeared to go against many of the assumptions of social gerontology and underplayed the inequalities that exist in later life even if it was no longer possible to claim that these inequalities defined it. Moreover, the fact that the idea of the third age was being discussed at the same time as a profound restructuring of the welfare compact was occurring in both the US and UK meant that articulating such a perspective was seen as reinforcing shifts away from welfare citizenship and towards greater inequality (Estes, 2001). Consequently, the linking of old age, the third age and consumption are not only seen as problematic but also seem to undermine the generational compact between workers and retirees in the face of a changing demography. However, it is not just demography that is changing. As noted in Chapter One, the rise in post-war affluence has altered the relative fortunes of the majority of the retired population. The inequalities that exist within society are no longer structured by age but are reflected within it. As a result, an understanding of the third age and its development as a social space for later life is essential for understanding the role and significance of consumption in later life.

This chapter considers different typologies of the third age and explores the ways in which it is expressed and reproduced in different social contexts.

Introduction

This chapter examines the evolution of consumerism in UK health and social welfare policy with particular respect to older people. The chapter outlines the chronology of changes in health and social policy that have particular resonance for older people and the significance of these changes within ‘a society of consumers’ (Bauman, 2007, p 52). We chart the development and expansion of the post-war welfare state from its origins in the late 1940s to the mid-1970s, the ‘crisis’ of the welfare state and the subsequent reformulation of welfare policy that took place during the 1980s and 1990s. We go on to outline the new conditions of welfare consumerism that have been pursued by new Labour within a ‘choice and voice’ agenda before addressing our final theme, the potential significance of devolution for the diversification of welfare policy in the new Britain of the 21st century. The chapter ends by considering the role of health and social policy in the reconstruction of the older citizen.

The development of health and social care for older people in the post-war period

Prior to the creation of the National Health Service (NHS) in July 1948, healthcare in Britain was provided by a mixed system of hospital and primary care provision that was generally regarded as inadequate and unfair. Hospital care varied by geographic area, depending in part on the strength of local voluntarism and on historical circumstance, and was unequal in terms of quality and quantity (Mohan, 2003). Access to acute hospital treatment and to what we now term primary care was mostly contingent on the ability to pay. Two parallel hospital systems existed: the voluntary sector, self-governing and independent, and public hospitals that were, in theory at least, under the control of the local authorities. Substantial proportions of the population were unable to afford care of any sort, while others had access to only rudimentary forms of healthcare. Among the most disenfranchised were older people and those with chronic conditions, physical and mental.

Introduction

In this book, we have so far looked at a number of different aspects of the role of consumption in shaping the identity and experience of later life in contemporary Britain. Here we focus on health and health-related consumption. This is a rather different entity from those considered in earlier chapters where we looked at the growth of access to material goods by older people. Clearly, goods such as washing machines, videos and computers need little explanation or justification as ‘consumption items’. They are material objects that have both a physical form and convey a variety (or myriad) of meanings about identity, aesthetics and the consumer's sense of self. However, consumption is not only limited to the arena of tangible goods, but is also concerned with services (both tangible and intangible), leisure pursuits and ‘lifestyles’. Gould and Gould (2001) argue that intangibles such as health, not just healthcare, as well as tangibles can be conceptualised as consumption goods. Hence the study of health consumption involves a broad spectrum of activity, including the provision (and consumption of) goods and services, the development of health-related lifestyles and the experience and distribution of ‘health’ within and between populations. We therefore can examine health (care) practices via the perspective of consumption as a means of understanding health inequalities within and between specific social groups.

This proposition of health as a consumption good is not without its problems, particularly when we consider the extent to which health is produced and maintained by individuals, groups and communities. However, in the context of the growth of consumerism and choice as dominant motifs in the development of health and welfare policy, it is important to consider the extent to which the construction of older people as citizen consumers is linked to an increasingly individualised pattern of consumption of health and healthcare (Gilleard and Higgs, 1998). As we will see in the next chapter, the National Health Service (NHS) has become increasingly dominated by notions of (quasi-) markets, competition between providers, the development of commissioning (purchasing of services) and the development of the voice of the consumer (previously users or patients).

Introduction

The study of social change has always been at the heart of the sociological enterprise and the last decades of the 20th century have provided considerable material to work on. Not only did industrialisation and urbanisation reach unprecedented levels, but the integration of the world at economic, technological and cultural levels created the globalised conditions that transformed previous experiences of international linkages (Held et al, 1999). Within these macro social processes were contained many other transformations of social life, including education, health and social care and the control of fertility. Consumption must also be included in this list, given its extending role in everyday life and popular culture. Engagement in consumption is not just the epiphenomenon of production but has also taken on a significance of its own. The diffusion of mass consumer culture, as well as the lifestyles constructed within it, is one of the most arresting features of the transformed social world in which we live.

Less noticed but of equal significance have been changes to the nature of later life. With the rise of the modern retiree, the status of old age is no longer crystallised around that of the old-age pensioner. We have seen the emergence of retirement as a significant part of the lifecourse, a period that seeks to remove itself from the residual category of discarded labour to membership of a putative leisure class (Michelon, 1954). While these changes can be framed in terms of crisis and threat regarding the future of pensions or the burden of an ageing population on health and welfare services, this kind of ‘apocalyptic demography’ is but one side of the equation (Gee and Gutman, 2000). As Blackburn (2002) has pointed out, the longevity revolution is rather too conveniently presented as either a dystopian crisis or a utopia of health, wealth and vitality for all. The reality is more complex, reflecting the many processes of social and cultural change associated with the transformation of work, leisure and the family as well as the broader changes in peoples’ lives brought about by the rise of mass consumption.

The cohorts of people entering later life today are those who grew up in the midst of these transformations, and, perhaps more crucially, participated in their development. Earlier cohorts had entered old age with a very different (and much more limited) experience of affluence and consumer choice.