Household income and other socio-economic determinants of long-term institutional care among older adults in Finland

Abstract

An analysis of longitudinal data on Finnish older adults shows that the probability of admission to long-term institutional care is inversely associated with household income: women in the lowest income quintile are 35 per cent more likely, and men in the lowest quintile 59 per cent more likely to be admitted than those in the highest quintile, independently of age, first language, and area characteristics. Controlling for other socio-demographic characteristics and medical conditions reduces these differences by 59 and 78 per cent, respectively. Being a renter and living in poorly equipped housing increases the probability of admission to institutional care, while the possession of a car and living in a detached house decreases it, independently of other factors. These results imply that the future need for institutional care will depend not only on the increasing numbers of older people but also on socio-economic factors and housing conditions.

Keywords:

• institutionalization
• institutional care
• income
• aged
• population register
• prospective studies
• Finland

Notes

1. Elina Nihtilä is at the Population Research Unit, Department of Sociology, PO Box 18, FIN-00014 University of Helsinki, Finland. E-mail: [email protected]. Pekka Martikainen is at the Helsinki Collegium for Advanced Studies, University of Helsinki.

2. This study was supported by the Finnish Post-Graduate School of Social Sciences/Population, Health, and Living Conditions, and by the Academy of Finland. The research was part of an EU-funded research programme on Major Ageing and Gender Issues in Europe (MAGGIE). We are very grateful to Unto Häkkinen and Anja Noro from the National Development Centre for Welfare and Health (STAKES) for their guidance in designing and using the database, and for their expertise in health and social services, and to Seppo Koskinen and Antti Reunanen from the National Public Health Institute for helping us to use the hospital and medication registers. Earlier versions of these results were presented at the Twenty-Fifth International Population Conference of the International Union for the Scientific Study of Population, in Tours, France, on 23 July 2005.