The social stratification of access to long-term care in later life. The Italian case [La stratificazione sociale nell'accesso alle cure di lungo termine in età anziana in Italia]

Italy is a frontrunner in the process of population ageing, which is affecting most high-income countries in Europe and elsewhere. Increasing longevity, paired with decreasing fertility and a much slower pace in the reduction of later life morbidity, has and will lead to an increasing mismatch between long-term care needs and resources. Within this context, it is important to understand the extent to which (scarce) care resources are distributed in society. As a matter of fact, inequality in access to long-term care in later life can add to pre-existing inequalities and further aggravate already existing disadvantages. In the present paper, we present a systematic review of existing studies focusing on the social stratification of access to long-term care among the older Italian population. Three dimensions of social stratification are considered: education, income, and wealth. Previous results suggest that education is a key factor in the unequal distribution of care resources, especially in terms of formal care. Regarding access to informal care and the role of income and wealth, previous literature reports mixed findings. The review also identifies several significant limitations in previous studies on the topic.