So much has been written about ageing, health and care – what more is there to say? Well lots, according to the author of this book, and whilst the title isn't the most inspiring, it does accurately describe the contents. Although compact in size, this book is rich in content that is as interesting as it is diverse. The book primarily focuses on the health-care challenges associated with an ageing population. Drawing on a diverse range of UK data, the book aims to understand the implications of ageing on health, challenge dominant assumptions, and re-draw some of the stereotypical boundaries that surround health- and social-care provision for older people. Although the book explores the nature and extent of health problems in older age, its focus on policy and strategic responses to the health issues of older people challenges the reader to re-think how services for older people respond to their diverse health needs.
How older people define and understand the meaning of health in older age is a key concern in the text, and this is supported by an extensive analysis of the English Longitudinal Study of Ageing (ELSA). This is a key strength of the book, one of the first to make use of the ELSA database in this way. This approach serves to engage the reader in what in other contexts could be ‘dry statistics’, but because of the currency of the data and the integrated way they are presented, the evidence they provide brings a richness and freshness to the debates. A limitation of many textbooks on ageing is the overuse of figures and tables that often contain large amounts of indecipherable data. In contrast, the tables in this book are kept to a minimum, are current, and are used as an effective means of presenting salient information in a clear and concise manner.
The book consists of a general introduction followed by seven chapters. Within each chapter there are a number of common features, including definitions of key terms, activities, further reading and useful websites. Chapter 1 sets the scene with a demographic overview and a consideration of how older adults understand and conceptualise their health. Chapters 2 and 3 explore the different aspects of physical health in older age, consider the methodological challenges associated with studying health in older age and examine the evidence for the stereotype that the health experiences of older people are undifferentiated. The fourth chapter focuses on mental health in later life and makes a convincing argument for greater considerations of neglected mental health problems such as depression and suicide. Chapter 5 examines health and lifestyle in older age with a particular focus on ‘anti-ageing’ medicine and the ‘long history of trying to live longer’. Health- and social-care provision for older people is addressed in Chapter 6 with due regard and recognition of the role of family and friends in supporting older people. Looking to the future, Chapter 7 explores the potential impact of population ageing on heath and care in a global context and the balance to be reached between adding years to life and adding life to years.
All chapters begin with key points for consideration and this enables the reader to know exactly what to expect from the content therein. This style is also reflected in the conclusion of the chapters where the key points are summarised. From an educational perspective, an additional strength of the book is the inclusion of ‘activities’ throughout the chapters and ‘further activities’ at the end of each chapter that serve as a useful way of guiding the reader and consolidating existing knowledge. For example, at the conclusion of Chapter 3 on ‘Chronic disease and disability’, readers are asked to calculate the number of older people in their locality who have chronic illnesses, problems with activities of daily living, falls and incontinence, and then to consider the factors that might explain the class and gender differences in the prevalence of chronic illness and disability. These further activities are particularly beneficial to the independent learner but also can be used by educators to further enhance existing knowledge and understanding.
Undoubtedly, one of the key strengths of Christina Victor's latest work is the extent to which she recognises and respects the variability of health experiences in later life and the extent to which these are influenced by gender, age, socioeconomic status and ethnicity. As a respected academic in the field of Gerontology, Victor takes nothing for granted in terms of the knowledge base of the reader and has created a resource for a wide and varied audience. The book should be of interest to a diverse readership – students of gerontology, policy makers, educators and academics.