The Summer Generations Issue explores the uncertainties and vulnerabilities that older adults may face in their later years, especially people from groups that have been historically marginalized or discriminated against based on race, ethnicity, class, disability, and immigration status. In this edition, authors from a range of disciplines and community settings offer insights about how well or poorly U.S. social policies address differential exposure to risk in old age in an increasingly diverse society. Also raised, is how the COVID-19 pandemic is reshaping our understanding of risk and vulnerability in later life and creating enormous challenges for older adults. Not only are older people at greater risk than younger adults of hospitalization and mortality if infected with COVID-19, but also for many older people the pandemic has brought or intensified economic hardship, isolation, anxiety, and fear.
In this introduction, we use precarity as a lens through which we can understand the risks associated with contemporary aging. A precarity perspective reveals and highlights uncertainties, risks, and insecurities that exist for older adults as a result of economic and social change (especially in periods of rapid transition) and the hazards of contemporary life associated with globalization and neoliberalism (Gallie, Paugman, and Jacobs, 2003; Schram, 2015).
Neoliberalism is a policy framework that promotes the transferring of economic factors from the public sector to the private sector; it endorses limiting government spending, government regulation, and public ownership; and fosters stimulating free market capitalism (Brown, 2003; Greenhouse, 2010). Since the 1980s, with Ronald Reagan in the United States and Margaret Thatcher in the U.K., neoliberalism ushered in the policies of austerity and reduced government spending on social programs in general, and for older people (Pierson, 1995).
Historically, the concept of precarity has been largely applied to labor force conditions and working age adults. A central tenet is that the entrenchment of neoliberal capitalism in recent decades has resulted in the emergence of a precariat class characterized largely by lack of job security, including intermittent or underemployment (Standing, 2010). More recently, the concept of precarity, and its attention to risk, insecurity, and vulnerabilities is being extended to old age as a way to understand how shifting social and political contexts are creating uncertain, insecure, and challenging conditions and circumstances for many older people (see Grenier, Phillipson, and Settersten, 2020).
Disasters such as the COVID-19 pandemic are in many ways “revealing crises” for societies (Oliver-Smith, 1996). A reduction of societal priorities to basic necessities often lays bare preexisting social inequities and failures in social justice (Fjord, 2007; Cazdyn, 2007). Ageism, for example, was and continues to be central in the COVID-19 pandemic. Discussions of the virus and of healthcare rationing were used to cast older persons’ lives as less valuable than those of younger persons; particularly early in the pandemic, when deaths of older people were portrayed as an acceptable or reasonable sacrifice. The COVID-19 crisis also exposed the devastating effects of structural racism. Older people from marginalized and discriminated groups not only experienced higher infection rates, but also had less access to healthcare and community resources, including vaccination. Yet, in the midst of this public health emergency we witnessed the resilience of older persons, family caregivers, and the professionals who serve them.
Precarity is a way to understand how shifting social and political contexts create uncertain, insecure, and challenging conditions for many older people.
There is widespread agreement that the COVID-19 crisis has created a moment of hyper-uncertainty. However, a growing number of experts also suggest that emerging population, technological, and political trends in United States (and globally) may lead to decades of increased insecurity. The twentieth century saw the greatest increase in global population, from 1.6 billion in 1900 to 6 billion in 2000, as life span lengthened and infant mortality declined. Notably, demographers now predict that by the mid-twenty-first century the global population size will enter a sustained decline for the first time due to a fertility bust and population stagnation (Cave, Bubola, and Sang-Hun, 2021).
No one knows for certain how the future will unfold. However, a precarity lens offers a conceptual frame to explore how a smaller and older world population may lead to paradigm shifts in the roles of family and state, and potentially increase uncertainty and risk for some groups of older people.
The Contribution of Life-Course, Intersectionality, and Precarity Lenses
Life-course, intersectionality, and precarity perspectives are interrelated but distinct frameworks for understanding the social context of growing older, and in particular, aging and inequality. Life-course theory places individual and family development within social and historical contexts, and seeks to understand the multiple factors that shape people’s lives from birth to death (Elder, 1985; 1994; Dannefer and Settersten, 2010). In gerontology, it is largely recognized that to fully understand later life one must locate it within the entire socially constructed life course, in which risks and resources are unevenly distributed and through which existing structural inequities shape the lived experience of old age (Walker, 2009).
Research in this area, particularly on cumulative advantage and disadvantage, underscores the idea that circumstances and experiences of childhood and young adulthood have formative and cumulative effects, which may amplify disparities in later life (Dannefer, 2003; Crystal, Shea, and Reyes, 2016).
The concept of intersectionality, introduced by Crenshaw (1989), suggests that individuals embody multiple social characteristics or identities simultaneously, such as gender, race, ethnicity, age, and socioeconomic position. Fundamental to intersectionality is an understanding that subgroups are positioned differently in the social hierarchy and therefore have differential power, resources, and life chances. In gerontology, this set of ideas challenged the heterogeneity of aging, contributing insights on power relations in regard to age and multiple and diverse social locations (Calasanti, 2009; Calasanti and King, 2015). Importantly, intersectionality argues that social identities do not act independently of one another but interrelate to create systems of oppression, domination, and/or discrimination. Given its focus on inequities, many view the adoption of an intersectionality lens as key to the advancement of social justice–driven policy (Hankivsky et al., 2014; Holman and Walker, 2020).
The concept of precarity is positioned as an allied and complementary perspective to understanding aging and inequality. In addition to its focus on the social, cultural, and historic contexts of aging, it emphasizes the importance of how politics and policy create and sustain risk, insecurity, and vulnerability. It creates a conceptual linkage between understanding the structured conditions and experiences of aging and late life.
Butler (2009), for instance, defines precarity as a “politically induced condition in which certain populations suffer from failing social and economic networks of support and become differentially exposed to injury, violence, and depth.” As emphasized by Grenier, Lloyd, and Phillipson (2017), “Precarity draws attention to the implications of neoliberal practices that have altered late life through the combined impacts of the increased short-term contracts, decline in trade unionism, and declining forms of social protection that include a reliance on family/kin or market care, and private market pensions.”
The argument is that neoliberal capitalism, which advances an agenda of individualism, self-responsibility and independence (versus interdependence, social responsibility, and care), blames individuals for their poverty, and views precarity as a moral failure or weakness, rather than resulting from, or being the responsibility of social, political, and economic institutions. Impacted individuals such as “the elderly,” “the homeless,” “minorities,” and “migrants,” are labelled “other” and often stigmatized and viewed as undeserving of support and resources.
Even prior to the COVID-19 crisis, the relationship between the construction of older people and the political response to their needs was shifting. Since the 1980s, a vortex of complementary demographic (the older population’s tremendous growth), economic (anemic growth); fiscal (unprecedented budget deficits), and political (deeply embedded left-right conflict) pressures emerged (Hudson and Gonyea, 2012).
The rise of neoliberalism in the United States witnessed transformations in the political construction of old age whereby the older population went from being characterized as “dependent” to “advantaged” and, most recently, “contender” (see Hudson and Gonyea, 2012, for an historical overview). As contenders, the U.S. baby boomer generation is depicted as having arrived at old age with negative political baggage associated with their alleged self-absorption and strong sense of entitlement. This characterization has undermined the older population’s long-standing legitimacy for age-related policies based on notions of vulnerability and sacrifice by emphasizing the boomers’ material gains and a collective selfishness associated with the imagery of power (Hudson and Gonyea, 2012). Age-related policies therefore have increasingly come under intense scrutiny and sparked heated debate.
Precarious Aging
Precarity is not only structured—it is also an ontological experience. Precariousness is the lived experience of feeling uncertain, insecure, and/or vulnerable in one or more domains of one’s life. This sense of precariousness can include current challenging circumstances in an older person’s life as well as the anticipatory anxiety about emerging or future changes that may heighten one’s vulnerability, such as declining income and/or the need for care (Grenier, Lloyd, and Phillipson, 2017).
Circumstances and experiences of childhood and young adulthood have formative and cumulative effects, which may amplify disparities in later life.
In considering precarity, it is also important to explore resilience as older persons face uncertainty and adversity in their lives. The concept of resilience acknowledges the resources that people draw upon to cope with adversity; it highlights precariously placed individuals’ agency and adaptability when faced with uncertain or difficult circumstances. As Bates, et al. (2019) argue, “considering precarity and resilience in tandem can minimise the potential for precariously placed people to be stigmatised or seen as passive victims in the face of uncertainty and insecurity.”
However, the lens of precarity as a politically induced condition reminds us of the dangers of neoliberal responses, which use the resilience of populations to justify non-response (see Katz, 2004) and the need to balance our analysis of the structured conditions of inequality, with the required supports, as well as resources, strengths, and capacities of individuals, communities, and groups.
Uncertainty, Insecurity, and Risk Are Part of the Aging Landscape
This past year has further exposed how close to the edge of poverty, or precariously placed, many older Americans are. Together, the issue’s articles offer insights into the ways in which uncertainty, insecurity, and risk are part of the contemporary aging landscape for many older adults, particularly members of historically marginalized and discriminated groups. Authors speak to the realities of economic and material hardship in later life, the role of structural racism, and differential exposure to risk in old age. They also delve into the critical roles of governmental programs such as Social Security, Medicare, Medicaid, and SNAP.
Since the 1960s, the Federal Policy Level (FPL) has been the most widely used benchmark for economic disadvantage in the United States. In “Precarious Aging: The Spatial Context of Racial and Ethnic Disparities,” Jan Mutchler, Yang Li, and Nidya Velasco Roldán shift the policy narrative from the question of “What is economic disadvantage in later life?” to “What is economic self-sufficiency in old age?” or restated, “What does it take to get by in one’s later years?” Using the Elder Index, which calculates the amount of economic resources older households need to “get by,” based upon household necessities costs, the authors show that many more older adults, particularly older adults of color, are precariously placed than the FPL indicates. Their state-level analysis further reveals that racial disparities in late life economic insecurity are amplified by spatial disparities.
Weinliang Hou and Geoffrey Sanzenbacher, in “The Importance of Social Security as an Equalizer,” expand our understanding of economic precarity in retirement wealth. Treating Social Security as an annuitized form of wealth—that is, a guaranteed lifetime income stream backed by the full faith and credit of the U.S.- or a government-issued annuity, they show how this benefit reduces extreme racial/ethnic inequality in retirement wealth. The authors emphasize the need to protect Social Security’s fiscal solvency because future reductions in benefits would disproportionately affect minority households. Further, they underscore that proposed policy changes to “shore up” Social Security must not increase racial retirement wealth inequality.
Although the COVID-19 pandemic dramatically increased food insecurity in the United States, as Robert Blancato and Meredith Whitmire point out in “The Crucial Role of Federal Nutrition Programs in Promoting Health Among Low-Income Older Adults,” hunger, food insecurity, and malnutrition among the nation’s older population, including disparities based on economic, racial, and/or disability, were a reality long before the pandemic. The authors highlight the success of federal nutrition programs to alleviate food insecurity, at the same time noting that these programs reach far fewer older adults than are eligible or wish to participate. Blancato and Whitmire suggest that achieving nutritional security for all older adults will require a fundamental shift to an integrative approach centered on food security as a key social determinant of health.
In “A Tricky Balance: Medicare Affordability and Middle- and Lower-Income Beneficiaries’ Financial Stress,” Amber Willink outlines how the COVID-19 pandemic has further exposed gaps and flaws in Medicare. In particular, she points to its failure to respond to the needs of current beneficiaries, who are older, more diverse, and more often coping with longer-term complex medical conditions than earlier beneficiary cohorts. Willink documents how the high cost-sharing of covered services and costs associated with non-covered services have led to financial stress, especially for the 40 percent of beneficiaries with incomes below 200 percent of the federal poverty line, and contributed to delays or lack of medical care. She calls out the flawed assumption that cost-sharing and non-covered services always lead to public cost savings because individual-borne costs, particular high out-of-pocket costs, have been found to accelerate beneficiaries’ entry to Medicaid. She identifies policy options to better support Medicare’s original objective of providing financial protection and ensuring access to care, particularly for precariously placed beneficiaries.
Trinh Phan and Gelila Selassie draw our attention to the barriers older immigrants face in accessing public benefits, and the risks and implications that are not experienced by non-immigrant adults. In “The Diversity of Older Immigrants and Precarious Aging: Eligibility and Access to Public Benefits,” the authors speak to the impacts of the shifting political and social climate of the 1990s, particularly the repercussions of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, which imposed strict restrictions on immigrant eligibility for public benefits. This Act had long-term chilling effects that spread beyond those directly affected. Yet, Phan and Selassie also see emerging opportunities for policy reform, including how the COVID-19 pandemic made visible immigrants’ strong presence as essential workers and provided “insistent lessons” on interconnectedness.
The next set of articles consider context and place, further revealing forms of late-life precarity and demonstrating how precariousness affects older persons’ everyday lives, particularly those from marginalized and/or disadvantaged groups. As is known, but acutely revealed over the last year, precarity takes place on a global scale. Two articles in this issue focus specifically on the growing challenges of climate change, natural disasters, and pandemics to precarity and precariousness.
‘Precariousness affects older persons’ everyday lives, particularly those from marginalized and/or disadvantaged groups.’
In “Climate, Disasters, and Extreme Weather Events: Vulnerability, Resources, and Interventions for Older Low-Income Adults," Alexis Merdjanoff draws our attention to how older people, particularly those who are socially isolated, have lower-incomes, and/or health/technology needs, are disproportionately affected by the negative impacts of climate-related events and disasters, potentially causing long-lasting disruptions in their personal lives and communities. Merdjanoff outlines how disasters are a global policy and public challenge because they threaten health and access to basic needs such as clean air, water, food, and shelter. She highlights two key features to mitigate disasters’ negative effects including better planning and emergency preparedness and the development of community capacity and social support. The attention to disasters calls us to think beyond individuals, organizations, and systems to the unevenness of the disruptive effects and the larger environmental contexts that affect global lives.
Marc Garcia, Adriana Reyes, and Catherine Garcia deepen the analysis of the precarity to “unforeseeable events” by outlining how the effects of COVID-19 were unequally distributed. “The COVID-19 Pandemic and Precarious Aging: The Importance of an Equity Response” outlines how the pandemic disproportionately impacted older Black, Indigenous, and Latinx adults relative to older non-Latinx White adults, revealing the role of historical and structural racism. Their article draws attention to the multilayered impacts experienced by communities of color ranging from differential exposure and susceptibility to less access to resources, including the more than double rate of COVID-19 infections, the placement of blame for higher infection rates on these communities, and disparities in vaccine rollouts. In response, they underscore the need for a health equity lens to dismantle structural discrimination, remove barriers, and provide access to resources and develop equitable and just responses to communities of color in America.
The next three articles demonstrate how precarity and precariousness are experienced in relation to (and through) place. Supporting persons’ ability to “age in place” is now defined as a policy priority. Yet, while place is essential to understand and situate older people’s lives, the assumptions often made about place and home as a source of security can miss how disadvantage accumulates where older people live, and how neighborhoods and communities reflect larger structured inequalities and spatial divisions, and sources of strength and capacity building.
In “Addressing Health Equity for Older Adults at the Neighborhood Level,” Stephanie Robert and Meghan Jenkins Morales outline how the social determinants of health that are patterned by place (and over time) require solutions focused on community and neighborhood contexts. They address how neighborhood disparities can affect older people’s precarity (structured) and precariousness (feelings and experiences of) through greater exposure to hazardous, unsafe, and/or unhealthy conditions such as violence, substandard housing, and/or poor quality healthcare. They argue that to alter these patterns that are rooted in systemic racism, the response should be centered on health equity and strategic investments in socioeconomically disadvantaged neighborhoods. This could include targeted neighborhood measures such as deepening connections to age-friendly neighborhood initiatives, incentivizing health systems to invest in addressing local social determinants of health, and supporting the development of the grassroots community efforts. Homelessness and low-income subsidized housing are two locations on the housing continuum that reveal everyday precariousness.
Homelessness in later life represents a range of structural inequalities and trajectories of disadvantage related to racism and discrimination, patterns of under/unemployment, mental health or intimate partner violence, poverty and/or displacement, among others (Gonyea, Mills-Dick, and Bachman, 2010; Grenier, In Press, 2021). At the same time, housing stability, or the lack thereof in the case of homelessness, creates higher levels of exposure to threats and negative impacts of any additional event or disruptive circumstance. The needs of older people may intensify at the intersections of housing, health, and care.
In “Mitigating Homelessness Among Older Adults: Opportunities in Adapting the Permanent Supportive Housing Model,” Sonia Gupta Pandit and Rebecca Brown argue for the importance of permanent supportive housing as a means to address late-life homelessness and provide security to older people, particularly those with geriatric conditions. They draw attention to the unique needs of precariously housed or homeless older people, the risks they often encounter in the current shelter system, and argue that the provision of housing alone is not enough to address the needs of this growing population. In particular, they discuss how the expanding model of permanent supportive housing as a solution to homelessness requires adaptation where older people are concerned, and share four emerging models of practice to better link housing and care, and address the precariousness of being older and homeless.
In “Affordable Senior Housing Maintenance and Renovations, COVID-19, and the Precarity of Residents’ Health Safety,” Tam Perry, Zach Kilgore, Michael Appel, Michele Watkins, Claudia Sanford, and Dennis Archambault provide three case studies about how Senior Housing Preservation–Detroit kept residents safe during scheduled dwelling improvements, in a pandemic. The authors outline how the risks and precarities that affect the older people’s lives in normal times were accentuated throughout COVID-19. These everyday accounts offer a unique angle into how lives can be affected by the scheduled and the uncontrolled—drawing attention to the importance of trusted relationships, ongoing engagement of various stakeholders and actors, and adoption of a team approach as key factors in mitigating risks to older residents. They reveal how risks and precarity, intersecting with structural racism, disadvantage, and inequality, are experienced through place, and compounded in times of crisis such as the pandemic, and provide suggested directions for change.
Conclusion
This special issue explores the growing precarity of life for contemporary older Americans, specifically how the shifting social and political environments have increased the risk, insecurity, and vulnerability people experience in their later years. It explores myriad structures that produce precarity, the contexts within and against which precarity worsens, and the precarious experiences that affect older people. Aging in place—or the ability to live safely and comfortably in one’s own home and community and be socially engaged and connected (regardless of age, race, ethnicity, gender, income, and ability)—is the “ideal” held by the majority of older Americans. Yet, for too many older people, this is an increasingly challenging, if not impossible, goal.
Drawing attention to the precarity among older people highlights the need for policy reform. As the authors mention, the COVID-19 pandemic has revealed and magnified the extent to which social and economic inequities are rooted in racism, discrimination, and xenophobia. The pandemic also has revealed the depth of our polarizing political dysfunction as we sought to control this virus, ageism, and the replication of barriers to accessing health and social care. At the same time, the authors point to the implications of the pandemic as an opportunity to reexamine governmental responsibilities and to advance social rights, justice, and equitable approaches that will create a more equal, inclusive, and interconnected society.
This, too, is a message that international leaders, such the UN Secretary General António Guterres, have repeatedly voiced—that is, the COVID-19 crisis has revealed the urgent need for a new social contract based on inclusivity, sustainability, and social cohesion. Moving forward, it is critical that the construction of a new social contract address the link between structural racism, the creation and perpetuation of disadvantage, and an unequal old age. We would suggest that a precarity lens, which focuses on differential risk and insecurity, can inform how governmental policies and practices can be redesigned to promote equity and ensure the well-being of all older people.
Judith G. Gonyea, PhD, is professor and associate dean for faculty affairs at Boston University (BU) School of Social Work, as well as Senior Fellow at BU Institute for Health Innovation & Policy. Amanda Grenier, PhD, is professor and Norman and Honey Schipper Chair of Gerontological Social Work at the Factor-Inwentash Faculty of Social Work at the University of Toronto and Baycrest Hospital.
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