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Recent events—both economic and political—have made painfully clear rising levels of inequality in the United States. Financial data to that effect have been piling up since the turn of the century, with the publicity (and sales) surrounding Thomas Piketty’s (2014) 696-page tome Capital in the Twenty-First Century being perhaps the most unanticipated purveyor of the news. In the political arena, Elizabeth Warren’s election to the Senate in 2012 and Bernie Sanders’s emergence in the 2016 presidential campaign appear to herald a phoenix-like rise and partial institutionalization of 2011’s Occupy Wall Street movement. Yet, most of the attention surrounding “making an issue of income inequality” has focused on the hardships facing working-age and younger people as they struggle to put food on the table and find a place for themselves in the world of work. Receiving less attention in these analyses is the fate of millions of older adults who struggle in both similar and different ways from inequality’s effects. This absence results in part from the cross-sectional view commonly taken of older people: They are there, however they got there, and “God bless them.” But beyond this homogenizing stereotype is the more pernicious and misleading assumption that government programs—Social Security and Medicare in particular—have a major leveling effect on well-being in old age. That these programs are universal—with all the salutary consequences associated with that status—is conflated with assumptions about cross-class redistribution within them of which there is in fact very little. There is a need for the widespread disparities in well-being within the older population to be part of the broader discussion of wealth and income inequality in the United States. But documenting the degrees of inequality across the older population by virtue of race, class, and gender is only a first step. Where age and generation are concerned, a longitudinal lens is required, one that acknowledges the cumulative accretion of opportunities and constraints over time and throughout the life course. In the absence of midlife course corrections, there is no reason to believe that early life inequalities will somehow be lessened by the time individuals attain old age. Indeed, in the United States, where public policies on behalf of those aged 18–64 are stunningly absent, there is every reason to think that matters will get worse rather than better with the passage of life and time. Today’s age-based policies do provide an important cushion for millions of elders, but they do not reduce inequality. When the differential onset of aging-specific vulnerabilities is then added to this equation, one must believe that matters of inequality among the old are further exacerbated. In Corey Abramson’s apt phrasing, “the reality is that later life is not the end of inequality, it is inequality’s end game” ( Abramson, 2016 , in this issue). The disparate realities facing older Americans, their causes and consequences, are the topic of attention in the following pages. This issue opens with an article by Stephen Crystal who, by consensus, brought the issue of elder cumulative advantage/disadvantage to the attention of scholars and policymakers alike. His 1982 book, America’s Old Age Crisis and the Two Worlds of Aging , uncovered the structures, if not indeed the striations, that mark contemporary aging inequality in the United States. His article, “Cumulative Advantage, Cumulative Disadvantage, and Inequality Among Elderly People,” with Dennis Shea ( Crystal & Shea, 1990 ) launched the cumulative advantage/disadvantage (CA/D) frame as a topic of academic inquiry, having been cited and referenced hundreds of time since its appearance. Crystal introduces the topic here first by noting its rise beginning in the late 1970s following the 30-year post–World War II period where income and wealth were more evenly distributed. He notes that an important reframing of the incomes issue was the evolution from a discussion centered on poverty to one centered on inequality. Beyond income, Crystal highlights the place of (good and bad) education and health care as factors centrally affecting elder well-being. He speaks as well to pressing policy issues, expressing concern that the further “tiering” of Medicare plans could exacerbate health care inequality. Crystal calls for added Social Security benefits for those aged 75 and above for whom the accumulation of disadvantages can be especially stark. He also finds worrisome the presumption in many neoliberal and conservative quarters that elders are increasingly seen as an “advantaged” population and thus in less need of public support than was earlier understood to be the case. Crystal calls for research to make clear the deep fissures in elderly well-being and for reducing tax expenditures benefiting the wealthy as a means to fund initiatives on behalf of vulnerable elders. The conceptual contribution of the CA/D frame is demonstrated by Renee Beard and John Williamson who show its utility by contrasting it with the generational equity (GE) frame employed by critics of today’s age-based public policies. In contrast to GE’s contending that resource allocation is not fair across generations, CA/D emphasizes economic stratification within as well as across ages. A generational interdependence framing partially countered GE critiques of aging policy expenditures but did so in generational terms. CA/D’s being a distinct framing is seen in Robert Merton’s (1988) referring to cumulative advantage as the “initial comparative advantages of trained capacity, structural location, and available resources.” To CA/D’s credit, it brings a much sharper lens to issues of class and race than does GE, although the authors do acknowledge Ferraro and Shippee’s (2009) contention that CA/D does not adequately recognize individual or group agency or make needed room for nonlinear projections. Beard and Williamson clearly favor progressive policy reforms that follow from CA/D’s framing and object to the privatization and generational accounting alternatives that neoliberals associated with the GE framing are proposing. In their concluding comments, Beard and Williamson take particular note of the negative gender implications of the GE frame, its failing to acknowledge life course challenges and caregiving obligations faced by women. The CA/D frame calls attention to a series of policy domains. Melissa Hardy speaks here to “the legacies of risk and protection in the reproduction of health disparities.” As is well known, the poor have higher mortality and morbidity rates, and this continues to be the case despite the society-wide improvements made in public health, medical technology, and access to health care. Hardy expresses clear frustration with this ongoing state of affairs with the nation’s “presumption of an opportunity-based system of achievement.” Put differently, not only do the poor disproportionately face health-related risks, “prior exposure, priorities of medical research, diffusion of treatment, and safety of the environment rarely favor the poor.” A life course perspective underscores the ongoing disadvantages that poor circumstances generate. Low childhood socioeconomic status is linked to problems with adolescent development, educational attainment, occupational achievement, and adult poverty. Steps to alleviate these marginalizing conditions could be taken, but they come up against institutional barriers and quality of care/intervention barriers. Seen as particularly noxious are attempts to curtail Medicaid provisions addressing smoking, obesity, and other risky behaviors in the name of personal responsibility. Hardy does invoke individual agency as well as societal barriers, observing that how the health/wealth feedback loop occurs will favor either agency or structure. Speaking more broadly, she concludes that the disadvantaged can succeed in “merit-based” systems, difficult as that may be. In contrast, “endowment-based systems provide mechanisms for reproducing and enhancing early life stage advantages throughout adulthood, as parental resources can serve as partial substitutes for the merits of their offspring. That these benefits can accrue despite wide variation in ability and effort undermines notions of equality and opportunity and calls into question the openness of the class structure, since opportunity structures are themselves the pathways to success.” Laura Sullivan and Tatjana Meschede turn our attention to financial vulnerabilities across the life course as they affect the retirement of older women and women of color. Rising life spans, growing health care expenses, and declining pension security find these two groups especially at risk. Borrowing from their work at the Brandeis Institute on Assets and Social Policy, they specify low levels of homeownership, business development opportunities, and higher education access as especially high barriers to wealth development. The racial/gender wealth gap is wide, with full-time male workers earning $897 per week, compared to $734 for white women, $611 for black women, and $548 for Latinas. But it is over time where yet larger disparities emerge, with the wealth gap between blacks and whites increasing from $43,000 for those aged 25–54 to $225,000 for those aged 65–84. Among women, the difference of $7,000 for those 25–44 increases $132,000 for those 65–84. In short, wealth-building for women and especially for women of color is an enormous burden. The authors make a series of recommendations toward meeting this challenge, their having in common a life-span approach. As is clear throughout this issue of Public Policy & Aging Report , they make clear that life does not begin at 65. Richard Johnson from the Urban Institute also addresses the question of retirement income adequacy over time. Growing income inequality (the top 10% of workers receiving more than half of all earnings), plus the wealthier earning more, working longer, and having more substantial employer-based benefits, has problematic distributional consequences. Pressures on Social Security and shortfalls in private pensions raise the important question of what the future holds for retirement income. While those born between 1935 and 1945 have been something of a favored retirement generation, the prospects for the boomers, Gen X, and Gen Y are less clear. Johnson reports on findings from UI’s DYNASIM Model forecasting the likely future level and distribution of retirement income. He finds both good news and not so good news. First the good news: median retirement incomes will generally rise in inflation-adjusted terms for generations reaching age 70 through the early 2040s, partly because women are earning more, production gains will boost average wages, and many people are delaying retirement and working longer. The not-so-good news: while median incomes will continue to rise at older ages, many future retirees may be unable to maintain their living standards because average replacement rates will fall and the distribution of income is growing increasingly unequal. Rising expenses for the oldest old will stretch incomes even farther. In the absence of annuitization, retirees will face one of two types of problems: outliving income on the one hand, or spending too little to enjoy life on the other hand. As for public policy, increasing Social Security benefits for low-income workers and liberalizing the woefully out of date Supplemental Security Income asset test of $2,000 for a single elder and $3,000 for a couple would be in order. In our concluding article, Corey Abramson borrows from The End Game: How Inequality Shapes Our Final Years (2015), his well-received ethnographic study of the everyday lives of aging Americans from diverse backgrounds in four urban neighborhoods. By way of introduction, he makes two overarching observations: Who gets the chance to grow old is unequal, and aging is a stratified process that reflects the inequalities that structure our life chances from birth onward. Turning to his study, he strongly emphasizes that where seniors live has a profound effect on everyday life. A literature on environmental and neighborhood effects has focused much more on youth than on elders; yet the latter can be equally if not more strongly affected by such conditions. Abramson contrasts one of his affluent neighborhoods to one of the poor ones. The former possesses ecological resources, a “buffet of services,” reliable public (and private) transit, senior center and visiting programs, health fairs, well-stocked grocery stores, subsidized housing, and well-regarded hospitals and clinics. The poor neighborhood: austere amenities, unreliable public and little private transit, low-quality health care facilities, dangerous subsidized housing, and social organizations centered largely on youth. In his discussion, Abramson borrows from the “network inequalities” literature, where material, social, and emotional resources may be in greater or lesser abundance and density. His overall conclusion holds that “network inequalities carry over to our final years just as do unequal wealth and neighborhood resources.” Interventions should reflect the “contextual specificities” that seniors encounter in everyday life; they should begin before age 65 and should take into account disparities in neighborhoods, not only in individuals’ particular situations. Old age does not bring with it a lessening of disparities. Both aging and duration may further imbed conditions found at earlier points in time. Individual agency and social change can mitigate these default drive effects, but conditions left alone will not right themselves.
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