Inequalities in ageing well and the significance of transitions in later life (TRILL)

Sustaining an ageing population calls for increased focus on prolonging good health and wellbeing across the whole life span, including old age. The TRILL project addresses the impact of later life transitions (i.e. work exit, loss of health or functioning, loss of a spouse) on opportunities for ageing well across gender, socioeconomic position and local context. TRILL aims to contribute to placing later life and ageing as a core concern in research on stratification and inequality and to new interdisciplinary knowledge at the intersection of health promotion, ageing well and social health inequalities. TRILL’s main objective will be analysed in three steps (1) Unraveling potentially vulnerable transitions in later life; (2) Investigating differential effects of transitions on wellbeing and functioning; and (3) Assessing how some older adults manage transitions in later life well, despite a low SEP throughout their lives. TRILL uses a lifecourse perspective, which emphasizes possibilities for growth and adaption in old age, as well as the importance of significant others and local context in shaping individual lives. Through its focus on variations in ageing well, the project does justice to the substantial heterogeneity among older people, in particular among those with low socio-economic position. A major strength is the use of national large-scale longitudinal ageing studies (NorLAG and Tromsø study) in combination with register- and qualitative data. TRILL is a collaboration between the Health Services Research Unit (HSRU) at Akershus University Hospital, NOVA at OsloMet, the National Institute of Public Health and three leading institutes for ageing research in Europe, and includes representatives from a broad stakeholder group. During 2022 a Postdoc has been recruited to the project. By bringing together researchers from diverse disciplines such as gerontology, epidemiology, sociology, and psychology, the project fosters interdisciplinary collaboration and generates new knowledge at the intersection of health promotion, ageing well and social health inequalities. The project period is until summer 2025. So far, three scientific papers have been published, six scientific papers are in progress and there have been 18 user-directed disseminations. One paper, published in the special issue of Frontiers of Psychology «Psycho-Behavioral Factors and Longevity», tackles the impact of psychological factors for social inequalities in mortality after age 67. Findings underline that both structural (wealth) and perceived control continue to be important for life expectancy, also in older people. Another paper maps transitions that typically occur in later life (i.e., work exits, own and partner’s health limitations and loss of close family members) and analyses how these vary across sex and socioeconomic status. Findings suggest a higher number of transitions in older women, those with low education and least wealth. The latter group also has a significant larger probability to experience transitions earlier in life compared to those with the highest levels of wealth. The results thus suggest conditions that may contribute to unequal opportunities for ageing well. Retirement is considered a major life transition. The pension reform in Norway in 2011 contributed to more flexible retirements, which affects operationalisations of when a person exits working life. A recently published TRILL paper compares operationalisations based on survey and register data, which are used in subsequent TRILL research. The different operationalisations yield similar results at an aggregate level, but the choice of survey versus register data affects the defined time of work exit at the individual level. Currently (autumn 2023), TRILL's qualitative data collection is in progress, including personal interviews with participants from the Tromsø Study about their views on own ageing and ageing well. An overview of publications and activities in TRILL is available at the project’s website: News - TRILL - Social Inequalities in Ageing Well (oslomet.no).

The TRILL project addresses the impact of later life transitions on opportunities for ageing well. Sustaining an ageing population calls for increased focus on prolonging good health and wellbeing across the whole life span, including old age, and later life transitions transpire as important windows of opportunity for strengthening the possibilities for ageing well through interventions and policies. Ageing is remarkably unequal, even in a comprehensive welfare state like Norway, and requires attention to key stratifying factors, gender and socioeconomic position (SEP), which are core dimensions in TRILL. The project builds on the lifecourse approach, which strengths are the emphasis on change over time, thereby highlighting possibilities for growth and adaption also in old age, and the importance of significant others (linked lives) and local context in shaping individual life courses. By using theoretical concepts of differential capability and resilience, the project does justice to the substantial heterogeneity among older people, in particular among those with low SEP. Data from two large longitudinal studies (NorLAG, the Tromsø study), combined with register information and qualitative data, enable the disentangling of potentially vulnerable transitions in later life; analyses of the differential effects of transitions on wellbeing and functioning; and assessment of how some older people manage later life transitions well despite low SEP (resilience). TRILL is a collaboration between NOVA OsloMet, the National Institute of Public Health and three leading institutes for ageing research in Europe. By bringing together scholars from different disciplines, the project will contribute to new knowledge at the intersection between health promotion, ageing well and social inequalities. The project will also include a stakeholder group, including representatives from different levels of policymaking, as well as older people themselves.