[Social inequality, health and nursing care in old age].

BACKGROUND: Health and care services are an important aspect of public services as a basic obligation of the welfare state. Particularly in old-age, social inclusion, relatedness and integrity become the aims of health and care services beyond independence and autonomy.
OBJECTIVES: Provide an overview of inequalities related to socio-economic status, gender, and immigrant background in the context of health and care services.
MATERIALS AND METHODS: Analysis of differences in risks and problem situations, access to prevention measures, ambulatory and in-patient treatment, availability of social support, and care services in middle and older adulthood. Thereby, the contribution proceeds from our own contributions to prevention and rehabilitation research as well as from representative surveys.
RESULTS: People with lower socio-economic status, women, and migrants more often suffer from risks and problem situations and have less access to prevention measures and medical specialist care. Regarding in-patient treatment, people with private health insurance have a higher probability of being admitted to hospital. Migrants more often visit emergency rooms and less often get rehabilitation measures. The availability of social support depends on age, gender, and education; applicants from higher status groups more often receive services from nursing care insurance.
CONCLUSION: The results point to the necessity of status-, milieu- and culture-sensitive counselling, particularly focusing on patient rights and usefulness of optional health and nursing care services. Qualified professionals could take responsibility for respective tasks.