Ethnicity and Old Age: Expanding our Imagination 9781447328148

Citation preview

AGEING IN A

GLOBAL CONTEXT

ETHNICITY AND OLD AGE Expanding our imagination SANDRA TORRES

ETHNICITY AND OLD AGE Expanding our imagination Sandra Torres

First published in Great Britain in 2019 by Policy Press North America office: University of Bristol Policy Press 1-9 Old Park Hill c/o The University of Chicago Press Bristol 1427 East 60th Street BS2 8BB Chicago, IL 60637, USA UK t: +1 773 702 7700 t: +44 (0)117 954 5940 f: +1 773-702-9756 [email protected] [email protected] www.policypress.co.uk www.press.uchicago.edu © Policy Press 2019 British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Library of Congress Cataloging-in-Publication Data A catalog record for this book has been requested ISBN 978-1-4473-2811-7 hardcover ISBN 978-1-4473-2815-5 ePub ISBN 978-1-4473-2816-2 Mobi ISBN 978-1-4473-2814-8 ePdf The right of Sandra Torres to be identified as author of this work has been asserted by her in accordance with the Copyright, Designs and Patents Act 1988. All rights reserved: no part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise without the prior permission of Policy Press. The statements and opinions contained within this publication are solely those of the author and not of the University of Bristol or Policy Press. The University of Bristol and Policy Press disclaim responsibility for any injury to persons or property resulting from any material published in this publication. Policy Press works to counter discrimination on grounds of gender, race, disability, age and sexuality. Cover design by Policy Press Front cover image: istock Printed and bound in Great Britain by CPI Group (UK) Ltd, Croydon, CR0 4YY Policy Press uses environmentally responsible print partners

Contents About the author Series editors’ preface Preface

v vi viii

Part 1: Setting the stage for theorising one Introduction 3 Ethnicity: an elusive term and a starting point 5 Engaging in a theorising exercise: the why and how of it 7 The book’s raison d’être: wanting to expand our 11 imagination Timing: why now? 12 The scientific communities that this book addresses 14 Structure of the book: the what and the why 18 two

Population ageing and international migration 23 Population ageing: demography and discourse 24 Globalisation and the study of culture 27 Transnationalism: a specific aspect of globalisation 32 Globalisation and the study of migration, ‘periphery’ and inequality 34 Globalisation: the implications for the intersection 39 of ethnicity and old age Concluding remarks 48

three

Ethnicity and race: from essentialism to constructionism Ethnicity and race: seemingly straightforward yet elusive constructs Essentialist/primordialist perspective on ethnicity and race Structuralist/circumstantialist perspective on ethnicity and race Social constructionist perspective on ethnicity and race Concluding remarks

iii

51 53 61 65 70 74

Ethnicity and old age

Part 2: Theorising via a scoping review: what we know and need to find out four Literature on health inequalities 81 Main trends observed 84 Concluding remarks 98 five

Literature on health and social care Main trends observed Concluding remarks

103 105 119

six

Literature on social relations and caregiving Main trends observed Concluding remarks

123 125 140

seven

A new agenda: where we are at and need to head for Obstacles posed by the lack of an explicit research agenda Obstacles posed by narrow samples, perspectives and reference categories Obstacles posed by structure- and culture-obliviousness Obstacles posed by reliance on a small number of methodological approaches Obstacles posed by our choice of dissemination outlets Obstacles posed by the stagnation in understandings of ethnicity and race Obstacles posed by lack of analytic clarity Unleashing our imagination

145 147

148 151 154 157 159 161 166

References 171 Appendix: how the scoping review was conducted Selecting the databases used to identify the peer-reviewed articles Sampling criteria: deciding which articles to include Analysing the literature: sorting out and coding Deciding which references to allude to explicitly

203 203

Index

213

iv

206 208 211

About the author Sandra Torres is Professor in Sociology and Chair in Social Gerontology at Uppsala University, Sweden. As a sociologist of ageing and a critical social gerontologist, her work problematises old age-related constructs and deconstructs some of the taken for granted assumptions that inform research, policy and practice. Her main scholarly contributions come from studies that have used the sociology of migration and ethnicity to expand the social gerontological imagination. In 2016, she co-edited two anthologies for Routledge: Ageing in contexts of migration (with Ute Karl) and Older people and migration: Challenges for social work (with Susan Lawrence). She is also the co-editor (with Finnur Magnússon) of a book in Swedish titled Invandrarskap, äldrevård och omsorg (Migrantship in elderly care). Elected into the (Swedish) Royal Society of Sciences in 2016, she is also a fellow of the Gerontological Society of America (GSA), president of the Research Committee on Aging (RC11) of the International Sociological Association and co-chairs (with Allen Glicksman) the Interest Group on International Aging and Migration of GSA.

v

Series editors’ preface Chris Phillipson (University of Manchester, UK) Toni Calasanti (Virginia, Tech, USA) Thomas Scharf (University of Newcastle, UK) As the global older population continues to expand, new issues and concerns arise for consideration by academics, policy makers and health and social care professionals worldwide. Ageing in a Global Context is a series of books, published by Policy Press in association with the British Society of Gerontology, which aims to influence and transform debates in what has become a fast-moving field in research and policy. The series seeks to achieve this in three main ways. First, through publishing books which rethink the key questions shaping debates in the study of ageing. This has become especially important given the restructuring of welfare states alongside the complex nature of population change, with both elements opening up the need to explore themes which go beyond traditional perspectives in social gerontology. Second, the series represents a response to the impact of globalisation and related processes, thus contributing to the erosion of the national boundaries which originally framed the study of ageing. From this has come the emergence of issues explored in various contributions to the series; for example, the impact of cultural diversity, transnational migration, new forms of inequality, environmental issues and ageing, and related developments. Third, a key aim of the series is to explore interdisciplinary connections in gerontology. Contributions will provide a critical assessment of the disciplinary boundaries and territories influencing the study of ageing, creating in the process new perspectives and approaches relevant to the 21st century. Given the aims of the series, we are especially pleased to include a study which connects research in social gerontology with advances in scholarship in the field of ethnicity. Research focusing on issues relating to ethnicity has, especially in the case of Europe, tended to remain on the margins of work in the field of ageing. However, there is now some urgency in making ethnicity a core area of research in social gerontology. Demographic change will itself be a central driver in this process, with ethnic diversity increasingly characteristic of older as much as younger populations. But the broader social changes are equally important, in particular those associated with the rise of transnational communities, the impact of global migration, the influence of different ethnic groups

vi

Series editors’ preface

on neighbourhoods and communities, and the complex interaction between ethnicity and other key social statuses – notably age, class, gender and sexuality. This book provides a major reassessment of the intersection between ethnicity and research in the field of ageing, addressing in the process many of the key challenges facing researchers seeking to understand the global forces reshaping the lives of older people and the communities in which they live.

vii

Preface Writing a book is not an easy task. When the book one is working on is a scholarly contribution, as this one is, it is not uncommon to think about this momentous task in terms of what one wants to contribute to the scholarly debates that one has been following for years, which have ignited the commitment needed to embark on a book project. Spelling out what I personally wanted to accomplish with this book seemed like an appropriate way to start when I first thought about what this preface would be about. But the more I pondered on what to write, the more I realised that I wanted to do justice to the journey that has led me here. Because book projects are quite often journeys. As such, they take us from one destination to another along whirlwind roads often taken while gaining clarity regarding where you are heading and why. It is because of this that I decided to use this preface to tell the story of why I decided to write a book about ethnicity and old age in order to expand my own, as well as my peers’, imagination. Telling this story requires that I start from the very beginning, since I need to do justice to how this journey started and what it has meant to my scholarly self. When I first enrolled in the doctoral programme in sociology back in the mid-1990s here in Sweden, there was no one else who shared my research interests. Back then, I was conducting what people back home (and now I mean the US) often refer to as ethno- or anthropo-gerontology research and nobody in my department other than my supervisor thought I was on to something. Few sociologists in Sweden were interested in old age back then. Ethnicity and migration scholars in this country had yet to consider that old age was a part of the life course that deserved their attention. Consequently, finding a scholarly community that I could call my own was not easy when I first started out in academia. I remember how lonely I felt while attending international sociology of ageing conferences in the beginning, since nobody was working on issues related to culture and migration. I have actually lost count of the number of times I presented a paper on successful ageing (the topic of my dissertation) at either a sociology (or a gerontology) conference where I was placed in a session on older migrants since my empirical work was about Iranian migrants in Sweden. And back then, work on older migrants was not deemed to be relevant enough to the successful ageing debate. The fact that I was commissioned to write a piece on cultural values and successful ageing for the Oxford Research Encyclopedia of Psychology just a few months ago is something I now mention for the sake of those emerging scholars

viii

Preface

out there who feel alone in their scholarly quests, and are on the verge of losing interest in the areas they are passionate about because few in their immediate surroundings show any interest in the debates and/ or literatures that they are consumed by. To them I say: don’t give up! People often say that there is strength in numbers but I have come to realise that there is also strength in working on one’s own. The key is to find the scholarships that unleash one’s imagination, and grappling with them as one finds ways to make them accessible to others – and in the process, if possible, expanding their (and one’s own) imagination. Towards the end of my doctoral period, I had the great fortune of being awarded a doctoral fellowship by the Gerontological Society of America (GSA). Through that programme, I became acquainted with the variety of sessions that the Task Force on Minority Aging Issues hosts when the GSA holds its annual scientific meetings every November and I was able to identify a setting from which I could draw immediate inspiration for the work that I was doing. Thus, right from the very beginning, going to GSA meetings was the main event on my academic calendar. The friendships I have developed with colleagues on the other side of the Atlantic thanks to these gatherings have been instrumental in keeping my interest in social gerontology alive. Just as I was putting the final touches on my doctoral dissertation (in 2001) interest in older migrants started to emerge in Europe’s migration scholars, thanks in part to the funding that the European Science Foundation awarded to the Research Network on International Migration in Europe: Welfare Policy and Practice Implications for Older People. Working alongside retirement migration scholars like Tony Warnes (who led that group) and Russell King for the three years that this network met cemented my commitment to using migration scholarship to expand the imagination of social gerontology. It was then that I began to seriously think about what social gerontology could learn from migration, ethnicity and race scholarship. Before this network, I thought of my work as primarily a contribution to the small field of ethno- and anthropo-gerontology. In other words, I hadn’t yet realised that my work could offer something to what I often refer to as ‘mainstream’ social gerontology. When established European scholars in the sociology of ageing began to take notice of my work, I began to realise that I was not alone in finding the intersection that this book is dedicated to interesting, even if few were actually conducting research on these topics back then. I will never forget, for example, how Alan Walker started a conference in Paris organised by the European Research Area in Ageing (ERAAGE NET) by quoting my work. That single gesture solidified my commitment to regard (and argue that) the migratory life courses

ix

Ethnicity and old age

of some older people from minority ethnic groups as theoretically profuse sources of information about ageing and old age; an argument I have made on numerous occasions using different points of departure (from successful ageing via the globalisation of international migration and transnationalism to ethnicity and race, to name but a few). The Future Leader of Aging Research in Europe (FLARE) programme that Alan Walker started as part of ERA-AGE NET played a huge role in advancing my career. In the first round of this programme, I was awarded one of these grants to study cross-cultural interaction in nursing homes. It was then that I began to grasp how relevant our ‘imagination’ about who people from minority ethnic and racial populations are, and what they need, is to how we relate to others. And that this very imagination (or lack of) can sometimes get in the way of ‘seeing’ those to whom we assign such labels. Working on that project made me realise first-hand that the everyday implications of regarding ethnicity and race as identification grounds that have material consequences should not be dismissed, but grasping that these grounds are nothing more, in effect, than ‘ways of making up people’ (as Carter and Fenton, 2010, so poignantly write) may be more important than what we seem to be willing to admit. Through the FLARE programme, I met a number of emerging scholars who were working on topics related to ageing and old age but did not identify themselves as gerontologists. The inspiring conversations I had with them helped me fine-tune some of my early ideas about how the social gerontology imagination could be challenged and expanded by scholarship on migration, ethnicity and race. Chris Phillipson (who is one of the editors of the series to which this book belongs), asked me in the early 2000s to contribute to an anthology he was co-editing and he has been following my work ever since. All of these European social gerontologists have given my work a platform (some of them like Chris has been giving me feedback for years), and for that I am eternally grateful. Over the past three decades, I have met many scholars who have constructively challenged my thoughts on the intersection of ethnicity/ race and ageing/old age while encouraging me (albeit implicitly) to continue on the journey I had been committed to throughout; namely, the expansion of my own imagination as well as the imagination of social gerontologists alike who were either working on culture, migration, ethnicity and/or race or were considering starting their own journeys on this topic. Working on this book has re-ignited my commitment to this journey. Thus, although writing it has been challenging, I feel intellectually re-energised by the discoveries I have

x

Preface

made along the way and can no longer say that I feel alone. Over the past decade, I have witnessed how more and more migration scholars have ‘discovered’ old age and how sociologists of ageing (and/or social gerontologists) have begun to regard ethnicity and migration as interesting angles of investigation. Thus, although my journey started in the periphery of these fields, my research interests have become mainstream as the decades have passed. Sociologists know very well that the settings in which one finds oneself are instrumental to our journeys, so I would like to end this preface by thanking those whose help and support have been instrumental to this book project. My first thanks go to the Faculty of Social Sciences of Uppsala University for the sabbatical they offered, which allowed me to focus on this book for a whole term. Valentina Hleblec, who is professor and chair in social informatics and methodology at the University of Ljubljana, extended the first invitation to teach academic writing in Slovenia that I received. This was an invitation that coincided with my sabbatical and offered an intellectual heaven in more ways than I can describe. Sabina Otoničar, who often makes the arrangements when I visit Ljubljana, has been incredibly helpful as well. Without the four visits I have made to the University of Ljubljana since 2016, this book would not have been written so I am extremely grateful to them both for offering me a stimulating milieu in which to find inspiration. My daily academic life is filled with thought-provoking discussions, thanks to the amazing team we have in the Welfare and Life Course research group of the Department of Sociology at Uppsala University, a team I lead with Professor Hannah Bradby. The numerous discussions I have had with Hannah – a medical sociologist committed to expanding the imagination of her field through research on ethnicity and race have offered many insights. The thorough feedback I have received from the members of our research team has been very valuable as well. Some of them have offered substantial written comments on various versions of some of this book’s chapters, so a heartfelt thanks is hereby extended (in first-name alphabetical order) to Adele Lebano, Aija Duntava, Anna Olaison, Clara Iversen, Erika Willander, Gunhild Hammarström, Hedvig Gröndal, Ilkka Henrik Mäkinen, Liubov V. Borisova, Magdalena Kania-Lundholm, Magdalena Vieira, Maricel Knechtel, Marie Flinkfeldt, Marie Sépulchre, Pernilla Ågård, Rafael Lindqvist, Richard Gäddman Johansson, Sarah Hamed and Tom Burns. Colleagues in the Social Gerontology research team (who are based in different universities around Sweden but were ‘schooled’ in Uppsala) read and commented on two chapters early on in this process so thanks

xi

Ethnicity and old age

are also in order to Marianne Winqvist, Peter Öberg and Torbjörn Bildtgård. Last but not least in the list of professional support that I have had along the way is Katherine Stuart, the proof-reader whose services I enlisted. Saying merely thank you for the efficiency with which you have worked is truly not enough. My family and friends have kept me sane throughout this journey and since some of them have followed this book project closely, I would like to extend my sincerest thanks to my darling husband, Fredrik Örsten, who has always offered unflagging support, and my closest friends, Veerle Schrovens, Caroline Sutton and Annalena Norhammar, who listened patiently as I went on and on about the various epiphanies I often had while reading on topics I am passionate about. These are the four people that make my everyday world go around, and to whom I am most indebted. Thus, as I bring this preface to an end, it seems important to explicitly stress that inspiration is what this preface has been all about – the inspiration that I have received from others and the inspiration I want to offer my peers. It is my sincerest hope that this book will inspire a new generation of sociologists of ageing and social gerontologists so that they can start their own journeys, confident that their imagination will be expanded along the way. Sandra Torres Stockholm, 31 September 2018

xii

PART 1

Setting the stage for theorising

ONE

Introduction As I was putting the very final touches on this book it dawned on me that two phrases epitomise why this book was conceived. These are: ‘if you can’t imagine it, you can’t enact it’ and ‘define something as real and it becomes real in its consequences’ – which is a phrase we sociologist call the ‘Thomas theorem’. This book was namely conceived as an attempt to discover the unexploited potential that exists as far as what our understandings of ethnicity and race can mean for the study of ageing and old age; potential that can only be exploited if scholars working on the intersection between ethnicity and old age become acquainted with the literature on globalisation, international migration, transnationalism, ethnicity and race, and use that scholarship to re-image what this intersection is about. Thus, this book aims to do precisely what its sub-title indicates, that is, to expand our imagination on the intersection between ethnicity/race and ageing/old age, an intersection I will refer to as ethnicity and old age from now on. As such, this book draws attention to population ageing, the globalisation of international migration and transnationalism since these are the societal trends that have propelled the intersection in focus here into the foreground of the agenda of the social sciences, and presents how scholarship on ethnicity and race have advanced its understandings of what these identification grounds and/or social positions mean. One of the reasons why I have written this book is that virtually none of the books available about this intersection addresses these societal trends and/or present research on ethnicity and race in a comprehensive enough manner. Another reason is that the field that has paid the most attention to this intersection (that is, social gerontology) is at a crossroads, because although numerous advances have been made by ethnicity and race scholars regarding how these identification grounds and/or social positions are to be understood, these do not seem to have left their mark on scholarship on the intersection between ethnicity and old age. I have therefore argued elsewhere that social gerontology seems to have stagnated in its understanding of ethnicity (Torres, 2015a, 2015b). Yet another reason why this book was originally conceived is that scholarship on ethnicity – which has only recently discovered old age via its newly found interest in older migrants – would benefit from developing its understanding of not only population ageing, but also the kinds of questions that have received attention over the past two decades in social gerontology that focus on ethnicity and race. 3

Ethnicity and old age

The reasons why I have come to draw these conclusions are manifold. When it comes to gerontologists’ regard for ethnicity and race, it seems important to mention that the history of social gerontology clearly shows that North American gerontologists have been interested in ethno-cultural values since the mid-1940s,1 and that their inquiries played a critical role in expanding the imagination of social gerontology on ethnicity and old age half a century or so ago. This angle of investigation – which was crucial not only to social gerontology’s own understanding of ageing and old age but also to its understanding of the societal organisations that are developed to meet the needs of ageing populations – seems, however, to have been relegated to the periphery of the social gerontologist’s imagination between the late 1940s and late 1980s. In the late 1980s, gerontologists’ interest in ethnicity seems to have resurfaced, when the Gerontological Society of America created a Task Force on Minority Issues. But this resurrected interest seems to have led to the creation of a sub-field of gerontological inquiry: ethnogerontology. In the case of Europe, it seems necessary to note that in the late 1990s Blakemore (1997) – comparing British and North American gerontological traditions – argued that Britain had yet to develop an understanding of ageing and old age that is ethnicity-informed. Over the past decade, as more and more mainstream social gerontologists – without a substantial track record in ethnogerontological inquiries – have started becoming interested in the angles of investigation that ethnicity, race, culture, migration and/or diversity offer, it seems as if social gerontology has rediscovered ethnicity (Phillipson, 2015). Over the past two decades, I have witnessed how mainstream social gerontologists have become interested in the angle that ethnicity offers, and how ethnicity scholars have begun to realise that there is more to the course of life than childhood, young adulthood and middle age. Both of these developments are, of course, welcome but raise one of the questions that I have been grappling with for a while; namely, where do we go from here considering that these fields of scholarship do not share a common foundation from which to expand their respective imaginations as far as ethnicity and race are concerned? This book aims to do just that. But before I can explain why I deem this to be necessary, it seems important to clarify what ethnicity is.

1

For insights into how interest on the impact that ethno-cultural values have on ageing and old age ‘created’ anthropo-gerontology, and later on ethno-gerontology, see Torres (2011, 2015a).

4

Introduction

Ethnicity: an elusive term and a starting point The term ethnicity is an elusive one, which is why this book dedicates an entire chapter to addressing what ethnicity is, how this terms differs from the related term that is race, how understandings of ethnicity and race have evolved, and what all of this means for how ethnicity and race can be approached. The few books that are currently available on ethnicity and old age treat the identification grounds that are ethnicity and race in an extremely cursory manner. Often just a few sentences are offered about how ethnicity and race can be understood. This is one of the reasons why this book dedicates an entire chapter to scholarship on ethnicity and race and the ways in which this scholarship has evolved. Making the reader wait until Chapter Three to address what ethnicity is does not seem appropriate, so I will state here a few simple facts about this identification ground and/or social position (Chapter Three will address the differences between these two). The most important matter that needs to be stressed from the start is perhaps that ethnicity tends to be understood as an identification ground (see, for example, Cornell and Hartman, 1998). As such, ethnicity can be used to identify ourselves as either X or Y and is also often used by others when they try to identify who others are. The theorising exercise upon which Chapters Four to Six are based shows, for example, that it is very common for scholarship at the intersection in question to be based on the scholars’ own identifications of ethnic and racial groups, and to assume that these overlap with how the ‘members’ of these groups regard themselves. This is something I will return to later in the book. For now, I simply want to draw attention to the fact that identification (both the type we engage in ourselves, and the type others engage in when trying to make sense of who we are) lies at the very core of how ethnicity (and race) is understood. Relevant to ethnicity as an identification ground is the idea that identity matters. Jenkins explains, for example, As a very basic starting point, identity is the human capacity – rooted in language – to know ‘who’s who’ (and hence ‘what’s what’). This involves knowing who we are, knowing who others are, them knowing who we are, us knowing who they think we are, and so on: a multi-dimensional classification or mapping of the human world and our places in it, as individuals and as members of collectivities. … It is a process – identification – not a ‘thing’. It is not something

5

Ethnicity and old age

that one can have, or not; it is something that one does. (Jenkins, 2008:5, italics in original) In this definition, we clearly see that Jenkins is taking a stand as far as how he understands what an identification ground is. In doing so, he is implicitly alluding to the different theoretical perspectives that exist and the different understandings of what an identification ground is. Thus, when (in the quote above) he refers to identification as a process and not as something we have, he is in fact alluding to the social constructionist perspective, which is one of the perspectives that I will address in more detail in Chapter Three. Gelfand (2003), who is one of the few social gerontologists to define ethnicity in one of the anthologies on old age and ethnicity that I refer to in this introduction, argues that definitions of ethnicity often comprise three main components: the identification of the group as an ethnic group by others, the identification of the group as ethnic by the group members themselves, and the specific behaviour patterns that distinguish the group. Cornell and Hartmann (1998) refer also to claims of ethnicity (that is, the claim to kinship, the claim to a shared history, and the claim that certain symbols capture the core of the group’s identity). Thus, when we speak of ethnicity as an identification ground we often mean that this is a ground which assumes that a sense of personhood or shared descent can be established on the basis of national origin, cultural background (typically including language) and/or religious beliefs. In an earlier work, Jenkins (1997) explores how social scientists’ understandings of ethnicity have evolved from ‘the basic anthropological model’ to how we understand this identification ground today and argues that ethnicity is about cultural differentiation (bearing in mind that identity is always dialectic between similarity and difference); ethnicity is concerned with culture – shared meaning – but it is also rooted in, and the outcome of, social interaction; ethnicity is no more fixed than the culture of which it is a component, or the situations in which it is produced and reproduced; ethnicity is both collective and individual, externalized in social interaction and internalized in personal self-identification. (Jenkins, 1997: 165)

6

Introduction

Thus, by alluding to this definition of ethnicity, this introductory chapter aims to draw attention to the dialectic nature of this identification ground; a dialectic nature that seems to create some difficulties for social gerontologists interested in ethnicity as the reviews to be presented in Part 2 will show. For now, it is enough to know that ethnicity can be used to categorise others and ourselves (and is, of course, used by others to categorise us as well). It is worth noting also that by alluding to categorisation, I wish to draw attention to the assumed similarities and differences that we deploy when we try to establish who belongs to the ‘us’ with whom we identify and who belongs to the ‘them’ we regard as different from ourselves. This is, after all, one of the reasons why ethnicity scholars – such as the one quoted above – often refer to ethnicity as a source of differentiation, why social gerontologists have been interested in ethnicity for a few decades now, and why this book zeroes in on this identification ground. In this respect, it seems important to note also that we are all in fact ‘ethnic’ even if those who belong to the majority ethnic group within a society do not often think of themselves as such. Thus, although ethnicity is an identification ground that we tend to erroneously only deem to be relevant when dealing with minorities, it is imperative that we keep in mind that ethnicity and minority status are not the same thing. Jenkins writes to this end the following: ‘we need, however, to remind ourselves all the time that the ethnicity that each of us participates in is an ethnicity – and perhaps more than one – just like them, just like the Other, just like “the minorities”’ (Jenkins 1997: 14; italics in original).

Engaging in a theorising exercise: the why and how of it Over the past decade or so, I have become increasingly concerned that ethnicity scholars interested in ageing and old age and social gerontologists working on ethnicity and race lack a common foundation from where to expand their respective imaginations on the intersection between ethnicity and old age. The lack of such a common ground has the potential to bring about a stifled dialogue between these fields and could bring about the reinvention of the wheel at best, and intellectual stagnation at worst. I believe that social gerontologists could hit a wall, so to speak, if they continue to conduct ethnicity-and-race-focused research while neglecting the advances made in ethnicity and race scholarship. And since I also believe that the same could happen if ethnicity scholars approach the study of ageing and old age without acknowledging that there is research in

7

Ethnicity and old age

social gerontology that could inform their inquiries, I think that the time is right for a book such as this one. The original idea for this book was initially inspired by the notion of theorising, which in this case would entail taking stock of what we know and need to find out about the intersection in question. This notion of theorising is not new to the social sciences, but has experienced something of a revival over the past few years as a result of Swedberg’s (2012a) article on theorising, along with the essay he published the same year describing the inspiration he has drawn from Charles S. Pierce’s 1903 lecture on ‘How to Theorize’ (Swedberg 2012b), and the debates both of these pieces generated among sociologists interested in what theorising means, and how and why we should invest in theorising exercises from time to time. According to Swedberg (2012a), social scientists’ methodological expertise has increased since World War II while their capacity to formulate theory has stagnated. Part of the reason why this is the case, he argues, is that a shift has occurred as far as our priorities are concerned. He claims that in the early 1900s, social scientists shifted their attention from the context of discovery to the context of justification. The context of justification is where the testing of hypotheses takes place while the context of discovery is where we make the observations that could potentially guide the formulation of theory. Swedberg (2012a) argues that one of the reasons why we have switched our attention from discovery to justification is that the former has come to be deemed more scientific than the latter, since the context of discovery is believed to be ‘impossible to study with scientific rigour’ (Swedberg 2012a: 4); ‘believed’ being the keyword here. He claims also that ‘since there exist good reasons for believing that you draw on different ways of thinking when you theorise, and when you test and present your ideas to an audience, this neglect has had serious consequences for social scientists’ capacity to theorise’ (Swedberg 2012a: 4). Swedberg’s (2012a, 2012b) attempts to incite theorising exercises among social scientists is, for social gerontologists and sociologists of ageing, probably reminiscent of Birren and Bengtson’s (1988: ix) assessment that gerontology is a field that is ‘rich in data but poor in theory’ (see also Estes et al., 1992; Bengtson et al. 1997, 2009; Alley et al. 2010). The same could be said of the debate on atheoretisation that anthropo- and ethno-gerontologists engaged in around the same time; a debate that was ignited by Usui’s (1989) reference to the cultural insensitivity of these fields, and Burton’s et al. (1992) argument that the only way forward was to formulate culture-relevant frameworks for the study of ageing and old age. To some extent these parallels can be

8

Introduction

drawn. However, Swedberg is not urging us to formulate theory per se. He is instead urging us to understand that scientific inquiries need to strike a balance between being about the context of justification and being about the context of discovery, and that engaging in theorising exercises is necessary if we are to find a suitable way forward once we have promoted the context of justification to such an extent that we have relegated the context of discovery to the very periphery of our inquiries. Thus, it is Swedberg’s contention that sometimes fields find themselves at a crossroads where they are overwhelmed with so much data that they risk missing opportunities to make sense of it. This reminds us, of course, of the argument of Bengtson et al. (1997: 72) that ‘if our theories (explanations) are underdeveloped, we may end up with many empirical generalizations but little cumulative understanding’ and run the risk of ‘rediscovering the wheel’. But Swedberg is not asking social scientists to formulate more theory even if he hopes that the context of discovery could ignite theory formulation, but rather to engage in theorising from time to time so that the context of discovery isn’t relegated to the periphery of our inquiries. Besides arguing that social scientists need to focus a bit more on the context of discovery, Swedberg (2012a, 2012b) proposes various ways through which we can develop our theorising skills. One of these ways entails having a thorough understanding of the knowledge that is available in order to grasp the patterns that characterise it and the possibilities for novelty that this knowledge offers. He argues therefore that social scientists should wrestle with the core ideas of the research fields to which they wish to contribute. This is one of the suggestions that has inspired the way in which I have worked with Part 2 of this book, since that part is based on a scoping review of the peer-reviewed literature that has been published in English during the last 20 years in the major databases that are used by the two scientific communities that this book addresses (that is, social gerontologists and ethnicity scholars). Worth noting, perhaps, is that a couple of years ago I conducted a scoping review (Torres, 2015b) of how the peer-reviewed literature in English published in five of the top journals in social gerontology made sense of ethnicity and it is that review that sparked the idea on which this book is based. Some would say that that review was the pilot study for the scoping review that informs this book. The focus of the scoping review published before – which only aimed to identify the understandings of ethnicity that inform those articles – were the years between 1999 and 2014. This means that the pilot for Part 2 of this book was based on less than one third of the articles used in this part. The scoping review conducted for this book covers 20 years of research

9

Ethnicity and old age

(from January 1998 to December 2017; n= 336) and has a much broader interest than just bringing attention to the understandings of ethnicity that informs scholarship on the intersection between ethnicity and old age. Chapters Four to Six bring attention to the three topics that have received the most attention by this scholarship (that is, health and health inequalities, health and social care, and social relations and caregiving). Readers interested in the nitty gritty of how the scoping review was conducted are encouraged to read the Appendix. It seems necessary to stress that this book aims to contribute to scholarship at the intersection between ethnicity and old age irrespective of whether this scholarship has been published in journals on social gerontology or in journals catering to ethnicity scholarship. Thus, by conducting a scoping review that covers not only more years but also includes more articles than those published by the top five journals in social gerontology, I am hoping to be able to offer scholars in both fields a stepping stone for their future endeavours. In other words, Part 2 of this book aims to increase our understanding of the knowledge about ethnicity, race and old age that has been published over the past two decades, the patterns that characterise this knowledge, and the possibilities for novelty that the state-of-the-art of this scholarship actually offers. Related to this is Swedberg’s argument that the research process consists of two phases: ‘an early and imaginative phase of theorising and a later phase in which the major research task is carried out according to the rules of the profession. I call the former the theorising or discovery phase (or the pre-study), and the latter the phase of major research and justification (or the major study)’ (Swedberg, 2012a: 9). This book focuses on the ‘the discovery phase’, since one of the things I would like to do is to offer ideas for angles of investigation that are worth pursuing to social gerontologists working on ethnicity-related topics and ethnicity scholars interested in ageing, old age and/or elder care. As such, this book aims to give us insight into the approaches that are the most fruitful if we were to pursue research in this area in an ethnicity- and race-astute as well as globalisation-, international migration- and transnationalism-informed way. Phrased differently, one could say that this book was conceived as a theorising experiment which hopefully will inform other scholars’ theorising experiments and expand the imagination of scholarship at the intersection of ethnicity and old age, as the book’s subtitle suggests.

10

Introduction

The book’s raison d’être: wanting to expand our imagination Readers with a background in sociology probably recognise the allusion to the need to expand one’s imagination in the subtitle of this section and of the book the phrase ‘the sociological imagination’ would most likely come to mind for them. This is a phrase that was coined by C. Wright Mills (1959) in a book that most sociologists regard as ‘one of the classic statements of the discipline’ (Brewer, 2004: 317). Thus, even though most contemporary sociologists regard Mills’ version of our discipline’s imagination as an understanding of society that was ‘produced under the banner of a reverse orientalism’ (Denzin, 1990: 13), and is stuck in a modernist view of society that is ‘unsuited for the problems now confronting sociology’ (Denzin, 1990: 2), the phrase ‘the sociological imagination’ is still widely used (especially in AngloSaxon sociology teaching literature). In the appendix of Mills’ (1959) book – titled ‘On intellectual craftsmanship’ – Mills explains how social scientists should go about the business of reading, writing and thinking that is at the very core of what imaginative social scientists do. It is his ideas about intellectual craftsmanship that I have found most useful when deciding how to concretely approach the theorising experiment I embarked on. In the appendix, Mills argues that the sociological imagination ‘in considerable part consists of the capacity to shift from one perspective to another, and in the process to build an adequate view of a total society and of its component’ (Mills, 1959: 211). According to him, ‘imagination is often successfully invited by putting together hitherto isolated items, by finding unsuspected connections’ (1959: 201). In other words, Mills believed that there are steps one can take to stimulate one’s scholarly imagination. He argued that the art of reading, notetaking, thinking and rereading, which often lies at the very core of thinking ‘outside of the box’, became undervalued as more and more social scientists felt compelled to embark on empirical studies (or as Swedberg would say, as more of us shifted our focus to justification mode). Drawing parallels with Swedberg (2012a, 2012b) is easy. Mills (1959: 205) claimed that ‘there is no more virtue in empirical inquiry as such than in reading as such’. Although I would not go that far, I do believe that as far as the intersection between ethnicity and old age is concerned, much could be gained if we were to take a break from all of the empirical studies we are increasingly engaging in and instead seriously take stock of the knowledge that we have generated so far. And were we to do this while drawing inspiration from Mills,

11

Ethnicity and old age

this would entail reorganising the files we keep on the reading and note-taking that most of us regularly engage in while classifying and cross-classifying their contents, in order to expand our imagination about a specific topic. While I agree with Denzin (1990) that the kind of imagination that Mills (1959) proposed in his treatise is not particularly relevant to contemporary sociology, I do believe that the tips he offered on intellectual craftsmanship do have potential to expand our scholarly imagination. This is why I have drawn inspiration from what Mills (1959) wrote about intellectual craftsmanship when embarking on the theorising exercise that I embarked on prior to writing this book, the results of which can be seen in Part 2. I have not only read, reread and coded all of the articles that I have reviewed, I have also created tables for each of the topics on which Chapters Four to Six are based in order to determine what the literature is about, which examples are focused on and what understandings of ethnicity are employed. In doing so, I hope to be able to reveal what currently characterises scholarship on the intersection of ethnicity and old age and what this scholarship has yet to accomplish as far as our imagination regarding this intersection (see Chapter Seven).

Timing: why now? Some may perhaps be wondering by now why I believe that the time has come to theorise about the intersection in question. The most obvious reason, as stated earlier, is that a surprisingly small number of books addressing this intersection have been published over the past three decades2 and most of what is available seems to depart from 2

A search for books on ethnicity and old age published since 1990 generated only seven books that address the intersection in question specifically: Stanford and Torres-Gil’s (1992) Diversity: New Approaches to Ethnic Minority Aging; Barresi and Stull’s (1993) Ethnic Elderly and Long Term Care; Gelfand’s (2003 [1994]) Aging and Ethnicity: Knowledge and Services; Blakemore and Boneham’s (1994) Age, Race and Ethnicity: A Comparative Approach; Olson’s (2001) Age Through Ethnic Lenses: Caring for the Elderly in a Multicultural Society; Krajewski-Jaime’s (2014) Aging: Ethnicity and Gender Issues; and Whitfield and Baker’s (2014) Handbook of Minority Aging. In addition, there are two books that address the intersection in focus but through the lens of diversity: Mehrotra and Wagner’s (2009) Aging and Diversity: An Active Learning Experience, which addresses the main areas of interest to the intersection (such as health beliefs and behaviours; informal and formal care; work and retirement; religious affiliation and spirituality and death and dying); and Kolb’s (2014) Understanding Aging and Diversity: Theories and Concepts, which addresses the various theoretical approaches that can be used to study diversity

12

Introduction

social gerontology. This is an interesting observation in itself, but one that comes as no surprise considering that ethnicity scholars seem to have discovered old age only in the past decade or so (and this they have done via their interest on older migrants rather than because they are interested on ethnicity and old age as such). Something else worth noting is that most of the books available on the intersection which are focused on here are either edited collections focusing on empirical studies of single ethnic and/or racial groups (for example Olson, 2001; Krajewski-Jaime, 2014), books that address specific angles of investigation associated with the study of minority ethnic groups (such as health and social services in the case of Blakemore and Boneham, 1994), or books that focus on some of the themes that different disciplinary approaches to the intersection in question here tend to focus on (as is the case of Whitfield and Baker’s Handbook of Minority Aging, published in 2014). Thus, most of the books about the intersection of ethnicity and old age do not actually address the latest developments in ethnicity scholarship, and neither do they address the two societal trends (that is, population ageing and the globalisation of international migration) that make the intersection in question a particularly relevant angle of study. That is why these are the trends I will focus on in the next chapter. Something else which is striking about these books is that they seldom define what ethnicity is and/or distinguish ethnicity from the other terms that are often used to allude to ethnic groups (such as racial groups, minorities, migrants or diverse populations). These books seldom engage with scholarship on race either, even though they allude to race very often. If they do define what ethnicity is, they do so in just a few sentences (see for example, Gelfand’s definition from 2003 provided earlier, which is a relatively cursory treatment of the topic and one that does not differentiate all that well between ethnicity and minority status). Thus, these books neither allude to nor engage with the evolution in understandings of ethnicity, race and culture that have taken place within ethnicity scholarship in the past few decades. Against this backdrop, it is perhaps understandable why most books on ethnicity and old age raise more questions about the intersection in question than they in fact answer. These questions include: What is ethnicity and how is it different from race? Can the terms ‘ethnic’ and ‘minority’ be used interchangeably? What kinds of understandings of ethnicity are available and what do they mean for the knowledge (such as phenomenology, critical gerontology, feminist gerontology, life course gerontology and gerotranscendence).

13

Ethnicity and old age

that we can generate through them? Is ethnicity an identification ground worth exploring even if I am not interested in minority ethnic populations? Questions such as this one are the reason why this book dedicates an entire chapter to definitions of ethnicity, to ethnicity’s relationship to race, and to the theoretical perspectives that have been used over the years to make sense of what this identification ground means (Chapter Three). It is also because of all of this that the scoping reviews that lie at the very core of Chapters Four to Six not only give insight into the topics that the literatures in focus draw attention to, but pay specific attention to the underlying assumptions about ethnicity that have guided these inquiries and questions that have yet be raised. It is, after all, through the critical appraisal of the patterns that characterise the literature that is available, and looking at what is missing, that we can expand our imagination about the intersection in focus here.

The scientific communities that this book addresses Having given an idea of some of the sources of inspiration for writing this book, it seems necessary to address the question of the scientific communities that this book addresses and which I have so far referred to as social gerontology and ethnicity scholarship. The reason for addressing these two scientific communities is that these two fields seldom engage with one another, and therefore have very different reference points when approaching the intersection in question. Although ethno-gerontology has been studying ethnicity’s impact on ageing and old age for decades now, most social gerontologists’ knowledge about ethnicity remains rather limited. In turn, scholars of ethnicity tend to know relatively little about ageing and old age. This is why I am hoping that this book will be regarded as one of the contributions that set in motion the discovery context in these two scientific communities. It is my assertion that it is in the context of discovery that the stage for a much-needed dialogue between these fields needs to be set. Accordingly, this is why the first part of this book offers an introduction to population ageing for ethnicity scholars and an introduction to ethnicity and the phenomena that is known as the globalisation of international migration for social gerontologists (Chapters Two and Three). The second part of this book (Chapters Four to Six) aims instead to critically appraise the state of the art of peer-reviewed journal article scholarship at the intersection between ethnicity and old age by drawing in-depth attention to the three research topics that have received the most attention over the 20-year

14

Introduction

period between January 1998 and December 2017. In the appendix I explain in detail how the literature utilised in the second part of this book was identified, and to this end it is important to mention that there are other topics (besides health inequalities, health and social care, and social relationships and caregiving) that have received attention. However, since there were fewer than 20 articles on each of these topics,3 I decided to focus on the topics that have received substantial attention. Scholars who focus on the craft of research often argue that the key to scholarly writing lies in knowing who it is that one is addressing when one writes (Booth et al., 1995). Hence I deemed the identification of this book’s potential audiences to be a crucial step in the theorising experiment that this book entails, even though I am fully aware that demarcations such as these are more idealised than the official categories of the fields themselves. In spite of this, I think that the ‘analytical’ distinction between social gerontological scholarship and ethnicity scholarship has been useful. The reason why I deem it necessary to be clear about who I am hoping will be this book’s primary target audience is not only that I believe it is important to establish the parameters for the theorising experiment that lies at the core of Part 2 of this book, but also because I think it is important to be clear about where I am starting from (and why). Epistemological positions make a difference to how we think about ontological matters in different fields, and this is something I felt could have implications for the theorising exercise I have engaged in (the results of which you will see in Chapters Four to Six). Abbott (2012) argues, for example, that when one wants to theorise, one needs to create an environment that is conducive to the ‘surprisingness’ that theorising can unleash. This requires that one approaches the scientific communities that one wants to surprise ‘from a little further off, by setting oneself slightly outside’ (Abbott, 2012: 2). This is why I did not rely on my own expertise in this field when I embarked on this book project. After 20 years of conducting ethnogerontological research, I could have written this book solely based on my interpretations of the literature. I chose not to do that. Instead, I addressed the literature reviewed in Chapters Four to Six (some of which I had actually read when it first came out) as if I were reading it for the first time. This is why I engaged in the time-consuming 3

To name but a few, they include: recruitment issues, quality of life, successful ageing and life satisfaction, identity, finances, residential issues, attitudes, loneliness, coping and religiosity, and most of these topics only have a handful of articles to their name. See Appendix for more details.

15

Ethnicity and old age

and laborious task of coding all of the articles reviewed in Part 2 and creating presentations of the data (in this case, huge tables – or wallpapers as one of the editors of this book series called them) that map out not only what the literature is about, but also how ethnicity is made sense of in it. It is also because I have tried to approach the intersection of ethnicity and old age from the ‘little further off’ that Abbot (2012) urges when trying to theorise that I decided to abstain from alluding to the intersection of ethnicity and old age as ethno-gerontology. This may come as a surprise to those who are familiar with my work, since I have conducted most of my research in dialogue with this particular sub-field of social gerontological inquiry and identify myself as a sociologist who engages with critical social gerontology research that uses ethnicity scholarship to expand the gerontological imagination. As such, I take for granted that most social gerontologists (especially those who are not sociologists) would regard me as an ethno-gerontologist and know that some ethno-gerontologists often assume that I am an anthropologist by training. In other words, naming the intersection ‘ethno-gerontology’ would have been the most obvious, yet least appropriate, choice. The reasons for this are twofold. First, although most research carried out by gerontologists on this topic could have been easily described as ethno-gerontology a decade or so ago, this is no longer the case now that more social gerontologists appear to have become interested in ethnicity. Second, ethnicity scholars with an interest in ageing and old age adamantly reject the label of gerontologist, and I did not want to exclude them as readers. Thus, in order to expand my own ethnogerontological imagination I revised my original idea – that is, to focus on social gerontology literature only – and included the few articles that have been published by ethnicity journals on the intersection in question; articles I would have not found had I not taken the analytical distinction between scientific communities as my starting point and used that to guide me in my choice of databases to search in. It is worth noting also that in order to approach the intersection in question ‘from a little further off’ while also addressing these two different scientific communities, I dissected the programmes and books of abstracts that I have collected over the past two decades before I set out to write this book. I wanted namely to position myself ‘slightly outside’ and see if peeking in would lead to any epiphanies. In this respect, it seems necessary to mention that I have presented well over 100 papers at conferences organised by both of these communities since the mid-1990s, and have therefore amassed a sizeable collection of conference programmes and books of abstracts over the years. Thus,

16

Introduction

when I first started to contemplate embarking on this book project, I sat for hours critically assessing this material and noted, for example, that papers on ethnicity tended to be grouped together in social gerontology conferences. In other words, at such academic gatherings, papers on ethnicity, minority ethnic groups and/or ethno-cultural values that address, for example, key concepts in gerontology such as successful ageing or quality of life at gerontological meetings are seldom part of the sessions that have to do with these topics. Instead, they tend to be grouped into sessions of their own. The same seems to hold true for papers on ageing and old age at ethnicity-oriented conferences, even if it is first over the past seven or so years that we have begun to see designated sessions focusing on ageing, old age or elder care at such conferences. Prior to this time, the few papers that focused on such issues tended to be grouped rather haphazardly, even if they addressed key issues for ethnicity scholars such as social exclusion or discrimination. It is because of such observations among other things that I began to grasp that an interest in ethnicity for a social gerontologist means an interest in the ‘periphery’ of the field; and that an interest in ageing and old age for an ethnicity scholar seems to mean the same. Something else I have done in order to position myself ‘slightly outside’ of the intersection that I am addressing is to consult the types of books that could be deemed the most ‘canon-like’ within these fields: the numerous handbooks and encyclopaedias that both of these fields have published over the years as well as the few edited collections that have focused on this intersection. They are the kinds of books that research fields produce when taking stock of the body of knowledge that has been produced and are, as such, meant to offer us the ‘state of the art’ in a field. Thus, I have used these books as reference literature much in the same way as a novice in the field would. I have done this even though I have conducted research at the intersection of ethnicity and old age since I first began my graduate studies back in the early 1990s and therefore have a pretty good idea of what the state of the art is. In spite of this, consulting these reference books has led to a few epiphanies. For example, and just to mention one that I think is rather telling, although handbooks on ageing tend to have sections on ethnicity, culture and/or race,4 I have yet to see a handbook on 4

For example, The SAGE Handbook of Social Gerontology (Dannefer and Phillipson, 2010); The Handbook of Aging and the Social Sciences (Binstock and George, 2006); Handbook of Social Work in Health and Aging (Berkman, 2006); The Handbook of Theories of Aging (Bengtson et al., 2009); Handbook of Cultural Social Gerontology

17

Ethnicity and old age

either migration, ethnicity and/or race that has a section on ageing and old age, let alone age itself, even though they tend to have sections on gender, class and sexuality – which are the other bases for social position and/or identification grounds that social scientists focus on.5 Thus, the journey I embarked on when writing this book has been filled with a series of epiphanies. Some of the understandings about social gerontology literature on ethnicity and race that I used to regard as ‘qualified hunches’ have been solidified, since the meticulously structured theorising exercise I embarked on has clearly shown which assertions on what this literature is (and is not) about are accurate, and which ones are not. When I started this journey, I thought I would find a field that was in the midst of expanding its imagination. But that is not quite what I have found, which is why the subtitle of this book was added as this book project progressed. The intersection of ethnicity and old age is an intersection in dire need of theoretically and conceptually astute attention, and one that I hope this book can ignite enough interest in to expand our imagination concerning it.

Structure of the book: the what and the why As previously stated, this book is divided into two parts. Chapters One to Three comprise the first part, titled ‘Setting the Stage for Theorising’. It aims to give an introduction to the debates that make the intersection between ethnicity and old age a timely one to address. In addition, Part 1 offers an introduction to how the identification grounds that are at stake (that is, ethnicity and race) can be understood depending on which theoretical framework is being used to make sense of them. Part 2 comprises four chapters and an appendix. Chapters Four to Six focus on the critical appraisal of research in the areas that have received the most attention, followed by concluding Chapter Seven in which the book’s first and second parts are brought together. Additionally, Chapter Seven offers a new agenda for scholarship by suggesting topics that should demand scholars’ attention. Titled ‘Theorising via a scoping review: what we “know” and need to find out’, Part 2 reviews the literature that is currently available in the three areas that have received the most attention over the past

5

(Twigg and Martin, 2015); and Handbook of Minority Aging which of course focuses on these very angles of investigations (Whitfield and Baker, 2014). See for example, the Encyclopedia of Race and Ethnic Studies (Cashmore, 2004) and the Encyclopedia of Race, Ethnicity and Nationalism (Stone et al., 2016).

18

Introduction

two decades (that is, health inequalities, health and social care, and social relations and caregiving) while paying close attention to the understandings of ethnicity that characterise these inquiries. The idea is that if we have this insight, we are in a better position to theorise. Thus, if we use Swedberg’s (2012a, 2012b) ideas on theorising to describe what this part of the book is about, we would say that these chapters are meant to facilitate the discovery of the patterns that characterise the literature that is available, and unleash the imagination needed to address the intersection of ethnicity and old age in an ethnicity-astute manner. A more detailed account of this book’s structure follows next. Part 1: Setting the stage for theorising Chapter Two provides an introduction to the social science debates on population ageing (for the sake of ethnicity scholars) as well as the globalisation of international migration and transnationalism (primarily for social gerontologists). These are the societal trends that have reignited gerontologists’ interest in the intersection between ethnicity and old age and have put this intersection on the radar of ethnicity scholars. Chapter Three introduces social gerontologists to ethnicity scholarship and provides insight into how these scholars tend to think about these identification grounds. Thus, this chapter defines what the constructs of ethnicity, race and culture mean, and gives comprehensive insights into how ethnicity scholarship has evolved as far as its understandings of these constructs are concerned. Part 2: Theorising via a scoping review: what we ‘know’ and need to find out Chapters Four to Six review and critically appraise the literature on these topics in order to assess the current state of affairs (and knowledge gaps that exist within them) as far as ethnicity and race are concerned. As such, these chapters are based on the scoping review conducted for this book project. This review has focused on how these literatures address ethnicity and race, and what they end up suggesting about what we ‘know’ about these identification grounds and need to find out. Moreover the review – and the book as such – regards these literatures as the fundamental parts of the scholarship on ethnicity and old age that is in focus here, even though there are other topics that have received attention (see the Appendix for a list of the array of topics published

19

Ethnicity and old age

in journal articles during the past two decades, an array so varied that single chapters could not be authored on them). Part 2 is structured such that the chapters first offer insight into what the scholarship in focus assumes about their respective topics. After that the main trends observed from the theorising exercise are presented. These trends, together with the concluding remarks in each chapter, give readers an idea of what the context of ‘discovery’ has divulged (Abbott, 2012; Swedberg, 2012a, 2012b). The sections with italicised sub-headings are concerned with specific themes relating to the intersection of ethnicity and old age and are mostly relevant to scholars already specialising in one of these areas of research. Readers who want to follow the main arguments may skip these sections. Chapter Seven summarises the main problems identified by the scoping reviews that Chapters Four to Six present; problems which are getting in our way as far as understandings of ethnicity are concerned (in relation to old age). This chapter offers also a set of priorities for a future agenda for research at the intersection of ethnicity and old age, an agenda which will hopefully allow us to expand our imagination concerning ethnicity and race. In the final section, the Appendix, the process used to select databases is described as is the one used to identify the articles in peer-reviewed journals in English that have been used in the scoping review. In addition, this appendix explains the ways in which these articles were ‘analysed’, which is why one could regard this appendix as this book’s methods chapter. A list of the topics of articles which did not merit a chapter of their own is also included since the book is not only based on the literature reviewed in Chapters Four to Six but uses all of the articles that were read, reread and coded while working on the scoping review that this book project is partially based on. The findings of the scoping review performed while working on this book clearly show that scholars on ethnicity and old age need to become self-critical about the reasons why they collect and analyse data on ethnicity and race, and about how they go about making sense of their findings (see Williams and Wilson, 2001; Torres, 2015a, 2015b). This book therefore proposes that the time has come for us to reflect on the ways in which social gerontology research constructs ethnicity and race since ‘ensuring (that) these insights (can) become part of mainstream work in social gerontology will enable the development of the discipline which maintains relevance in a context of intense global change’ (Phillipson, 2015: 930). And since the literature originating from ethnicity journals is so limited, it is also my hope (as mentioned earlier) that this book can tickle the imagination of ethnicity scholars

20

Introduction

so that they begin to regard ageing and old age as theoretically profuse sources of information about ethnicity and race. Their insights and perspectives have a lot to contribute to unleashing our imagination on ethnicity and old age. Ultimately, this book argues that time has come for scholars working on the intersection of ethnicity and old age to shift their focus from the research object (in other words ethnic ‘Others’) to the phenomena that – using Cornell and Hartman’s (1998) – ‘built, rebuilt and dismantle’ the vulnerabilities with which these groups are associated. Such a shift would entail moving from wanting to know what older ethnic Others are all about, to wanting to shed light on the structures and processes that allocate to them or deprive them of resources, the conditions under which they interact with others, and the ways in which these conditions expand (and contract) their agency depending on what other social positions – besides ethnicity – are at stake in different situations. My contention is, however, that before that shift can take place, we need to do a bit of building, rebuilding and dismantling of our own. The thorough inventory of how the scholarship on the intersection between ethnicity and race has been addressing ethnicity and race, which I have conducted in the form of a scoping review and report on in Part 2 of this book, is my contribution to mapping out where we are at, and where we need to head if we are to advance our scholarship on this intersection. That way, we can begin to build, rebuild and dismantle our imagination about this intersection. It is my hope that this contribution inspires others to join those of us who want to advance our understandings of what ethnicity and race actually mean to ageing and old age.

21

TWO

Population ageing and international migration This chapter aims to introduce ethnicity scholars to the societal challenge that is population ageing, and social gerontologists to the challenges that are posed by the globalisation of international migration and by transnationalism. The idea is that both fields of scholarship will gain insight into what has been written in each field about the challenge that lies closest to their expertise and what makes the intersection of ethnicity and old age an interesting angle of investigation for their fields of interest. This insight will hopefully give the audiences that this book addresses a common ground from which their dialogue can begin. It is, after all, these societal challenges that are at the core of the growing interest in the intersection of ethnicity and old age. More importantly, if we use Swedberg’s (2012a) work (as mentioned in the previous chapter) to set this chapter in motion, we could say that the societal trends that this chapter discusses (population ageing, globalisation, international migration and transnationalism) are trends that make the theorising exercise in the second part of this book a timely one. My argument in this chapter is thus that one of the reasons why we should engage in the imaginative phase of discovery that Swedberg calls theorising is that the time is right because the premises on which our understandings of ethnicity and old age have been built have become obsolete due to the societal trends mentioned here. The chapter begins with population ageing, which is the societal challenge that both audiences for this book have in common and then moves on to discuss globalisation, transnationalism and international migration in general terms (with specific attention paid to the implications of these trends for the study of culture, ‘periphery’ and inequality). These are the societal trends that ethnicity scholars would most likely know more about, and which gerontologists interested in ethnicity need to become more conversant about. The chapter includes a section that explicitly addresses why the challenges in focus here need to be taken into account when thinking of research, policy and practice at the intersection between ethnicity and old age. This book argues that these trends challenge the way in which this intersection was conceived prior to the societal challenges described in this chapter

23

Ethnicity and old age

having emerged. This chapter argues therefore that the societal challenges in question urge those of us interested in this intersection to become more astute not only about population ageing but also about the globalisation of international migration and transnationalism.

Population ageing: demography and discourse It used to be the case that reaching old age was an exceptional thing. This is something that must be kept in mind when trying to understand what population ageing is and what the discourse on it actually implies. The demographic trend that is population ageing, and the discourse surrounding it, are in fact not as compatible as one might expect. It is because of the disjuncture between the two that we tend to regard the great achievement that population ageing actually is as a problem. This is why Katz (1992) has described the discourse on population ageing as ‘alarmist demography’. As a gerontologist who regards ageing as a natural part of the life course, and old age as a positive stage in our lives, he does not regard population ageing as a catastrophe but rather as an extension of the opportunities that the life course offers. Demographers, however, regard old age as a variable devoid of all of the personal and social experience that ageing actually entails. Thus, to demographers, old age is a number they use to differentiate one population segment from one another. Most gerontologists, on other hand, are assumed to regard age as a social construct and often deem chronological age to be less important than most non-gerontologists do. Thus, just like the globalisation of international migration is a transition which has caused migration scholars to question most of what they have taken for granted, population ageing is a transition that has meant the end of the world as demographers have known it. Vallin (2002) writes about the unprecedented changes that we are bound to face as life expectancy has risen by using adjectives such as ‘dramatic’. And to understand his choice of words, we must bear in mind that for most of human history, the average life expectancy was actually as low as 25 years of age. This probably comes as a shock to some but is an interesting take on why population ageing has received as much attention as it has. Thus, the fact that more and more people today are reaching old age and that this is the case worldwide is something exceptional, since living into old age was not something most people did some decades ago. In 1950 the average life expectancy was 47 years (UN, 2002). It is against this backdrop that one can make sense of what the National Institute of Health, the National Institute of Aging and the

24

Population ageing and international migration

World Health Organization have described as ‘the dramatic increase in average life expectancy during the 20th century ranks as one of society’s greatest achievements’ (NIH, 2011: 6). When describing what this dramatic increase has implied, these organisations list the fact that life expectancy at birth now exceeds 83 years in Japan and is at least 81 years in several other countries. They write also that ‘the most dramatic and rapid gains have occurred in East Asia, where life expectancy at birth increased from less than 45 years in 1950 to more than 74 years today’ (NIH, 2011: 6). This is why it is worth noting that while only 8 per cent of the world’s population was 60 years old or older in 1950, it is anticipated that by 2050 this segment of the population will be 21 per cent (Bloom et al., 2015). It is against these backdrops that the ‘alarmist discourse’ (Katz, 1992) of population ageing must be understood. There is more to population ageing, however, than average life expectancy, even if that is the one thing that most people associate with this trend. Viewed as a demographic transition (which is how most demographers regard this; for example Vallin, 2002; Bloom et al., 2015), population ageing is the term that demographers began to use when they first noted not only that fertility rates and mortality rates were declining, but that longevity was increasing. However, actual drivers of population ageing are not the same in all countries. Using the UN classification system of countries (which differentiates between more developed countries [MDCs] and less developed countries [LDCs]1), Preston and Stokes (2012) analysed the differences in fertility, mortality and migration that an array of countries have experienced over the past decades. They assert that ‘the massive improvements in survivorship from one birth cohort to the next during the past century are principally responsible for the aging that is occurring in more developed countries’ (Preston and Stokes, 2012: 227). The patterns they observed in LDCs are a bit different. Thus, although LDCs have also experienced huge increases in survival from one cohort to the next, the thing that differentiates these countries from MDCs is the speed at which their populations are ageing. This is the result of the fact that the growth rate in births has declined faster in LDCs when compared with MCDs. The sources of population ageing are thus different in different parts of the world2 even if demographers 1

2

European countries, North American countries, Australia, New Zealand and Japan are the countries that the UN classification system calls MDC. The remaining countries belong to the LDC category. For insights into the variations in the sources of population ageing, see Davies and James (2011). For insights into the drivers of population ageing in Central

25

Ethnicity and old age

often refer to fertility and mortality data as well as increased longevity when describing the reason why different countries are ‘greying’. Irrespective of what is driving the ageing of the world’s population forward, population ageing is a demographic transition that worries demographers and policy makers alike, since the rapid ageing of populations means that new challenges related to health, labour supply and economic growth will arise. Concerning health challenges, it has been noted, for example, that ‘nearly one quarter of the world’s burden of disease is attributable to illnesses in adults aged sixty and over’ (Bloom et al., 2015: 82–4). This is why countries around the world (and especially those with highly developed welfare systems) are worried about the growing disease burden that they expect population ageing to bring. The challenge is not only being able to provide the care that growing numbers of older people are believed to need but also that countries’ economic growth is expected to slow down because the kinds of diseases that older people tend to suffer from (such as heart disease, cancer, musculoskeletal conditions and mental disorders such as Alzheimer’s disease and other dementias) are not only expensive to treat but also require new ways of designing health care in old age (Prince et al., 2014). The fact that these diseases can diminish our capacity to participate in the labour market is also a source of concern for policy makers since one of the economic challenges that population ageing is believed to bring is a shortage of labour. In regard to this, Bloom and colleagues (2015: 84) argue that in many countries, labour force participation falls off drastically at older ages. As a result, population ageing may slow down national economic growth, reduce asset values, strain existing pension and health systems and weigh down younger generations in the process. Of interest here is the fact that they use the verb may as opposed to will. Their take on the matter is that the challenges we are facing are not caused by population ageing but by the fact that most countries today have institutional arrangements that are not suitable for ageing populations and the kinds of demographic transitions we are witnessing. In their article, they cite numerous ways in which we could offset the and Eastern Europe, see Botev (2012). Those interested in what different welfare regimes are doing to address the challenges that the ageing of their populations could bring are recommended to read Aysan and Beaujot (2009).

26

Population ageing and international migration

gloomy outlook that demographers’ view of population ageing has led to (such as increasing the labour supply with women, older people and immigrants, and increasing retirement ages and rates of savings during working years to name a few). A similar take on population ageing can be found in Yenilmez (2015), who suggests that countries could make changes to workforce participation, the pension system retirement age and the labour supply and, in doing so, grasp the fact that ‘overall, the risks entailed by population ageing need not necessarily have a negative impact on social and economic trends if the essential policies are implemented. On the contrary, population ageing could become an opportunity’ (Yenilmez, 2015: 750). Addressing the ways in which population ageing can be offset lies outside of the scope of this chapter. The point that I am trying to make here is that population ageing is a demographic transition whose end result (that is, greater numbers of older people) could be viewed as a testament to humankind’s achievements as opposed to a challenge. From this it follows that we need to differentiate population ageing – the transition – from the ‘alarmist’ discourse that this demographic shift has generated. The former draws attention to how we turned the exceptionality of old age into something achievable while the latter draws attention to the anticipated economic and social consequences that we would face as more and more people reach old age unless societies figure out how to adapt.

Globalisation and the study of culture It is often claimed that since the 1980s social scientists around the world have drawn attention to the fact that social, economic and cultural networks across the world were beginning to become globalised (see, for example, Hamelink, 1999, who summarises the numerous societal transformations that globalisation is claimed to have brought about by referencing both those who support the globalisation thesis and those who are more sceptical about it; see also Robertson, 1992, 1995). Wherever we stand in terms of what globalisation is and what it entails and whether the transformations associated with it are in fact myth or reality (Martin et al., 2006), it was around the late 1980s and early 1990s that we started to see broad claims about what globalisation meant for what we social scientists regard as ‘the social’. The exact time when the globalisation debate started is difficult to pinpoint, however, for as Martin et al. (2006) have argued, at the beginning of the 20th century the founders of the French School of Sociology and German sociologists had already noted some of the societal changes with which

27

Ethnicity and old age

globalisation is associated. Some trace the changes in question back to the 1500s (see, for example, Nederveen, 1994) since the progression of modern capitalism which Marx drew attention to could be claimed to be the beginning of globalisation. Irrespective of when social scientists started to draw attention to globalisation, the past three decades have witnessed an intensified debate about what globalisation is and what it entails as far as the study of society is concerned. Archer (1990) for example summarised the implications of the globalisation phenomenon by stating that each ‘major aspect of social reality… is simultaneously undergoing globalisation’ (Archer, 1990: 1). In a similar vein but rather more recently, Marsella (2009) reflected on globalisation by stating that irrespective of whether we wish this trend to be the case or not, ‘the reality is that few things are either local in origin and/or consequence. This simple fact – this reality – has changed all of our lives by revising our past, complicating our present, and confusing our future’ (Marsella, 2009: 124). Addressing all that globalisation encompasses lies outside of this chapter’s scope. This chapter focuses specifically on the one aspect of globalisation which is most relevant to the intersection between ethnicity and old age, an aspect that migration scholars tend to refer to as the globalisation of international migration. But before this specific aspect of the globalisation process can be addressed, it seems necessary to note that among the transformations that are deemed to be constitutive features of globalisation, we have the geographical expansion and increased density of international trade; the development of a worldwide capitalist economy and of multinational corporations; the emergence of what Beck (2000) called ‘polycentric world politics’; the dispersion of mass media across the world; and the variety of innovations that have taken place in information and telecommunications technology (including the invention of a cyberspace with all that this entails for everyday social interaction). According to globalisation theorists, the transnational actors, communities, social spaces and structures that these transformations imply, have brought about a variety of worldwide exchanges that have made the transcendence of traditional national boundaries possible. Back in the early 1990s, Smart (1993) for example argued that ‘an adequate understanding of social life, social relations, identity and experience can no longer be derived from an analysis limited in scope to “society”, particularly when the latter is conceptualized as equivalent to the geopolitical order of the modern nation-state’ (Smart, 1993: 135). In other words, globalisation is often regarded as a societal force and/or social change that is having an impact not only on the world as we knew it, but also the way in which

28

Population ageing and international migration

we acquire knowledge about the world. This is why, back in 2006, I urged ethno-gerontologists to take into account the implications that globalisation was posing for the study of culture, migration and inequality (Torres, 2006a). With regard to the study of culture, it is important to state that globalisation is challenging the geopolitical order that modern nationstates tended to take for granted, as well as the implications of this order for how social scientists made sense of what society is. Prior to globalisation challenging how we think of society and culture, we used to take for granted that cultural values were taught primarily through the immersion into specific localities that socialisation was believed to entail. In its most primitive form, this type of understanding thus assumed that there was a lineal relationship that ran from society to culture to values. Thus, prior to globalisation having challenged the ‘national version’ of society3 that deemed culture to be a point of reference that is essentially territorial, we used to regard cultural values as the frames of reference that people learned through socialisation within territorially bounded spaces. In other words, social scientists used to take for granted – and some of them still do, in fact (as Chapters Four to Six implicitly show) – that because people originated from a specific place, they had been socialised within specific localities and upheld the cultural values with which these localities were associated. This is the very idea that the World Value Survey, for example, builds on, and is the idea that lies at the core of the notion that there are such things as majority cultures (see, for example, van Oudenhoven and Ward, 2013). Globalisation questioned this cause-and-effect-like regard for the relationship between society–roots–culture–values because the idea of fixed locality as the sole point of departure of social science investigations about society and culture was heavily questioned once globalisation processes started to erode the national (see, for example, Swindler, 1986; Tomlinson, 1999). In this respect, it seems interesting to draw attention to King‘s poignant statement about globalisation’s impact on culture when he wrote that the challenge was ‘not just that, increasingly, many people have no roots; it’s also that they have no soil’ (King, 1991: 6). 3

Acknowledged hereby is the fact that this version of reality has been questioned on numerous occasions. For an insightful critique of it, see Archer and colleagues who question not only equating society with nation and culture but also the idea that ‘any weakening of the power of sovereign states via global flows will necessarily lead to the emergence of different forms of cultural identities and belongings’ (Archer et al., 2007: 120, italics in original).

29

Ethnicity and old age

Thus early on globalisation was believed to challenge the ways in which we made sense of, and studied, culture because the societal transformations that globalisation was bringing to the fore begged for culture to be thought of a ‘general human software’ that is not necessarily locally learned and that is most definitely not confined to a specific territory (Swindler, 1986). Phrased differently, one could say that prior to the globalisation debate having challenged our understandings of culture, it was not uncommon for social scientists to regard cultural values as the ‘backpack’ that people put on when born within a culture; a backpack that contained the cultural values that people were territorially socialised in, and which they would carry with them through life. When discussing the implications that globalisation has had for the study of culture, renowned anthropologists such as Hannerz argued that ‘the autonomy and boundness of cultures must nowadays be understood as a matter of degree’ (Hannerz, 1992: 261). Gille and Riain later on warned anthropologists to take note that their ‘ability to straightforwardly access the social by going to the local becomes problematic under conditions of globalisation’ (Gille and Riain, 2002: 273). In a similar fashion, van Oudenhoven and Ward (2013) have warned social psychologists to rethink the ways in which they conceive majority cultures since in globalised times such as ours they are ‘fading’. It is against these backdrops that I urged ethno-gerontologists to rethink the assumptions they tend to take for granted about how culture affects the experience of growing old, which is the underlying assumption of most of their inquiries into ethno-cultural values (namely the idea that cultural differences about the way in which old age is conceived and experienced can easily be traced back to specific localities); and to rethink their fascination with intercultural differences and relative disregard for intracultural ones (Torres, 2006a). Although all of these allusions to globalisation theorists’ writings on culture probably suggest that globalisation means the end of culture as we have known it, it is necessary to stress that this is not the case. Globalisation prompted the acknowledgement that ‘non-places’ (such as cyberspace for example) were becoming interesting non-nation based localities for those of us interested in the ways in which ethno-cultural values are learned. It is worth noting, however, that globalisation scholars have always argued that this does not mean that the emergence and the increased importance of non-nation based localities meant that globalisation would not necessarily bring about ‘a world culture’ (that

30

Population ageing and international migration

is, a single unified system of meaning shared globally) even if some have made it sound as if this could end up being the case.4 Tomlinson (1999) for example argued that the emergence of such a monolithic culture is not necessarily going to bring the destruction of ‘real’ localities, nor is it going to obliterate the importance of localised experience to identity formation. On a similar note, Beck (2000) stressed that the effects of globalisation will always be experienced within the context of the ‘local’ irrespective of where this local is situated geographically. Thus, although globalisation is believed to be bringing about a sense of a unified world, globalisation experts have always acknowledged that localities will most likely continue to be our primary points of reference even in highly globalised times such as we are experiencing today. In other words, the fact that the world can sometimes be experienced as a single place (a fact that cyberspace makes possible), does not in and of itself suffice to undermine the importance that differing positions have for the acquisition of cultural, social and economic capital and/or, as Mittleman (2000) would suggest, for the importance that the hierarchisation of cultures has for our understanding of the world. Phrased differently one could say that globalisation scholars do not mean to undermine the importance of the local when suggesting that we nowadays must recognise the impact of the global on our locally situated lives. Thus, even if globalisation is expected to alter ‘the context of meaning construction: how it affects people’s sense of identity, the experience of place and self in relation to self, how it impacts on the shared understandings, values, desires, myths, hopes and fears that have developed around locally situated life’ (Giddens, 1994: 95), there is still a locally based context in relation to which most of us orient ourselves. Growing interest in the globalisation of international migration, however, drew attention to the fact that for some migrants the question was not necessarily to which locally situated life they were orienting themselves (that is, the one they came from or the one they moved to) but rather how many localities they were using as points of reference and how often the points of reference for their orientation shifted. Relatively early on in the debate on the globalisation of international migration, some migration scholars noted that the intensification of 4

For example, Kessler (2000: 931) claimed that globalisation is ‘producing for the first time, no matter how unevenly, a single, interdependent humankind and, in prospect if not yet in actuality, a single worldwide human community ... [and as such] the experiential basis for the emergence of a genuine and uncompromised moral universalism’.

31

Ethnicity and old age

transnational ties that we were witnessing – and the transnationalism that these ties entail – needed to be differentiated from the greater trend that is the globalisation of international migration. That is why the section that follows focuses on transnationalism.

Transnationalism: a specific aspect of globalisation In the late 1990s and beginning of the 2000s a group of migration scholars began to draw attention to the specific aspect of globalisation that is transnationalism (Glick-Shiller et al., 1992). Faist described, for example, the relationship between transnationalism and globalisation by stating that Transnationalization overlaps globalization but typically has a more limited purview. Whereas global processes are largely decentred from specific nation-state territories and take place in a world context above and below states, transnational processes are anchored in and span two or more nation states, involving actors from the spheres of both state and civil society. (Faist, 2000a: 192) Vertovec offered also a definition of transnationalism as a specific condition in which despite great distances and notwithstanding the presence of international borders (and all the laws, regulations and national narratives they represent), certain kinds of relationships have been globally intensified and now take place paradoxically in a planet-spanning yet common – however virtual – arena of activity. (Vertovec, 1999: 447) Portes and colleagues (1999) – who were also part of the emerging transnationalism theorists back then – argued, for example, that although back and forth movements by migrants have always existed, it is only since the beginning of the 1980s that the intensity and simultaneity of long-distance, cross-border activities have brought about the distinctive normative social structures and social fields that we call transnationalism (Faist, 2000b). They contended therefore that not all migrants belong to the transnational category, since it is only those that have access to the transportation and technological prerequisites of transnationalism who can sustain such ties over time. Thus, when speaking of transnationals, they were referring to people who ‘live

32

Population ageing and international migration

dual lives: speaking two languages, having homes in two countries, and making a living through continuous regular contact across national borders’ (Portes et al., 1999: 217). Transnational migrants are, in other words, people who stay ‘connected’ with, and are simultaneously influenced by, more than one culture at a time (see also Glick-Shiller et al., 1995). It is because of this that migration scholars have referred to transnationalism’s influence on culture in ‘translocal’ terms (Smith and Guarnizo, 1998) or by using terms such as ‘social morphology’ and ‘diasporic consciousness’ (Vertovec, 1999). Thus, the first writings on transnationalism aimed to differentiate transnational migrants from ‘conventional’ migrants who they defined as those who had “occasional and fleeting contacts’ between (themselves) and ‘the relatively immobile people’ who inhabited their countries of immigration and the societies that hosted them (Faist, 2000a: 190). The idea was that scholars focusing on transnationalism needed to distinguish transnational fields from global fields and that scholars focusing on the more general trend that is globalisation needed to make sure that they did not start to regard all migrants as transmigrants. Concerning the impact that transnationalism could have on the way in which we think about post-migration integration, it must be noted that Portes and colleagues argued very early on that ‘for immigrants involved in transnational activities and their home country counterparts, success does not so much depend on abandoning their culture and language to embrace those of another society as on preserving their original cultural endowment, while adapting instrumentally to a second’ (Portes et al., 1999: 228-9). Transnationalism thus poses its own set of challenges to the study of culture, since the assumptions that were being made prior to the intensification and spread of these interaction networks meant that migrants’ challenges were easily described in terms of the disruption of the lineal relationship mentioned earlier (that is, society–culture– values). The lifestyles and life courses of ‘conventional’ migrants’ entailed something else, that is, society (of origin)–culture–values– (host)–society–culture–values, while transnational migrants’ lifestyles and life courses entailed a complication of this linearity, since these were people who were neither ‘here nor there’; they were instead ‘in between’. They are, in other words, grappling with both the values of their societies of origin and the ones in their host societies but are not doing so one step at a time (that is, first one, then the other) but are instead constantly faced by both since they travel in between these countries not only once in a while but constantly. With regards to ageing and old age, it is important to note that research on transnational

33

Ethnicity and old age

lifestyles has shown that older transmigrants live lives that are very much characterised by the intense long-distance mobility, cross-border activity and social interaction patterns (especially those focusing on family relations) that are transnational in character even though they may not always speak two languages, have homes in two countries or make a living through continuous regular contact across national borders (Dwyer, 2000 , 2001; Ackers and Dwyer, 2002; Treas and Mazumdar, 2002; King and Vullnetari, 2006; Baldassar, 2007; Treas, 2008; Lunt, 2009). It is because of this that I have elsewhere argued that much of the literature that focuses specifically on transnationalism (especially the theoretical literature on this trend) is oblivious to old age (Torres, 2013). Irrespective of how we define what constitutes a transmigrant and a ‘conventional’ migrant, and/or whether we choose to differentiate between them or not, it is important to note that the theoretical literature on transnationalism (and especially the first writings drawing attention exclusively to this specific trend) differentiated between the globalisation of international migration and transnationalism. However, the impression one gets from recent work that uses terms such as transnationalism or transnational is that these terms have slowly but surely become diluted. Often nowadays, they are used to allude to the state of affairs that migration brings about in rather general ways (see Wilding, 2007, who problematises the use of the term ‘transnational’). An ethnicity-aware and globalisation-informed discussion of ageing and old age needs to take this into account, since migrants whose lives are characterised by the constant shift in frames of references that transnationalism implies (and the intense mobility patterns with which this type of migration is associated) are bound to face specific challenges in old age.5

Globalisation and the study of migration, ‘periphery’ and inequality After having provided some insight into what the globalisation of international migration and transnationalism entails, and after 5

For example, see Dwyer (2001) who discusses this in relation to health care rights, and Torres (2013) who does so in more general terms when drawing attention to what transnationalism ‘from below’ (as Faist, 2000a, 2000b would call this) could mean to the study of ageing and old age. See also Horn and Schweppe (2016) who have recently argued that transnational ageing can be regarded as both a research perspective and an agenda for future research.

34

Population ageing and international migration

acknowledging some of the implications that these trends have for the study of culture, it seems appropriate to move on to discuss how the study of migration and inequality is challenged by globalisation. These are some of the areas that are relevant if we want to understand why the sheer number of ethnicity-informed studies of ageing and old age seem to have increased over the past few decades, and if we want to be able to theorise about the intersection between ethnicity and old age in this time and age. The very reason why a book like this one dedicates a chapter to globalisation is that this societal trend challenges the ways in which we think about ethnicity’s implications for ageing and old age and the manner in which we regard and approach the ageing of people in minority ethnic populations. Globalisation theorists warned social scientists from the start that this societal trend would affect the ways in which we regard migration and migrants (see, for example, Castles and Miller, 1998; also Castles, 2000, who wrote about the implications that ‘the age of migration’ would have on the way in which migration and migrants were studied). For those unfamiliar with these debates, it seems necessary to mention that the age of migration is the name of a book by Castles and Miller published in 1998, which argued that ‘the global order based on sovereign national states is giving away to something new’ (Castles and Miller, 1998: 1). This new order is witnessing not only the intensification of international migration but also the feminisation (Slany et al., 2010) and differentiation of migration waves across the world. These international migration trends are therefore deemed to be different than the ones we had a couple of decades ago, when international migration also existed but migration flows had a slightly different ‘flavour’. This is why migration scholars differentiate between international migration meaning the movement between countries that takes place for a variety of reasons, and the globalisation of international migration, which entails not only the intensification of these flows but also the change in character as far as which countries send and receive migrants and who migrants are (in other words, why they come and where they come from). The globalisation of international migration that we have been witnessing for several decades now is challenging the way in which we study migration movements and their implications for national and international policies (for example, Castles and Davidson, 2000), and the manner in which we approach the study of migrants and policies relevant to their needs (Kivisto, 2001). This is the case because, as Richmond (2002) has argued, globalisation weakens the distinction between ‘sending’ and ‘receiving’ countries, as well as the stereotypical

35

Ethnicity and old age

assumptions about immigrants and refugees that are often made, which is why I argued (Torres, 2006a) a few years later that gerontologists needed to rethink the underlying assumptions that often guide their inquiries about the ageing of migrant populations. A similar argument was made by Warnes and colleagues (myself included) (2004), who urged gerontologists to take into account that the mobility which characterised the globalisation of international migration increased the heterogeneity of migrant backgrounds and poses numerous challenges for the formulation and implementation of ageing policies, since these need to address not only increased diversity but also the different backgrounds and needs that this diversity entails. Related to all of this is, of course, that very early on globalisation theorists drew attention to the fact that the processes discussed in the previous sections were bound to make it virtually impossible to continue to disregard the ‘rest’ since the rest were moving into the West so to speak, and globalisation disrupts the way in which we think about the West. In this respect Marsella poignantly wrote [The] demographic changes that are occurring are shaping a new global profile within and among nations. Consider these demographic realities: Five of six people in the world are non-Caucasian. The total Caucasian populations of the United Kingdom, Ireland, Germany, all of Scandinavian countries, Holland, Belgium and Luxembourg is less than the population of Indonesia. Ninety percent of the world’s population growth is occurring in developing countries. (Marsella, 2009: 125) Thus, globalisation is making it virtually impossible to continue to regard the world in the manner in which Western scholarship around culture (and ethnicity) has done in the past -assuming that the periphery’s concerns were not our own, and/or that our assumptions were relevant to all. The ‘us’ is in the minority, and although this has always been the case, it has become much more difficult in globalised times such as ours to continue to pretend that this is not the case. In addition, globalisation is expected to intensify the resource gaps that already exist between rich and poor nations, the ‘first’ and ‘third’ worlds, the ‘centre and the periphery’ and between the ‘West and the Rest’ (Giddens, 1994; Bauman, 1998; Beck, 2000; Mittleman, 2000; Richmond, 2002). Thus, although globalisation has been claimed to have the potential to challenge these distinctions, social scientists interested in various angles related to these transformations proposed

36

Population ageing and international migration

quite early on that various ‘winners’ and ‘losers’ among social groups and nations will continue to develop as a result of the transformative processes mentioned in the beginning of this section. Richmond (2002: 715) claimed, for example, that ‘in a global economy based on unregulated free market principles, the rich are bound to get richer and the poor relatively poorer’. In this respect, Beck also argued that the study of social justice (to which inequality studies belong) was bound to be challenged by globalisation, since the transformations in question will eventually demand that the ‘very losers of globalisation will in the future have to pay for everything – from the welfare state to a functioning democracy’ (Beck, 2000: 6). Related to all of this is Bauman’s (1998) assertion that the relationship between globalisation and localisation reflected the polarisation of the world into the ‘globalised rich and the localised poor’ (see also Massey, 1994; Castles, 2000). The former have the world as their oyster while the latter are confined to the locality in which they ‘belong’. In this regard, Bauman poignantly argued that For the first world, the world of the globally mobile, the space has lost its constraining quality and is easily traversed in both its ‘real’ and ‘virtual’ renditions. For the second world, the world of the ‘locally tied’, of those barred from moving and thus bound to bear passively whatever change may be visited on the locality they are tied to, the real space is fast closing up. This is a kind of deprivation which is made yet more painful by the obtrusive media display of the space conquest and the ‘virtual accessibility of distances that stay stubbornly unreachable in non-virtual reality. (Bauman, 1998: 87-8) Speaking of the poor in ‘local’ terms does not, however, mean that they are excluded by globalisation or that affluence is a prerequisite for the impact of globalising forces to be felt. Tomlinson (1999) argued, for example, that globalisation has a basic ‘applicability’ to most people and countries irrespective of whether the resources they have at their disposal mean that they can be classified as rich or poor. In other words, globalisation theorists discussed from the start the implications of this societal trend as something that no one is really exempt from, even though they argued that the rich and the poor are bound to experience the effects of globalisation differently. With regard to the main pillars of social differentiation (that is, ethnicity, race, class, gender and age) and the impact that globalisation would have on them, the argument is that

37

Ethnicity and old age

it is clear that some are going to live deterritorialized culture more intensively, actively and (on balance) enjoyably than others. The distance between [a] ‘yuppie’ couple and [poor] pensioner is illustrative of this. But it would be a mistake to see the experience of deterritorialization as something which only arrives at a certain threshold of socio-economic advantage, above which is a switch to the ‘hyper space’ of a ‘cosmopolitan’ lifestyle and below which there is a simple exclusion from the whole process of globalisation and a different order of experience. (Tomlinson, 1999: 132) Thus, when speaking of inequality and globalisation at the macro level, it is imperative that we do not mistakenly assume that lack of resources and power means exemption from the process. In fact most globalisation theorists assume that the transformations in question are having (and will continue to have) an impact on us all although in varying degrees, regardless of whether or not we live in the ‘first’ or ‘third’ world. Tomlinson (1999) quite early on argued that the poor and marginalised might actually be more affected by globalisation than the rich are for example, since lack of power does not necessarily impede the global nexus from intruding into their localities as well as their daily lives. In this respect, it seems worth drawing attention to Ackers and Dwyer (2002) as well as Dwyer and Papadimitriou (2003), who have shown, for example, that transnational senior citizenship can bring about the widening of inequalities in old age. If resource inequalities continue, fears regarding the negative impact of globalisation may turn out to be correct. With regard to the intrusion of the global, it might further be argued that globalisation challenges the study of inequality, not only because it brings about the growth of inequalities between the centre and the periphery but also because the experience of marginalisation within the periphery is also challenged by globalisation. This is the case because telecommunication-related advances are changing the way in which marginalisation is experienced. In this regard, it seems important to draw attention to Appadurai (1990), who very early on asserted that advances in telecommunications and access to the global mass media meant that an increasing number of marginalised people are confronted with the spectrum of possible (and most importantly, prosperous) lives on a daily basis. This means therefore that ‘imagined worlds’ are now virtually accessible to most people. This is why early on I urged ethno-gerontologists to take into account the fact that globalisation affects the study of inequality, not only because of the transformations

38

Population ageing and international migration

at a macro level that globalisation brings about (the accentuation of existing inequalities, hierarchies and modes of exclusions that these presuppose), but also because at the micro level of everyday life, these transformations may end up being experienced in more intense ways (Torres, 2006a, 2012, 2013).

Globalisation: the implications for the intersection of ethnicity and old age It is perhaps relatively clear by now why the globalisation of international migration (the one aspect of globalisation which I have argued to be the most relevant for the task at hand), and the societal trend that overlaps this but which has a much more limited purview (that is, transnationalism), pose specific questions to research agendas at the intersection between ethnicity and old age. In this final section, I will present some of these questions in order to spark the interest of those who are interested in ageing and old age as well as ethnicity and race but have not yet embarked on studies of their own. There is in fact an array of research questions that the societal challenges alluded to here make relevant as far as research, policy and practice are concerned with ageing and old age. One issue that comes to mind is the way in which ideas about, and ethno-cultural values around, ageing and old age are challenged by the unsettling relationship between cultural values and national locality that globalisation brings to the fore. One of the assumptions taken for granted that characterises social gerontological inquiries (which we will see more clearly in Part 2 of this book) is the idea that national locality and the ethno-cultural values associated with specific localities are at the core of the cross-cultural differences that have been documented as far as understandings and experiences of ageing and old age are concerned. As has already been implied in the previous sections, this assumption – which in fact implicitly guides most studies of the understandings of ageing and old age by people from minority ethnic groups - is undermined by globalisation. This means that the ways in which social and cultural differences between ageing populations are addressed is bound to be challenged by the processes with which globalisation is associated. When reflecting on this, Phillipson – who is a European critical gerontologist - made the point that ‘diverse populations will ... have greater variability in respect to images and definitions of ageing. The notion of what it means to grow old, when old age begins, and normative behaviours for old age, will all show much wider variation in one society than has historically been the case’ (Phillipson, 2002: 6).

39

Ethnicity and old age

In this respect it seems necessary to draw attention to Kearney’s (1995) assertion that cross-cultural studies take for granted a variety of classifications that have made the comparative study of cultures possible and this is one of the many issues that globalisation upsets. As already mentioned, globalisation makes it difficult to think of individuals as members of bounded and/or of ‘either or’ groups, and to study culture while assuming bounded and fixed territoriality. This is why I have elsewhere argued that research on transnational lifestyles in old age is needed as transnational migrants become a significantly large group within migrant populations across the world (Torres, 2013). The hybridisation of cultural values implicit in such lifestyles (Nederveen, 1994) is still relatively unexplored within gerontology. The same can be said with regard to ethnicity scholarship even if the latest trend among migration scholars who study ageing and old age is to study different angles that are relevant to transnational ageing (Ammann and van Holten, 2013; Horn et al., 2013; Horn and Schweppe, 2016). One of the challenges that globalisation and transnationalism pose for the study of ageing and old age concerns the way in which older transnational migrants ‘negotiate’ the meanings they attach to the experience of ageing when growing into old age takes place while being both here-and-there and when both either-or applies. At the core of gerontological knowledge lie a variety of assumptions regarding continuity across the life course, which is not a characteristic of the migrant’s life course (and especially the transnational migrant). The life course of older migrants is in fact characterised by the very opposite experience – that is, discontinuity. Thus, a globalisationaware and transnationalism-informed agenda for studies of ageing and old age needs to take into account the impact that the ‘biographical discontinuity’, which is a given in most migrants’ lives (and especially so in the case of transnational migrants), has on adjustment to and in old age, since continuities in identity are becoming less and less common as the result of globalisation of international migration. Something else worth mentioning when it comes to the implications that the globalisation of international migration and transnationalism have for studies at the intersection between ethnicity and old age is that there are a number of gerontological concepts (such as quality of life, well-being, life satisfaction and successful ageing) which have yet to be explored in any substantial manner against the backdrop that these societal challenges pose. Concepts such as these are highly value laden, which is why I have argued elsewhere that they are bound to be affected by the kinds of uprooting and subsequent adaptation processes that international migration implies - not to mention the

40

Population ageing and international migration

kind of culture hybridity that characterises transnational lifestyles (Torres, 2013). The fact that there is ongoing debate about some of these concepts suggests that insight into the actual values that people hold is needed if we are to develop these areas of inquiry further. The reason for this is that being in between cultures, which the process of migration brings about and that transnationalism entails, can sometimes lead to exposure to ‘foreign’ ideas regarding what constitutes a good old age. A synthesis of ideas can sometimes occur, which does not, in the end, resemble either what is considered to be typical of the ethno-cultural values of the migrant’s culture of origin or what is assumed to be characteristic of the host culture that has become his or her new frame of reference. For insight into the implications of all of this to the debate on successful ageing see Torres (1999, 2001, 2002, 2003) while Torres (2001, 2004, 2006b) addresses how the process of migration can challenge the ethno-cultural values and understandings of successful ageing that people hold. The fact that by virtue of their lifestyle transnational migrants are simultaneously exposed to two (often different) cultures over long periods of time suggests therefore that their experiences and understandings of ageing are a great source of information about ageing and old age. With regard to the implications that the globalisation of international migration has for the study of ageing and old age, as already stated, there is the impact that this societal trend will have on the study of migration and the ways in which we regard migrants. In this respect, it is worth noting that besides the challenges already described in the previous section, studies of ageing and old age that are ethnicity-aware and globalisation-informed need to take into account the increased diversity that characterises migrant populations in global times such as ours. Ethnicity scholars have been interested in intracultural differences for a long time but the same cannot be claimed for gerontologists, since most of them are still focusing on intercultural differences. As a result of this, it is not uncommon for gerontologists to speak of migrant populations as populations that are relatively homogeneous as far as their ethno-cultural backgrounds are concerned, which is why they often tend to think of them as interesting because they are different from the backgrounds of non-migrant populations. In globalised times such as ours, seeing migrant populations as ethnic ‘Others’ whose ageing and old age is different from non-migrant populations (Torres, 2006c) does not sit well with the lessons that globalisation theorists have taught us through the years. One of the main messages that these theorists have tried to spread is that globalisation brings about increased diversity both within countries and within the minority ethnic groups

41

Ethnicity and old age

that can be found within different societies. For example, crosscultural psychologist Greenfield argues that ‘in response to globalised social change, national culture has actually diminished over time’ (Greenfield, 2014: 40) and that this is why ‘values vary more within countries than between countries because culture values are adapted to sociodemographic conditions’ (Greenfield, 2014: 37). As already stated, because of the numerous transformation processes that globalisation and transnationalism entail, neither ‘conventional’ migrants’ nor transnational migrants’ experiences of culture and values follow the assumptions taken for granted about society-culture-values alluded to earlier. It is because of this that the debate on the globalisation of international migration from the start has been concerned with dismantling some of the assumptions taken for granted about migrants, migration policies, mobility and citizenship by migration scholarship prior to globalisation having been acknowledged. Thus, whether or not being in between cultures, which is characteristic of the first stages of immigrants’ adaptations, becomes a permanent state of affairs for transnational migrants or not, the debates in question have argued that globalisation has made it particularly difficult to speak of territorially bounded cultural values. It is because of this, among other things, that Warnes and colleagues (myself included) have argued that ‘the number of older people who have been international migrants and have cultural differences from the host population will undoubtedly increase during the coming decades’ (Warnes et al., 2004: 309), and this is bound to pose numerous challenges to those interested in welfare planning and provision. Related to this is also their assertion that ‘in European countries today, older migrants include people who are among the most deprived and excluded in our societies ... and others who are in the vanguard of innovative, developmental and positive approaches to later life’ (Warnes et al., 2004: 310–11). Older migrants come in all shapes and forms in globalised times such as ours. With regard to this diversity, it seems appropriate to mention the typology of older migrants in Europe that Warnes and colleagues (2004) formulated a decade or so ago. This typology – which was formulated by means of a literature review of research on older migrants in Europe – proposed that there were basically four different types of older migrant at that point in time, and that these could be roughly classified into two groups (those who had migrated between European countries and those who had come from outside this region, and those who had migrated early in life for work and those that had done so late in life for family reunification purposes and/or amenity-seeking reasons). Although involved in the team that

42

Population ageing and international migration

originally proposed this typology, I have argued elsewhere (see Torres, 2009) that this classification does not acknowledge that some older migrants do not migrate voluntarily. Older refugees, for example, who have migrated for political and/or religious reasons and who have done so both early and late in life are not addressed in this typology. This is probably because there was no literature on this group when we performed the literature review that guided the formulation of this typology. Thus, although the typology in question does address the differentiation associated with ‘the age of migration’, it should not be regarded as a typology that encompasses all the potential types of older migrants. This typology does propose, however, what globalisation theorists often claim: that the diversity of backgrounds and motives for migration is greater these days and that this is due to globalisation. What all of this therefore suggests is that the study of ageing migrants, which is bound to interest scholars working at the intersection that is the focus of this book, must take into account not only the differentiation between migrants and non-migrants that has been a source of inspiration for studies of ethnicity and old age for decades, but also the differentiation that exists within migrant groups as a result of the diverse ways in which people have migrated - the reasons that have driven them to migrate in the first place and the stage of the life course in which they have migrated. Something else worth mentioning with regards to the relevance of globalising processes to the study of minority ethnic elders with migrant backgrounds is the fact that globalisation (but most specifically transnationalism) is changing what gerontologists call ‘the political economy of informal care’. This is the case since ‘globalisation is producing a new kind of ageing in which the dynamics of family and social life may be stretched across different continents and across different types of societies’ (Phillipson, 2002: 3). Related to all of the above is Wilson’s (2002: 657) argument that ‘globalisation has been accompanied by changes in the patterns and numbers of people migrating [and this has] implications for support in later life, as families are fragmented and entire communities lose their mid-life members’. This means that the pressures to secure care and support in old age might become intensified in a globalised world, which is why it might become necessary to develop social policies that can handle the transnational interactions mentioned earlier and the various effects that these might have in unsettling filial obligation norms, for example (see the work that migration scholars have done in this respect: Treas and Mazumbar, 2002; Baldassar, 2007; Carling, 2008; Treas, 2008; Zechner, 2008). The impact that globalisation and

43

Ethnicity and old age

transnationalism have on the ways in which care in old age is provided among families whose lives feature the discontinuity mentioned earlier and the being both ‘here and there’ that these societal trends imply is one of the many research angles that these societal trends have brought to the fore. Thus there is an array of research questions regarding care arrangements for those interested in the intersection between ethnicity and old age, including how ‘gifts of communality’ are repaid in transnational relationships; how the ‘moral economy of social belonging’ and the implications that this has for migrants’ relationships to their ethno-cultural backgrounds works for those migrants who are transnational; how the ‘asymmetries of long-distance closeness’ that characterise transmigrants’ relationships affect older people; and how older transmigrants handle the guilt-inducing processes resulting from their constant mobility, to name a few. These are all questions that an agenda informed by globalisation and transnationalism for the study of ageing and old age bring to the fore. But the chapter on social relationships and caregiving in this book will show that this remains a relatively underdeveloped area of research when it comes the intersection of ethnicity and old age.6 In this respect, it must be mentioned that when discussing the impact of migration on intergenerational solidarity, we must also take into account – which gerontologists seldom do – that those who are left behind are also affected by the types of migration flows discussed in these chapters.7 Thus, although the study of migrants is only one of the many angles of study that the intersection on ethnicity and old age draws attention to, these are all questions that the globalisation of international migration and transnationalism are begging scholars of ageing and old age to

6

7

It is acknowledged that there are some European studies in this area besides the ones mentioned above. See, for example, Katz and Lowenstein (1999) and Cylwik (2002), whose samples constituted primarily European international labour migrants; de Valk and Schans (2008) whose sample constituted people who belong to all four groups in the Warnes et. al (2004) typology (European international labour migrants, non-European international labour migrants, family-reunification international retirement migrants and amenity-seeking international retirement migrants); and Zechner’s (2008) sample, which constituted exclusively European international labour migrants. Few studies of amenity-seeking international retirement migrants seem to have focused on intergenerational relationships, however (the study by O’Reilly, 2000, seems to be the exception). For examples on how parents cope when their adult children migrate, see Coles (2001), Miltiades (2002) and King and Vullnetari (2006) whose studies have been conducted in Turkey, India and Albania, respectively.

44

Population ageing and international migration

address, irrespective of whether they depart from gerontology or ethnicity scholarship. It is because of all of this that globalisation theorists have long drawn attention to the fact that the globalisation of international migration and transnationalism makes the formulation of migration policies, and of policies that cater to the diversity that migration brings about and/or that bring attention to the ‘business’ of coping with cultural diversity, much more difficult (Faist, 2000a; Kivisto, 2001). The weakening of the sovereignty of national borders that globalisation entails means that established models for the ‘handling’ of cultural diversity within national borders are also being destabilised as a result of globalisation. In this regard, it seems necessary to draw attention to the fact that scholars in social policy have long debated the specific impact that transnationalism is bound to have, since the kinds of movements that it alludes to question the very idea that policy can be formulated by solely focusing on national borders as one’s point of departure.8 The opposite is also true, of course, since as Faist (2000a, 2000b) has argued, social policy can determine the future of transnational communities. One specific policy angle which has received some attention as far as transnationalism is concerned is immigration law; an angle that has numerous implications for studies at the intersection between ethnicity and old age (see, for example, Acker and Dwyer, 2002; Lunt, 2009). Immigration law dictates the conditions under which family reunification can take place across national borders, and as such can facilitate the hybridisation of ethno-cultural values that can lead to disruption within families as a result of the integration of new ethno-cultural values that migration into a different culture can bring about (Nederveen, 1994). Related to this is Kofman’s (2004) review of European studies of family-related migration. She has argued quite convincingly that ‘when we speak of family migration in the European Union context, we mean the nuclear family as defined by the state; migrants cannot [in fact] determine for themselves the persons that constitute their family’ (Kofman, 2004: 245). It is for this reason among others that older transmigrants and their families tend to be creative in the way they utilise immigration law to their advantage. With respect to this – and on the basis of older transmigrants in the US – Treas (2008) has examined how the transnational caregiving loyalties of older migrants match (or rather do not match) the visa categories that regulate who migrates to the US for family reunification purposes. Through 8

Here it seems appropriate to draw attention to the special issue of transnational social policy published in 2005 by Social Policy and Society, 4(4).

45

Ethnicity and old age

interviews with transnational older migrants, she drew attention to how little bearing US immigration categories actually have on the transnational lifestyles of these older people. In this regard, she writes Virtually all informants fell into one of the three immigration categories – temporary visitors, permanent U.S. residents, or naturalized U.S. citizens. The narratives of older adults, however, revealed several incongruous types. There were ‘permanent’ visitors, permanent residents who were not permanent, and U.S. citizens who naturalized to maintain ties to another country. Given existing immigration law, older adults worked out strategies to reconcile their desire to be close to their U.S.-based children with their affection for their homeland and family members left behind. Their strategies bore little resemblance to the tidy immigration categories and stated requirements of U.S. law. (Treas, 2008: 472) Similar findings have emerged in Europe via the work of Ackers and Dwyer (2002) who – through a study of older migrants across Europe showed the creative ways in which they move across this continent and use immigration law and pension regulations to their advantage as they navigate health and social care systems. Of interest here is the issue of pension portability; an issue of great importance for older migrants in general as well as for older transmigrants in particular (Dwyer, 2000, 2001). Related to this is also Lunt’s (2009) argument that responding to the numerous challenges that the globalisation of international migration, and to the transnational lifestyles that this entails, requires that we move beyond migration statistics that are geographically bounded on the basis of national states (see also Kofman, 2004). Lunt has argued, for example, that Most national pension schemes were not designed with mobility in mind; portability is a major issue for transnational retirees and, with increased population exchange and lengthening lifespans, is likely to become ever more pressing. If the issue is viewed from the perspective of someone choosing to retire overseas, then where they choose to retire can have a major bearing on their pension entitlement. (Lunt, 2009: 247)

46

Population ageing and international migration

It is worth pointing out, however, that Lunt (2009) was not the first to note the above. Ackers and Dwyer’s (2002) ground-breaking study on the implications of retirement migration for senior citizenship and Dwyer’s research (2000, 2001) on retirement migrants’ welfare and health care rights are all studies from the beginning of the 2000s that convincingly show that older people who migrate late in life across Europe face numerous difficulties as they fall through support gaps (Hardill et al., 2005). Ackers and Dwyer’s (2002) work showed, for example, that these older people’s attempts to manage these difficulties can lead to the development of innovative strategies to access the health and social welfare systems in both the countries they have left behind and the countries to which they have moved. Although their work does not explicitly address the implications that transnational lifestyles have for senior citizenship, it does implicitly suggests that social citizenship rights need to be formulated irrespective of where mobility practices may take us. In short, transnationalism has numerous implications for the political economy of care (Phillipson, 2002) and the health and social welfare policy that are formulated to cater to older people’s needs. Here, it seems worth noting what Treas (2008: 477) has suggested with regard to how formal care policies and practices are formulated that ‘just as the ethnic diversity of the immigrant population demand culture sensitivity, diverse legal circumstances also call for special attention’. It is against this backdrop that it is easy to claim that the globalisation of international migration and transnationalism pose a variety of policyrelated challenges that have great relevance to ageing and old age. With respect to transnationalism’s impact specifically, it seems important to acknowledge that Faist (2000a) argued, relatively early on, that we needed to distinguish between processes of transnationalisation in the economic sphere and processes in the political and cultural realms. With regard to the latter, he also argued that transnationalism could end up forcing us to abandon national citizenship in favour of transnational citizenship arrangements (Kastoryano, 2000; Schmidtke, 2001), and could therefore challenge the ways in which we formulate national policies in numerous ways. These are all forewarnings which ought to inform gerontological policy debates but that do not seem to have left any significant mark on how such debates are being carried on at present. Something else worth mentioning concerning the implications of the globalisation of international migration for studies at the intersection between ethnicity and old age is the fact that globalisation draws attention to peripheral or poorer societies (Austin-Broos, 2003). In this respect, and related to population ageing, which is the first societal

47

Ethnicity and old age

trend that this chapter addressed, is Polivka’s (2000) allusion to the fact that older populations in societies that mainstream gerontologists regard as ‘peripheral’ (that is, societies that belonged to the developing world or are regarded as societies that belong to the rest in ‘the West and the Rest’ differentiation mentioned earlier) are growing even faster than their counterparts in developed countries; a circumstance he claimed that social gerontologists had not yet recognised. In this context, it seems necessary to reiterate his argument that ‘the elderly in developing countries will not only outnumber those in developed countries – they are and will be incomparably poorer and less healthy than those in the West’ (Polivka, 2001: 156). There is therefore ample reason to assume that the globalisation of international migration we are addressing here could bring about an increase in the number of people from these societies who migrate late in life. Disregarding the increased inequalities that globalisation brings to the fore is therefore the same as failing to recognise that there are new migrant groups whose ageing and understandings of old age we have yet to address in a systematic enough fashion. The globalisation of international migration means that a greater number of people in the ‘rest’ will make the move to the West, which means that the diversity of older migrants that those of us interested in studies at the intersection of ethnicity and old age want to draw attention to is not only greater but brings new issues to the agenda of ageing and old age studies.

Concluding remarks Having suggested some areas of inquiry at the intersection of ethnicity and old age that could potentially be challenged by globalisation, international migration and transnationalism (as well as the implications that these trends have for the study of culture, ‘periphery’, and inequality, which are all relevant to this intersection), it seems imperative to conclude this chapter by restating some of the points I made in the beginning. First, the increase in the number of older people that population ageing brings about need not necessarily mean that the ‘alarmist discourse’ associated with this demographic shift will play out the way in which some have imagined. Population ageing draws attention, of course, to the intersection of ethnicity and old age. But it is, I would argue, the globalising processes alluded to in the previous sections that pose the real challenge. They challenge the ways in which research agendas concerned with the study of the ageing in minority ethnic populations are set, and question both the problems with which scholars

48

Population ageing and international migration

of ageing and old age are concerned and the ones that they insist on disregarding (as Chapters Four to Six will show). Second, globalisation and the hybridisation of cultures that such a state of affairs presupposes (or the global mélange that this hybridisation poses, as Nederveen, 1994, referred to it) challenges mainstream conceptualisations of what ageing means and how old age is experienced. The question is whether research at the intersection of ethnicity and old age can take these things into account and in doing so expand the social scientific imagination about this intersection. As I have argued elsewhere (Torres, 2006a, 2009, 2013), in globalised and deterritorialised times such as ours, it is minority ethnic and ‘peripheral’ older people who are becoming particularly interesting for the study of ageing and old age. It therefore seems worth reiterating what Gustafson, a migration scholar based in Europe, has argued, namely that studies of older persons may contribute to the understanding of transnationalism and globalization ... Further investigation of retirement migration and other forms of later life mobility may therefore provide new knowledge, not only about aging and wellbeing, but also about globalization and transnationalism. (Gustafson, 2001: 391-2) Similarly, Treas (2008: 469) has argued that ‘because older immigrants feel the pull of past places, later life is a strategic time for the study of transnational processes’. Both of these researchers have proposed that focusing on ageing and old age is a propitious point of departure for studies of international migration and transnationalism. But studying ethnicity-related issues in globalised times such as ours is not as easy as it was in the past. This is why the next chapter will address the ways in which ethnicity has been regarded over the past century, how race has been and is understood at present, and the impact that the societal trends mentioned here have had on how we conceive of both these identification grounds. In globalised times such as ours, we need to expand the ways in which we think about these positions so that we do not fall prey to essentialist notions of what ethnicity and race can mean. Finally, the third point I would like to reiterate is that I believe timing is important when embarking on a theorising exercise. There are in fact specific points in time when this is more appropriate to do and I for one believe that the societal trends described in this chapter – as well as the great implications they have for how social scientists have conceived of and approach the study of culture, ‘periphery’ and inequality – make the timing of the theorising exercise in Chapters

49

Ethnicity and old age

Four to Six particularly appropriate. The intersection of ethnicity and old age has become more important as more and more people are reaching advanced old age and as a sizeable number of them migrate into countries with ethno-cultural values that differ from the ones into which they were originally socialised. This in and by itself make the intersection in question relevant at this time. However, what makes the theorising exercise in Part 2 timely is that our understandings of ethnicity and old age need to be revised so that they reflect the implications of the societal trends discussed in this chapter. Paraphrasing Swedberg’s (2012a) words, I would therefore say that this chapter has been about motivating why it is that the context of discovery should be at the forefront of our inquiries into ethnicity and old age. We have had enough of the context of justification, as Chapters Four to Six will show. But the question now is: can we discover new ways of thinking about ethnicity and old age now that the world has become as globalised as it has?

50

THREE

Ethnicity and race: from essentialism to constructionism As explained in the previous chapter, population ageing, the globalisation of international migration and transnationalism are all bringing about increased diversity among the older segments of our populations. The fact that more and more ethnicity scholars have discovered old age as a life-course stage worth focusing on and the fact that social gerontologists’ understandings of ethnicity seem to have stagnated (Torres, 2015b) have led me to believe that this is an appropriate time to take stock of what we know and need to find out about the intersection of ethnicity and old age. It is against this backdrop that this chapter engages with the constructs of ethnicity and race and presents the different theoretical strands that scholars specialising in this area rely on. As we will see in the chapter that follows a considerable amount of the literature reviewed in Chapters Four to Six tends to mix up ethnicity with race. Hence, this chapter needs to clarify the difference between these two terms. This is why it begins with a section that addresses these differences. Once these terms have been defined, a presentation follows that gives us insight into the theoretical discussions that have led ethnicity scholarship to evolve its understandings of ethnicity and race. In relation to this evolution, it is important to point out that scholars working on the intersection of ethnicity and old age have different disciplinary backgrounds and have been engaged in research at this intersection for different amounts of time. Clearly, this has consequences for the topics that have received the most attention over the 20-year period (and which are the focus of Chapters Four to Six), and also for how useful the different chapters of this book will be for them. The fact that it is not uncommon for ethnicity scholars to state which disciplinary backgrounds have guided their reading of what are deemed to be some of the classics in scholarship of ethnicity and race is part of the reason why I have deemed it necessary to ‘position’ myself as I did in the Introduction and will do in more detail here (Jenkins, 1997; Cornell and Hartmann, 1998; Elias and Feagin, 2016). The other reason why I have chosen to do this has to do with the argument of Booth et al. (1995), that making sure that one’s

51

Ethnicity and old age

audience understands where one is coming from is just as important as ‘knowing one’s audience’, and that both of these angles are key to how one communicates effectively with the scientific communities one wishes to address. In light of the above it seems important to stress that categorisation is central to how understandings of ethnicity (and race) have evolved. The same can be said of reflexivity, which is a skill most scholars of ethnicity hold in high esteem (Emirbayer and Desmond, 2012). Against this backdrop, it is perhaps understandable that scholars working on ethnicity and race often disclose which disciplines they belong to, which parts of the world they come from (and/or are based in), and what their disciplinary and geographical backgrounds may mean to how they interpret ‘the classics’ as far as scholarship on ethnicity is concerned. Attempting to summarise close to a century’s worth of scholarship on ethnicity is therefore not an easy task. Due to the importance of locality to their subject matter, ethnicity scholars tend to be extremely aware that the ways in which they themselves understand ethnicity (and race) have most likely been coloured by the disciplines responsible for their ‘primary socialisation’ and/or the part of the world that they call ‘home’. Thus, inspired by their self-categorising practices I would like to reiterate that I am a sociologist (based in Sweden) who has conducted social gerontological and ethno-gerontological research since the mid-1990s. I regard myself – and tend to be regarded - as a critical gerontologist. It is worth noting also – as stated in the introduction – that I intend to use ethnicity and race scholarship to expand the gerontological imagination. My interest in this scholarship started back in the place I sometimes still regard as home (the US) and more specifically while I was an undergraduate in psychology at New York University. Thus, as a scholar whose first formal scholarly socialisation was in psychology, whose second was in sociology and who defines herself as a critical gerontologist contributing to both social gerontology and ethno-gerontology, it seems necessary to point out that I do not regard myself as an ethnicity scholar. The merits of this chapter do not lie in either the way it presents things chronologically or the allusions made to the disciplines that have launched certain ideas first. Instead, and because this chapter has been primarily written in order to introduce social gerontologists to ethnicity scholarship, it is the lines of reasoning presented here that lie at the core of this modest attempt to try to summarise the vast body of work that has been produced on ethnicity over the past century. Thus, it goes without saying that this chapter will most likely not offer anything new to ethnicity scholars except for its glimpse into how

52

Ethnicity and race

social gerontologists reason. Their reasoning can be deduced from how I have structured this chapter and the examples I use to illustrate the contributions that ethnicity scholars have made (and still could make) if social gerontologists interested in ethnicity and race were to let scholarship on ethnicity inform their inquiries.

Ethnicity and race: seemingly straightforward yet elusive constructs This section focuses on the ways in which understandings of ethnicity and race have evolved and the implications of this evolution for the ways in which ethnicity scholars refer to these constructs. Some scholars refer to them as background variables, some regard them as social positions or locations, and some refer to them as identification grounds (Cornell and Hartmann, 1998). Whichever way one chooses to refer to these constructs, ethnicity and race are constructs that we tend to use to denote the social group to which a person is believed (or claims) to ‘belong’. The basis for this ‘belonging’ can be either the fact that they share (or are presumed to share) phenotypical characteristics with other people (such as skin colour, body structure and/or hair texture); the fact that they share (or are presumed to share) national and regional backgrounds, historical circumstances, language and/or ethno-cultural values with other people; and the fact that (as a result of this) they share (or are presumed to share) behavioural patterns. The sharing of phenotypical characteristics is what is (or at least used to be) most central to the construct of race as it is used in contemporary social sciences, whereas the notion of attachments of different kinds is what lies at the core of the construct of ethnicity. It is worth noting also that the construct of race was once used to denote the genetic distinctiveness of different sub-populations. Understanding the ways in which the term ‘race’ has been used through the centuries is not as easy as one might expect, since it all depends on where one starts. For example, Banton (2016) refers to the 15th century as the period when the word is believed to have entered Western European languages (see also his book from 1998), while Cashmore (2004) explains the shifts in meaning associated with this construct as beginning in the 16th century, since that is when the actual word ‘race’ entered the English language. This is in and of itself an interesting illustration of how geographical background and/or point of reference has determined when the etymology of the term race is believed to have started. Irrespective of when one starts and which language one uses as the starting point, most scholars agree that

53

Ethnicity and old age

it is important to distinguish between race as a classification, race as a signifier and race as a synonym (Cashmore, 2004). The former – race as classification – refers to the use of the expression ‘race’ in the law, census, and in official documents, may appear to give government sanction to a classification which is no longer explanatory value in zoology, and to keep alive a pre-Darwinian belief that it is important to the understanding of differences which are now known to be of social, cultural, and economic character. (Banton, 2004: 334) In contrast to the use of the term race as a classification device, there is the use of it as a signifier. This usage of the term is the one that those interested in discourse analysis are concerned with. Discourse analysts treat race as a signifier; that is, ‘an utterance, sound or image whose meaning are made possible only by the application of rules or codes’ (van den Berghe, 2004: 334). This is why race can ‘mean different things to different parties at different points in history’ (2004: 334). Last but not least, when it comes to the use of the term race we have ‘race as synonym’, which draws attention to the fact that this term has been used as a synonym for subspecies in biology and in physical anthropology, has been used as a synonym for nation or ethnic group and has been used to refer to groups of people ‘who are socially defined in a given society as belonging together because of physical markers’ (van den Berghe, 2004: 336). These three usages of the term race are important to keep in mind especially since most of the scholarship I have reviewed in Part 2 of this book does not take into account this distinction, yet it is clearly relying on the assumption that the term race can be used to classify people and also as a synonym. This is why scholarship at the intersection between ethnicity and old age tends to sometimes use ethnicity and race as if they were terms we could use interchangeably. Irrespective of what Part 2 will show, it is important to clarify that research has shown that genetic differences among humans are ‘inconsistent and typically insignificant’ (Cornell and Hartmann, 1998: 21; see also the entry on genotype in Cashmore, 2004). This is why scholars of ethnicity (and race) tend to refer to the phenotypical characteristics deriving from them as opposed to genetics. Hence, it is not uncommon among ethnicity and race scholars to claim that ‘race as biology is fiction, racism as a social problem is real’ (see, for example, Smedley and Smedley, 2005, who actually used this phrase in the

54

Ethnicity and race

title of their article). It is worth noting in this respect also that social gerontologists – probably because studies of health are so central to our field as Chapter Four will show – are far more cautious about making statements such as this one. For example, one of the chapters in the Handbook of Minority Aging is titled ‘What does knowing about genetics contribute to understanding the health of minority elders?’ (Whitfield et al., 2014). Thus, for these scholars, genetics are important when the intersection between ethnicity and old age is at stake. Wherever one stands on this debate, it is important to note that advancements in human evolution suggest that there are ways in which biological reality and social constructionist ideas about race – which are often thought to be incompatible lines of reasoning and which I will refer to in the last section of this chapter - can be made sense of quite easily once one understands that biological races are far more dynamic than most of us grasp with our lay understandings of biological race (Andreasen, 1998). In other words, there are many controversies about what race means and whether or not it is a useful category or not. But since some of the scholarship reviewed in Part 2 of this book insists on using race as a classification, a signifier and a synonym, I have deemed it necessary to refer to this construct in this chapter. In terms of race and classification, it is important to draw attention to the fact that a couple of paragraphs ago I wrote ‘belong’ in inverted commas. The reason why I did this is that ethnicity – in terms of what it means to people’s identity - is always a situationally determined, subjective matter. The same holds true for race as well, since more and more people have parents of different races and therefore have phenotypical characteristics that are not as clear-cut as when the races did not mix as much with each other as they do now. Identifying with (and being identified as) a ‘member’ of an ethnic or racial group is therefore always something that is subjectively determined, which is why it can vary from one situation to the next. The fact that for us sociologists, Weber’s definition of ethnicity is central to our disciplinary tale of how ethnicity and race can be understood, is related to this, of course, and is the reason why most sociologists think of ethnicity and race as social constructions. This is the case even though his ideas on the subject have been criticised on numerous occasions.1 In 1922, Weber 1

Weber is believed to have ‘stressed putative origins and a shared history’ (Behnken and Wendt, 2013: 4) of ethnicity and race, which is one of the many reasons why some have accused him of writing ‘unreflectively and in a racist and ethnocentric ways about an array of racial matters’ (Elias and Feagin, 2016: 32). However, it is important to stress that Weber focused mostly on the angle of beliefs when

55

Ethnicity and old age

published a book called Economy and Society and launched the idea about ethnicity which became pivotal to how we currently think about this identification ground. He claimed that ethnicity has more to do with perception than with actual facts, and that it is perception that is the most interesting thing about ethnic and racial groups. This was contrary to what anthropologists were claiming, since at that point in time most of them were referring to ethnic groups in a primordialist / essentialist way (more on this approach to ethnicity in the next section). For Weber, however, ethnicity is the belief that members of specific ethnic groups share that they are a distinct group and are therefore, as such, different from other groups. He argued that ‘ethnic membership does not constitute a group; it only facilitates group formation of any kind, particularly in the political sphere ... it is primarily the political community, no matter how artificially organized, that inspires the belief in common ethnicity’ (Weber, 1978: 389; my italics). In a similar manner, he described ethnic groups as ‘groups that entertain a subjective belief in their common descent’ (Weber, 1961: 306). Whether or not we agree that it is in the political sphere that beliefs about common ethnic descent are inspired, sociologists like me are trained to regard the ‘belief quality’ of ethnicity as the most important aspect of it. This is the case because it is beliefs and assumptions about common descent that set the categorisation of people into ethnic groups in motion with all of the consequences that this entails. And, as I will show in Part 2, it is the beliefs of scholars working at the intersection of ethnicity and old age about common descent that, I would argue, lead them to regard ethnicity and race as a useful classification device. But in sociology at least, it is the perception of ethnicity that is pivotal to our understanding of ethnicity as a background, position/location or identification ground whichever way one chooses to refer to this. Hughes (1994) – who first published his ideas on ethnicity in 1948 (that is, more than two decades after Weber had written about this) – wrote, for example, that An ethnic group is not one because of the degree of measurable or observable difference from other groups: it is an ethnic group, on the contrary, because the people in it and the people out of it know that it is one; because both the ins and outs talk, feel and act as if it were a separate describing how he regarded ethnic groups. This is why he is often referred to as one of the first scholars to have widely spread the notion that ethnic groups are more subjective than actual.

56

Ethnicity and race

group. This is possible only if there are ways of telling who belongs to the group and who does not, and if a person learns early, deeply, and usually irrevocably to what group he belongs. (Hughes, 1994: 91) Thus, for sociologists (and later on for anthropologists as well), ethnicity and race are categories that we rely on because we are socialised into thinking of ourselves (and others) in those terms, and because we sometimes insist on interacting with one another on the basis of group membership as if that membership was a given. Wallman (1979) wrote, for example, ‘ethnicity refers generally to the perception of group difference ... and the sense of difference which can occur when members of a particular cultural ... group interact with non-members. (Wallman, 1979: ix) It is because of all of this that ethnicity and race scholars deem categorisation and boundary making to be central to the ways in which these constructs are regarded, the manner in which people use them to differentiate between people, and the ways in which people perceive them to be central to who they are, what they are like, how they behave, and what they prefer. To this end Gelfand (2003) – who is one of the most well-known American ethno-gerontologists and one of the few to have written a book about ethnicity and old age – has written that definitions of ethnicity often have three components: self-identification, other’s identification, and the specific behaviours with which an ethnic group is associated (and/or with which they associates themselves). Ethnicity scholars Cornell and Hartmann (1998) refer to the claims we make about kinship, common history, and the fact that certain symbols, practices and/or norms capture the essence of the ethnic identities people identify with (and/or are assigned to by others) when explaining how ethnicity and race can be made sense of. It is worth noting in this respect is that when we categorise people as either members of a group that we ourselves belong to (or to one which we deem to be different from our group), we are drawing a boundary between the ‘us with whom we identify, and the ‘them’ whom we regard as different (Tajfel et al., 1971). Anthias (1998), a sociologist known for her work on stratification and the consequential disparities that this creates, has argued that categorisation, and the drawing of boundaries that we engage in when we categorise, are the mechanisms we use when constructing ‘otherness and sameness’. All of this is related to the argument I made in the previous chapter, that in globalised times such as ours (and when diversity between, and within, groups is greater than ever before) it is particularly important

57

Ethnicity and old age

to ask how we go about drawing boundaries between ethnic/racial categories; whether or not members of different groups are more similar to one another than we might expect; and whether the actual boundary making that we are engaging in as we categorise people along ethnic/racial lines can augment the perception of difference between groups while blurring similarities between them. In other words, it is a well-known fact that ethnicity and race are two of the most relied on backgrounds/positions/locations/identification grounds when people are differentiated. But the implicit question this book asks is: what do we gain (and lose) by differentiating people on the basis of ethnicity (and race)? Whatever we might think about the necessity of asking ourselves such a question, it is important to keep in mind that when we use ethnicity and/or race to denote social groups, we are in fact implicitly alluding to the idea that there are different cultures (because of the values, attitudes and norms that people ‘belonging’ to these groups tend to hold), and that this has implications for who people are, what they think and/or how they behave. Culture is, after all, the construct we use to refer to the ways in which ‘belonging’ becomes meaningful to people. In other words, there is a difference between the construct of ethnicity, race and culture that most ethnicity scholars tend to be pretty clear about ( Aspinall, 2007). This is why vast amounts of literature have been dedicated to the relationship between the construct of ethnicity and other constructs such as race and culture (Jenkins 1997; Cornell and Hartmann, 1998; Castles, 2000). But even though, technically speaking, ethnicity and race are not really the same thing, it is not uncommon for health researchers to use race as a differentiating category, and for social gerontologists interested in health inequalities to do the same. This is in part due to institutional requirements (such as, for example, the National Institute of Health in the US, which requires that researchers report the racial backgrounds of study participants), and may explain why so many of the publications reviewed in Chapters Four to Six either use ethnicity and race interchangeably or use one identification ground to refer to one of the groups in their sample and another one for another. Another reason why ethnicity and race tend to be used interchangeably, even though these constructs refer to different identification grounds is that in some parts of the world – due to historical events such as colonialism and the slave trade – the importance of skin colour is deemed to be worthy of its own attention. Elias and Feagin (2016) have recently argued, for example, that the importance of race cannot be relegated to the periphery of social scientists’ imaginations as long as institutional and systemic racism exist. In their thought-provoking book

58

Ethnicity and race

on how racial theories within the social sciences have slowly but surely become so irrelevant that an ‘unreflectively white-framed’ (Elias and Feagin, 2016: ix) mainstream social science has evolved, they critically assessed ‘how the field of race and racism studies often get replaced by ‘ethnic’ or ‘diversity’ studies’ (Elias and Feagin, 2016: 3). By taking us through a historical exposé of how the social sciences and race theory have grown in tandem (and by dissecting the lack of racial awareness that characterises the work of August Comte, Herbert Spencer, Karl Marx, Émile Durkheim and Max Weber), they lay out a thesis for how ethnicity has come to replace race (and/or that the two have become conflated) as the master category of differentiation in social scientific analyses. They argue that failing to differentiate between these two constructs will lead us to remain stunted as far as social analyses of human beings and explanations of the social world are concerned. When doing this, they critically dissected the work of social scientists such as Loveman (1999), Emirbayer and Desmond (2012), Wimmer (2013) and Brubaker (2015), who have all addressed the question of what race is (and sometimes how race is related to ethnicity) and who have all, according to Elias and Feagin (2016), contributed to erasing or marginalising the notion of racial groups, something they regard as detrimental to social scientific studies of social interaction. Against this backdrop it is not surprising that they also argue that failing to recognise that race is not the same as either culture or ethnicity will ultimately impede us from recognising and adequately analysing the significance that ‘racial meanings, racial grouping, and systemic racism play in greatly shaping contemporary society and human relations’ (Elias and Feagin, 2016: x). Irrespective of how one regard these race theorists’ arguments (and whether or not we believe them to be mostly relevant to US society, where racial questions have a distinct flavour, or to other societies, see Feagin, 2014), it is their assertion that there would be ‘much more analytic clarity in viewing “ethnic groups” as largely separate social formations and “racial groups” formations as involving more powerful and encompassing social structural realities in many societies and globally’ (Elias and Feagin, 2016: 93). They therefore regard racial groups as socially and historically crude categories of people based mainly on physical features such as skin color. They typically were constructed during histories of highly exploitative relationships between peoples of different geographical regions of the globe. While socially and

59

Ethnicity and old age

historically constructed and human-made, crudely defined racial groups have, as a result, come to represent very real social realities for those who identify or are identified within on racial category or another. This is due to the very material construction and maintenance of a racial hierarchy by dominant white groups in modern societies, wherein different groups are labeled, ordered, and rewarded or penalized according to a racial classification system developed and substantially maintained by whites. (Elias and Feagin, 2016: 94–5; italics in original) In contrast to this definition, they define ethnic groups ‘as socially constructed groups primarily distinguished by cultural or geographical characteristics such as religion or national origin’ (Elias and Feagin, 2016: 95). In their opinion, as well as in the opinion of numerous ethnicity and race scholars and others (myself included), it is important to keep ethnicity and race as distinct categories not only because the logic behind the creation of each of these constructs is different but also because conflating these constructs with one another means not only losing sight of what racism as an ideology and racialisation as a process (see Miles, 1989; Bairot and Bird, 2001) can mean for social relations, but also what ‘Whiteness’ (as the master category) means to our inquiries (see Bonilla-Silva, 2012). The literature reviewed in Part 2 of this book does not, however, seem to agree with me on this. Scholarship on the intersection between ethnicity and old age uses race interchangeably with ethnicity and therefore gives the impression of being oblivious to the consequences that this has for the maintenance of the racism ideology and the racialisation processes and racialising discourses on which this ideology relies. Therefore, on the whole, this scholarship gives the impression that races exist. But it does not give the impression of being reflective enough to grasp that by mixing ethnicity with race, this scholarship engages itself in the kind of racialisation process that allows racism as an ideology to persist, and the use of ‘Whiteness’ as the master category to remain unquestioned. Related to this is also the fact that ‘the substitution of “ethnicity” for “race” as a basis of categorization is accompanied by increasing unwillingness among the dominant group to accept responsibility for the problems of racism’ (Essed, 1991: 28). So conflating these two constructs means losing sight of the social forces behind discriminatory and racist practices. Thus, even though ethnicity shapes the social world of many societies where racialisation plays only a small role,

60

Ethnicity and race

the interchangeable manner in which we tend to refer to these terms means that we are sometimes comparing apples with pears and missing, as a result of this (I would argue), the bigger picture. Chapters Four to Six illustrate how this happens in scholarship at the intersection of ethnicity and old age, which is why I have deemed it necessary to use understandings of ethnicity and race as the starting point for the theorising exercise that this books engages on as it goes about trying to expand our imagination on the intersection of ethnicity and old age which is after all this book’s raison de être. In letting the scoping review on which these chapters are based be guided by both the conceptual and theoretical debates that are presented here, I aim to expose the assumptions about ethnicity (and race) that are taken for granted and that the area of scholarship in question does not seem able to question even though any ethnicity scholar peeking into this scholarship would probably be baffled by the ‘racialisation practices’ that it relies on. Grosfoguel (2004) defines racialisation as ‘the process through which groups (frequently the dominant ones) use cultural and/or biological features/criteria to construct a hierarchy of superiority and inferiority among collective social actors’ (Grosfoguel, 2004: 326–7). For insight into how racialisation discourses accomplish the racialisation of ethnic groups, see Dick and Wirtz (2011). Having provided a little insight into what the constructs of ethnicity, race and culture mean and why it is important to distinguish between them, it is now time to move on to how social scientific understandings of these constructs have evolved.

Essentialist/primordialist perspective on ethnicity and race The first understanding of ethnicity and race that behavioural and social scientists utilised is known as the essentialist and/or primordialist perspective. Earlier versions of it were based on the notion that ethnicity and race determine who we are at the biological level. Thus, it is a commonly known fact that racial biology was very much a part of the kind of reasoning about ethnic groups that was common in the earliest versions of this perspective. According to Cornell and Hartmann (1998), however, the version of this perspective that underscores the understandings of social scientists today is the one that Isaac introduced in the mid-1970s. He built his understandings of ethnicity and race on the work of sociologists like Shils (1957) and anthropologists like Geertz (1973), and claimed that ethnicity and race were about ‘the ready-made set of endowments and identifications’ (Isaac, 1975: 38) that people share with other people solely on the basis of the family they were born into and the specific time and place of their birth. Thus, although the

61

Ethnicity and old age

racial biologist understandings that underpinned the earlier version of essentialism were not as rampant in the mid-1970s, the version of this perspective is regarded by ethnicity scholars as the actual ‘roots’, so to speak, of the notion that people do indeed have ‘roots’ that determine who they are. It is worth noting also that the reason why this perspective is sometimes referred to as primordialism is that both Shils (1957) and Geertz (1973) respectively referred to ‘endowments and identifications’ as ‘primordial attachments’. Cornell and Hartmann write therefore that ‘this notion of primordial attachments gave birth to primordialism, the idea that ethnicity is fixed, fundamental, and rooted in unchangeable circumstances of birth’ (Cornell and Hartmann, 1998: 48). Thus, at the very core of the essentialist/primordialist perspective is the idea that ethnicity and race – which tended to be understood as backgrounds back then – condition us. It is worth noting that the sociological notion of ethnicity mentioned earlier, which argued that ethnic groups exist only because of our beliefs about them, is not rooted in an essentialist/primordialist understanding of ethnicity. This understanding was namely most prominent in anthropology originally (which was the discipline that first started focusing on the study of cultural groups). This is what Jenkins (1997) writes in his seminal book Rethinking Ethnicity: Arguments and Explorations. Jenkins is a social anthropologist who has worked in sociology departments for most of his career and who therefore writes authoritatively about the differences between anthropological and sociological understandings of ethnicity. In his book, he gives us some insight into how understandings of ethnicity have evolved within anthropology, and argues that although his original discipline did eventually replace the notion of ‘the tribe’ with its ‘perhaps less embarrassingly colonial, “ethnic group”’ (Jenkins, 1997: 17), the underlying presumptions about tribes and ‘primitive’ people – which used to be the sole subject matter of anthropology at least when that discipline was first establishing itself - have not necessarily changed. He credits the shift in understandings that eventually occurred in anthropology – from primordialist/essentialist understandings to social constructionist ones - to Barth’s (1969) seminal book Ethnic Groups and Boundaries: The Social Organization of Culture Difference. However, a close reading of Jenkins’ book gives the impression that the essentialist/primordialist legacy is still very much a part of anthropological thinking, even though most anthropologists have either abandoned the perspective as such, or have replaced it with social constructionism or have chosen to combine these two perspectives in their writing.

62

Ethnicity and race

Irrespective of how the notions of perceptions and beliefs found their way into understandings of ethnicity and race, when the principal understandings of these identification grounds were thought to be rooted in essentialism/primordialism, it must be stated that it was mostly the work of Isaac (1975) who showed the way. He thought that ethnic and racial backgrounds are a matter of: phenotypical traits (the way one looks, one’s body size and shape, eye colour, etc.); personal names (both the individual’s and the family’s); the history and origins of the group into which one was born; one’s nationality; one’s first language; the religion into which one was born; the culture into which one was born; the geographic and topographic features of the place where one was born. Worth noting is that genetics was not explicitly mentioned in his version of the perspectives we now refer to as either essentialism or primordialism, even though the idea of phenotypical traits does implicitly refer to genetics. Isaac, as well as others like Geertz and Shils mentioned earlier, considered these things to be important because they are the things that happen to us first (in other words, that happen to us before we are able to choose). In light of this, it is perhaps understandable that ethnic and racial backgrounds were thought to be fixed and unchangeable back then. And that it took many decades for sociologists’ understandings of ethnicity to gain acceptance, since it was anthropologists who originally had the patent, so to speak, on ‘understanding the cultural Other (defined, historically, from a European or North American cultural viewpoint)’ (Jenkins, 1997: 4). The fact that ethnicity (and race) are sometimes used as a classification device (Cashmore, 2004) originates therefore from this understanding. Thus, when Cornell and Hartmann present the essentialist/ primordialist perspective in one of their books (a book that ethnicity and race scholars of my generation regard as seminal) they allude to the fact that part of the reason why this perspective has been so enduring, even though ‘the colloquial understanding may not involve the same breakdown of elements that Isaac offers’ (Cornell and Hartmann, 1998: 49), is that primacy is an alluring way of reasoning about who we are and why we are that way. They argue therefore that even though today’s versions of the essentialist/primordialist understanding of ethnicity and race may not necessarily depart from all of Isaac’s elements, and might not even spell the elements out, they tend to ‘end up in much the same place, viewing ethnic attachments and characteristics as basic, enduring, and somehow natural’ (Cornell and Hartmann, 1998: 49). This is something I will refer to in Part 2 of this book since the scoping review I have conducted – which is the basis for Chapters

63

Ethnicity and old age

Four to Six – clearly shows that the pervasiveness of the essentialist/ primordialist legacy is very tangible in scholarship at the intersection of ethnicity and old age. Thus, irrespective of when the essentialist/primordialist understanding of ethnicity and race had its heyday, it is a well-known fact that it is still a relatively common way of regarding these identification grounds. It is not uncommon to draw conclusions about people (often unconsciously as Cornell and Hartman, 1998 would argue) based on the backgrounds we ascribe to them, thereby making a connection between ethnicity, race and character. When we do so, we assume that people are one thing or the other because they have a certain ethnic and/or racial background. Thus, by presupposing that people’s ethnic and racial backgrounds shape who they are, we are in fact assuming that the primary socialisation that they received (and the cultural values they hold as a result of it) dictate who they are (and sometimes even who they are bound to become) as individuals. It is in light of this that Cornell and Hartmann argue that it is not uncommon for people to think, for example, that ‘assimilation came to grief because ethnic ties are far more deeply embedded in the human psyche and in human relationships than we realized’ (Cornell and Hartmann, 1998: 49). And why in a similar fashion, Jenkins reminds us that ‘although we talk about them [culture and ethnicity] in these terms endlessly, neither culture nor ethnicity is “something” that people “have”, or indeed to which they “belong”’ (Jenkins, 1997: 14). This is why I always refer to belonging parenthetically. Ethnicity scholarship does not in fact regard ethnicity in this essentialist/primordialist way. Scholarship on the intersection of ethnicity and old age does not seem to grasp this however. This literature gives the impression that ethnic and racial ‘belonging’ is a given, which is why it relies so often on ethnicity and race as classification devices. Irrespective of what we think of ethnicity and race ourselves, the main thing that this section is trying to convey is that the essentialist/ primordialist understanding of these identification grounds is still very rampant even though ethnicity scholars have been questioning it for decades (and abandoned it as the principal understanding that it once was). Cornell and Hartmann (1998) argue that the essentialist/ primordialist understanding of ethnicity was deemed obsolete once scholars started to acknowledge that some people claim to be a part of more than one ethnic group (see Behnken and Wendt, 2013, on hybrid identities); that not all people deem ethnicity to be central to who they define themselves as being; that not everybody claiming to belong to an ethnic group agrees on what membership of that group

64

Ethnicity and race

means; and that out-group members need not agree with what ingroup members regard as important to their ethnic ‘belonging’. Last but not least, the fact that the essentialist/primordialist perspective cannot explain the fact that the importance of ethnicity changes over time and across contexts is also one of the reasons why this perspective was slowly but surely replaced with other perspectives (the structuralist/ circumstantialist perspective and the social constructionist perspective). Cornell and Hartmann argue therefore that There is simply too much change and variation in ethnicity and race around the world to support the primordialist account. As a result of these and other problems, primordialist views have been the target of sharp and sustained criticism. (Cornell and Hartmann, 1998: 52) It is for all of these reasons that most ethnicity and race scholars have long abandoned this perspective as the principal understanding for research on how and why ethnicity and race matters, even though they acknowledge that the pull of the essentialist/primordialist understanding lies in the fact that it explains how people come to feel connected to other people on the basis of common ancestry, how they can agree to mobilise and be mobilised on this basis, as well as why this understanding can be powerfully functional for people, since such ideas can prove useful at different times. It is against this backdrop that it is often taken for granted (among ethnicity and race scholars at least) that the essentialist/primordialist understanding has an endurance that cannot be easily resisted, and that acknowledging this is perfectly reasonable as long as we ‘instead of beginning with blood ties than in turn produce an ethnic identity that therefore has power, we begin with an identity that we claim is rooted in ties of blood and we thereby give it power’ (Cornell and Hartmann, 1998: 55). In other words, this distinction is crucial for these scholars, even though they always stress that what is important is not that we ‘belong’ to ethnic and/or racial groups, but rather that we claim to ‘belong’ and use blood ties as an explanation for our ‘belonging’.

Structuralist/circumstantialist perspective on ethnicity and race The structuralist understanding of ethnicity and race is sometimes called circumstantialism, a vivid term that gets to the crux of the matter, which is that circumstances determine the meaning that ethnicity

65

Ethnicity and old age

and race takes on (or as van den Berghe, 2004 would phrase this: how ethnicity and race become signifiers). This understanding of ethnicity is often accredited with having introduced the idea that what is most interesting about this position/location and/or identification ground is not necessarily what it means to who we end up being regarded as (and who we regard ourselves to be), but rather what ethnicity offers and/or renders unavailable to us. Central to this perspective is therefore the assumption that ethnicity and race can be understood in terms of the advantages and disadvantages that ‘ethnic and racial backgrounds’ can entail in different contexts. In other words, it was primarily the structuralist/circumstantialist understanding of ethnicity and race that introduced the idea that these identification grounds should not be thought of as backgrounds but rather as a social positions or locations. In their insightful book on how understandings of ethnicity and race have evolved, Cornell and Hartmann (1998) refer to how these understandings have developed by stating that while primordialists ‘responded to the apparent failure of the assimilationist model by emphasizing the deeply rooted, enduring aspects of ethnic attachments and affiliations’, circumstantialists did not necessarily regard ‘the deep roots of ethnic and racial identities that accounted for their persistence’ as the problem. Instead, they focused on trying to draw attention to the ‘practical uses’ of ethnicity and race, which they believed to be ‘derivative of their circumstances and contexts in which ethnic and racial groups found themselves’ (Cornell and Hartmann, 1998: 56). Of interest here is that these theoreticians often refer to these perspectives as respectively primordialism and circumstantialism, even though they acknowledge that it is not uncommon to refer to them as respectively essentialism and structuralism in other disciplines. This is why I have chosen to use both terms in the subtitles of these sections. Key to the structuralist/circumstantialist understanding of ethnicity and race is the notion that what is most important about identification along ethnic and racial lines is access to certain resources which would be out of reach without them. Cornell and Hartmann write, for example, that common to circumstantialist approaches, regardless of the degree to which they focus on interests or instrumentality, is the idea that ethnic groups are largely the products of concrete social and historical situations that – for a variety of reasons – heighten or reduce the salience and/or utility of ethnic and racial identities ... sometimes circumstances even create new group ties by placing previously unassociated

66

Ethnicity and race

persons or groups in common situations over extended periods ... in the circumstantialist view ethnicity and race are dependent variables. They are less independent forces than products of other forces, less creators of circumstances or situations than products of them. (Cornell and Hartmann, 1998: 60) Although Weber’s previously shared quote about the mobilisation of ethnicity through the political sphere (and Hughes’ reference, made originally in 1948, which I also quoted earlier) may remind some of the main argument in Cornell and Hartmann’s (1998) quote above, I think primarily of the work of Glazer and Moynihan (1963) when I think about what characterises the structuralist/circumstantialist perspective on ethnicity and race. As an undergraduate at New York University (NYU) back in the mid-1980s, their book Beyond the Melting Pot: The Negroes, Puerto Ricans, Jews, Italians, and Irish of New York City was part of a syllabus for one of the courses I took in the social sciences while majoring in psychology. Contrary to what I was being taught in psychology – which resembled the essentialist/primordialist understandings of ethnicity and race that we associated solely with anthropology back then – their book had a profound effect on how I came to understand these social positions. It was their work that taught me that ethnic and racial groups can be basically thought of as interest groups. In other words, these groups are not necessarily about who we are at our very core (as anthropological and psychological thinking was teaching me back then), but can instead be thought of as lobbying groups. I remember vividly how I tried to explain this to one of my fellow students with whom I pulled numerous all-nighters at the NYU library, studying for hours on end and discussing politics during our short breaks. For the two of us, grasping this fact was like an epiphany for numerous personal reasons that would take too long to explain here. It was that epiphany that lies at the very core of my uneasiness with social gerontologists’ apparent obliviousness to the fact that the process of racialisation which they inadvertently engage in when they mix up ethnicity with race and treat the two as unproblematic classification grounds has consequences for the ideology of racism, which some of them seem aware of yet seldom acknowledge as having profound effects on the ethnic and racial groups they study. The notion that people can choose to accentuate and/or undermine the importance of their own (and others’) ethnic and racial backgrounds depending on the context in which they find themselves is thus central to the structuralist/circumstantialist understanding of ethnicity

67

Ethnicity and old age

and race. This is presumably why, when trying to explain what this perspective means to those unacquainted with it, ethnicity scholars tend to change how they refer to ethnicity and speak of a social position (or location) instead of a background (which is the terminology often preferred by essentialists/primordialists). Thus, whereas the essentialist/ primordialist perspective posits that ethnic and racial backgrounds determine who we are (as the independent variable), the structuralist/ circumstantialist perspective cares about ethnicity and race because of what these identification grounds can mean for what we have (or lack) (as the dependent variable). In other words, understanding ethnicity and race in structuralist/circumstantialist ways means making sense of these social positions on the basis of the resources and scopes of action that are available to us or out of our reach, depending on our ethnic and racial position/location (Yancey et al., 1976). Thus, when Cornell and Hartmann summarise what the essence of this understanding is, they write In short, by the circumstantialist account, individuals and groups emphasize their own ethnic and racial identities when such identities are in some way advantageous to them. They emphasize the ethnic or racial identities of others when it is advantageous to set those others apart or to establish a boundary between those viewed as eligible for certain goods and those viewed as ineligible ... Similarly, they ignore ethnic and racial bonds when circumstances change and other interests, poorly served by an ethnic or racial boundary, come to the fore. Ethnic and racial attachments are not superficial ... nor are they necessarily easy to mobilize. It is not always simple to figure out which bases of identity and action best serve individual and collective interests or to act effectively on those bases even when their advantages are clear. Both identity and action, however, are mediated, if not determined, by the circumstances and contexts in which individuals and groups find themselves. (Cornell and Hartmann, 1998: 58) In other words, the structuralist/circumstantialist perspective takes for granted that ethnicity and race can sometimes end up meaning a disadvantageous position and sometimes an advantageous one. It is worth noting, however, that these theoreticians argue that it is not the interests of people per se that are key to this understanding, but rather the circumstances that put people in different positions, which

68

Ethnicity and race

either encourage them or discourage them to regard their interests in particular ways. Thus, one of the many reasons why this perspective is different from the essentialist/primordialist perspective referred to earlier is that ethnic and racial identity are regarded as changeable in different circumstances as opposed to being thought of as fixed due to the attachments that sustain them. However, when describing these identities, these theoreticians also make the point that circumstances can encourage or produce identities ‘without the intervening mediation of interests’ (Cornell and Hartmann, 1998: 59). This, they claim, is crucial to how one can think about this understanding of ethnicity and race, since regarding these identities as solely interest-driven would mean missing that it is the ‘logic of social organization’ and not ‘the logic of interests’ that is the driving force here. To this end, it seems important to acknowledge that the structuralist/ circumstantialist perspective has received its fair share of criticism. Most of it comes from debates among scholars of ethnicity and race who disagree on whether it is the interests or the circumstances that are the most important thing. Cornell and Hartmann, who are the ethnicity scholars I rely on most in this presentation, argue that it is the circumstances. But there are others who argue for the interests and who therefore focus more on the instrumentalist aspect of these approaches. For example, most of Weber’s work (and especially his references to the importance of political organisation, which of course resembles the idea of ethnic and racial groups as lobbying or interest groups) can be said to understand ethnicity and race in an instrumentalist way. The same can probably be said of Elias and Feagin’s (2016) approach to race. Irrespective of the angle being stressed, the main thing about the structuralist/circumstantialist understanding of ethnicity and race is that it shifts attention away from attachments and origins to the everchanging array of circumstances in which people find themselves. It is because of this, among other things, that the circumstantialist/ structuralist perspective regards these social positions /locations as fluid and contingent, while the primordialist/essentialist perspective regards them as fixed and unchangeable. It is worth noting also that Cornell and Hartmann (1998) warn scholars against discarding either one of these perspectives and have argued that both of them are needed if we are to understand how important this background/position/location and/or identification ground is to people’s identity. Thus, irrespective of whether we draw attention to the socio-historical contexts in which the salience of different ethnic and racial groups have become important (and what such contexts mean for what relations between ethnic groups can look like), they stress that both perspectives complement

69

Ethnicity and old age

one another. This is perhaps why these scholars acknowledge that attachments and assumptions about origins are central to how people make sense of their own ethnic and racial identities and how others make sense of them as well.

Social constructionist perspective on ethnicity and race The last perspective to be presented here is the one that informs ethnicity and race scholarship today: the social constructionist perspective. There is little consensus among ethnicity and race scholars on who launched this understanding first (and even who can be said to have introduced some of its main lines of reasoning). Barth’s work is, however, often cited when alluding to one of the key ideas of social constructionism, which is the argument that the ethnicity (and race) others ascribe to us and the ethnicity (and race) we claim for ourselves are important to how social constructionists regard these social positions/locations. Barth (1969, 1989) argues that ethnic groups emerge in the interaction between attribution and ascription (in other words, what others claim we are) and self-assertion (that is, who we claim to be). It is for this reason that he has argued that the relevance of ethnic backgrounds is always contextually dependent. Thus, when ethnicity and race are understood on the basis of the social constructionist perspective, the focus shifts from the when of these social positions (which is what is mostly at stake when the structuralist/circumstantialist approach makes sense of ethnicity and race) to the how (that is, how ethnicity and race are allowed to play a determinative role in our lives and by whom). The line between the when and the how is, of course, not a clear-cut one, since most social constructionists make allusions to the when as well. But some would argue that this is less frequent, since they tend to be more interested in the nitty-gritty of the how. Whether it is the when or the how (or both) that is/are at stake, the difference between the social constructionists’ and essentialists’/ primordialists’ understandings of ethnicity and race is pretty clear: the former are not interested on what ethnicity and race are while the latter are very much concerned with it. From this, it follows that while essentialists/primordialists assume that ethnic and racial groups are clearly defined, social constructionists assume that ethnic and racial boundaries are fluid, since the ‘us’ that we invoke when we describe ‘them’ is always just as fluid as the ‘them’ that we describe when we try to separate ‘us’ from ‘the Other’. This is what Barth (1969) means when he argues that our definitions of who ‘the Other’ is are always contingent on who we are assumed to be (the ‘us’). Thus, scholars of

70

Ethnicity and race

ethnicity and race that let social constructionism inform their inquiries take for granted – just like structuralists/circumstantialists would – that boundaries between ethnic and racial groups are fluid precisely because they are situational. This explains why ethnicity and race scholars often talk about these social positions as identification grounds that can be negotiated to some degree in interaction. Jenkins (1997, 2000) usually calls this ‘the negotiable nature of ethnicity’, which implies that ethnicity (and some would claim race) is negotiated in social contexts through one’s own definition of oneself (a definition one lays claim to when answering the question of who one is) and the external definitions others ascribe to us, when they, in turn, draw conclusions about who we are. The fact that ethnicity and race can be negotiated does not mean, however, that all claims on negotiation are acceptable. This is an important point that is sometimes disregarded. The negotiable nature of ethnicity (and to some extent race) requires that others accept the claims that we make. In other words, there are limits on how much we can renegotiate our ethnicity and race, and these limits are determined by who we negotiate with, the type of context we negotiate in, and where on the historical timeline the negotiation takes place. It is also worth noting at this juncture that although this resembles what structuralists/circumstantialists also claim, there is an important angle to stress here which the structuralist/circumstantialist perspective on ethnicity and race misses. And that is what has been called ‘reciprocal fluxion’. Social constructionists thus stress that reciprocity is at work when claims are made by those who belong to the ‘us’ and those they regard as ‘them’, and that this is crucial to how we can make sense of ethnic and racial boundaries. Cornell and Hartmann make this very clear when they write ‘identities are made in the circumstantialist account, but not by the groups involved. On the contrary, circumstances do the work’ (Cornell and Hartmann, 1998: 73). Thus, while structuralists/ circumstantialists play up the importance of the structures and/or the circumstances in which ethnic and racial identities are exploited, social constructionists play up the how of actors’ efforts to shape, reinforce or transform these identities. The actual ways through which identities can be transformed, shaped and reinforced depend on many factors which I do not consider necessary to address at length for the task at hand. Suffice it to say that Cornell and Hartmann (1998) discussed this at length by referring to what they call ‘the comprehensiveness of ethnic and racial identities’ (which has to do with the degree to which these identities organise social life and collective action, which can vary over time [Sanders,

71

Ethnicity and old age

2002]), and the ‘degree of their assertion or assignment’ (which has to do with how active the ‘us’ and ‘them’ are in creating boundaries). To this end, it seems necessary to note that these theoreticians stress ‘the creative role’ that assertion and assignment play. They argue that construction involves both the passive experience of being ‘made’ by external forces ... and the active process by which the group ‘makes’ itself. The world around us may ‘tell’ us we are racially distinct, or our experiences at the hands of circumstances may ‘tell’ us that we constitute a group, but our identity is also a product of the claims we make. (Cornell and Hartmann, 1998: 80) To some extent, this book is interested in finding out what scholarship at the intersection of and ethnicity and old age communicates not only about the ethnic and racial groups it draws attention to, but also about ethnicity (and race to a lesser extent) as an organising variable to which scholars working at this intersection attend. As such, Part 2 of this book pays attention to whether it is the assignment of ethnicity (and race) that has guided this scholarship, or whether assertion is mostly in focus. In addition, Chapters Four to Six pay close attention to how this scholarship understands ethnicity. When I looked into both of these angles (that is, the understandings of ethnicity that inform this scholarship and whether or not the literature focuses on assigned ethnic and racial identity or the self-assertion of it) in an earlier, much more limited and rather cursory attempt to determine this (see Torres, 2015b), I concluded that there were little traces in the literature that can be seen as social constructionist in their approach to ethnicity. This approach understands ethnicity and race in a very specific way but tends also to focus on the ways ethnic and racial identities are built, rebuilt and sometimes dismantled over time. It places interactions between circumstances and groups at the heart of these processes. It accepts the fundamental validity of circumstantialism while attaining to retain the key insights of primordialism, but it adds to them a large dose of activism: the contribution groups make to creating and shaping their own identities. (Cornell and Hartmann, 1998: 72) Social constructionist understandings of ethnicity and race regard what we do as the most important determinant of what these

72

Ethnicity and race

identification grounds/social positions/locations mean. Thus, they are not as interested in the actual claims people make about who they or others are, since this perspective does not view ethnicity and race as designations or categories that a person can be forced into. The social constructionist approach to ethnicity and race thus presupposes that we have some power to accept, refuse, negotiate and specify when and how this designation will influence us. Yuval-Davis phrases this rather poignantly when she writes that ‘belonging tends to be naturalised and becomes articulated and politicised only when it is threatened in some way’ (Yuval-Davis, 2010: 266). Thus, social constructionists assume that it is not only background and circumstances that determine how we regard and experience ethnicity and race, but also how we relate to the situations we find ourselves in. Phrased in the crudest of terms, one could say that ethnicity and race does not matter unless somebody lets it matter. The question this raises is, of course, does scholarship at the intersection of ethnicity and old age suggest that scholars in this field understand this? And are their inquiries asking relevant questions as to when these identifications matter and for what reasons? The impressions one gets when reading the literature reviewed in Chapters Four to Six as a whole is that scholars working on the intersection of ethnicity and old age in the 20-year period reviewed here do not seem to grasp (as social constructionism suggests) that there are ways by which ‘ethnic and racial identities are built, rebuilt and sometimes dismantled over time’ (Cornell and Hartmann, 1998: 72). The social constructionist perspective thus takes for granted that ethnicity can be experienced as fixed when people choose (and/or are forced) to identify themselves with their ethnic background in order to create meaning. This is why Nagel argues that for ethnic groups, questions of history, membership, and culture are the problematics solved by the construction process. Whether ethnic divisions are built upon visible biological differences among populations or rest upon invisible cultural and ideational distinctions, the boundaries around and the meanings attached to ethnic groups reflect pure social constructions. (Nagel, 1994: 167–8) Phrased differently one could say - as Carter and Fenton do - that if ‘we can recognize ethnicity as a way of making up people, we can examine the social effects of this way of making up people yet not lose sight of the fact that ethnicity is simply a way of making up people’

73

Ethnicity and old age

(Carter and Fenton, 2010: 9-10). From this it follows that in conducting the scoping review to be presented in Chapters Four to Six, I have wondered over and over again if scholars at the intersection of ethnicity and old age recognise that their classifications of people into ethnic and racial groups (which almost never take into account whether or not people themselves self-assert the ethnicity and race that scholars have assigned to them) are just ‘a way of making up people’ (2010: 9-10). The impression I get is that they seem to be oblivious to the fact that using ethnicity and race as classification devices (Cashmore, 2004) does not necessarily mean that these identification grounds matter to the people being studied. According to Cornell and Hartmann (1998), there are two factors that are particularly decisive for how ethnicity and race are given meaning. These are the situations in which various groups find themselves and the resources and traits they take with them into these situations. They describe these situations as construction sites and claim that these sites are interesting if one wishes to understand how ethnic and racial groups are constructed in one way or another (that is, how conceptions of them can be tied to certain traits or behaviours). These scholars have argued therefore that the political sphere (or political debates and discussions), the labour market, people’s neighbourhoods, various social institutions, and the cultural sphere and daily experience are the construction sites where assumptions about ethnicity take shape. These are the spheres (they argue) in which different assumptions about ethnicity are made. What makes these contexts particularly interesting is that people form their identities within these sites and make claims on resources and scopes of action of various types within them. I have elsewhere argued (Torres, 2015a) that gerontological research, policy and practice could be regarded as constructions sites as well, since they make claims about what ethnicity and race means (albeit implicitly as we will see in Chapters Four to Six) and therefore construct what ethnic and racial groups can be believed to be like in old age. This is why Part 2 of this book draws attention to how scholarship at the intersection of ethnicity and old age constructs ethnicity and race.

Concluding remarks This chapter has been written in order to introduce social gerontologists to some of the basic debates in scholarship on ethnicity and race. As such, this introduction has referred to some the main findings to be presented in the scoping review in Chapters Four to Six in order to give these scholars an idea of why ethnicity and race scholars’ debates

74

Ethnicity and race

are relevant to their inquiries. In doing so, ethnicity and race scholars were given a few glimpses into how scholarship on the intersection between ethnicity and old age regards certain crucial elements of their debates, such as how this scholarship most often approaches ethnicity and which angle on ethnicity (assigned identity as opposed to asserted identity) is most often used in this scholarship. The chapter started by describing the importance that ethnicity and race scholars often place on their own disciplinary (and geographical) backgrounds and the fact that they regard them as relevant to how their own understandings of ethnicity and race have evolved. In this chapter, I have also implicitly argued that disciplinary backgrounds and scholarly identities have relevance for the problems identified through the theorising exercise I have performed and refer to in Part 2. Part of the reason why I have come to strongly believe that this is the case has to do with the fact that social gerontology – contrary to my ‘mother’ discipline of sociology – is often preoccupied not only with the advancement of gerontological research but also with contributing to gerontological policy and practice as well (the holy RPP as I refer to this triad when I teach social gerontology to undergraduates). In order to illustrate why this is important, it seems necessary to make a few things clear about the key theoreticians on which I have relied most heavily in this chapter. In doing so, I hope to be able to offer the reader an idea of why it is that I deem the disciplines of those engaged in scholarship at the intersection of ethnicity and old age to be relevant to how this scholarship has evolved (or failed to evolve) as far as its understandings of ethnicity are concerned. But in order to make this point – which I will discuss further in Chapter Seven of this book – it seems necessary to mention that to the best of my knowledge, Cornell and Hartmann (1998) are social scientists (sociologists most likely). The fact that they acknowledge circumstantialism as a unique understanding is therefore understandable. Social scientists whose scholarship is informed by sociology deem structure and circumstances to be crucial to understanding the resources that people have access to (and/or lack). Jenkins, on the other hand, is a social anthropologist who, by his own admission, has ‘spent most of [his] teaching career identified – by job title and by most significant others – as a sociologist’ (Jenkins, 1997: 3). This, I would argue makes a difference to his presentation of how understandings of ethnicity have evolved. His 1997 book addresses his fellow anthropologists specifically. Thus, even though some of his other publications (such as Jenkins, 1986, 1993, 2000) clearly show – potentially because they are concerned with the labour market and

75

Ethnicity and old age

social class – that he is well-versed in structuralism/circumstantialism], this one book is a treatise on ‘the basic social anthropological model’ written from the perspective of a specific scholarly identity, which is perhaps why it does not engage with the structuralist/circumstantialist perspective. At the very beginning of his 1997 book, he claims that he has never thought of himself as anything else but ‘an anthropologistdoing-sociology’ (Jenkins, 1997: 3). Thus, as a trained anthropologist who, in the very first chapter of his book, purposefully states: ‘my identity as an anthropologist is, I know, altogether dubious in the eyes of some of them’ (Jenkins, 1997: 3),2 he seems to be writing for other anthropologists and therefore makes the assumption that the most interesting understandings of ethnicity for ‘his audience in that specific book’ are primordialism and social constructionism. As a mere example of what I mentioned in the beginning of this chapter about ethnicity and race scholars’ tendency to start their books with ‘disclaimers’ such as the ones I have just cited, these positioning attempts are relevant in more ways than one might care to admit. By referring to them, however, I do not wish to stress that point further but rather to illustrate that although ethnicity and race scholars who summarise last century’s multidisciplinary scholarship on these identification grounds /social positions or social locations seldom agree on the actual bigger brush strokes used in their summaries, they do not disagree too much when they explain what these brush strokes have meant to the evolution of their understandings of why ethnicity and race matter. Another example that could be mentioned to illustrate this point is that while Jenkins (1997) (and I) as sociologists working in Europe regard Weber’s notions of ethnicity as central to our understanding of ethnicity, Cornell and Hartmann (1998) as social scientists based in the US just mention him once in their book. Elias and Feagin, who are sociologists based in the US specialising in race, mention Weber numerous times by referring to him as a central figure ‘in the racialized analysis in social science’, who operated ‘out of a limited white racial framing of society’ (Elias and Feagin, 2016: 28) and who is known ‘for his negative personal framing of blacks, seen in his letters’ (2016: 29). These race scholars argue that this had great relevance for the fact that despite ‘his brilliance as class analyst’ (2016: 28) his work is characterised by ‘blindness to the importance of black working-class 2

See Booth et al. (1995) about what scholarly positioning means to the research questions we pose, the ways in which we go about answering them and the manner in which we report our findings.

76

Ethnicity and race

revolutions taking place before him’ (2016: 29). Worth mentioning is also that their book’s treatise is that debates on ethnicity have ‘stolen’ the attention that race deserves and since they seem to regard Weber as one of the central figures of European sociology whose work has contributed to this being the case, they refer to his work a lot more than Cornell and Hartmann (1998) do. By referring to all of these things in this chapter’s concluding remarks, I am trying to raise the awareness of those who I believe to be my main audience (social gerontologists interested in ethnicity and race, some of whom have received their formal training in the field of gerontology as opposed to disciplines like sociology or anthropology) that categorisation is relevant to how we understand the scholarship on which we build our understandings - not to mention the very classifications on which we rely. After all, it is not a coincidence that the scholarship at the intersection of ethnicity and old age that originates from the US relies most heavily on race as a classification device (Banton, 2004) rather than ethnicity (and/or mixes up ethnicity and race). The point that I am trying to make is when we categorise ourselves (and others) as scholars ‘belonging’ to a specific discipline (or having a background in a specific part of the world) we are, in fact, engaging in the very phenomenon that is pivotal to our understanding of why and when ethnicity and race matters. Categorisation, in other words, is far more important to group identification than we may care to admit. And it is why Jenkins (1997), in his presentation of the scholarly self he shares with his fellow anthropologists, does not mention structuralism/ circumstantialism – and why social gerontologists based in the US tend to rely on race rather than on ethnicity (as Chapters Four to Six will note). Whatever the reasons why Jenkins chose to address anthropologists in one of his publications but sociologists in others, he made a choice that is consequential for future generations of ethnicity and race scholars who first enter the field through his book. The same holds true for Cornell and Hartman (1998), who rely heavily on this strand of thought in their book. Thus, I believe (just like the ethnicity scholars I am referring to here seem to do) that my background – both in terms of where I come from, where I have been based for almost 30 years (Sweden), and the fact that I am a critical ethno-gerontologist who is trying to raise my field’s awareness of what ethnicity is – is all relevant to how I am presenting this summary of close to one hundred years of scholarship on ethnicity and race to this book’s audience. The choices I have made, as well as the specific tone I have adopted to address my audience in

77

Ethnicity and old age

this chapter, is not happenstance: it is a choice made in order to lay the groundwork for the arguments I put forward in my concluding chapter. This choice, as well as the decision to engage in a theorising exercise at this point in time and to rely on a scoping review that uses the evolution of understandings of ethnicity (and race) referred to here to accomplish just that, are all choices I have made because I deem scholarship at the intersection of ethnicity and old age and my primary audience (social gerontologists) to be in dire need of developing their understandings of ethnicity and race. Having explained why it makes sense to position oneself when describing the state of affairs of a field (as ethnicity and race scholars often do and as I have done in the introduction as well as in this chapter), I would like to conclude this chapter by stating the following about ethnicity – which is the identification ground that this book is mostly concerned with. I understand ethnicity as Cashmore does, as a term that ‘encapsulates the various responses of different groups’ due to assumptions made about ‘commonness of subjective apprehensions, whether about origins, interests or future (or a combination of these)’ (Cashmore, 2004: 145). It is also worth noting that I do not believe that there are races in the biological sense of the term despite the fact that ‘many ethnic groups that organise themselves ethnically are often regarded as a “race”’ (Cashmore, 2004: 145). Moreover, just like Cashmore (2004) and Cornell and Hartmann (1998), I believe not only that ‘material deprivation is the most fertile condition for the growth of ethnicity’ but also that ‘ethnicity (and race) may be used for a number of purposes, sometimes as an overt political instrument, at other times as a simple defensive strategy in the face of adversity’ (Cashmore, 2004: 145). Thus, in this book, I approach ethnicity and race in line with the social constructionist tradition and acknowledge that although essentialist/primordialist understandings are still rampant, it is mostly through the structures and circumstances that shape the interactions of ethnic and racial groups that ethnicity and race are given meaning. I do this because I believe that ethnicity appears as a cultural phenomenon, but it is a response to material conditions. This is why I regard scholarship at the intersection of ethnicity and old age as one of the many construction sites on which the identification grounds/social positions and social locations that are ethnicity and race are given meaning, and it is precisely that meaning that Part 2 of this book is interested in shedding light on.

78

PART 2

Theorising via a scoping review: what we know and need to find out

FOUR

Literature on health inequalities The chapters in Part 2 are structured such that, initially, they offer an insight as to what the scholarship in focus assumes about their respective topics; after that the results of my theorising exercise are presented to shed light on what the context of the ‘discovery’ divulges (Abbott, 2012; Swedberg, 2012a, 2012b). Worth noting is that this approach is for the benefit of both ethnicity scholars wanting to become acquainted with the nexus in question and for social gerontologists who work on this nexus or want to embark on studies about it. The sections with italicised sub-headings offer detailed information about specific themes for scholars already specialising in one of these areas of research. As mentioned in the Introduction, the theorising exercise that this book engages in utilises a scoping review of scholarship on the intersection of ethnicity and old age in order to gain insight into the understandings of ethnicity that inform this scholarship. This chapter aims specifically to describe what characterises the portion of this scholarship that focuses on health inequalities (n=117) and has been published during the 20-year period in focus here (see Appendix for details on how the scoping review was conducted). In order to grasp the state of affairs of research before the period in question begins I will give the reader insight into what handbooks, encyclopaedias and edited collections on the intersection of ethnicity and old age describe as givens as far as health inequalities, ethnicity and old age are concerned. It is worth noting that all of these publications are based on US findings, since interest in the intersection of ethnicity and old age as it pertains to health inequalities in other parts of the world seems to have emerged much later (as the coding of the articles conducted while working on the scoping review shows). One of the things that was often pointed out in the early 1990s in US publications1 is that older people with minority ethnic/racial backgrounds tend to have poorer health than their majority ethnic counterparts (Gelfand, 2003). This is probably one of the reasons why the topic of health inequalities is the one that has received the most attention during the period covered by the scoping review to be presented in the sections that follow. For example, in the Handbook of 1

See Introduction, Note 2, for textbooks that are currently available.

81

Ethnicity and old age

Aging and the Social Sciences there is a chapter titled ‘Race, ethnicity, and aging’ (Williams and Wilson, 2001) that draws attention to the health and health care needs of older people in minority ethnic groups. Using these starting points, this chapter addresses the socioeconomic circumstances in which older people in minority ethnic groups in the US find themselves, and the impact of these circumstances on their health and social care needs. By citing data from the US censuses collected at different points throughout the 1990s, Williams and Wilson (2001) stress that older people in minority ethnic groups constitute a large proportion of those who are considered to be economically vulnerable (that is, those with annual incomes that are either below or just above the poverty threshold). The chapter also points out that older people from minority populations that are often referred to as AfricanAmerican/Black and Hispanic tend to have lower levels of education than their White counterparts. Against this backdrop – and taking into account the key notions at the very core of the gerontological literature on health inequalities - they argue what most researchers of health and social care take for granted, that is, that ‘race differences in SES [socioeconomic status] among the elderly are important because of the profound effects on SES in health’ (Williams and Wilson, 2001: 165), even if there are differences between ethno-cultural groups in survival rates, mortality rates and death rates. Worth noting here is, of course, the use of the term race refers to the differences noted. This is the first of many indications that race is often used as a classification device just as Cashmore (2004) and Banton (2004) have argued and I have alluded to in the previous chapter. It is worth noting also that Williams and Wilson end their contribution to the Handbook of Aging and the Social Sciences by stating that multiple explanations have been offered for these racial disparities in medical care. It has been argued that they could reflect the geographic mal-distribution of health resources, racial differences in patient preferences, physiology, economic status, insurance coverage, place of treatment and trust, knowledge and prior experience with medical procedures. However, all of the available evidence suggests that systematic discrimination, some of which may be unconscious, remains the central, plausible explanation for this striking pattern of racial disparities. (Williams and Wilson, 2001: 171)

82

Literature on health inequalities

It is against this backdrop that the patterns observed through the scoping review of the literature to be presented in the next section can be made sense of. The disparities in health that US research at the intersection of ethnicity and old age have documented are namely one of the central backdrops against which studies on ethnicity/race-based health inequalities in old age tend to be designed. In recent years, however, a new handbook specialising in the intersection of interest to this book has been published, that of Whitfield and Baker’s (2014) Handbook of Minority Aging. In the chapters that focus on health inequalities in this publication (for example, Markides and Gerst-Emerson, 2014; Mehta et al., 2014), we are offered a more nuanced way of thinking about inequalities at the intersection of ethnicity and old age. According to Markides and Gerst-Emerson (2014), for example, in the late 1970s and all through the 1980s, the focus of social gerontologists working at this intersection and focusing on health was solely on minority ethnic status and old age. This is why the ‘double jeopardy hypothesis’ – which stipulated that being from a minority ethnic community and being old was often a disadvantage (Dowd and Bengtson, 1978; Bengtson, 1979) – was popular back then. At that point in time, it was often taken for granted that the health disparities that had been observed in middle age would become greater as people grew older. As the study of health inequalities in old age evolved, and crosssectional analyses started to be used, the empirical evidence did not add up to what was expected, since ‘racial differentials in health in middle age declined in old age most likely because of the greater selective survival among African Americans’ (Markides and Gerst-Emerson, 2014: 105). Findings such as this one led health inequalities scholars working on ethnicity and old age to propose the ‘ageing-as-leveller’ hypothesis, which suggested that racial inequalities in health could decline in old age (Mutchler and Burr, 2011). In recent years, the ‘cumulative advantage-disadvantage’ perspective (see, for example, Dannefer, 2003) has been launched as well. This perspective, which could be thought of as a more nuanced version of the ‘double jeopardy hypothesis’, suggests that socioeconomic status (rather than just minority ethnic status) needs to be taken into account if we are to grasp how ethnicity/race-based health inequalities operate in old age. As a body of literature (that is, approached as a whole), the research that will be presented in the sections that follow is informed by these three perspectives even though the articles reviewed do not always make this explicit.

83

Ethnicity and old age

Main trends observed Having given the reader an idea of the assumptions taken for granted that guide research on ethnicity and old age, which focuses specifically on health inequalities, it is now time to describe the trends observed while reading and coding the peer-reviewed articles that this chapter is based on. To this end, it seems important to clarify that this chapter does not offer detailed insight into the articles reviewed. This book does not aim to critically appraise the literature on health inequalities as such, but rather to appraise what this literature tells us about the way in which ethnicity is approached in scholarship at the intersection of ethnicity and old age. Thus, this chapter, and the other two chapters that will follow, will give insight into what seems to have occupied the ‘imagination’ of the literature on health inequalities that constitutes a big part of what the scholarship on the intersection between ethnicity and old age during the 20-year period in focus here is about. This will be done in order to ‘discover’ (Swedberg, 2012a) where we are at and where we should be heading if we are to advance our knowledge about this intersection in imaginative and ethnicity-astute ways. This is why this chapter will first present what characterises the literature as a whole as far as ethnicity-related angles are concerned, before giving a bit more insight into the topics that have received the most attention.2 The first point that must be noted is that the vast majority of the literature reviewed here is based on those US studies focusing on the minority ethnic groups that have received the most attention in that part of the world (that is, African-American/Black and Hispanic people, both separately and in comparison with their White counterparts). Asian-American people have received some attention in this literature as well but not nearly as much. This finding makes clear in itself that only a handful of the minority ethnic groups that exist in the US (not to mention the rest of the world) have received attention in the peerreviewed literature analysed here. The exceptions can be found in the following studies (see italics for the name of the countries from which they originate): the study of Quine (1999) and Stanaway et al. (2011) who study older minority ethnic groups in Australia: the first one focuses on the health concerns of older Anglo and ethnic Australian people and brings attention to people of Italian, Chinese, Arab and Greek heritage, while the second 2

Of interest is perhaps the number of journal articles on each topic: general health (n=23); physical functioning, disability and mobility (n=26); disease specific (n=19); mental health (n=26); cognitive functioning (n=23).

84

Literature on health inequalities

one focuses only on falls among older Italian-born men; the study by Tung and Mutran (2005), which focuses on health disparities in Taiwan and compares Mainlanders to Taiwanese older people; the studies from Canada by Koehn et al. (2013) and Khan et al. (2017), which are both scoping reviews, as well as the study by Koehn et al. (2012) which uses focus groups: the first one focuses on the North American literature on health and brings specific attention to older minority ethnic populations in Canada and particularly to the literature that focuses on Black, Chinese, Filipino, Japanese, Korean, Latin American, South Asian, Southeast Asian and West Asian older people; the second one focuses only on Canadian research on the health of people belonging to a visible minority ethnic group; the third focuses on Chinese-Canadian people’s pathways to a diagnosis of dementia; the study by Chan et al. (2016) which focuses on active life expectancy among older Singaporeans with or without a Chinese background; the study by Forrest et al. (2012) which brings attention to changes in grip strength among older Afro-Caribbean men in the Caribbean island of Tobago; the study by Osman and Walsemann (2017) which brings attention to the onset and progression of functional limitations among older people in Israel with Jewish and Arabs backgrounds, as well as Jewish immigrants from the former Soviet Union; the studies from the UK by Silveira and Ebrahim (1998a, 1998b), which bring attention to psychiatric morbidity among Somali and Bengali immigrants and their White British counterparts, and mental health among Somali, Bengali, White British and Gurajati groups; the study by Lawrence et al. (2011), which brings attention to how dementia is experienced by Black Caribbean, South Asian and White British older people; the study of physical and psychological well-being among Mãori and non-Mãori in New Zealand which Dulin et al. (2011) have conducted; the study by Khaltar et al. (2017), which draws attention to depression among older people in Sri Lanka and focuses on those who are Sinhalese, Tamil and Muslim; the study of the role of mastery in the relationship between perceived ethnic discrimination and depression conducted by Slotman et al. (2017), drawing attention to Surinamese, Turkish, Moroccans and Ghanaian immigrants in the Netherlands; the study by Momtaz et al. (2013) focusing on depression among Malay and Chinese older people in Malaysia. The fact that so few studies originate from Europe as well as from other parts of the world is puzzling. There are sizeable populations of older people of minority ethnicity in other countries. Why their health situation has received so little attention during the 20-year old period in focus here is a clear sign, I would argue at least, of how little

85

Ethnicity and old age

interest the research topic of health inequalities at the intersection of ethnicity and old age has had in other parts of the world. It is worth noting also that the literature on health inequalities reviewed here is not only based on a handful of minority ethnic groups in a handful of countries, it seems also ill-informed as far as the impact that different socio-cultural settings can have on these inequalities. This of course raises the question of whether or not the patterns that this literature takes for granted (as referred to in the previous section) are, in fact, relevant to the vast number of people around the world who are deemed to be of minority ethnicity. The patterns that the literature refers to and takes for granted might just as well be solely based on what the sampling bias of this literature allows us to tap into, rather than on what is important to understanding ethnic/racial disparities in old age as far as health is concerned. The second point to mention, considering that this part of the book aims to critically assess the state of affairs of the health inequalities literature, is that very few articles actually define how they approach ethnicity (and race) and most of the articles mix up these identification grounds. With regard to the latter, and in order to provide insight into how some of the few articles that do define ethnicity regard this identification ground, let me now draw attention to one of the most cited articles in this body of work. This article, which is an overview piece that specifically addresses the health of racial and ethnic populations in the US, gives us insight into some of the background information necessary to understand how (and why) health inequalities have come to be the way they are in that socio-cultural context. In this piece, which addresses a string of conceptual and methodological issues of ‘racial statistics’ in the US, Williams specifies how and why ethnicity and race tend to be mixed up so often in articles that focus on health: ‘Race’ (is viewed) as capturing ethnicity: common geographic origins, ancestry, family patterns, language, cultural norms and traditions. Historically, racial categories have also reflected oppression, exploitation, and inequality. Accordingly, race has been an important marker of differential access to societal resources and rewards, and health status is no exemption. Given the arbitrary nature of racial categorization and the preference of the majority of Hispanics to have this category treated as a racial category (Tucker et al., 1996), in the interest of economy of presentation the term ‘race’ is used to refer to all of the official Office of Management and Budget (OMB) racial

86

Literature on health inequalities

and ethnic categories. Moreover, in the recognition of individual dignity, I use the most preferred terms for each group (such as Blacks and African American or Hispanic and Latino) interchangeably. (Williams, 2005: 53) This quote gives us some insight into how American scholars engaged in research on ethnicity and old age that draws attention to health inequalities regard the identification grounds of ethnicity and race, and why they tend to mix up these categories. As such, this reminds us of Cashmore’s (2004) allusion of the need to differentiate between race as a classification, race as a signifier, and race as a synonym (see Chapter Three), something that the literature reviewed in this chapter seldom does (see also Bradby, 2003, and Baer et al., 2013, who discuss the patterns and implications of how ethnicity and race are used in health research and problematise the lack of sophistication associated with these patterns). Most of it is concerned with race as either a classification or a synonym. In other words, the nuanced debates presented in the previous chapter about how ethnicity and race can be approached, and why it is important to use these identification grounds in nuanced enough ways, do not seem to have left their mark in the literature on health inequalities reviewed here. It is worth noting also – and this is the third point that I would like to make about what characterises this literature - that most of the articles approach ethnicity and race from either the essentialist/primordialist and/or the structuralist/circumstantialist perspectives as described in Chapter Three. Most of these articles assume that ethnicity, race and old age ‘determine’ our health either because of biology (even though this is seldom explicitly stated) or because of the socioeconomic aspects that are often associated with these identification grounds. In addition, the vast majority of the articles reviewed seem oblivious to the fact that ethnicity and race can be studied from different angles (that is, on the basis of others’ identification, group members’ identification, and the attitudinal/behavioural patterns with which different ethnic and racial groups are associated). Most of the articles reviewed are only concerned with ethnicity and race based on other’s identification (since they rely on respondents picking from the ethnicity and race alternatives that most surveys use in the countries in which they originate). In other words, none of the studies review here double-check whether this identification is in tune with respondents’ own identities and/or is an identification that they themselves deem to be meaningful. This means that these articles seem oblivious to the notion that these different angles need not always coincide with one. Thus, the possibility that

87

Ethnicity and old age

individuals described as ‘belonging’ to a specific ethnic and/or racial group may not necessarily self-identify with the identification ground that they have chosen is something most articles do not seem to take into account. In this respect it seems necessary to note, for example, that in a critical overview of health disparities in the US which spells out some of the various limitations linked to the quality of the data that is available, Williams writes that ‘an overwhelming 97% of people who mentioned that they belonged to a racial category other than the standard OMB ones offered in the census indicated that they were Hispanic. That is, many Hispanics report their national identity when requested to indicate their race’ (Williams, 2005: 56). It is worth noting also that, although some of these articles end up briefly referring to the fact that the attitudinal/behavioural patterns with which different ethnic/racial groups are associated could potentially explain their results, most of these studies have not in fact relied on a design that explicitly addresses these patterns. This is why most studies on health inequalities reviewed here speculate about which ethno-cultural values, practices and/or preferences can explain the results they present once they move on to discuss their findings. My fourth point is that the vast majority of studies reviewed here are studies that rely on survey methodology and are based on surveys that are not specifically designed to explore the nexus in focus here (that of ethnicity, race, old age and health). For example, even though the question of discrimination (and life-course marginalisation) is often alluded to in the literature in one way or another as a potential explanation for the inequalities that have been documented for decades in the US, few studies have, in fact, explored this angle. The exceptions can be found in the work of Kim and Choi (2010) on mental health disorders, since they take into account perceived discrimination; in Ayalon and Gum’s (2011) study, who specifically explore whether major lifetime discrimination and everyday discrimination affects mental health; in Sabik’s (2013) work, who looks specifically at how ageism affects older women’s body esteem; and in Browne et al. (2014) who by giving voice to native Hawaiian elders tap into the issue of discrimination. In addition, the work of Kim et al. (2017), who analyse how perceived discrimination affect health-related quality of life; the study by Slotman et al. (2017), who study the role of mastery in the relationship between perceived discrimination and depression; the study by Kim and Fredriksen-Goldsen (2017), who focus on mental health quality of life and tap into the role of perceived discrimination and social

88

Literature on health inequalities

connectness among LGB (lesbian, gay, bisexual) older people; and the work of Zahodne et al. (2017), who also use perceived discrimination as a variable in the study of racial disparities in cognition are all exceptions. The interesting thing here is, however, not only that few studies address health inequalities from the perspective of perceived discrimination but also that the few that do that are studies that have been conducted fairly recently. In other words, the vast majority of studies reviewed during the 20-year period used in this scoping review do not explicitly study this angle and tend only to allude to it in passing. Something else worth mentioning when describing the literature on health inequalities – and this is the fifth point I want to make in terms of what characterises this literature - is that most articles are based on large-scale (and often longitudinal) quantitative studies that utilise survey methodology to ask a battery of questions that are not necessarily informed by ethnicity scholarship. The exceptions are the few articles that utilise qualitative methods to explore a limited number of potential angles of investigation that one could employ when tackling health inequalities. These are: Quine’s (1999) Australia study on how the health concerns and expectations of older Australians of minority ethnic status compare with their Anglo counterparts; Browne et al.’s (2014) study of native Hawaiian elders’ understandings of ageing, health and care preferences; Pan et al. (2014) on the ways in which White, African-American and Chinese-American people regard Parkinson’s disease; Lawrence et al. (2011) on the lived experience of dementia among Black Caribbean, South Asian and White British people in the UK; the study from Canada by Koehn et al. (2012) on pathways to a dementia diagnosis among Chinese-Canadians; and Laditka et al. (2013) who explore how a cognitive impairment is understood in a multi-ethnic sample in the US. In relation to the type of studies that tend to inform our understandings of health inequalities, it seems necessary to note also that Kelley-Moore warns us that this scholarship’s reliance on social surveys needs to be scrutinized more critically. She claims that part of the reason why this literature reports variously inconsistent results may be that there are ‘group differences in response behaviour across interview modes’ (Kelley-Moore, 2006: S212). She argues, for example, that since ‘some research has shown that where a discrepancy exists in responses between face-to-face and telephone interviews, the difference is greater in potentially vulnerable populations such as older adults and racial minorities’ (Kelley-Moore, 2006: S212). This is an angle of investigation that deserves attention. Whatever the specific interview mode may have contributed to the inconsistencies

89

Ethnicity and old age

observed, it is important to note that because most of the literature reviewed relies on questionnaires, we are, in fact, dealing with data that regard ethnic and racial categories as ‘a crude proxy for location in varying social contexts’ (Williams, 2005: 56). In relation to this (and because most studies have not been designed to study ethnicity’s relationship to health specifically but instead use data collected for other purposes), Jackson (2005: 66) argues that health scholars working at the intersection of ethnicity and old age need to use ‘applicable and challenging theoretical paradigms that embrace, rather than avoid, the complexity of the intersection of race, class, and gender’. This particular trend (that is, the use of ethnicity and race as crude proxies) is the sixth point I would like to make when summarising what characterises the literature on health inequality that brings attention to the intersection of ethnicity and old age. Related to the above is the fact that the few articles that are either based on reviews of the existing literature and/or appraise the state of affairs of this literature tend to be critical not only of the constant reliance on survey methodology, but also of the fact that most of the literature is not theoretically astute enough to address ethnic and racial disparities. In this regard, it seems necessary to note that Koehn and colleagues, who conducted a scoping review on how ethnicity and health is studied in scholarship at the intersection in focus here, state that although there is recognition that intersectional analyses are needed, ‘this seems to be honoured more in principle than in how research is undertaken, or at least how the results are written up’ (Koehn et al., 2013: 457). My impression after having read and coded all of the 117 articles published between 1998 and 2017 is that this is a correct statement of the state of affairs of this scholarship. For the sake of those interested in setting an agenda for future inquiries on health inequalities and the nexus in focus here, I will now proceed with more detailed information about the specific themes that have received attention in this literature. General health Most of the literature on general health explores the relationship between health, gender, ethnicity/race and an aspect of socioeconomic status (for example, Jackson 2005; Williams, 2005; Martin et al., 2007). This relationship is also explored in relation to specific angles, such as the impact that health has on engagement in social activities (Rodriguez-Galán and Falcón, 2010); the impact that caring for grandchildren has on health (Chen et al., 2015); the association between

90

Literature on health inequalities

social isolation and health (Miyawaki, 2015); life expectancy (Chan et al., 2016); and health-related quality of life, which is what Kim and Fredriksen-Goldsen (2017), and Kim et al. (2017) do while focusing on LGBT (lesbian, gay, bisexual, transgender) minorities. Whatever the origin of the studies belonging to this specific topic (and most come from the US, even though there are some exceptions3), most end up showing what the abridged review referred to in the introduction to this chapter describes. In other words, minority ethnic and racial status and lower socioeconomic status are strong risk factors for poor health. It is worth noting, however, that few of these articles focus on exploring location-related aspects as some of the factors that could potentially mediate the relationship between lower socioeconomic status and poorer health. For example, Cagney and Agree (2005) explore the influence of neighbourhood structural resources and self-rated health; Robert and Ruel (2006) look into the relationship between racial segregation and the same; and McFarland et al. (2012) study how the forgiveness-health connection is mediated by neighbourhood deterioration. Thus, during the period reviewed we witnessed an increased interest in disentangling why it is that lower socioeconomic status and minority ethnic and racial status is so often associated with poorer health. Of particular relevance to this angle is one of the latest articles published during the period reviewed which addresses the cumulative disadvantage/advantage perspective mentioned in the introduction to this chapter (that is, Lin and Kelley-Moore, 2017a, 2017b, who explore the age and social patterning of intra-individual variability). Only one of the studies on general health explicitly explores the implications that perceived discrimination has on health-related quality of life. This is the study by Kim et al. (2017) who focus on lifetime LGBT-related discrimination. There is also an article that discusses how different theories could be used to select the measurements for racial/ethnic health disparities to be used among older adults. This article argues that although advancements have been made in the measurement of perceived discrimination within health disparities research, the available measurements may have limitations when used 3

The exceptions are: the study by Quine (1999), which explores the health concerns of older minority ethnic populations in Australia and relates them to their majority counterparts; the study that focuses on health disparities in Taiwan (Tung and Mutran, 2005); the scoping reviews focusing on the health of older minority ethnic populations in Canada (Koehn et al., 2013; Khan et al., 2017); and the study from Singapore looking at life expectancy (Chan et al., 2016).

91

Ethnicity and old age

to study older cohorts. Thus, the authors conclude that ‘advancing research on the health effects of perceived discrimination in older adults will require thoughtful consideration of the measurement implications of theoretical frameworks relevant to the study of racial/ethnic health disparities’ (Thrasher et al., 2012: 1035). It is worth noting also perhaps that the articles that describe Hispanic populations seem mostly concerned with disentangling the effects of ethnicity from the ones that can be attributed to birthplace, since immigration has been shown to play a role in the health situation of Hispanic people in the US (for example, Buckley et al., 2000). The reason can be found in what is termed the ‘Hispanic paradox’, the term used to refer to the paradoxical finding that Hispanic people tend to have health outcomes that are comparable to, or in some cases better than, those of their non-Hispanic White counterparts, even though Hispanic people have lower average income and education. Readers interested in this paradox can consult Markides and Eschbach (2005), who present findings on a variety of health outcomes in looking at whether or not there is, in fact, such a paradox and end up suggesting that it is mostly found in Mexican Americans, and that in relation to mortality rates, this paradox is more prominently observed. Physical functioning, disability and mobility Just as was the case with the other two topics mentioned in the previous sections, the literature on physical functioning, disability and mobility4 is mostly based on quantitative research conducted in the US that explore not only ethnicity/race but also gender and sometimes socioeconomic status-related angles. Almost all of these studies focus on the two largest minority ethnic groups in that part of the world (that is, Black/African-American and Hispanic people, often in comparison to their White counterparts). The few studies about physical functioning that do not come from the US are therefore exceptions to the rule. These are: the study from Israel of functional limitations among Israelis (Osman and 4

Physical functioning: for example, Furner et al. (2004), Liang et al. (2009), Haas et al. (2012), Cantu et al. (2013), Kelley-Moore and Huang (2017), Lin and KelleyMoore (2017a). Disability: for example, Simonsick et al. (1998), Tennstedt and Chang (1998), Kelley-Moore and Ferraro (2004), Mendes de Leon et al. (2005), Ozawa and Yeo (2008), Taylor (2008), Fuller-Thomson et al. (2009), Chiu and Wray (2011), Latham (2012), Laditka and Laditka (2015). Mobility: for example, Boyington et al. (2008), Spoelstra et al. (2010), Latham (2014), Nicklett and Taylor (2014).

92

Literature on health inequalities

Walsemann, 2017); the study focusing on falls in Italian-born men in Australia (Stanaway et al., 2011); and the study on grip strength change in Afro-Caribbean men in Trinidad and Tobago (Forrest et al., 2012). This means that once again the samples used to draw conclusions about the nexus in question are very limited. Thus, the literature that looks specifically into physical function, disability and mobility comes almost exclusively from the US. Something else worth noting is that the experiential angle is not addressed in this body of work. In other words, we do not know much about how older people in minority ethnic groups experience the physical limitations, disability or mobility challenges that they face. Disease specific As was the case in relation to general health, the articles that focus on specific diseases rely on methodology that cannot capture how older people in minority ethnic groups experience the diseases that afflict them. Since all of the literature focusing on diseases comes from the US and based on what I have stated earlier regarding the general trends observed in the literature on health inequalities as a whole, it is more or less a given that almost all of these studies focus on comparisons between African-American/Black older people and their White counterparts. It is worth noting, however, that about half of the articles that focus specifically on a disease also bring attention to Hispanic older people (although almost always in comparison with the two other groups). Thus, in the disease-specific category, there are no studies originating from other parts of the world and only a handful of the minority ethnic populations in the US have received attention during the period in focus here. All of the studies about this specific topic are based on quantitative data. So once again the experiential angle is not addressed in this literature. It is worth noting also perhaps that studies that focus on health inequalities and the nexus in question, and which draw attention to specific diseases, are based on inquiries that address an array of issues.5 Of interest is also perhaps that overall, these disease-specific studies tend 5

Among them are: osteoporosis and bone mineral density (Turner et al., 1998; Crespo et al., 2011); suicide (Braun et al., 2001); mortality (Kuchibhatla and Fillenbaum, 2002; Sherkat et al., 2007); alcoholism (for example, Satre and Areán, 2005; Bryant and Kim, 2012); body perception, body esteem and body mass index (Schuler et al., 2008; Sabik, 2013); osteoarthritis pain (Jones et al., 2008); oral health (Arcury et al., 2011); chronic back pain (Beissner et al., 2012); morbidity (Cantu et al., 2013); Parkinson’s disease (Pan et al., 2014); diabetes (Karter et al., 2015; Kim

93

Ethnicity and old age

to be framed mostly in terms of the specific research gaps that exist in the literature on the diseases they focus on. Almost all of the studies belonging to this category however end up arguing that ‘belonging’ to an minority ethnic group means faring more poorly, health-wise. In other words, it is not uncommon for the disease-specific literature on health inequalities to start by summarising previous research on these diseases, focus on them in their design, but end up talking about health in more general terms. Thus, it seems that irrespective of whether or not research focuses on general health, or uses a specific disease as its starting point, minority ethnic status is often expected to, and most often is shown to, play a role in how people fare, health-wise. The way in which perceived discrimination affects the relationships that these studies explore remains unexplored, however. The only study on this topic that explored this angle did so on the basis of ageism’s impact on older women’s body esteem (Sabik, 2013). Mental health The patterns observed as far as where the studies originate from (that is, the US), which methodology they most frequently rely on (quantitative), and which minority ethnic groups they most often focus on (Black and Hispanic), are all patterns that also characterise the literature on mental health. There are a handful of studies that bring something else to the table in terms of where they originate from. For example, from the UK there is a study of psychiatric morbidity and well-being from London comparing the White British majority in that city with Bengali and Somali people (Silveira and Ebrahim, 1998a); a study on mental health comparing London White British with those of Somali, Bengali and Gujarati heritage (Silveira and Ebrahim, 1998b); a study on psychological well-being from New Zealand which compares Mãori with the majority ethnic population (Dulin et al., 2011); a study of depression from Sri Lanka that focuses on people who are Sinhalese, Tamil and Muslim (Khaltar et al., 2017); and a study from the Netherlands focusing on the role that mastery plays in the relationship between perceived ethnic discrimination and depression and focusing on people who are Surinamese, Turkish, Moroccan and Ghanaian (Slotman et al., 2017). Despite these exceptions to the rule, so to speak, most of the literature on mental health that draws attention to ethnicity and old age during the 20-year period reviewed here is literature that et al., 2015); inflammation (Mitchell and Aneshensel, 2017); and cardiovascular disease (Gerst Emerson and Gray, 2017).

94

Literature on health inequalities

originates from the US and focuses on the minority ethnic groups that have received the most attention in that part of the world. Something else that must be noted when it comes to the literature on mental health, ethnicity and old age is that a little less than half of the articles falling under this theme are about depressive symptomatology in one way or another. The exceptions are the study of psychiatric morbidity and well-being (Silveira and Ebrahim, 1998a); the study by Silveira and Ebrahim (1998b) on mental health; the study by Cohen et al. (2008) on suicidality; the study by Hawkley et al. (2010) exploring whether loneliness predicts increased blood pressure; the study by Dong et al. (2012) which draws attention specifically to self-neglect; the study by Jang et al. (2015) exploring whether social capital in minority ethnic communities affects mental health and focuses on Korean immigrants specifically; and the study by Kim and Fredriksen-Goldsen (2017) which explores the influence of LGBT-related discrimination on mental health quality of life. Overall, these studies focus on the fact that belonging to a minority ethnic group tends to be associated with poorer mental health. Of particular interest to this book’s core interests is the study by Mills and Edwards (2002), who critically review the literature on mental health-related issues that specifically looks at older African-Americans (published during the 1990s; n=58). They argue that although social gerontologists tend to mention in passing that historical eras, cohort location, and life-course development should not be disregarded when studying various dimensions of the ageing process, ‘this type of theorising is still in its infancy’ (Mills and Edwards, 2002: 273) when it comes to the study of mental health among older African-Americans. The reason why they claim this is that ‘virtually none of the studies that (they) have reviewed have sufficiently addressed the historical, biographical and structural factors; or the context of being Black in America’ (Mills and Edwards, 2002: 296). It is worth noting also that this article gives us an insightful historical overview of research on African-Americans’ mental health in the US dating back to the mid-1800s. It also gives us insight into some of the missing historical dimensions which demand attention when studying the mental health of this group (such as the relationship between traumatic life experiences and mental health, which they claim is an angle of study that the literature seldom, if ever, addresses). In doing so, this article offers a convincing argument for why it is so important that ethnicity is not used as ‘a crude proxy for location in varying social contexts’ (Williams, 2005: 56). Historical contextualisation (as well as insight into the various forms of discrimination that African-Americans still face

95

Ethnicity and old age

in contemporary America) make the social position of ‘being Black in America’ far more complex than research on health inequalities at the intersection of ethnicity and old age focusing on mental health tends to acknowledge. The same could be said, of course, of the literature that addresses the other health-related topics that this review covers, even if no other scholar in the entire literature reviewed here mentions all of the context-related issues that Williams (2005) draws attention to and which he argues are relevant to these inquiries. In this respect, it seems important to note that only a few of the articles on mental health explicitly address the role that perceived discrimination plays. These studies are: Kim and Choi (2010) who addressed this angle when investigating mental disorders in older Asian Americans; Ayalon and Gum (2011) who explored the relationship between major lifetime discrimination, everyday discrimination and mental health; the Slotman et al. (2017) Netherlands study of the role that mastery plays in the relationship between perceived ethnic discrimination and depression; and Kim and Fredriksen-Goldsen’s (2017) study which looks into the roles that lifetime LGBT-related discrimination, social connectedness, socioeconomic status and perceived stress play in the disparities that have been observed in mental health quality of life. All of these studies point toward the fruitfulness of studying perceived discrimination explicitly and suggest – just as Williams (2005) and Jackson (2005) have argued so eloquently - that studying health inequalities in old age among minority ethnic and racial populations while missing the important angle of everyday discrimination makes little sense. Cognitive functioning With regard to the last theme that has received attention in the literature on health inequalities, it must be noted that, as has been the case with the other themes described so far, the vast majority of the studies on cognitive functioning rely on quantitative data, originate from the US and focus on the three minority ethnic groups that often receive attention (that is, African-American, Hispanic and Asian people). Thus, with the exception of the qualitative study from the UK which explores how dementia is experienced by Black Caribbean, South Asian and White British older people (Lawrence et al., 2011), and the qualitative study from Canada that explores the pathways to a dementia diagnosis that older Chinese-Canadians have experienced (Koehn et al., 2012), most of the research on cognitive functioning which focuses on the intersection of interest to this book is only relevant to one specific

96

Literature on health inequalities

socio-cultural context (that is, the US). The fact that most research on this angle is also not in tune with the actual experiences of the older minorities that the research claims to be about is also something that must be kept in mind. As can be expected considering what this theme focuses on, the vast majority of the literature on this topic focuses on either cognitive performance as such (for example Zsembik and Peek, 2001; Lee et al., 2012; Castora-Binkley et al., 2013; Early et al., 2013; Blankson and McArdle, 2013; Benn et al., 2015 ) or on the relationship between this type of performance and other factors deemed interesting for the study of cognitive functioning in old age (such as education as in the case of Mungas et al., 2009; Barnes et al., 2011 and Zahodne et al., 2017). Some of the articles also focus on Alzheimer’s disease and/or dementia (for example Woodward et al., 1998; Lawrence et al., 2011; Koehn et al., 2012; Momtaz et al., 2013; Sherzai et al., 2016; Mayeda et al., 2016). In terms of findings, it must therefore be noted that, just as expected, most of this literature points towards the fact that minority ethnic status seems to entail disadvantage as far as cognitive performance in old age is concerned, even if education can offer some buffer (Barnes et al., 2011). It is worth noting also that one of the few articles that addresses cognitive functioning in a qualitative way (the study by Laditka et al., 2013, which is based on focus group interviews involving 396 individuals with a number of ethnicities), argues that although there are minor ethnic differences in how the people interviewed view those with cognitive impairments, there is also considerable within-group heterogeneity. This is why they suggest that ‘neither the word ethnicity nor the categories of ethnicity that participants reported can adequately characterize the groups we studied’ (Laditka et al., 2013: 386). This interesting and insightful acknowledgement reminds us of Koehn and colleagues. (2012), who argue that ‘an intersectional approach to analyses of ethnocultural minority of older adult populations facilitates a better understanding of the differential impacts that markers of social inequality have on their social support and health outcomes than the essentialist models typically applied to such populations’ (Koehn et al., 2012: 53). But as stated, when the overall characteristics of the scholarship on health inequalities were presented a few sections ago, the vast majority of studies on this issue seem to be informed by either an essentialist and/or a structuralist understanding of ethnicity and do not, therefore, address ethnicity in the constructivist manner – as presented in Chapter Three - which some suggest is the most fruitful

97

Ethnicity and old age

if we want to shed light on ‘the differential impacts that markers of social inequality have’ (Koehn et al., 2012: 53).

Concluding remarks There are a few points to note when thinking about the knowledge that the literature which addresses health inequalities and contributes to scholarship at the intersection of ethnicity and old age has generated over the period in focus here. As is the case with Chapters Five and Six, this chapter aims, after all, to address what characterises this literature - not in terms of what it suggests about health inequalities as such but rather in terms of what it reveals about scholarship on the nexus that this book focuses on. In other words, the idea with the chapters that belong to Part 2 is that they should give us some insight into what is available, but can also offer inspiration to scholars who are about to embark on research that aims to contribute to the scholarship in focus here via studies of health inequalities. These chapters are only based on 20 years of research in this area, and are also based on a very specific approach to the ways in which this literature has been read and coded. This is, after all, a scoping review that focuses on the understandings of ethnicity that have informed the literature and the manner in which ethnicity has been approached rather than being a review about what the literature on health inequalities suggests about ethnicity. Thus, in these concluding remarks, only the issues that are particularly worthy of our attention in light of the very specific aims of this book will be addressed. One feature noted was that because most of it comes from the US, the vast majority of the literature reviewed here is based on a very limited number of minority ethnic groups from a limited number of socio-cultural contexts who, it can be assumed, have been exposed to very specific histories of oppression. This revelation reminds me, at least, of Fraser’s (1996, 1997, 2009) social justice framework and the notions of redistribution, recognition and representation on which this framework is based. According to Fraser, in order for injustices to be relieved, we need not only to redistribute economic resources more evenly, and to recognise that ethno-cultural differences need to be acknowledged without being hierarchised in a ‘more-valued-to-lessvalued continuum’, we need also to give minority groups’ representation (which is the same as giving them a voice). Thus, if Fraser’s framework were to be used as a lens through which the scoping review is assessed, we would have to admit that the literature does not even scratch the surface when it comes to the issue of representation, it does not seem

98

Literature on health inequalities

aware of what redistribution could entail, and is also not in the least concerned with how recognition should be achieved if scholarly endeavours are to avoid contributing to the injustices they probably hope to alleviate – that is, if they were conducting their studies with an awareness of social justice. This is the case not only because the health of so few minority ethnic populations outside of the US have received scholarly attention but also because so few of the articles reviewed here in fact aim to give older people of minority ethnic status a voice as far as their health is concerned. The literature in question almost always uses ethnicity and race as crude proxies for location (or as Magai et al., 2003, calls them ‘descriptive-level labels’ which is the same as claiming that it uses race as classification as Cashmore, 2004, calls it). The literature gives also the impression that the groups described when alluding to ethnicity and race are far more heterogeneous than the data sometimes allows us to grasp (Williams, 2005). Both of these trends seem puzzling considering that scholarship on health inequalities has problematised the use of ethnicity and race in such ’inadequate ways‘ (Nazroo, 2003; see also Bradby, 2003, and Baer et al., 2013), and has convincingly shown that the actual way we use to go about the business of identifying ethnic groups has implications for our interpretations of health inequality data (Nazroo, 1998). These are two of the issues deemed to be problematic about this literature and what it suggests about scholarship at the intersection of ethnicity and old age. The fact that most of the data on which this literature is based does not explore whether ethnocultural values, preferences and/or practices play a role in how health is experienced and understood, means also that we know in fact very little about what makes ethnicity and race interesting angles of investigation for the study of health inequalities in old age - other than the fact that ethnicity and race often tend to be associated with a less disadvantageous socioeconomic status (at least in the country where most of the literature comes from, that is, the US). From Fraser’s standpoint, it also seems necessary to mention that this literature is very much characterised by an insatiable curiosity to explore how minority ethnic and racial populations fare in comparison with the ethnic and racial majority. As such, this scholarship seems oblivious to the fact that ‘being subjected to patterns of interpretation ... that are associated with another culture and are alien and/or hostile to one’s own’ (Fraser, 1996: 7) – which is what cultural domination is all about – is one of the ways by which injustices can be maintained over time. Thus, by failing to address the variation between and within ethnic and racial groups from which health inequalities can

99

Ethnicity and old age

be discussed, and by failing to give a voice to the older people of minority ethnic status that these studies focus on, this literature fails to recognise that half the battle if one wants to remedy injustices is recognising that the diversity that characterises our societies these days is far greater than what the literature recognises. The problem is of course, however, that this body of work does not seem to make the connection between health inequalities and injustice and therefore does not address what could be done to remedy the inequalities that it documents. In fact, the literature seems quite content to just state that there are inequalities, and seems satisfied enough with just aiming to identify the parameters around which these inequalities play out without striving to conduct intersectionality-informed analyses. These analyses ‘involve the concurrent analyses of multiple, intersecting [and interacting] sources of subordination/oppression’ (Denis, 2008: 677; see also Burkner, 2012, and Winker and Degele’s 2011 methodological contribution to this debate). Something else worth mentioning before bringing this chapter to an end is that, after reading and coding all of the literature on health inequalities and the nexus in focus here, it is not difficult to agree with Williams’ (2005) statement that research on health inequalities is in dire need of understanding the multiple ways in which racism can affect the health of socially disadvantaged populations. As already mentioned, only less than a handful of the articles reviewed explore the angle that exposure to lifetime discrimination entails as far as health inequalities are concerned. This seems alarming considering that this literature comprised over 100 articles, and health inequalities scholars have argued that the impact of racism needs to be included in analyses of these inequalities when we are dealing with minority ethnic and racial groups (see Nazroo, 1998; Karlsen and Nazroo 2002a, 2002b). Related to this is the fact that health inequalities research has also shown that ‘despite substantial differences in the experience of racial discrimination, the detrimental impact on health (can be) the same across socio-demographic groups’ (Bécares et al., 2009: 504). This very study has even suggested that even fear of racism – and not just the actual experience of racism – can be detrimental to our health. Thus, the fact that the literature reviewed in this chapter raises more questions than it actually answers not only about the relationship between socioeconomic status and ethnicity/race, but also about the impact that racism can have on health inequalities in later life, is one of the many reasons why I agree with Williams’ assertion. The fact that most of the literature comes from the US – a country known for its racial tensions (Feagin, 2014) - means in fact that the actual number of

100

Literature on health inequalities

articles that explicitly pay attention to racism’s implications for health inequalities is not only mind-boggling but downright alarming. In this respect, it seems important to draw attention to Jackson (2005). She alludes to the MacArthur Scale on Subjective Social Status when trying to disentangle the relationship between objective and subjective socioeconomic status and the role these measurements play in explaining health inequalities. Her main argument is that objective measurements of socioeconomic status only offer us a small part of the bigger picture behind the relationship between socioeconomic status and health inequalities. In her article, she refers to the fact that this scale uses a pictorial format when asking people to place an X on the rung on which they feel that they stand in relation to others and claims that Preliminary data suggest that individual’s perceptions of their place in the hierarchy as assessed by the ladders are associated with health. The socioeconomic status -health relationship may be mediated by the subjective feeling of being lower or higher on the ranking. This specific line of reasoning begs the question of the appropriate comparison group ... Insofar as social standing has beneficial effects on biological processes related to health, standing on the community ladder may be as important as standing on the SES [socioeconomic status] ladder. (Jackson, 2005: 64) This very fact is developed in one of the latest contributions to scholarship on health inequalities by McGovern and Nazroo (2015) who aim to disentangle the patterns and causes of later life inequalities by using a Bourdieusian approach to health inequalities that measures not only occupational and secondary characteristics of objective social class, but also subjective social class. Their analyses show how subjective social status can partly mediate the effects of objective social class on health, which is why they argue that ‘if the health status of older people is partly the result of structural factors that operate in cultural and civic domains then the provision of public resources to encourage cultural and social participation more widely will have positive health effects’ (McGovern and Nazroo, 2015: 155). It is because of this and other factors that Jackson (2005) states that this literature’s disregard for the role that institutional and individual-level discrimination plays in health inequalities is not only problematic (this is, of course, as already mentioned, something that Williams, 2005, argues as well), but quite telling of how the importance of race is acknowledged through proxies but never addressed in relation to the topics that we know to be relevant

101

Ethnicity and old age

to ethnicity and race scholarship. In other words, the scholarship in focus here seems mostly to be focusing on constantly rehashing what we already know (that minority ethnic and racial status is associated with poorer health) as opposed to trying to address in a systematic manner why this is the case, and whether racism, discrimination, marginalisation and exclusion (which are distinctive phenomena of their own) have anything to offer the study of health inequalities that focuses on the nexus of ethnicity, race and old age. My contention is that part of the reason why this scholarship seems to be covering the same ground, over and over again, as opposed to showing us new paths to explore, is that its reliance on survey methodology that has not been specifically designed to address ethnic/racial inequalities is preventing this scholarship from moving forward. Thus, although I agree with Jackson (2005) that we need intersectionality-informed data because new statuses are formed at the intersection of age, class, ethnicity and gender (and that these statuses are sometimes more than the sum of their individual parts), I would actually go further than her and argue that if we fail to complement the methodologies we tend to rely on with subjective-astute ones, we will not be able to move this scholarship forward at all. The methodologies that the literature on health inequalities reviewed here tends to rely on are not in fact equipped to shed in-depth light on the subjective dimensions of the social positions they claim to tap into; positions that are central to shedding light not only on what discrimination, marginalisation and oppression throughout the life course actually mean to the health of older people in minority ethnic groups, but also to how all of these things are experienced. It is because of this that I propose that methodological renewal and ethnicity-informed theory is needed if we are to expand the imagination of the literature on health inequalities at the intersection of ethnicity and old age. This literature seems namely to be stuck at the moment, and part of the reason why this is the case is that the methodologies it relies on do not allow it to explore what exactly it is about ethnicity and race that lead to poorer health.

102

FIVE

Literature on health and social care This chapter focuses specifically on those issues in the literature related to health and social care (n=55) which draw the intersection of ethnicity and old age. This means that this specific theme was addressed in just under half of the articles addressed in the previous chapter. Before we begin to describe what the scoping review conducted ended up revealing, it seems necessary to provide a bit of insight into the themes that are often associated with this topic by consulting, as I did in the previous chapter, the handbooks, encyclopaedias and edited collections that are available. What is immediately noteworthy about the health and social care literature and the nexus of interests focused on here is that both tend to depart from the fact that, as stated in the previous chapter, older people with minority ethnic and/or racial backgrounds tend to have poorer health than their majority ethnic counterparts, which is believed to have implications for an array of issues regarding health and social care. In the first handbook specifically addressing issues related to older people with minority backgrounds – the Handbook of Minority Aging - there is one entry on health and social care, which begins by stating that ‘the complex mix of services and funding makes it difficult to provide a comprehensive picture of LTSS [long-term services and supports] use by minority elders, but it appears that the net result is that formal LTSS use overall continues to be lower for minority elders’ (Padilla-Frausto et al., 2014: 221). Against this backdrop, it is perhaps understandable that when one consults handbooks and encyclopaedias of relevance to this book’s topic, one notes that it is often taken for granted that most of the health and social services that are available are not optimal for minority ethnic populations. Scholars in this field tend to argue that this is the case because these services have been designed with majority populations in mind and lack the kind of culture sensitivity that is needed if minorities’ needs and preferences are to be taken into serious consideration when planning and providing formal care services. Padilla-Frausto et al. (2014), who summarise research on the usage of health and social care in the US by older people in minority ethnic groups, conclude their chapter in the above-mentioned handbook by stating that if one wants to understand why uptake is as low as it often is, one needs to take into

103

Ethnicity and old age

account that the long-term care system would need to be restructured if the disparities in access and usage were to be addressed. They list health care coverage, income and housing support and language barriers as some of the structural issues that these older minority ethnic populations face while also alluding to the fact that ‘cultural issues such as filial piety and trust must also be integrated in the design and delivery of long-term care services’ (Padilla-Frausto et al., 2014: 232). In The Cambridge Handbook of Age and Ageing, for example, there is a chapter titled ‘Ethnic diversity in ageing, multicultural societies’ (Jackson et al., 2005) that almost exclusively focuses on the care needs of older minority ethnic groups (even if the title is much broader than that), and the fact that ethno-cultural differences in preferences, expectations and needs have been documented through survey data in both the US and Europe. The chapter in question discusses, for example, the vulnerable positions in which older people from minority ethnic groups often find themselves and the ways in which these positions translate into expectations (or misapprehensions) about the services that the health and social care sector can provide. Gelfand (2003), who has written one of the few books available about the intersection in focus here, has two chapters in his book that specifically address the topic of this chapter, that is, health and social care services for older people in minority ethnic groups. He claims – mostly on the basis of data collected in the US and without actually substantiating all of his claims with references, which raises of course the question of what we actually know and what we presume about this topic - that there are a number of factors which are specific to ‘ethnic’ populations and that these play a role in determining these populations’ usage of health and social care services. According to him, these are the lack of knowledge on the part of the ethnic aged about cultures other than their own; stereotypes among the ethnic aged about other ethnic groups; lack of knowledge among ethnic aged of available services; unwillingness of the ethnic aged to travel beyond certain defined neighbourhood boundaries; low expectation of services on the part of the ethnic aged and strong preferences among the ethnic aged for the maintenance of ethnic culture. (Gelfand 2003: 141) His use of the term ‘ethnic aged’ can be problematised since it shows that ethnicity is regarded as something that is exclusively characteristic of the ‘Other’ is in itself interesting and rather telling (we are all, after all, the ‘ethnic aged’ in the true sense of the term). His claims are quite

104

Literature on health and social care

informative concerning what literature of this nature tends to convey. It is worth noting in this respect that all of his claims are about what the ‘ethnic aged’ think or prefer. No mention is made of how health and social care planners and providers think (and/or how they engage with these ‘ethnic aged’) which is, of course, interesting considering what we learned in Chapter Three about the implications for ethnic and racial groups’ preferences and practices of how the Other identifies them. Group-based ‘explanations’ for service utilisation problems (which we do not, in fact, know much about, as the results of the scoping review I have conducted will clearly show) are also something that I would like to draw attention to. I would argue that all of these things are illustrative, not necessarily of what we actually know but seem to be based instead on what we presume about the populations we often refer to as ‘older ethnic minorities’.

Main trends observed Having given an idea of the kind of assumptions taken for granted that guide research on health and social care that focuses on the nexus of interest here, it is now time to describe the trends observed in the literature reviewed for this book. Before I proceed it seems necessary to restate what I mentioned in the Introduction (and repeated in the previous chapter): namely that some of the central questions one should ask oneself when theorising are what characterises the literature that is available, what is missing and where should we head if we are to advance the knowledge we have accumulated so far. That is why the chapters that belong to this part of the book do not offer any detailed insight into the articles reviewed as such, but focus instead on the specific objective of the theorising exercise that lies at the core of this book; namely what characterises the understandings of ethnicity that inform scholarship on the nexus of interest here (ethnicity, race and old age). Keeping this mind, the first point I would like to make is that the topics that have received attention during the period in question as far as health and social care is concerned are: access and usage of care services (n=22); attitudes, preferences and experiences of relevance to health and social care (n=17); suitability of different programmes/ interventions/ services (n=10), and the types of self-care practices in which older minority ethnic groups engage (n=6). The fact that so little literature is available on health and social care at the intersection of ethnicity and old age is in itself an interesting observation, considering that awareness of the disparities that exist in health and social care usage is relatively high and what we have already established about

105

Ethnicity and old age

the health of older people from minority ethnic backgrounds in the previous chapter. Now that we have a general idea of the focus of the health and social care literature I want to draw attention to the fact that, although there are differences between topics in terms of the preferred methodological approaches, most articles are based on studies that use quantitative methods. This is, of course, not surprising considering what we learned about preferred methodology when reviewing the literature on health inequalities in the previous chapter. The exception to this pattern can be found on the topic of attitudes, preferences and experiences, which is based on articles that use qualitative methods almost as frequently as quantitative ones. Thus, when studying the attitudes, preferences and experiences of health and social care at the intersection of ethnicity and old age, Adler et al. (1998) use video vignettes to study how a group of ethnically diverse woman regard patient assertiveness; Pang et al. (2003) use focus group interviews to shed light on the health-seeking behaviour of older Chinese-American people; Heikkilä and Ekman (2003) use individual qualitative interviews to draw attention to older Finns’ care expectations in Sweden; Koehn et al. (2012) use focus group interviews to explore how older minority ethnic populations in Canada access care; Lambe et al. (2011) draw attention how African-American people regard brain donation through focus groups; Glass and Samuel (2011) use qualitative interviews in order to shed light on how Black and White people in the US regard cremation; Small et al. (2015) explore the quality of communication between care staff and residents in a ethno-culturally diverse long-term care facility in Canada using video-recording of their interactions; Ellins and Glasby (2016) explore how older people from minority ethnic groups experience hospital stays in the UK using interviews; while Söderman and Rosendahl (2016) rely on the same data collection method to explore how nursing staff in Sweden experience caring for people with an ethnic background different from their own. However, the vast majority of the studies that draw attention to health and social care are studies that utilise ethnicity and/or race as crude proxies for older people’s ‘location’ in this context. My second point is that the general characteristics of the literature reviewed here should come as no surprise considering what we have learned about health inequalities in the previous chapter. The vast majority of the literature on health and social care is based on US studies that focus on the minority ethnic groups which have received the most attention in that part of the world (African-American, Hispanic and Asian-Pacific Islander, in that order) while comparing them with the White ethnic majority. It is worth noting also perhaps that only a

106

Literature on health and social care

handful of the studies reviewed here focus on Native American people. Thus, irrespective of which minority ethnic group the articles focus on, this literature remind us – as a whole - of Williams and Wilson’s (2001: 174) assertion that ‘in contemporary American society race is viewed as a master status: a key determinant of social identity and access to power, privilege and resources in society’. In terms of studies that come from other parts of the world, it seems interesting to note, in order to make explicit which societal contexts other than the US one have received some attention, that three of them come from the UK: Jolley et al. (2009) who bring attention to a programme designed to teach Black older people and their peers from other minority ethnic groups about dementia (and focus on African-Caribbean and South Asian groups); Shah et al. (2009), who focus on the experiences of consultant psychiatrists who work with Black and minority populations; and Ellins and Glasby (2016), who bring attention to the hospital experiences of Asian or Asian British, Black or Black British and Gypsy Travellers. In addition to these studies we have the two articles from Sweden: Heikkilä and Ekman (2003), who focus on how older Finns perceive elder care and Söderman and Rosendahl (2016) who focus on the experiences of nursing staff who care for both Swedish-speakers and Finnish-speakers. Moreover, there is the one from Israel focusing on the composition of Arab, Jewish and Russian immigrants’ social networks and how these affect public homecare utilisation (Litwin, 2004); the study from Singapore (Nyunt et al., 2009), which analyses whether the Geriatric Depression Screening Scale (GDS-15) is suitable for use among older minority ethnic groups; the study from Mexico focusing on how rural indigenous older people (from the Quintana Roo, Chihuahua and Guerrero regions) utilise health care and the barriers they perceive to accessing it (PelcastreVillafuerte et al., 2017); and two studies from Canada, one focusing on Punjabi, Hispanic and Vietnamese older people’s take on how they access care services (Koehn, 2009) and the other focusing on the quality of communication between staff and residents of long-term care facilities and bringing attention to an array of language backgrounds (Chinese, Filipino, Polish, Hindi, Spanish, Latvian, Punjabi, Italian, Dutch and Arabic). Thus, only a handful of the studies reviewed here offer us insights into other minority ethnic populations besides the ones that have received the most attention in the US and/or refer to health and social care services originating from welfare regimes other than the US one. This is troubling considering that there is research that shows that elder care regimes and migration regimes (and the understandings of ethnicity that

107

Ethnicity and old age

characterise these regimes) affect the ways in which the intersection of ethnicity and old age plays out in different health and social care contexts (Karl and Torres, 2016). The fact that welfare regimes and the different institutional contexts they generate can influence the actual needs and preferences of older people from minority ethnic backgrounds, and the ways in which minority ethnic and racial status can affect the manner in which older people in these groups regard health and social care, are angles of investigation that receive almost no attention in the literature reviewed here. In other words, not one of these aspects – societal settings, care regimes, migration regimes – is explicitly addressed as the backdrop to the data related to ethnic and racial relations which this literature could undoubtedly tap into. My third point about the general trends observed in the literature reviewed here has to do with the ways in which ethnicity and race are approached and the understandings that inform these studies. Most of the articles reviewed here do not explore if ethnicity and race are identification grounds that actually matter to the care services that people use. Instead they take for granted that ethnicity and race do matter and focus on trying to explain how this is the case (and please note that I purposefully do not write about why this is the case, since most of this literature focuses on shedding light on trends observed as opposed to explaining why these exist). As argued elsewhere (Torres, 2018), the literature on health and social care reviewed here does not seem interested in exploring why the injustices in access, usage and experiences observed actually exist. Instead, the literature just reiterates that inequalities exist as far as these angles of investigation are concerned. Related to this is also the fact that most of these articles do not define ethnicity and race and give us little explicit indications of how these identification grounds have been approached. The literature suggests, however, that a combination of the essentialist/primordialist and the structuralist/circumstantialist approaches informs a little over half of these studies, while the other half seems to be informed by the social constructionist perspective. Thus, in contrast to the literature on health inequalities, the literature on health and social care does seem to have begun to approach ethnicity and race in ways that resonate well with the evolution of understandings mentioned in Chapter Three. Fourth, it must be noted that less than half of the articles shed light on the views of the older people whose situation they draw attention to. This may seem like just a few, but considering how little attention older people’s voices get in relation to health inequalities, this is actually an improvement. The other half of the articles reviewed here use data that has been collected via the extraction of information from

108

Literature on health and social care

databases on health care utilisation, by asking for the views of the adult children or caregivers of older people from minority ethnic and racial backgrounds, or by asking staff for their opinion on an array of issues related to their clients’ care service access and usage, for example. With regard to the latter it is noted that Solway et al. (2010) explore what leaders in mental health and ageing in the UK think about the access barriers that people from minority ethnic populations face as far as mental health services are concerned; that Söderman and Rosendahl (2016) explore how nursing staff in Sweden experience caring for people with an ethnic background different from their own; and that PelcastreVillafuerte et al. (2017) shed light on health care staff – as well as older indigenous people – when assessing whether the health care system in Mexico offers services suitable to this population. This means that the views of those whose practices are important for the outcomes being studied are seldom addressed, which is why the literature as a whole gives the impression that we are only getting half the story. This latter point is perhaps understandable if we regard Gelfand’s (2003) take on access and use (as referred to earlier in the chapter) as ‘representative’ of American scholars’ take on this issue. If scholars in this area believe that the reasons for the lack of access and usage of services by older people in minority ethnic populations can be determined entirely from older people’s own perspectives, then it follows that scholars would not deem the practitioner’s and policy maker’s take on these issues to be of interest. I for one disagree, however, since I believe that part of the reason why older people of minority ethnic status use services as seldom as they do (considering that they are often in poorer health) may lie in the actual practices of practitioners and the ways through which these practices inhibit older people of minority ethnic status from accessing and utilising the services that are available. However, this line of reasoning does not seem to be deemed interesting if we are to take the literature as a whole as an indicator of where scholars’ interests lie. My fifth point is that – just as was the case in most of the articles that address health inequalities - the articles on health and social care do not explicitly address the way in which ethnicity is understood (in other words, ethnicity, and race for that matter, are neither defined in these articles nor are the understandings of these identification grounds explicitly referred to in the literature). From this it follows that the literature as a whole gives the impression that there is a consensus as to what ethnicity means, which we learned in Chapter Three is far from the truth. Thus, most studies seem to have been designed using ethnicity (and race) as crude proxies for location, as was the case for

109

Ethnicity and old age

the literature on health inequalities. This means therefore that on closer inspection it becomes clear that this literature does not actually tell us much about what ethnicity and race can mean as far as access and usage are concerned. The exception to this is the few qualitative studies on attitudes, preferences and experiences mentioned earlier, which give us some insight into the ethno-cultural beliefs, values and behavioural patterns that might explain the results they present. However, it is worth noting in terms of how ethnicity and race are understood and/or approached in the literature as a whole that in spite of what we learned in Chapter Three about the elusiveness of these constructs, only one of the articles reviewed for this chapter acknowledges that this is the case. The article in question (Lambe et al., 2011) acknowledges that the ethnic label they use to refer to the minority ethnic group in focus (African-American or Black) is not as straightforward a label as it may seem. These scholars acknowledge that the participants in their study, who came from either the Caribbean or who have an African heritage, could not agree on whether they should be referred to as Black or as African-American. Thus, this article gives us a glimpse of the complexity that ethnicity and race – as identification grounds that feed not only on people’s own identification but also on how others identify them – actually entails. However, most articles do not acknowledge that there are different angles from which ethnicity can be studied (others’ identification, group members’ identification and the attitudinal/ behavioural patterns with which the group is associated) and that these angles do not necessarily overlap. This is therefore the sixth thing worth noting about what characterises the literature on health and social care at the intersection between ethnicity and old age. Less than a handful of the articles reviewed here refer to definitions of ethnicity and/or the different understandings that have been used to explain why, how and when ethnicity and race matter. Thus, most of these articles are actually studying ethnicity from the premise of others’ identification of it with little regard for the way in which people actually self-identify as far as ethnicity is concerned. This means that the literature assumes that self-reported ethnicity (which is often the same as having just picked from a range of ethnic groups) is the same as regarding oneself as a person for whom ethnicity matters. The fact that most articles do not take into account the attitudinal and behavioural patterns that characterise ‘membership’ of the minority ethnic groups that people claim to be a member of (and/or who scholars categorise them as) is also something that must be noted. This is therefore the seventh thing to note about the main trends observed in this literature. Thus, although most of these articles end up referring

110

Literature on health and social care

to these patterns in their discussion sections, they are not in fact based on studies that have taken these patterns into account in their design and/or address these angles explicitly. In light of all of this, it seems necessary to point out what Williams and Wilson argued over a decade ago that ‘future research must give greater attention to comprehensively assessing racial minority status including identifiers of ethnic variation within each of the major racial and ethnic categories’ (Williams and Wilson, 2001: 174; italics added). However, this is something we do not seem to have even begun to address. In the sections that follow I will give a little more insight into what the different themes addressed under the heading of health and social care are about. Access and usage in health and social care The literature on health and social care that draws attention to access and usage seems well aware of the fact that – at least in the US – there is a discrepancy between the needs of older people in minority ethnic groups (considering the health inequalities that they experience as referred to in the previous chapter), and the extent to which these minorities utilise the services that are available. Thus, it is not uncommon for the articles reviewed to summarise their findings with statements such as ‘for reasons that are unrelated to financial assets, blacks remain vulnerable in their ability to access services …’ (White-Means, 2000: 76) or ‘results provide evidence that racial/ethnic disparities in utilization of drugs used to treat dementia exist and are not accounted for by differences in demographic, economic, health status, or health utilization’ (Zuckerman et al., 2008: 328). In terms of the minority populations that have received attention, it goes without saying that the vast majority of these studies – which utilise quantitative methods - focus on African-American/Black people and compare their access and usage to that of their White counterparts (for example Wallace et al., 1999; Coleman and O’Sullivan, 2001; Bradley et al., 2004; Zuckerman et al., 2008; Boaz et al., 2017). Few of the articles focusing on access and usage look at Hispanic populations. The ones that do tend to be based on studies which focus on White and Black groups as well (Tennstedt et al., 1998; Calderón-Rosado et al., 2002; Dunlop et al., 2002; Laditka and Laditka, 2006; Bowen and González, 2008; Kwak et al., 2008; Zuckerman et al., 2008; Miller et al., 2014; Bakk et al., 2017). Only one focuses on Asian and Pacific Islander people (Nguyen, 2012), while two focus on a different sociocultural setting from the North American one. These are the study by Litwin (2004), which focuses on Arab, Jewish and new Russian

111

Ethnicity and old age

immigrants in Israel (and explores the impact that social networks have on their utilisation of public home care); and the study by PelcastreVillafuerte et al. (2017), which focuses on the ways in which indigenous groups in Mexico assess health care and draws attention to the many barriers that they (and staff serving them) perceive. In terms of the issues addressed when studying access and usage, it seems worth stating that most of these articles draw attention to the different care arrangements that older people from minority ethnic groups make and/or the types of care services that they use or do not use (Wallace et al., 1999; White-Means, 2000). Some of the studies reviewed here address, for example, the mediating effects that family structure and social class can have (Cagney and Agree, 1999); the social norms concerning family caregiving that affect access and usage of health and social care by minority ethnic groups (Bradley et al., 2004); the impact that the timing of parenthood can have on health care usage (Cagney and Agree, 2005); the ways in which social support affects usage (Peng et al., 2003); the impact that acculturation can have on this (Calderón-Rosado et al., 2002); the importance of economic access (Dunlop et al., 2002); and the ways in which disability can influence how people utilise health and social care (Li and Fries, 2005; Bowen and González, 2008; Miller et al., 2014). In other words, the literature reviewed here which looks at access and usage of health and social care takes into account other aspects besides ethnicity (and sex, which is a category that is almost always taken into account) when explaining the health and social care disparities observed. Irrespective of what is being explored besides ethnicity, however, most of the research on access and usage reiterates the fact that there are ethnic and racial differences in the types of services that older people use (for example, Cagney and Agree, 1999; Wallace et al., 1999; Kwak et al., 2008), and that minority ethnic and racial groups’ access and usage can best be described in terms of inequality, since they tend to use fewer services than what one would expect considering how they are doing health-wise (for example, Tennstedt et al., 1998; White-Means, 2000; Coleman and O’Sullivan, 2001; Dunlop et al., 2002; Zuckerman et al., 2008). It is worth noting perhaps that because most of the studies do not address the attitudinal/behavioural aspects of ethnicity, the body of knowledge on access and usage reviewed here is in fact, as already stated, using race and ethnicity as a proxy for culture just as was the case in the literature reviewed for the previous chapter. Thus, the actual cultural values and/or preferences that are characteristic of the different ethnic/racial groups that this literature draws attention to is not something that these articles address in an explicit manner. This is

112

Literature on health and social care

perhaps why the discussion sections of these articles tend to state that future research should look into this angle (for example Dunlop et al., 2002; Kwak et al., 2008; Zuckerman et al., 2008). An article that is not included in this scoping review since it failed to meet the inclusion criteria, states that ‘social and cultural factors not typically included in multivariate models such as the Behavioural Model of Health Services may be especially salient in understanding social service use among racially and ethnically diverse populations’ (Scharlach et al., 2008: 342). These authors argue therefore that qualitative approaches may be particularly helpful in explicating caregiving processes among various racial and ethnic groups, including the ways in which culture affects decisions about the types of assistance caregivers seek and the sources from which assistance can be obtained. (Scharlach et al., 2008: 343) In other words, the literature on access and usage which documents that there are ethnic differences as far as health and social care usage patterns are concerned often suggests that ethno-cultural values may be the reason why some of the observed differences exist. But this is not something that the literature studies explicitly. Few studies mention that discrimination may also play a part in explaining why older people from minority ethnic backgrounds do not utilise the health and social care services that are available. The fact that the literature on access and usage does not take into account that health and social care staff could perhaps offer us interesting insights into this topic is also noted since, as already stated when referring to Gelfand’s (2003) remarks, scholars in this area seem to be looking for answers that depart from older people in minority ethnic populations, while disregarding the interrogation of the structures and practices that are supposed to cater to their needs. Attitudes, preferences and experiences of health and social care The literature on health and social care that focuses on the nexus of interest here also draws attention to the angle that attitudes, preferences and experiences offers. As could be expected, and as already mentioned a few sections earlier, about half of the articles on this topic come from studies that use qualitative methods to collect their data. The exceptions can be found in the article that reviews the literature on end-of-life decision making among minority ethnic populations by Kwak and

113

Ethnicity and old age

Haley (2005); the study of attitudes toward adult care homes and family caregiving among African-American and their White counterparts by Sudha and Mutran’s (1999); the study by Mutran et al. (2001) on satisfaction among White and African-American residents who reside in adult care facilities; Stoller and Perzynski (2003) on the impact of ethnic involvement on retired Sunbelt migrants’ plans to move into nursing homes; Dupree et al. (2005) on African-American and White people’s preferences for mental health care; and the article by van Liew et al. (2016) who try to disentangle whether it is ethnicity or caregiving experience that affect the decisions of older people in minority ethnic groups to hire health care advocates. In terms of context, and as was the case in terms of access and usage, most of the articles focusing on attitudes, preferences and experiences of health and social care at the intersection of ethnicity and old age come from the US. There are, however, two studies from Canada (Koehn, 2009; Small et al., 2015), two from Sweden (Heikkilä and Ekman, 2003; Söderman and Rosendahl, 2016) and one from the UK (Ellins and Glasby, 2016) on this very topic and the specific angles they focus on have already been mentioned. The articles that are based on data collected in the US draw attention to the attitudes and/or preferences angle and focus primarily (though not exclusively) on African-American/Black people and compare them with their White counterparts (and sometimes with other minority groups as well). These articles are about how older woman with ethnically diverse backgrounds (African-, Chinese-, European- and Hispanic-American) who are breast cancer patients regard patient assertiveness (Adler et al., 1998); how ethnicity affects attitudes to assistance use (Noelker et al., 1998); how Black and White older people regard physicians (Jackson and George, 1998); how older African-American and White people regard adult care homes and family care (Sudha and Mutran, 1999); how satisfied both groups are with such facilities (Mutran et al., 2001); the similarities and differences in these groups’ preferences for mental health care (Dupree et al., 2005); how African-American people enrolled in an Alzheimer’s research programme regard brain donation (Lambe et al., 2011); and how Black and White people regard cremation (Glass and Samuel, 2011). Also coming from the US is one article that draws attention to Asian minority groups mentioned earlier, which focuses on breast cancer patients (Adler et., 1998); the study that focuses on the health-seeking behaviours that Chinese American people prefer (Pang et al., 2003); and the one that explores whether caregiving experience and ethnicity plays a role when Asian Pacific Islander, Black, Hispanic and White people hire health care advocates (van Liew et al., 2016).

114

Literature on health and social care

Another US article focuses on older migrants to Florida and explores how ethnic attachment affects their considerations of nursing homes as a possible long-term care plan (Stoller and Perzynski, 2003). Thus, with regard to the literature on attitudes, preferences and experiences that comes from the US, it seems necessary to stress that none of the articles reviewed here draws attention to the question of access as such, and the ways in which different minority ethnic groups perceive the access barriers that they experience. Instead this literature is concerned with usage. In terms of the articles on attitudes, preferences and experiences that come from other parts of the world, it seems interesting to note – especially considering that most of the studies from the US do not focus on the experiential angle – that these articles are mostly about the ways in which older people in minority ethnic groups experience their contact with the health and social care sector (for example, Koehn, 2009; Ellins and Glasby, 2016) and/or the ways in which those who care for them within formal care services experience and handle the provision of care across ethno-cultural and linguistic boundaries (for example, Söderman and Rosendahl, 2016). The two articles from Canada, for example, focus on how older people in minority ethnic groups and their families (as well as health and multicultural service providers) regard access to care and the numerous barriers to care that these minority populations experience (Koehn, 2009); and on the verbal and non-verbal communication patterns used by staff and residents in ethnoculturally and linguistically diverse long-term care facilities (Small et al., 2015). The two articles from Sweden focus on the Finnish minority, albeit in different ways. One of them draws attention to the care preferences that older Finns in Sweden have (Heikkilä and Ekman, 2003), while the other focuses on how nursing staff in a Finnish-speaking and a Swedish-speaking group home for people with dementia experience the challenges that caring for people from a minority ethnic background can entail (Söderman and Rosendahl, 2016). Last but not least, it seems worth mentioning for the sake of offering insight into what is available that the only article from the UK that focuses on experiences is an article that draws attention to both older people who had recently experienced a hospital stay and people who have an older relative who has been hospitalised (Ellins and Glasby, 2016). At first glance, the literature reviewed in this section may seem quite broad in terms of the topics that it addresses. However, most of the literature that comes from the US focuses on the perspectives of care recipients while the literature from other parts of the world has

115

Ethnicity and old age

a broader take on these issues, since it draws attention to the actual experiences of both those who receive and those who provide care. Considering that the literature on access and usage constantly draws attention to the inequalities that older people in minority ethnic groups face, it is thought provoking to note that so little of the literature reviewed in this chapter draws attention to the ways in which these inequalities are experienced. Thus, although some of the literature on attitudes, preferences and experiences seems to want to explore why access and usage is limited among older people from minority ethnic populations, few studies do in fact interrogate whether ethno-cultural values and/or beliefs lie behind the patterns observed. Against this backdrop, it makes perfect sense that studies on this topic sometimes end with statements such as this one: ‘the identified differences in endof-life decision-making preference and practice suggest that clinical care and policy should recognize the variety of values and preferences found among diverse racial and ethnic groups’ (Kwak and Haley, 2005: 634). Suitability of different programmes, interventions and services Another angle of investigation that the literature on health and social care has explored – albeit to a lesser extent – has to do with the assessment of the suitability of programmes, interventions and services. The array of services that have received attention is actually quite large if we consider their focus. Among the studies found on this topic, we find the following: a study assessing the suitability of a health promotion initiative that taps into spirituality through its focus on faith-based communities and focuses on older African-American people and their White counterparts (Parker et al., 2002); a study evaluating whether a practice-oriented service model can increase the use of respite services among older people in minority ethnic groups (Montoro-Rodriguez et al., 2003); a 10-week exercise programme designed for delivery either at a health clinic or a church in order to see if these settings increase the participation of urban women with an African-American or a Hispanic background (Dornelas et al., 2007); the assessment of a memory training service offered to African-American, Hispanic and White people as part of a project called SeniorWISE (McDougall et al., 2010); a church-based health promotion programme which paired African-American and White older people with each other in order to increase their awareness of the spiritual, physical, emotional, mental and social dimensions of health (Pope et al., 2013), and the assessment of the suitability of an intergenerational programme for older people of

116

Literature on health and social care

minority ethnicity, since their views on such programmes have seldom been sought (Young and Janke, 2013). In addition, the literature focusing on this topic includes three studies from outside of the US. Two of them are come from the UK: one of them assesses the suitability of a programme designed to increase awareness of dementia and related disorders among Black and minority ethnic populations (Jolley et al., 2009); the other study describes the experiences of consultant psychiatrists who work with older Black people and those from a minority ethnic background in light of the changes that have taken place in mental health provision after the new Mental Capacity Act 2005 (Shah et al., 2009). The last study from outside the US which brings attention to the question of programmes, interventions and/or services suitability is a study that tests the validity and reliability of the geriatric depression screening test (GDS-15) for usage with different ethnic groups in Singapore (Nyunt et al., 2009). One of the interesting things to note about this literature – especially considering that there are so few studies on this angle during the period reviewed – is that most of the literature is based on newly designed programmes that aim to cater to the specific needs that older people in minority ethnic communities are expected to have. This means that very few of the articles reviewed here come from studies that assess the suitability of services, programmes and/or interventions that have been designed for the ethnic majority but which are offered to ethnic minorities. This means that research during this period does not assess the suitability of the vast number of programmes that are available at present in spite of the fact that there is ample evidence suggesting that these are not being used by older people in minority ethnic populations to the extent that one might expect considering that their health situation is often poorer than their majority ethnic counterparts. However, most of the articles reviewed here stress that the services that are available need to be developed if we are to meet the needs of older people in minority ethnic groups and/or to design culturally appropriate programmes for them. In other words, the literature focusing on this topic is literature which stresses the ‘peculiarities’ of minority ethnic groups and urges us to address this as opposed to being literature that accepts that older people with minority ethnic status use fewer services as the literature on access and usage has established. Self-care practices engaged in by older minority ethnic groups Last but not least when it comes to the research on health and social care reviewed here, we have the small number of articles that draw

117

Ethnicity and old age

attention to the specific self-care practices that people from minority ethnic backgrounds engage in. All of these articles come from the US and are based on quantitative studies of older people in minority ethnic groups except for a review of the literature that is available on the four ethnic groups with which the US literature on ethnicity and old age is most often concerned (African-American, Hispanic, Asian-American and American-Indian). One review article (Gallant et al., 2010) tries to integrate research on minority ethnic families with research on chronic illness self-care and argues – as was the case in several articles on access and usage – that ‘differences in self-care behaviours are partly attributable to the fact that current approaches to self-care have not adequately incorporated cultural values related to health and illness management’ (Gallant et al., 2010: 37) and that without understanding such values, we risk failing to design self-care interventions that fit the needs of the ethnically diverse older population. Thus, once again we see that the literature acknowledges that ethno-cultural values have not been in focus even though one might imagine that they would have been, considering that the literature assumes that ethnicity and race-based patterns are at stake and that these patterns stem from ethno-cultural values, preferences and/or behaviours. Thus, most of these articles acknowledge that the differences documented are probably based on ethno-cultural factors that are not addressed in their study design. Last but not least, it seems important to note that the articles in the US that draw attention to the self-care practices of older people from minority ethnic backgrounds focus on diabetes self-care (Schoenberg et al., 2008; Brewer-Lowry, 2010), self-management in relation to osteoarthritis (Albert et al., 2008), and there are also two articles on how older people from minority ethnic backgrounds who have chronic illnesses self-manage daily symptoms (Arcury et al., 2012, 2015). It is worth noting also that the one article that did not find any differences in self-care practices was based on a study with an ethnically varied sample who all shared the same lower-income background. This article argues that ‘lack of resources appears to exert a stronger influence on self-care than race/ethnicity/residence’ (Schoenberg et al., 2008: 372) and leaves open for discussion whether it is ethnicity as such, or another social position (such as class, socioeconomic status or gender to name but a few), that lies behind the differences in self-care practices that the literature tends to take for granted (and has also found evidence for) in the studies from the US that have been conducted on this issue.

118

Literature on health and social care

Concluding remarks When thinking about the knowledge that the literature on the intersection of ethnicity and old age addressing health and social care has generated, there are a few things that need to be noted. This chapter – just like the other chapters belonging to the second part of this book – aims specifically to address what characterises scholarship at the intersection in focus here as a whole, and to point out a couple of the things that are missing about how this scholarship regards ethnicity and studies the relationship between ethnicity and old age. The idea behind these literature-specific chapters is therefore not (as already stated) that they will give us insight into what is available and what is missing in terms of the specific topics that different literatures address. Thus, as stated in the Introduction, these chapters do not aim to set an agenda for research on specific topics but rather to assess what this research suggests about scholarship on the nexus of ethnicity, race and old age. The idea is to advance this scholarship’s understanding of ethnicity in imaginative ways (which entails taking into account the advancements that have been made in ethnicity scholarship as presented in Chapter Three), while addressing the numerous challenges that both population ageing and the globalisation of international migration pose as far as diversity in old age is concerned (see Chapter Two). In other words, the attempt to set an agenda that I will embark on in the concluding chapter of this book is not literature-specific (it is not an agenda for research on health inequalities, health and social care or social relations and caregiving, which is the topic of the next chapter) but an agenda for the scholarship to which this literature contributes (scholarship at the intersection of ethnicity and old age). In these concluding remarks, I will therefore only address a couple of the things that struck me as particularly worthy of our attention considering what the task at hand actually is. The first point to note – which was also the case regarding the literature on health inequalities presented in the previous chapter – is that because most of this literature comes from the US, this body of work draws attention to a very limited number of minority ethnic groups with very specific histories of oppression, in a very specific kind of socio-cultural context and welfare regime. Thus, even if there are some studies that give older people in minority ethnic populations from other parts of the world a voice (especially in comparison to what is the case for the literature on health inequalities), the vast majority of studies reviewed here are studies that only give us insight into how a very small percentage of minority ethnic populations regard health

119

Ethnicity and old age

and social care. If we take into account what was mentioned in the previous chapter regarding Fraser’s (1996) argument that if we are to combat the injustices that people in minority ethnic groups face, they must be represented, it can be noted that the literature reviewed here does not really take this into account. Thus, the fact that this literature could benefit from studies that give these populations a voice and which focus on societal settings that have more varied types of histories as far as inter-ethnic group relations are concerned, and/or that host a greater variety of minority ethnic groups, is something that is perhaps obvious to most. If we are to have a clear sense of how older people in minority ethnic groups regard the services that health and social care sectors around the world make available to them, and why they (at least in the US) use services to a lesser extent than one might expect considering the fact that they tend to have poorer health, we need to launch studies from other parts of the world that include other minority ethnic populations besides the ones that have received attention thus far. Understanding how older people from minority backgrounds regard the services that they take advantage of requires also far more research than what is available at present. The literature reviewed here gives us some insight into these questions, but not enough to be able to say that we have the type of knowledge we need in order to be able to know, not only if the services available are in fact catering to the needs of older people in minority ethnic groups, but also how we could go about designing and delivering health and social care services that meet their needs. Related to this is the fact that the literature on health and social care reviewed here is mostly based on the angle that care recipients offer, and therefore gives little insight into the views and experiences of the care planners and providers who are meant to cater to the needs of older people from minority ethnic groups. Adding that angle of investigation seems therefore to be a piece of the puzzle that a future agenda for this specific literature could address. The fact that so many of the articles reviewed refer to attitudes and behavioural patterns in passing instead of having aimed to explicitly address these patterns in their study design is also something worth mentioning, since the literature keeps on stating that ethnicity and/ or race matters but very seldom shows us how and why this is the case. However, in comparison to the literature on health inequalities, this literature does in fact fare a bit better in both of these respects. But there is so much more we need to do if we are to advance the study of how people from minority ethnic backgrounds access the health and social care services that are available to them, how they utilise services

120

Literature on health and social care

when they opt to utilise them, why they abstain from doing so in spite of the fact that their health is often worse than their majority ethnic counterparts’, and how they experience these services. Particularly baffling is the fact that almost none of the studies reviewed here take into account the impact that perceived discrimination may play for health and social care access and usage. This is surprising considering that most of the literature comes from the US, a country with a history of oppression that we all know continues to have an impact on ethnic relations. Thus, although we know that older people from minority ethnic communities experience barriers to accessing care, and utilise care to a lesser extent than their majority ethnic counterparts (at least in the US), we know in fact very little about why this is the case, since most studies that focus on, for example, assessing the suitability of services (at least during the period in question), are concerned with assessing new services but not already established ones. Last but not least, it must be noted that because most of the literature reviewed here comes from quantitative studies that rely on the ethnic or racial categories that the services or register data uses (instead of asking people themselves which ethnic group, if any, they identify with), we know in fact very little about older people from minority ethnic backgrounds and their own take on the role that their ethnicity/ race plays on these matters. And since we know very little about the potential mix-match between the ethnicity and race that the older people in minority ethnic groups are assigned to and the ones that they themselves regard as relevant, it is virtually impossible to know which ethnic and racial identities we are dealing with when discussing the barriers to access and usage of health and social care that the literature reviewed here brings attention to. There is, in short, a lot that remains unexplored about the intersection of ethnicity and old age in relation to health and social care, and an agenda for future research needs to take into account that in fact we are in dire need of discovery as opposed to reproducing what we think we know about these matters.

121

SIX

Literature on social relations and caregiving This is the last chapter that belongs to the part of this book based on the scoping review conducted prior to writing this book (for more information on this review, see the Appendix). This particular chapter is based on the literature on social relations and caregiving that brings attention to the intersection between ethnicity and old age that has been published in the 20-year period in focus in this review (n=52). As was the case in the previous two chapters this chapter begins by looking at where it is believed that research on the topic of this chapter was at before presenting the results of the scoping review. This is why I have consulted the handbooks, encyclopaedias and edited collections that are available in order to get a bird’s eye view of scholarship at the intersection that focuses on social relations and caregiving before diving into the results of the scoping review performed. In the entry on social relationships found in the Handbook of Aging and the Social Sciences, Krause has a specific section titled ‘Variations by race’ in which he writes that it is not uncommon to assume that different ethnic and racial groups have different cultural values and that this may influence their social interactions, although ‘findings from the literature on race differences in social relationships, however, are by no means clear’ (Krause, 2006: 194). Furthermore, after summarily addressing some of the questions that the literature has raised, he ends up suggesting that a future agenda for social gerontology in this area needs to include not only more sophisticated research on racial differences in relation to social relationship measures but also studies of the implications of cross-racial relationships for ageing/old age-related issues as well as cohort-astute studies of the differences found in social relationships among minority group members. In the chapter ‘Social relationships and health among minority older adults’ in the Handbook of Minority Aging, Lincoln (2014: 25) writes: ‘despite volumes of research on social support, many questions of conceptual, methodological, and theoretical importance remain. This is especially the case for older racial and ethnic minorities’. She lists ‘the widely accepted but recently challenged belief that some groups, such as African Americans and immigrants, receive more social support’

123

Ethnicity and old age

as one of the angles of investigation that deserves more attention (Lincoln, 2014: 25). In the same handbook, in their chapter ‘Social networks and minority elders’ Dilworth-Anderson and Hilliard draw attention to the fact that although presumptions about the importance of cultural values are common, there is much to be learned about how such values affect the social networks of older people from minority ethnic and racial groups. They argue therefore that we not only need methodological pluralism but also ‘more robust conceptual theories’ about the nexus between culture, ethnicity, race and social networks (Dilworth-Anderson and Hilliard, 2014: 413). Something else worth mentioning when it comes to scholarship on ethnicity and old age that draws attention to social relations and caregiving is that - contrary to what is the case when it comes to the other two topics that this book touches on (health inequalities and health and social care) – having a minority ethnic background is not always associated with being at a disadvantage as far as social relations and caregiving are concerned. That is at least the impression one gets when reading through handbooks, encyclopaedias and edited collections that address this topic while paying specific attention to ethnicity and old age. Even though it is a known fact that our social networks of affiliations tend to thin out as we grow older, research suggests - as Gelfand (2003) has posited in one of the few books focusing on ethnicity and old age – that older people with these ‘backgrounds’ sometimes fare better than their majority ethnic counterparts when it comes to caregiving, for example, which we will see later on in this chapter. Citing research from the late 1970s and 1980s he stresses that part of the reason why this is the case is that it is not uncommon for minority ethnic groups to live in closer proximity to their family members than is the case for their majority counterparts, and that it is also not uncommon for African-American families to live in multigenerational households. Since most research on older minority ethnic groups cited in handbooks, encyclopaedias and edited collections that draws attention to ethnicity and old age tends to focus on older African-American people as the minority ethnic group par excellence, it is not uncommon for such books to take for granted that minority ethnic communities tend not only to have larger families but also families who live closer to them and whom they can count on. The fact that the validity of this assumption could easily be questioned if the research were to be based on other minority ethnic communities and/or come from other countries is seldom acknowledged in these books. Thus, once again we see how a very specific type of reality is taken for granted without

124

Literature on social relations and caregiving

critically assessing whether it is a matter of the samples used as opposed to the actual groups being described (that is, minority ethnicities) and/ or a matter of the socio-cultural contexts explored that are actually at stake. Something else that is striking about the assumptions which are taken for granted and often made about minority ethnic populations is that ‘filial responsibility (the responsibility of children to their parents) is an important norm among many ethnic groups’ (Gelfand, 2003: 108). This is part of the reason why in some cases a minority ethnic ‘background’ can be considered an asset when it comes to social relations in general and caregiving arrangements in particular.

Main trends observed Having provided an idea of some of the assumptions that guide the scholarship that focuses on social relations and caregiving and draws attention to the nexus of interest to this book, it is now time to describe the trends observed while conducting the scoping review. But before I proceed, I need to restate what I mentioned in the Introduction; namely that one of the central questions one should ask oneself when theorising is what characterises the literature that is available, what is missing and where we should be heading if we are to advance the knowledge that we have accumulated thus far on the specific topic that we are interested in. That is why the chapters that belong to this part of the book do not offer any detailed insight into the articles reviewed. Instead these chapters focus on shedding light on the characteristics observed when addressing the literature as a whole, paying specific attention to what these characteristics tell us about how the intersection of ethnicity and old age is understood. Having made this clear, it seems necessary to mention that the themes which have received attention during the period in question, as far as social relations and caregiving are concerned, are social relations, social support and help (n=21), and caregiving (n=31). Now that we have a general idea of what the literature on social relations and caregiving focuses on, I would like to draw attention to the first trend observed in this scoping review, which is the fact that most articles on social relations and caregiving are based on studies that use quantitative methods. This is exactly the same pattern that I documented in relation to the other two topics that have received the most attention during the period covered in the scoping review that this part of the book is based on (health inequalities, and health and social care). By way of engaging with what is often referred to as disconfirming evidence, it is important to note, however, that the articles that rely on qualitative

125

Ethnicity and old age

methods explored an array of issues (and are here listed in the order in which they were published). Levkoff et al. (1999), for example, interviewed African-American, Chinese-American, Puerto Rican and Irish-American caregivers to older people with Alzheimer’s disease in order to explore the role that ethnicity and religion plays in their help-seeking behaviour. Through the use of diagrams and interviews, Armstrong (2000) studied the friendship networks of AfricanAmerican older women and compared them to the networks of older White women. Mahoney et al. (2005) conducted a meta-synthesis of interviews with African-American, Chinese and Latino family caregivers in order to assess the similarities and differences that these studies found concerning their impressions of the onset and diagnosis of dementia that the older people they cared for had received. Mand (2006) drew attention to the ways in which ethnicity and gender have an impact on the narratives of the social relations between Sikh men and women. Martinez et al. (2009) used focus group interviews to explore the social activities that African-American and White older women (of different socio-economic backgrounds) prefer to engage in and the ones they would like to participate in but cannot due to various barriers. Umberson et al. (2016) explored how tales of childhood adversity affect Black and White men’s relationships in adulthood. In the only qualitative study that is not based on data collected in the US, Palmberger (2017) shed light on the role that engagement in ethnic/ religious/political-based associations can have on the social ties and embeddedness of Turkish migrants in Vienna. Last but not least when it comes to the few qualitative studies on social relations and caregiving that draw attention to ethnicity and race, we have the two studies that used mixed methods. These are the study by Miyawaki (2017), who explored how the relationship between scores on filial responsibility and acculturation scales affected three generations of Japanese-American caregivers; and the study by Ajrouch (2017), who combined survey data with qualitative interviews in order to shed light on how the social relationships of Muslim people – with both migrant and non-migrant backgrounds and of various ancestral origins – are shaped. While some of the studies in this scoping review use qualitative methods and are therefore able to explore what ethnicity means to the understandings, practices and experiences of social relations and caregiving that they draw attention to, the vast majority of the literature reviewed here is based on studies that use ethnicity and race as proxies. When it comes to methodology, it is also important to note that two literature reviews and a meta-analysis are also part of this scoping review. One of the literature reviews focused on research published

126

Literature on social relations and caregiving

between 1996 and 2000 about the racial, ethnic and cultural differences that have been found when the dementia caregiving experience has been studied (Janevic and Connell, 2001); the other covered a 20-year period, focusing on the same issues but drawing attention to caregiving research in more general terms (Dilworth-Anderson et al., 2002); and the meta-analysis – which used quantitative methods – focused on ethnic differences in stressors, resources and psychological outcomes of caregiving (Pinquart and Sörensen, 2005). The second point worth mentioning as far as the general trends observed is that – just as was the case for the two other topics that this scholarship as a whole primarily focuses on (health inequalities, and health and social care) – the vast majority of peer-reviewed articles on social relations and caregiving reviewed here come from studies conducted in the US. Thus, once again, the focus is on the minority ethnic groups that have received the most attention in that context (African-American, Hispanic and Asian, in that order) and often in comparison with White people. In terms of the studies that come from other parts of the world, it is noted that one comes from Israel and focuses on Jews and Arabs (Lowenstein, 1999); two originate from Canada and focus on either Asians, East Asians, Southern Europeans and British (Keefe et al., 2000), or on people of English or French descent (Meshefedjian et al., 1998); one originates in the transnational space that migration between Punjab and Tanzania creates (Mand, 2006); one comes from the Netherlands and focuses on Turkish, Moroccan, Surinamese and Antillean people and the Dutch ethnic majority (Schans and Komter, 2010); two come from New Zealand and focus on Mãori, Pacific islander and Asian people, and the ethnic majority which is of European descent (Stephens et al., 2011) and on Mãori and the ethnic majority which is of European descent (Alpass et al., 2013); two studies come from the UK: one of them focuses on Indian, Pakistani and Bangladeshi, White British, White Irish, Black Caribbean, Black African and mixed descent people (Willis et al., 2013), while the other draws attention to White British, White Irish, South Asian, Mauritian and Black British people (Willis, 2012); and one comes from Austria and focuses on the Turkish population (Palmberger, 2017). Thus, just as was the case for research on health inequalities and research on health and social care, the literature that focuses on social relations and caregiving does not in fact take into account the range of socio-cultural contexts that could potentially affect what the networks of affiliations of older people in minority ethnic and racial groups, as well as the caregiving that their families provide them, look like. In other words, the fact that there are differences in the ways in which the formal services offered

127

Ethnicity and old age

by different welfare systems around the world affect these topics is something that we have yet to explore. The number of ethnic groups studied is also rather limited in this literature. Third – just as was the case in most of the articles that address health inequalities and those that focus on health and social care – very few articles on social relations and caregiving explicitly address the ways in which ethnicity and/or race are understood. By this I mean that few define what ethnicity and race means and also that few are explicitly alluding to the perspective that informs their work. With respect to the former – the few definitions alluded to in these articles – it seems interesting to note that there are differences in the definitions that are offered; differences that are quite telling about the sort of confusion about what ethnicity and race means that is characteristic of the scholarship in focus in this book. One of the few exceptions can be found in the article by Ajrouch et al. who studied the social networks of older Black and White people and stated that race is a social status that influences life chances such that minorities may incur more hardship and less opportunity than the dominant group, thus affecting network resources. Furthermore, racial status influences life chances in that minorities, even those with high education and high income, often experience stress from exposure to racism and discrimination. (Ajrouch, et al: S113) The fact that here – even though both Black and White populations are in focus – race is defined as minority status is illustrative of the confusion that seems to exist in most US studies about what it is that one studies when one studies ethnicity and/or race-related issues; a confusion the first author of this article acknowledges in one of her latest contributions to the study of ethnicity and old age (Ajrouch, 2017).1 In contrast to this definition of race, we have DilworthAnderson et al. who studied the cultural justifications that AfricanAmerican and White caregivers use to motivate why they provide care to their loved ones and who write – in relation to race and culture which are the two concepts that are critical to this specific study – that

1

In this contribution, Ajrouch aims instead to make sense of ethnicity by using the social constructionist perspective, which she describes as a perspective that ‘invites a focus on culture as a way of seeing as opposed to a way of being’ (Ajrouch 2017: 132).

128

Literature on social relations and caregiving

race is used in this discussion to provide a context for the life experiences of people based on their identified racial group classification and, when coupled with the discussion on culture, to provide a larger landscape from which to assess and interpret the lives of people. (Dilworth-Anderson et al., 2005: S257) The differences in the definitions that are offered when it comes to ethnicity are also rather tangible. In a study from Canada on the impact on ethnicity on helping older relatives, ethnicity is conceptualised ‘as including a cultural dimension and a structural dimension (capturing the relationship between ethnicity and social inequality)’ (Keefe et al., 2000: 318). Willis et al., who are the only ones that elaborate on the different ways in which ethnicity and race can be conceptualised and compare how US conceptualisations differ from British ones, write that In Britain, the concepts of race and ethnicity are intertwined. Ethnicity refers to a sense of belonging to a group of people who share characteristics such as cultural values, language, religion, history and skin color … Therefore, in the British context, ethnicity is similar to both ethnicity and race as understood in the United States. (Willis et al., 2013: 279) In their qualitative study of the role that religion and ethnicity play in the help-seeking behaviour that family caregivers – who care for older people with Alzheimer’s disease and are of African-American, Chinese, Puerto Rican or Irish-American descent – Levkoff et al. (1999) also define ethnicity. They write that they view ethnicity as a threecomponent construct: ‘1) as a set of local cultural resources available for constructing identity and developing behavioral strategies, 2) as a means for negotiating differences in interpersonal and institutional settings, and 3) as a form of identity’ (Levkoff et al., 1999: 337). Last but not least when it comes to definitions of ethnicity, we have the one offered by Pinquart and Sörensen who write that ethnic or ethnocultural groups are distinguished on the basis of a common history, a unique language or communication system, group-held values and beliefs as well as normative expectations and attendant customs and practices, the intergenerational transmission of these shared values, and a common locale or country of origin. (Pinquart and Sörensen, 2005: 90)

129

Ethnicity and old age

All in all, it is clear that huge differences exist in how the few articles that define ethnicity and/or race in the literature on social relations and caregiving at the intersection between ethnicity and old age conceptualise these constructs. This, as well as the fact that so few of the articles reviewed here actually define them at all, makes it easy to understand why Dilworth-Anderson et al. in their review of articles on caregiving published between 1996 and 2000 write in their conclusion that ‘when we as researchers use race as a proxy for understanding the issues noted earlier, the underlying meaning of racial and ethnic diversity is not fully conceptualized in our research’ (Dilworth-Anderson et al., 2002: 267). However, despite the fact that the understandings of ethnicity that mostly inform the literature are the essentialist/primordialist or the structuralist/circumstantialist perspectives or a combination of the two (see Chapter Three for insight into what these perspectives are about), there are a few articles that claim to be informed by the social constructionist perspective on ethnicity (Stoller, 1998; Ajrouch, 2017; Palmberger, 2017). Related to all of this is also the fact that only two of the articles reviewed here acknowledge that ethnicity and race are, in fact, rather elusive constructs as stated in Chapter Three. The first of these is the study from Canada by Keefe et al. (2000) who reported on the fact that 274 ethnic groups were originally generated by their sample’s responses to the question they had posed in order to operationalise ethnicity (which was: ‘In addition to being Canadian, to which ethnic group do you feel you belong?’). They also state in their article that even though they instructed their respondents to only give two responses to this question, they ended up with as many as 274 ethnic groups and therefore had to narrow down the groups they originally had by combining different ones into bigger groups so that they could assign their respondents to a feasible number of groups. A similar challenge was acknowledged in one of the UK studies included in this review. Willis wrote that the ‘participants sometimes chose different terms for themselves from those the census form would use to categorise them’ (Willis, 2012: 206), and that ‘many rejected the census categories when given the choice, which demonstrates the difficulties and sensitivities around reducing ethnic identity to a few categories in the census’ (Willis, 2012: 212). Thus, even if two of the articles reviewed here acknowledge the elusiveness of the constructs they are dealing with, most of the articles do not acknowledge that there are different angles from which ethnicity and/or race can be studied (that is, others’ identification, group members’ identification and the attitudinal/behavioural patterns with

130

Literature on social relations and caregiving

which the group is associated) and neither do they take into account that not all of these components need to overlap. This is therefore my fourth point, as far as the general trends observed in this literature. This means that the vast majority of the articles reviewed here are actually studying ethnicity and/or race from the premise of others’ identification with little regard for the way in which people self-identify as far as these social positions and/or backgrounds are concerned. The fact that most articles do not take into account the actual attitudinal and behavioural patterns that characterise ‘membership’ of the minority ethnic groups that people are claimed to be members of is also something that must be noted, as is the fact that componentoverlap is always taken for granted. These two observations constitute my fifth and final point as far as the main trends observed in the literature on social relations and caregiving are concerned. Thus, although most of these articles end up alluding to the patterns that they believe characterise membership of the groups they focus on in their discussion sections, they are in fact not based on studies that have taken these patterns into account in their design nor address this angle explicitly. In light of this, it is perhaps not surprising to note that it was not uncommon to find statements such as the following towards the ends of the articles reviewed in this chapter: ‘given our findings when conceptualizing race as a marker of social status, future research needs to explore ways in which cultural beliefs, values, and the distribution of resources are related to caregiving strain’ (Bowman et al., 1998: 561). As with Chapters Four and Five, more detailed information now follows about the specific themes that have received attention in this literature. Social relations and social support/help Contrary to the literature on caregiving, the literature on social relations and social support/ help is a bit disparate regarding the themes that it addresses. The articles that focus on social relations and social support/ help come mostly from the US and almost always compare Black people with White people and, with few exceptions, compare these two groups with Hispanic and/or Asian people. For example, Baxter et al. (1998) compared the impact that social network factors have on the perceived quality of life of rural Hispanic and non-Hispanic White communities. Armstrong (2000) studied the friendship networks of African-American and White women to find out whether these women’s networks differed in size, composition, recruitment strategies and opportunities for support exchange. Peek and O’Neill (2001)

131

Ethnicity and old age

studied the differences between the social support networks of White and Black people. Laditka and Laditka (2001) drew attention to racial differences in adult children’s likelihood of spending time, and hours actually spent, in helping their parents. Ajrouch et al. (2001) studied the effects that age and race have on the size, frequency of contact, geographical proximity and composition of the social networks of Black and White people; Szinovacz et al. (2001) studied the ways in which gender, race and marital status affected the ways in which family obligations played a role in people’s retirement decisions. Fiori et al. (2008) studied the social exchange patterns of older people who were US-born European-American, immigrant Russian/Ukrainian, USborn African-American, and immigrant English-speaking Caribbean; and in another study the effects that ethnicity, gender and income have on the attachment styles of older people who were African-American, English-speaking Caribbean, Haitian, Dominican, Puerto Rican, Eastern European and European-American are the focus of attention (Fiori et al., 2009). Martinez et al. (2009) shed light on the ethnic and class variations in the social activities that older African-American and Caucasian people found interesting, and the factors that influenced their participation. Tsunokai and McGrath (2011) explored the willingness of Black and White people to cross racial boundaries when searching for love through a matchmaking website; Park and colleagues (2014) drew attention to the ways in which family cohesion and family conflict are associated with depression among older Asians and Latinos. Umberson et al. (2017) in turn shed light on the ways in which childhood adversity affected White and Black men’s relationships in adulthood. The two studies of social relations, social support/help that come from the US but did not utilise the usual samples are the studies by Stoller (1998) who explored how Finnish-American retirement enclaves affected the informal exchange with non-kin that this group engages in; and the study by Ajrouch (2017) who focused on the social relations of a varied group of Muslim-American people. Irrespective of their focuses and samples, most of these articles end up concluding that ethnic/racial differences do exist when it comes to the types and angles of social relations that they studied (for example Armstrong, 2000; Ajrouch et al., 2001; Fiori et al., 2008, 2009; Martinez et al., 2009; Tsunokai and McGrath, 2011; Park et al., 2014). Disentangling why this is the case is not possible, however, since most of these studies do not in fact address what exactly it is about ethnicity or race that accounts for the differences observed. A look at the literature that focuses on social relations, social support/ help that does not come from the US and which therefore draws

132

Literature on social relations and caregiving

attention to ethnic groups that are seldom in focus in scholarship at the intersection of ethnicity and old age reveals that the following topics have been investigated: the impact of ethnicity on the provision of help to older relatives in Canada, focusing on British, Eastern European, North-Western European, Southern European, Asian, East Indian, French and Caribbean people in a sample of employed Canadians (Keefe et al., 2000); the social relations that older Sikh men and women have established while moving from Punjab to Tanzania (Mand, 2006); the ethnic differences in intergenerational solidarity in the Netherlands looking specifically at Dutch, Turkish, Moroccan, Surinamese and Antillean populations (Schans and Komter, 2010); the effects of social network types, perceived social support received and loneliness on the health of older people in New Zealand, looking specifically at Mãori and non-Mãori (Stephens et al., 2011); the UK study of whether ethnicity determines the instrumental support that people received, which zeroed in on White British, White Irish, Other White groups, Indian, Pakistani, Bangladeshi, Black Caribbean, Black African groups plus a category they called mixed, and another they called other ethnic groups (Willis et al., 2013); and the study in Austria of the social ties that older Turks have established through cultural associations in Vienna (Palmberger, 2017). In terms of findings, it is noted that the literature that originates from other parts of the world (that is, not from the US) ends up suggesting either that ethnicity or race matters (for example, Mand, 2006), that the observed differences are better explained by socioeconomic and/ or other structural family-related factors (for example, Keefe et al., 2000; Stephens et al., 2011; Willis et al., 2013) or that ethnicity/race matters sometimes but not for all of the angles of investigation that a study has shed light on (for example, Laditka and Laditka, 2001; Schans and Komter, 2010). Caregiving (and receiving) The literature about the nexus in focus here that draws attention to caregiving is mostly based on those who provide care. However, there are a few articles that draw attention to the older people who are receiving the care. These are the study by Peek et al. (2000) who explored how older African-American and White people experience the care they receive; the study by Feld et al. (2004) who focused on White, Black and Mexican-American people and explored whether race/ethnicity or marital status explains caregiving networks; the study by Lum (2005) who examined the caregiving networks of older

133

Ethnicity and old age

White, Black and Hispanic people; the study by Roth et al. (2007) who asked community-dwelling middle-aged and older adults if they have a potential caregiver in their networks; and the study by Min and Barrio (2009) who explored the caregiver preferences that older Mexican-American and White people had in the event of a hip fracture. Irrespective of the angle of investigation that these studies followed, it is clear that there are ethnic/racial differences in the themes they explored. Three of these studies explained those differences by referring to either family structure (Peek et al., 2000) or family/household structure in combination with socioeconomic status and/or cultural values (Feld et al., 2004; Lum, 20052). Another study talks about race and marital status as the variables that explain the differences they found (Roth et al., 2007). Finally we have the one study that actually took cultural factors into account in the actual design, and found that these matter (Min and Barrio, 2009). Thus, once again, because few studies operationalise what it is about ethnicity/race that the researchers believed to be influencing the differences they tapped into, it is difficult to know what exactly it is that these studies are shedding light on other than the existence of differences between groups. The only study that added ethno-cultural values to its design (Min and Barrio, 2009) did end up finding, however, that these account for the ethnic differences found. A few words about this study are merited, since this is one of the few studies that actually took into account in the study design the ethno-cultural values that could potentially explain the ethnic/ racial differences that the authors expected to find. Min and Barrio (2009) added four statements measuring cultural values to Andersen’s behavioural model of health care utilisation (which is one of the most commonly used models in the health care utilisation literature). By doing so, they were able to account for the differences they found, since fewer Mexican American older people preferred to rely on formal caregivers and more of them would rather rely on informal caregiving networks. Thus, these authors go as far as stating that ‘in the present study, variables that have been associated with preference for long-term care in previous research (that is, age, gender, education, self-rated health status and functional limitations) did not have a significant effect on preference for the caregiving arrangement’ (Min and Barrio, 2009: 235). In doing so they are, in fact, implicitly criticising studies that use 2

It is worth noting that neither of these studies operationalise what they mean by cultural values. They have found differences and attribute them to either cultural values or ethnicity/race but they have not, in fact, studied this angle.

134

Literature on social relations and caregiving

ethnicity and/or race as a proxy as opposed to actually tapping into the ethno-cultural values that these social positions are associated with. In terms of caregiving from the perspective of those who provide care – which is the perspective most studies about this topic are actually based on – it must be noted that the range of issues investigated is pretty large. Besides the studies that are either based on reviews of the existing literature or meta-analyses of it, which I will come back to at the end of this section (Janevic and Connell, 2001; Dilworth-Anderson et al., 2002; Pinquart and Sörensen, 2005), there are a few sub-themes under which these studies could be categorised. One of these has to do with whether the studies focus on caregiving without referring to a specific type of disability, even if disability or health concerns among the care recipients are acknowledged, of course,3 or whether the studies are about caregiving when a person is suffering from Alzheimer’s or another type of dementia.4 And as it is clear just by counting the number of studies (see Notes 3 and 4 below) there are fewer studies that draw attention to caregiving in cases of dementia than there are studies approaching caregiving in more general terms. Another way to categorise the literature on caregiving based on the perspectives of the caregivers is to use the themes that the articles explore as one’s point of departure. If we were to do this, we would find that roughly speaking this literature can be divided into five themes. The first theme comprises articles that draw attention to the variations in either caregiving availability or caregiving networks among different ethnic/racial groups. These are articles that explore what it is (for example, race/ethnicity, culture, gender, socioeconomic status, family and/or household structure, marital status or working conditions) that determines the ethnic and racial differences in caregiving that they find. For example, White-Means and Rubin (2008) draw attention to caregiving patterns of Black and White people and find that, although there are similar patterns in ADL (activities of 3

4

As is the case with the studies by Bowman et al. (1998), Peek et al. (2000), White et al. (2000), Navaie-Waliser et al. (2001), Feld et al. (2004), Lum (2005), DilworthAnderson et al. (2005), Roth et al. (2007), White-Means and Rubin (2008), Kim and Knight (2008), Min and Barrio (2009), Willis (2012), Lahaie et al. (2012), Alpass et al. (2013), Friedemann et al. (2013), Rote et al. (2014), Santoro et al. (2016) and Miyawaki (2016, 2017). As is the case with Meshefedjian et al. (1998), Lowenstein (1999), Levkoff et al. (1999), Ho et al. (2000), Burgio et al. (2003), Gallagher-Thompson et al. (2003), Mahoney et al. (2005), Hilgeman et al. (2009), Heo and Koeske (2011), Sun et al. (2012).

135

Ethnicity and old age

daily living) support, both parental need and race influence the IADL (instrumental activities of daily living) support that caregivers give to their parents. It is worth noting, however, that the study design does not, in fact, operationalise exactly what it is about race that matters, since race is used as a proxy rather than being operationalised in a more sophisticated fashion. Lahaie et al. (2012) zeroed in on White, Black, Hispanic and the category they call ‘Other’ in their study of what working conditions mean for caregivers and also what caregiving has meant to people’s job outcomes. They found that gender, immigration status and educational attainment are better predictors of working conditions and caregiving job outcomes than ethnicity. Friedemann et al. (2013), who used a variety of measurements (including some looking specifically at ethno-cultural values), focused on Cuban, other Hispanic, non-Hispanic White and Caribbean Black people in Miami, Florida, when studying what influences caregiving patterns. They found that ‘very few group differences based on ethnicity in the way that caregivers felt about their role, took care of patients, and reacted to their situation’ (Friedemann et al., 2013: 148). Last but not least in this category we have the study by Miyawaki (2016) who focused on Asian, Hispanic and non-Hispanic White people in California and explored whether assimilation theory could explain differences across generations’ caregiving practices. She finds that the ‘caregiving patterns revealed underlying cultural values related to filial responsibility, even among later generations of caregivers of color’ (Miyawaki, 2016: 35). All in all, studies that draw attention to caregiving patterns, networks and/or preferences end up suggesting different things concerning the influence of ethnicity and race. Thus, despite the fact that ethnic and racial differences are often found, there does not seem to be any consensus (at least within this theme) as to what it is that leads to the differences observed. The second theme that characterises the literature on caregiving reviewed here is the one concerned with caregivers’ understandings or experiences. For example, the study by Navaie-Waliser et al. (2001) which drew attention to White, Black and Hispanic caregiving experiences found a variety of similarities but also differences worth commenting on since these authors found a pattern that is often alluded to in the previous research to which most studies refer; namely that while Black caregivers appear to have a heavier caregiving workload, they are half as likely as White caregivers to report difficulty in providing this care. The study by Mahoney et al. (2005), which explored how African-American, Chinese and Latino caregivers regarded the onset and diagnosis of dementia, found that ‘a lack of

136

Literature on social relations and caregiving

knowledge about Alzheimer’s disease rather than culturally influenced beliefs was the major deterrent to having an elder’s memory assessed’ (Mahoney et al., 2005: 783) and is also an example of a study of caregiving, ethnicity and old age that draws attention to caregivers’ understandings or experiences. The study by Dilworth et al. (2005), which uses the Cultural Justifications Caregiving Scale to study how African-American and White groups explain why they provide care to their dependent older relatives, found that although education and gender have an impact on how cultural justifications are used, AfricanAmerican people tend to rely more heavily on them when justifying the caregiving they engage in. The study by Santoro et al. (2016) is also interesting in this regard, since it looks at a range of factors (such as perceived filial responsibility and perceived severity of health condition) in order to establish if White, Black, Asia-Pacific Islander and Hispanic caregivers would hire health care advocates. Last but not least, with regard to the second theme which I am claiming can be used to categorise the caregiving literature at the intersection in focus here (that is, understandings and experiences), we have the study by Willis (2012) of the cultural assumptions that White-Irish, White-British, South Asians, Mauritian and Black-Irish older people use to explain why they engage in family caregiving. In this study, Willis found that culture-based explanations were given more commonly by the nonWhite-British people in her study. All in all, these studies – which are all examples of caregiving studies addressing either understandings or experiences and are designed so that the impact of ethno-cultural values on the differences they find can be explained - raise questions about the studies’ failure to assess cultural values. This failure often leads to findings pointing us in other directions (such as, for example, socioeconomic factors) when trying to explain the ethnic/racial differences that have been documented. This is the case not only in the caregiving literature but also in the literature on other issues discussed in the previous chapters. The third theme into which one could categorise the articles on caregiving based on the caregivers’ perspectives is the one made up of studies that address the effects of caregiving on well-being, physical and mental health. In this category we find the following studies: the study by Meshefedjian et al. (1998) on the factors associated with depressive symptomatology among informal caregivers to people suffering from dementia in the community; as well as the study by Lowenstein (1999), which compares Jewish and Arab caregivers in Israel and found that ethnicity (which is not operationalised in terms of ethno-cultural values but is only used as a categorisation device for

137

Ethnicity and old age

the sample) and parent-child relations were the strongest predictors of health in these caregivers. In addition, there is the study by White et al. (2000) focusing on African-American and White people, which found that although African-American women reported less stress and more rewards in their parental caregiving role than White women did, there was no significant difference by race for depressive symptomatology; also the study by Kim and Knight (2008) of Korean-American people who explored whether the common assumption that caregiving status is associated with poor health holds for this particular population and found that this was so for this group as well. The study by Alpass et al. (2013) of Mãori and non-Mãori people in New Zealand, which explored whether Mãori provide more care than the non-Māori and if care provision is associated with poor health, needs to be mentioned here as well. They found that this was the case on both counts and also that gender, as expected, also determined who provides care. The study by Rote et al. (2014) of Mexican-American caregivers explored what type of impediment in the older people receiving the care was associated with depressive symptoms in the caregivers. All of these studies are examples of literature on caregiving at the intersection of ethnicity and old age which focus on what caregiving means to people’s health. The importance of ethnicity to these findings is not as clear cut in these studies except for White et al. (2000), who singled out the seemingly paradoxical situation in which African-American caregivers sometimes find themselves (that is, providing quite a lot of care, yet feeling less stress and finding caregiving to be rewarding). The fourth theme into which we can categorise the studies on caregiving and the nexus in focus here focuses on caregiving stress either as a theme on its own or in relation to other issues. For example, Hilgeman et al. (2009) tested a theoretical model for the study of stress processes in Alzheimer’s caregiving using race as a moderator and focusing on White, Black and Latino caregivers. They found that ethnicity/race did moderate the stress that caregivers experienced but in different ways depending on what resources these groups have at their disposal. By drawing attention to African-American, Chinese and Latino caregivers who belong to less educated and more economically disadvantaged groups, Ho et al. (2000) studied what caregiving stress meant to these minority ethnic groups’ use of social services. They concluded that although no significant ethnic differences in the need for services was found, unmet need for services did vary according to ethnicity. Sun et al. (2012) explored whether ethnic differences existed in the ways in which quality of care – as perceived by caregivers – predicted their desire to institutionalise the people with

138

Literature on social relations and caregiving

dementia whom they cared for. They found that there were indeed differences and that these need to be taken into account when designing interventions in order to address caregiving stress. Last but not least, when it comes to studies of caregiving that focus on caregiving stress, we have the two intervention studies designed to alleviate this stress: Gallagher-Thompson et al. (2003), which focused on Anglo and Latino female caregivers and found no ethnic differences in the ways in which caregivers responded to the interventions; and Burgio et al. (2003), which drew attention to how White and African-American caregivers responded to two psychosocial interventions and found that there were indeed differences. All in all these studies found that, for the most part, ethnicity/race seems to matter even if once again we cannot always know exactly why this is the case. The fifth theme comprises studies of caregiving that draw attention to either religious coping or to the role that religion plays in caregivers’ help-seeking behaviours. The study by Heo and Koeske (2011), for example, looked at how African-American, White and Hispanic people use religion to cope and what this meant to how they appraised their caregiving burden. They found that African-American people use religion as a coping strategy the most. Levkoff et al. (1999) studied the role that religion plays in the help-seeking behaviours of AfricanAmerican, Chinese-American, Puerto Rican and Irish-American caregivers and found that religion and ethnicity can both aid and hinder caregivers from seeking help. As stated earlier in this section, besides the studies that focus on caregivers and the ones that focus on care recipients, there were three review/meta-analysis-type articles during the period in focus here. These review-type articles had slightly different aims. The study by Janevic and Connell (2001) was a follow-up study (using the same methodology used by Connell and Gibson 1997 and analysing what studies published between 1996 and 2000 (n=21) on dementia caregiving experiences claimed as far as racial, ethnic and cultural differences are concerned). They found that previous research on caregiving has consistently found that White caregivers appraise caregiving as more stressful and tend therefore to report greater depression than their African-American counterparts, but that ethnic differences with regard to caregivers’ coping and support are more mixed. It is worth noting that one of the conclusions they draw from their review is that most studies in fact do not test the specific pathways by which race/ethnicity exerts the impact that the studies claim that these backgrounds/positions exert.

139

Ethnicity and old age

The other literature review published during this period is the one by Dilworth-Anderson et al. (2002) who conducted a narrative analysis of what 20 years of research on caregiving in general (not just dementia caregiving) has claimed when it comes to ethnicity/ race and culture. They found similar results to Janevic and Connells (2001) and end up asserting that ‘future research on caregiving needs to give more attention to such issues such as acculturation, assimilation, and cultural values, beliefs and norms’ (Dilworth-Anderson et al., 2002: 237) since our persistence in using ethnicity/race as a proxy for difference does not in itself allow us to actually tap into what it is about these social positions/backgrounds that actually leads to the differences that have been found. Last but not least, when it comes to the review-type studies of caregiving at the intersection of interest here we have Pinquart and Sörensen’s (2005) study, which is a metaanalysis of the 116 caregiving studies published before 2004 that draws attention to the nexus of interest to this book. Their focus is on ethnic differences in stressors, resources and psychological outcomes of family caregiving and their findings indicate that ‘observed ethnic differences in burden and depression were influenced by study characteristics, such as type of illness of the care recipient and the representativeness of the sample’ (Pinquart and Sörensen, 2005: 90). In spite of this, they stress that ‘specific theories are needed to explain differential effects of ethnic minority groups of caregivers’ (2005: 90) since it is clear that most studies have shown not only that minority ethnic caregivers tend to offer more care than their White majority counterparts and have stronger filial obligation beliefs, they also differ in their socioeconomic backgrounds, since they tend to have a lower socioeconomic status, are often younger and less likely to be a spouse, and are more likely to receive informal support.

Concluding remarks There are several points that need to be noted when thinking of the knowledge that the literature on the intersection of ethnicity and old age which addresses social relations and caregiving has generated over the period in focus here (1998–2017). As was the case with the literature on health inequalities and on health and social care (which were the focus of the previous two chapters), this chapter aims, after all, to address what characterises this literature as well as what it suggests about scholarship on the nexus that this book focuses on. In other words, this review is not meant to assist those interested in conducting research on social relations and caregiving at the intersection between

140

Literature on social relations and caregiving

ethnicity and old age but rather to assist those who are interested in grasping how literature on social relations and caregiving contributes to scholarship on ethnicity and old age. This book aims to set an agenda for future research that is imaginative enough to advance this scholarship’s understanding of ethnicity while being astute enough about the various challenges entailed by the societal trends referred to in Chapter Two (population ageing and the globalisation of international migration) and the innovations of ethnicity scholars as referred to in Chapter Three. But before this can be accomplished, we need to draw attention to what characterises the understandings of ethnicity that characterise the literature on social relations and caregiving. First, most of the studies reviewed here are based on quantitative research. This means that the majority of the studies referred to in this chapter use ethnicity and/or race as a proxy (or as Cashmore, 2004, calls it, a classifier), and do not actually engage in any substantial way in exploring what the identification grounds in focus here (ethnicity and race) actually mean to social relations and caregiving in old age. Thus, although some articles end up suggesting that ethnicity makes a difference to the topics that they focus on, there are also some that claim that ethnicity does not matter. Thus, taken as a whole, the literature on social relations and caregiving reviewed here gives inconclusive evidence about the role that ethnicity plays in the social relations that older people engage in, the support and help they receive, the caregiving that adult children offer to their parents, and the caregiving that older people offer to other older people. Taken as a whole, the discussion sections of most of the articles reviewed here end up suggesting an array of things about ethnicity and old age but fail to actually show us – in a convincing enough fashion – whether ethnicity matters and if so, how. Second, it must be kept in mind that because most of this literature comes from the US, this body of work draws attention to a very limited number of ethnic groups which hold – presumably – very specific ethno-cultural values, live under specific socioeconomic circumstances (with all that this is bound to entail for social relations and caregiving), and have access (or lack access) to very specific kinds of formal care services. Thus, if we take into account what has been mentioned in previous chapters about Fraser’s (1996) argument regarding what is needed if we are to address injustices of different kinds, it seems necessary to note that, on the whole, the literature reviewed here does not really do a good job when it comes to the angle that Fraser calls representation, since so few of the ethnic backgrounds that could potentially be studied when it comes to social relations and caregiving

141

Ethnicity and old age

in old age have, in fact, received attention. It is because of this that I would argue that this literature could benefit from studies conducted in more varied social, cultural and historical settings and focusing on ethnic groups whose social relations and caregiving we have yet to shed light on. Third, relatively few articles address the ways in which ethnicity and/or race are made sense of. Just a few of the articles reviewed here offer a definition of ethnicity and/or state explicitly how they understand this identification ground, social position or social location. Thus, taken as a whole, this literature does not really engage with the complexities referred to in Chapter Three and/or give the impression of being aware of the differences in understandings of ethnicity that inform the scholarship of those who specialise in this identification ground. In other words, although a few articles seem to be informed by the latest development in ethnicity scholarship (the social constructionist understanding referred to in Chapter Three), the literature on social relations and caregiving as a whole gives the impression of being stuck in a bit of a time warp as far as understandings of ethnicity are concerned. Related to the complexities associated with this identification ground, it must be noted that two of the articles reviewed for this chapter acknowledge the fact that ethnicity and race are elusive constructs especially when one tries to take into account how people regard themselves in ethnic and racial terms instead of relying on researchers’ identifications or the frequently used ‘chooseone-of-these-alternatives’ approach (Keefe et al., 2000; Willis, 2012). Last, when it comes to the trends observed in the literature on social relations and caregiving, it seems important to note that a couple of topics are either missing in the period reviewed or have received limited attention. Few articles on social relations look at the impact that ethnicity and race can have on friendships and/or intimate romantic relationships, and none of them measures the impact that perceived discrimination could have on either one of these themes. In terms of caregiving, it is noted that few articles shed light on the impact that ethnicity can have on how caregiving preferences, understandings and/or experiences, and none shed light on the impact that this identification ground could have for how caregiving responsibilities are negotiated within families. A closer look at the titles of the articles reviewed here will show that not all of the angles of investigation that have been addressed in the caregiving literature reviewed here have been addressed with a range of ethnic groups, so there is more to be done on this as well. In short, the literature on social relations and caregiving that draws attention to the intersection between ethnicity

142

Literature on social relations and caregiving

and old age just scratches the surface of what ethnicity means for these topics and seems – on the whole – in dire need of being developed further as far as the understandings of ethnicity and race that inform it.

143

SEVEN

A new agenda: where we are at and need to head for Ending a book is always one of the exciting parts of writing one. It is in the concluding chapter that one wraps things up and argues, in a nutshell, for what the book has offered to the scholarships to which it aims to contribute. A book’s conclusion should therefore spell out what one ought to have learned while reading it. Referring back to this book’s Introduction therefore seems like a good way to start. After all, we need to recap what it is this book intended to do if we are to summarise what it claims to have accomplished. Thus, it seems necessary to restate that I started by stating that this book aimed to expand the imagination of scholars working on the intersection of ethnicity and old age, and show where the potential for growth lies as far as our scholarly understanding of what it is that ethnicity and race mean for the study of ageing and old age. The reason why I began this journey is that I had noted that the ways in which social gerontologists made sense of ethnicity and race did not chime with the advancements that have been made in scholarship that focuses on these identification grounds over the past few decades. I suspected that this was bound to have consequences for ‘the imagination’ of scholarship on the intersection of ethnicity and old age. Back then, I didn’t quite know exactly what the state of this scholarship was like, but since I am a sociologist whose critical gerontology research uses ethnicity scholarship to expand the gerontological imagination, I felt I could make an educated guess. Thus, in the introduction to this book I proposed that social gerontologists (myself included, of course) were at a crossroads since, as a whole, our scholarship needed to rethink how it made sense of ethnicity and race. I argued also that this very fact - together with the fact that ethnicity scholars (and especially those working on migration) had just recently discovered old age and ageing as angles of investigation for their inquiries - meant that the time was right to embark on a theorising exercise so that we could take stock of what we knew and needed to find out as far as understandings of ethnicity were concerned in relation to scholarship that focuses on the intersection of ethnicity and old age.

145

Ethnicity and old age

Inspired by the notion of theorising, which was introduced over a century ago and which Swedberg (2012a, 2012b) has reignited interest in, and the ideas on ‘intellectual craftsmanship’ that C. Wright Mills (1959) wrote about when coining the concept of the ‘sociological imagination’, I set out to conduct a scoping review of the past 20 years of scholarship in question, focusing specifically on the understandings of ethnicity and race that inform this scholarship. I did this because I believe there is a difference between the context of discovery (in other words, where we make observations that could potentially guide the formulation of theory) and the context of justification (that is, where the testing of hypotheses takes place). Also I thought Swedberg’s claims, that social scientists’ capacity to formulate theory could stagnate when our priorities shift from discovery-oriented research to justification-driven work, resonated well with the assessment of social gerontologists Birren and Bengtson (1988) that our field was characterised by ‘data richness but theory poorness’ and the contention of ethno-gerontologists that their field was not only characterised by atheoretisation but by culture irrelevance (see, for example, Usui, 1989; Burton et al., 1992; and Torres, 1999, 2001, to name a few). According to Swedberg, in order for us to be able to discover new things about the fields of research we want to contribute to we need to engage in theorising. This entails wrestling with the core ideas of these fields and is the reason why Part 2 of this book is based on a scoping review that explored what characterises the strands of literature that have received the most attention from the scholarship in question over the past two decades. And since the theorising exercise I embarked on led to the writing of this book, I could not just ‘wrestle with those core ideas’; I had to offer some insight into the general themes that these literatures have focused on while describing the ways in which ethnicity and race have been addressed in this scholarship. In this chapter, I therefore summarise the results of the theorising exercise in the previous three chapters, as well as the coding of the articles that were part of the scoping review but did not get a chapter of their own due to the fact that they were about too many disparate topics. The time has come, in other words, to spell out what the context of discovery has meant for my own realisation that if we are to move forward in more ethnicity- and race-astute ways, and to expand the imagination of this intersection as the sub-title of this book states, we need to come to grips with the obstacles that our imagination is facing. Failing to address these obstacles means risking that the formulation of theory that the context of discovery could potentially lead to (but which is not part of what this book has aimed to do) may never take place. There is

146

A new agenda

also an impending risk that failure to address these obstacles will lead to a scholarship that remains oblivious to the fact that globalisation, international migration and transnationalism not only challenge the understandings of ethnicity and race that inform this scholarship but urge us to rethink how research on the intersection in question is to be conducted in the future. Hence, the sections that follow will address the array of obstacles that we face (and some of the reasons why these need to be addressed) and will delineate the contours of a future agenda for research at the intersection ethnicity and old age. It is worth noting perhaps that some of the obstacles listed below are obstacles that are intimately related to each other. However, the reason why I list them one by one is that not all of the articles reviewed that I would list as illustrative of how one obstacle manifests itself, and which at first glance we might deem to be intimately related to another, are necessarily illustrative of other obstacles as well. Thus, the presentation below is not interested in the interaction between obstacles (even if it acknowledges of course that some of these themes are intimately related to one another), and neither is it interested in arguing which of these obstacles can be deemed to be a cause and which an effect. An interest in both of these things would mean that I would begin to shift my attention away from the context of discovery, since both of these angles are about the formulation of hypotheses and I do not believe that we are there yet. Instead, and in order to remain true to the context of discovery that is this book’s main focus, the focus henceforth is on listing the array of obstacles that the scoping review clearly shows that we are facing and some of the reasons why these need to be addressed. Thus, although I will indulge in delineating the contours of a future agenda for scholarship at the intersection of ethnicity and old age which is, of course, part of how one prepares to move on to the context of justification, I do not presume to have the ‘solution’ to the obstacles that I present here. What I am proposing is that in order to move forward, we need to grasp why our scholarship’s imagination is facing these obstacles, and why it is that we need to address them.

Obstacles posed by the lack of an explicit research agenda The first obstacle I believe our scholarship is facing is the fact that our work does not seem to be guided by a sufficiently clear agenda as to what it is that we are hoping to accomplish in terms of our understandings of ethnicity, race and old age. The scoping review performed suggests instead that most of the research that has been

147

Ethnicity and old age

conducted on the intersection of ethnicity and old age over the past 20 years is based on studies that are interested in other topics (such as health inequalities, health and social care, and social relations and caregiving) and just happens to have ethnicity and race data that we can exploit. In other words, the different strands of literature that make up the scholarship at the intersection in question lack an agenda for what it is trying to accomplish (if anything) in terms of how to make sense of the relevance of ethnicity and race to ageing and old age. It is because of this that the sections which follow – that address each of the obstacles associated with this very obstacle of a lack of a research agenda – include a section based on what unleashing our imagination on ethnicity and old age while informing our scholarship with the lessons learned in Chapters Two and Three of this book could lead to. In other words, after each of the sections that follow addressing one of the various obstacles that the scoping review identified, I include a series of suggestions for questions that could be posed if we were to formulate an ethnicity- and race-astute agenda for research on the intersection of ethnicity and old age that is equipped to address the challenges that the globalisation of international migration and transnationalism poses (as delineated in Chapter Two) and which is informed by the advances made in understandings of ethnicity and race (as described in Chapter Three). It is worth noting that I address each of these obstacles in the order in which I think these obstacles could be tackled. The obstacles I start with are therefore those that are about the need to increase the input from scholarship originating from other socio-cultural settings and/or using other methodologies, while towards the end of the chapter I tackle obstacles of a more analytical nature. Thus, the sections that follow move from addressing the ‘material’ aspects that the scoping review have revealed as aspects that require our attention to addressing ‘abstract’ aspects that demand greater reflexivity and are more about unleashing our imagination in ways that we have yet to conceive.

Obstacles posed by narrow samples, perspectives and reference categories One of the obstacles that the imagination of scholarship on the intersection between ethnicity and old age faces is the narrowness of samples, perspectives and reference categories. This is problematic on three different (yet related) accounts. First, most studies used narrow samples of groups (only a very limited number of the potential minority ethnic and racial populations in the US have received significant

148

A new agenda

attention). As a collective whole, this scholarship only scratches the surface as far as ethnic and racial groups are concerned. The number of ethnic and racial groups that this scholarship could focus on is endless, yet the literature focuses mostly on a handful of such groups. By failing to design studies on the intersection of ethnicity and old age that draw attention to the many potential groups that this scholarship could focus on, we are missing numerous opportunities not only to test whether the ‘truths’ we have begun to take for granted (such as minority ethnic and racial status often means poorer health) do in fact make sense for ethnic and racial groups who are a minority in most socio-cultural settings, but also to pose questions that are pertinent to specific groups as opposed to being about what our limited imagination regards as angles that are worthy of investigation. Second, we have the narrowness of the perspectives in focus and the fact that it is almost only older people who have been the subject of investigation. As stated in Chapter Six, the exception was, of course, the literature on caregiving, which drew some attention to family members and informal support givers. It is worth nothing that a look at the topics that were not allocated a chapter of their own because few articles were about them (see Appendix for list) shows that the obstacle that narrow perspectives poses is not only an obstacle related to the topics that Chapters Four to Six discuss but is an obstacle that the entire scholarship is facing. Thus, scholarship on the intersection of ethnicity and old age is based on an incredibly narrow take on the array of subjective angles from which we could shed light on what ethnicity and race means to ageing and old age. The scholarship in question has yet to embark, for example, on inquiries that take into account the subjectivities of those who may be ‘responsible’ for creating the conditions under which ethnic and racial ‘groups’ find themselves. This means that the angle of investigation that the planners and providers of the care could offer, for example, does not seem to be on this scholarship’s current radar and neither is the angle that policy makers could offer. Phrased in a different way – and using Chapter Three as inspiration – the scholarship in question seems to be bogged down in assuming that it is the attachments between people that are the most important angle of investigation when the intersection between ethnicity and old age is in focus as opposed to moving beyond this to address the circumstances in which ‘different’ people find themselves. Thus, this scholarship’s insistence on focusing on the perspectives of single individuals who are presumed to form a group as opposed to the perspectives of the institutions that cater to their needs ends up meaning that the scholarship as a whole fails to realise that there is

149

Ethnicity and old age

more to ethnicity and race than who people are (and/or what they have or need), since the conditions that dictate their everyday lives are seldom dictated by these identification grounds per se. Third, we have the narrow sampling of reference categories. By this I mean that, because most of the articles come from the US and end up using the ethnic majority category as their reference category – defined most often in terms of race (that is, White) as opposed to ethnicity – this scholarship ends up relying on only one ‘version’ of a specific ethnic majority as its reference point. This ends up meaning that we never in fact explore what exactly it is about ‘being’ an ethnic racial majority that makes certain values, preferences, norms and practices seem ‘normal’ and others (deemed to be different from those) to be regarded as ‘deviancy worthy of an explanation’. Is it really the sheer number of cases that determines ‘normality’, or is it the fact that we are dealing with the kind of ‘White framing’ (and an incredibly narrowed version of it at that) that Bonilla-Silva (2012) have alerted ethnicity scholars to be cognisant of? Are we interested in studying the effects of volume or the effects of privilege? Both of these questions are two of the many questions that scholarship on the intersection of ethnicity and old age raises but never actually addresses (at least within the period that this book focuses on). Related to the specific sets of obstacles described here is, of course, Fraser’s argument that ‘being subjected to patterns of interpretation ... that are associated with another culture and are alien and/or hostile to one’s own’ (Fraser, 1996: 7) - which is what cultural domination is all about and why it is recognised as one of the ways through which injustices over time can be maintained – is what scholarship on ethnicity and old age insists on doing (even though inadvertently). As a collective whole, the scholarship reviewed here (especially but not solely as it pertains to health inequalities) is very much characterised by an insatiable curiosity to see how minority ethnic and racial groups fare in comparison to their majority ethnic and racial counterparts (which most studies– by virtue of the narrowness of their sampling – equate to be the same as White American). To this end, it seems interesting to note that it did not go unnoticed that this very fact reminds us of what Elias and Feagin claim about the ways in which the crude categories we use (in this case the ones that social gerontologists most often used in the ‘construction site’ that is social gerontological scholarship (see Chapter Three) contribute to the ‘material construction and maintenance of a racial hierarchy ... wherein different groups are labelled ... according to a racial classification system developed and substantially sustained by whites’ (Elias and Feagin, 2016: 94-5; see also Bonilla-Silva, 2012, on

150

A new agenda

Whiteness being the master category and what that means to inquiries on ethnicity and race). An ethnicity- and race-astute agenda for the expansion of the imagination of scholarship on ethnicity and old age that takes these obstacles into account needs to invest in research that draws attention not only to a broader group of ethnic and racial groups, as well as research that is driven by multiple perspectives, but also research that takes into account a larger group of reference categories (if and when these are deemed to be needed). In other words, in order to expand our imagination on ethnicity and old age we need to unleash our imagination concerning the groups, perspectives and reference categories we have so far deemed worthy of our attention. Failing to address the narrowness of samples, perspectives and reference categories means in fact failing to expand the radar of our scholarship in ways that can challenge the ‘truths’ about ethnicity and old age that we assume we have uncovered so far.

Obstacles posed by structure- and culture-obliviousness The obstacles that obliviousness to structure and culture pose are threefold. First, there are the obstacles posed because an incredibly small number of societal contexts have received attention so far and the impact that structure plays on the issues being explored, which remains an open question. Second, because most studies reviewed do not operationalise the ethno-cultural values, attitudes and preferences which are deemed to be characteristic of the ethnic and racial groups studied, the imagination of our scholarship faces the obstacle that is culture-obliviousness. These two types of obstacles mean that our scholarship does not, in fact, acknowledge in sophisticated enough ways that both structure and culture play a role for the circumstances in which ethnic and racial groups find themselves and the behaviours, values, attitudes and preferences we often deem to be at the very core of the ‘difference’ we try to shed light on as we focus attention on different groups. The study designs we insist on using seldom attempt to operationalise what it is about structure and culture that bring about the findings that our scholarship presents. This means that more often than I at least had expected we lack insight into the actual ‘reasons’ or ‘causes’ for the findings that our scholarship puts forward as ‘truths’ about different ethnic and racial groups. We deduct them through speculation but we seldom study them through explicit operationalisations. Scholarship at the intersection of ethnicity and old age is not, in other words, analytically sophisticated enough to operationalise the ethno-cultural values, attitudes and preferences

151

Ethnicity and old age

about which this scholarship consistently makes assumptions but seldom studies in solid, operationalised ways (see Dilworth-Anderson et al., 2002; William, 2005; and Dilworth-Anderson and Hillard, 2014, who have argued the same). The importance of context seems, in other words, to have become relegated – at least during the period reviewed here - to the periphery of our scholarship’s imagination. This is interesting (and baffling to say the least) considering that, as mentioned in the introduction chapter, ethno-gerontology grew out of anthropo-gerontology and it was this field that actually put the study of structure and culture on the gerontological agenda back in the late 1940s (see Torres, 2011, 2015a, who discusses this at length; and specifically Simmons, 1945, as well as Press and McKool, 1972, which are both examples of how structure and culture used to get serious attention when studies of the impact of context on ageing and old age were first conceived). Third, it has been noted that the scholarship in question has yet to design studies that tap into how the societal challenges that are the globalisation of international migration and transnationalism influence ageing and old age. In fact, the scholarship reviewed heretofore seldom acknowledges that these societal trends are destabilising our understanding of how sociocultural values ‘work’ and seems therefore oblivious to the fact that the national container-of-values approach that used to be how we regarded socio-cultural values has been heavily questioned over the past two decades. In other words, the fact that people who are immersed in a socio-cultural context are socialised into those contexts and ‘develop’ values, attitudes and preferences characteristic of those contexts is something that the scholarship on ethnicity and race still takes for granted, even though the connections between soil, roots, values, preferences and attitudes have become destabilised as more and more people have migratory life courses. The globalisation of international migration and transnationalism has brought about a ‘new’ reality, and the way in which we go about asking research questions and exploring potential answers must reflect that we have at least some sense that this is the case. The underlying agenda of the scholarship at the intersection of ethnicity and old age that I have reviewed while working on this book is very local however, even if ethnicity and race scholarship has become more global in its purview. In the scoping review conducted for this book I found virtually no examples of studies that attempt to explore how ethnicity and race are experienced by the same ethnic and racial groups but in different settings, even if transnationalism has meant that studies like this are designed quite often by ethnicity and migration scholars these days (Torres and Karl, 2016).

152

A new agenda

In light of all of this, it is my contention that an ethnicity- and raceastute agenda for scholarship on the intersection between ethnicity and old age needs to engage more seriously with the national and societal contexts in which studies are launched so that it can find ways to acknowledge and make these contexts part of study designs. Launching studies focusing on the same research question with the same ethnic and racial groups but in different national and societal contexts is also something that this scholarship needs to do if it is to manage to get itself out of the ‘national container’ approach that it is relying on primarily at present. Failing to design studies that aim to break out of this ‘national container’ understanding of ethno-cultural values means not only failing to seriously acknowledge that national, societal and socio-cultural contexts matter to the values people hold, but also failing to explore how they actually matter. Last but not least – with respect to the societal trends addressed in Chapter Two - it also seems necessary to note that scholarship on ethnicity and old age has yet to seriously engage with what transnationalism means to the study of ageing and old age. This is therefore also something that I deem necessary if this scholarship is to move forward in an imaginative way and with an awareness of transnationalism. In terms of the obstacle of the lack of operationalisation of the ethno-cultural values, attitudes and preferences with which different ethnic and racial groups are associated, it seems important to stress that a future agenda for research on the intersection of ethnicity and old age needs to be cognisant of the fact that failing to operationalise these angles of investigation means relying on stereotypical understandings of what different ethnic and racial groups are all about (if they are about anything specific at all which is, of course, also possible). Most of the literature reviewed here tends to draw conclusions about ethnocultural values, attitudes and preferences based on what previous research has claimed. But since the previous research it relies on has seldom operationalised these angles of investigation itself, in fact we are most of the time dealing with assumptions that are passed on as ‘research findings’ by sheer virtue of the fact that we have attached a reference to them and made them seem like they are evidence-based understandings. While working on the scoping review conducted for this book, I pursued references that scholars were citing as evidence that an ethnic and racial group was a certain way and/or held specific values, attitudes and preferences, and was surprised how many of these were in fact references that had not themselves operationalised these angles either. Thus, scholarship on ethnicity and old age needs to take serious stock of what it actually knows for a fact and what it

153

Ethnicity and old age

needs to find out concerning different ethnic and racial groups’ values, attitudes and preferences, since so little of what is available (at least during the 20-year period explored here) is in fact based on thorough operationalisations of such angles.

Obstacles posed by reliance on a small number of methodological approaches The scoping review showed that scholarship on the intersection of ethnicity and old age relies heavily on a small number of methodological approaches and that this constitutes an obstacle if we want to expand our imagination about what ethnicity and race mean to ageing and old age. There are two methodological shortcomings that strike me as the most acute at this juncture. The first one has to do with narrow study designs (for example, the fact that a large number of studies rely on data that comes from studies that do not seem to have actually been designed to study the intersection in question). The second one has to do with narrow approach to the social positions studied, which does not solely have to do with the lack of intersectional approaches to the study questions that studies pose, but also encompasses the fact that few of the studies reviewed seem aware that there is such a thing as ethnicity and race that is assigned by others, and ethnicity and race that people self-identify with, or that these two need not necessarily coincide. The obstacle that narrow study designs poses is one of the ones that I found most baffling about our scholarship as a whole when I settled myself ‘slightly outside’ and reviewed the literatures from a ‘little further off’ (Abbott, 2012). As stated earlier, the impression one gets when reading the literature published during the past two decades in one go is that we are dealing with data that seems to have been very seldom collected with ethnicity and racial concerns in mind. The fact that, for example, so few studies explicitly explore how perceived discrimination – a matter we all know is crucial for most minority ethnic and racial groups - could affect the findings they present is one of the things I found to be most perplexing about the scholarship as a whole. An ethnicity- and race-astute future agenda for research on ethnicity and old age needs to seriously engage with the ways in which marginalisation, exclusion, segregation and discrimination may affect the research questions being explored. Measuring the impact of such mechanisms therefore needs to inform the study designs of future research on this intersection if we are to expand our imagination on how ethnicity and race affect ageing and old age. In this respect it seems necessary to draw attention to Thrasher and colleagues, who have critically appraised

154

A new agenda

the ways in which discrimination measures for racial/ethnic health disparities are used and who argue that ‘no discrimination measure has yet been specifically developed with an ageing perspective that addresses older adults’ unique developmental and social circumstances’ (Thrasher et al., 2012: 1034). The obstacle posed by the narrow approach to the social positions studied which characterises the literature as a whole is also something that needs to be noted. This is related to two specific characteristics: first, the fact that most studies rely on ‘the one variable at a time approach’ (and lack therefore an intersectional take); and second, the fact that few studies seem aware that the ethnicity and race that is assigned to a person by others and the ethnicity and race that people self-identify with need not coincide. The first issue has to do with the fact that most studies shed light on ethnicity and/or race and sometimes socioeconomic status-related positions (through the use of income, education and/or class-related data) but not much else. I claim this even though some studies do in fact take sex into account, since most studies that do so almost never engage with gender-related aspects (such as how being perceived as a woman or man and/or living in a society with specific gender regimes affects the results that the studies shed light on). Few studies attempt to explore the interaction between all of the identification grounds and/or social positions (age, sex, sexuality, ethnicity, race and class). Thus in other words, intersectional analyses are conspicuously absent in this scholarship, even though they are assumed to be fundamental if we want ‘to reconcile structure and agency without promoting cultural essentialism’ (Bürkner, 2012: 181; see also YuvalDavis, 2006). To this end it is important to note that although the notion of intersectionality has been around for quite some time, we are still lacking methodologies for studying it (Denis, 2008). Attention should therefore be drawn to attempts to develop methodological approaches that allow empirical inquiries to resonate well with the theoretical advancements that have been made in the theoretical debate on this notion (Winker and Degele, 2011). And in this respect, it seems necessary to state that I personally believe that by focusing on old age, scholarship on the intersection of ethnicity and old age has the potential to contribute to the elaboration of intersectionality-astute methodologies, since the expertise we have on the life course is bound to be useful when designing such methodologies. Related to this is an observation I have made while working on the scoping review which is that although most studies control for whether sex and/or socioeconomic status-related issues make a difference to the findings they present, only a miniscule proportion of the articles

155

Ethnicity and old age

reviewed in fact try to disentangle how it is that these social positions affect the findings they shed light on. In other words, intersectional approaches to the intersection of ethnicity, race and old age are virtually non-existent in the scholarship reviewed while working on this book. Such approaches aim to ‘foreground a richer and more complex ontology than approaches that attempt to reduce people to one category at a time’ (Phoenix, 2006: 187) and draw attention not only to differences between groups but also to differences within them (Crenshaw, 1991; Staunaes, 2003). The reason why this is the case is that intersectional analyses draw attention to different sources of subordination/oppression and the fact that these seldom operate on their own. However, the scholarship reviewed while working on this book is not concerned with the different sources of subordination and oppression that exist. In fact as already shown, the study of these sources (which would entail the explicit analysis of ageism, sexism and racism for the findings presented among other things) is not part of what this scholarship seems particularly interested in exploring. From this it follows that an awareness that these sources of subordination and oppression seldom operate on their own, which lies at the very core of intersectional approaches to the study of inequalities and injustices, is not part of the compass used to launch studies on the intersection of ethnicity and old age at this point in time. Intersectional analyses are ‘based on the premise that the impact of a particular source of subordination may vary, depending on its combination with other sources of subordination (or of relative privilege)’ (Denis, 2008: 677), but this is not something that the scholarship reviewed in this book takes for granted. Neither does this scholarship seem particularly aware that the impact of particular sources of subordination not only leads to inequality but also to privilege. Phrased differently, one could say that this type of analysis rejects the assumption that one subordination source has primacy over others. But this is not what the scholarship reviewed here assumes. Thus, although there are most definitely a couple of articles that make this assumption, most give the impression of being oblivious to this being the case. Staunaes’ (2003: 104) argument that the reason why intersectional analyses are needed is that ‘social categories are not the cause of certain behaviour but rather the effect of certain behaviour’ is, of course, relevant to this presentation of what the obstacle of narrow approaches to the social positions studied is all about. Staunaes (2003: 105) urges social scientists to study ‘the doing of intersectionality ... the doing of relations between categories, the outcome of this doing and how this doing results in either troubled or untroubled subject positions’.

156

A new agenda

From this it follows, of course, that an ethnicity- and race-astute agenda for future research on the intersection of ethnicity and old age needs also to be intersectionality aware, which is why future studies should be designed so that we can begin to grasp when ethnicity and race is an asset and when a burden, and what it is about such identification grounds and/ or social positions that – combined with a particular gender, sexuality and class – end up inhibiting or facilitating ethnic and racial experiences to be about one or the other. Last but not least when it comes to the obstacle that narrow approaches to the social positions studied is the variety of questions raised by the fact that the literature reviewed seldom acknowledges that not everybody who self-assigns him/herself to an ethnic and racial category and/or picks an ethnic and racial category for him/herself actually means – through that self-identification – that this is how others view them and/or that this is in fact a relevant category in their lives. Therefore, the inclusion of more ‘nuanced’ variables regarding ethnicity and race seem to be one of the things that an ethnicity- and race-astute agenda for research on the intersection of ethnicity and old age should consider. In other words, unleashing our imagination on ethnicity and old age should also entail moving beyond the assumption that ethnicity and race are solely meaningful because others regard us as ethnic and racial ‘beings’ so that we can acknowledge – explicitly and through the study designs we employ - that a person’s ethnicity and race are not always as crucial to their circumstances as the scholarship reviewed here assumes them to be.

Obstacles posed by our choice of dissemination outlets Another obstacle for the expansion of the imagination of scholarship on the intersection of ethnicity and old age is posed by the scientific community most often chosen as the audience par excellence for this scholarship or the fact that the dissemination outlets chosen to publish work on this intersection are often outlets that cater primarily to scholars on ageing and old age. This, I would argue, has great implications for the ethnicity and race ‘imagination’ that characterises the scholarship in question (or the lack of it, being rather blunt in my assessment). When we choose to publish our work in social gerontology journals and fail to expose it to the peer-reviewed process that would be carried out by ethnicity and race scholars, we are in fact, I would argue, cheating ourselves out of expanding our imagination on these issues. The use of crude proxies for the study of the implications that social positions (such as age, ethnicity, class, race, gender and so on) have to an array

157

Ethnicity and old age

of issues is something that the scholarship under scrutiny in this book often does. This ‘practice’ would not go as easily unquestioned (at least as far as ethnicity and race are concerned) if we were to expose our work to peer-reviewed processes that use ethnicity and race scholars’ expertise as their point of departure. Even the appropriateness of the ways in which we discuss the implications of ethnicity and race for our findings could potentially be questioned in slightly different ways when a manuscript undergoes peer review in a social gerontology journal and when it does so in a journal catering to ethnicity and race scholars. It is because of this that I would argue that the actual audiences whose scrutiny scholarship at the intersection of ethnicity and old age demands have implications for the string of obstacles this concluding chapter zeroes in on. This is why I have deemed the choice of audience to be an obstacle and something which we need to consider addressing (see Booth et al., 1995, who discuss how the craft of research is advanced and hampered by the very scholarly audiences to which we chose to present our work). Related to the question of scholarly audience (and the dissemination outlets used by them) is, of course, the question of our scholarly identity which, so far at least, seems to be guided by this scholarship’s legacy. The notion of legacy is new but those that have followed my contributions to the field of ethno-gerontology for a while will know that I have written about why it is that ethno-gerontology seems to have failed to keep up on a range of issues.1 Thus, on numerous occasions I have used the anthropological legacy (not its present, since anthropology has evolved a lot since ethno-gerontology relied on this discipline as its primary source of imagination) as one of the explanations for why things are as they are at the moment concerning this scholarship’s understandings of ethnicity and race. Phrased differently one could say that although anthropological thinking has advanced considerably since we in social gerontology started to be inspired by it, the scholarship on ethnicity and old age reviewed here gives the impression of being guided by the anthropological legacy as well, a legacy that is – just as other fields’ legacies are – essentialism/primordialism-based. This brings me to the next set of obstacles I have identified as getting in the way of this scholarship’s advancements. 1

From the way it understands culture (see, for example, Torres, 1999, 2006, 2011, 2015a), to the way it regards migration (see, for example, Torres, 2001, 2004, 2006, 2008, 2011, 2012, 2013; as well as Torres and Karl, 2016), to the ways it understands ethnicity (Torres, 2015b), old-age exclusion (Torres, 2012) and most recently, its obliviousness to injustice (Torres, 2018).

158

A new agenda

Obstacles posed by the stagnation in understandings of ethnicity and race In the previous chapters, I have made clear that scholarship on ethnicity and old age departs from either the primordialist/essentialist understanding of ethnicity and race, the structuralist/circumstantialist understanding or a combination of these two. Understanding ethnicity and race solely in these ways is what led Green (1989: 383) to argue that ‘a more powerful ethno-gerontology would be one in which the emergent quality of ethnicity, its salience rather than its giveness, would be the starting point’. Related to this is also what Kramer and Barker (1994) - on the basis of a review of a couple of books that had just been published about the intersection of ethnicity and old age back in the late 1980s–early 1990s – claimed when they argued that if we are to develop an ethno-gerontological imagination that is astute about ethnicity scholarship, we need to stop regarding ethnic groups as large homogeneous population blocks. Regarding them as such leads to a conflation of ethnicity with race, of ethnicity and race with minority status, of ethnicity with the experience of being an immigrant, and constitutes a disregard for the kind of cohort, sex, class, historical and regional differences that are at the very core of what the study of culture – understood as context – is actually about. By arguing all of this and drawing attention to other scholars who have argued similar things, I am not implicitly claiming that only understandings of ethnicity inspired by social constructionism should inform all of our inquiries, since there are plenty of research questions that could be informed by the other two understandings. My contention is, instead, that as a collective whole, the scholarship in question does not seem to be engaging in any substantial way with social constructionism, and neither does it seem to be aware of the various nuances referenced in Chapter Three about, for example, the differences between ethnicity, race and culture, as well as the ways in which different understandings of ethnicity and race can be interpreted. Thus, scholarship on the intersection of ethnicity and old age does not seem to have kept up with the innovative thinking that has challenged ethnicity and race scholarship for decades now - thinking which is clearly guided by the acceptance that if ‘we can recognize ethnicity as a way of making up people, we can examine the social effects of this way of making up people yet not lose sight of the fact that ethnicity is simply a way of making up people’ (Carter and Fenton, 2010: 9-10). The fact that the scholarship reviewed while working on this book seems oblivious to what this would entail is, I would argue, the very

159

Ethnicity and old age

reason why we insist on assuming that ethnicity and race ‘determine’ what happens to people as opposed to trying to grasp when it is that people allow these constructs to happen to them (that is, when they use them to their advantage and/or rely on them as explanations, even if there is evidence that there may be other explanations besides those driven by ethnicity and race); and when it is that others rely on ethnic and racial boundary making in order to ‘determine’ the resources that ethnic and racial groups have access to and the circumstances in which they end up finding themselves. An ethnicity- and race-astute future agenda for scholarship on ethnicity and old age therefore needs to engage in a substantial way with the social constructionist perspective and the kinds of questions that designing research in this vein would put on our research radars. As stated in Chapter Three, the employment of such a perspective would mean that we would move toward inquiries that ask not only how ethnicity and race are made meaningful in old age but also how ethnic and racial groups ‘negotiate their identities’ and for what purposes. This reminds us of Cornell and Hartmann’s argument that the construction of people as ethnic and racial ‘beings’ ‘involves both the passive experience of being ‘made’ by external forces ... and the active process by which the group ‘makes’ itself ’ (Cornell and Hartmann, 1998: 80). With this in mind, it is interesting to note that, as stated in the appendix, few articles have focused on identity during the two decades reviewed. Scholarship on ethnicity and old age gives the impression that identity and the question of how ethnic and racial ‘beings’ who are older are ‘made’ and ‘create themselves’ is not an interesting angle of investigation. This is perhaps understandable considering that this scholarship – by virtue of the fact that it often relies on essentialist/primordialist and/ or structuralist/circumstantialist understandings of ethnicity and race – assumes that ethnic and racial groups are a fixed given that can easily be identified (and identify themselves as such). However, if we take the implications of Cornell and Hartmann’s argument that ‘the world around us may ‘tell’ us we are racially distinct, or our experiences at the hands of circumstances may ‘tell’ us that we constitute a group, but our identity is also a product of the claims we make’ (Cornell and Hartmann, 1998: 80), one cannot help but wonder why it is that scholarship on ethnicity and old age does not seem interested in exploring the claims that ethnic and racial groups make in old age. From this it follows, of course, that inquiring into the claims that practitioners and policy makers use to ‘make’ ethnic and racial groups into distinctive collectives while ‘telling them that they are ethnically and racially distinct’, as well as the material effects that such claims

160

A new agenda

have on the ability of minority ethnic and racial populations to access resources of various kinds, is bound to be part of what an ethnicityand race-astute research agenda for scholarship on ethnicity and old age would want to do. To some extent, one could say that this book itself is my attempt to investigate the claims that scholars on ethnicity and old age have made over the past 20 years about ethnic and racial groups, and that the obstacles I am identifying in this chapter while summarising the results of the scoping review conducted are my way of encouraging my peers to unleash their imaginations on the intersection of ethnicity and old age so that we are able to ask questions and design studies that resonate better with the societal trends alluded to in Chapter Two, and which are in accord with the advances in ethnicity and race scholarship described in Chapter Three.

Obstacles posed by lack of analytic clarity The obstacles posed by the lack of analytic clarity (see Elias and Feagin, 2016) have to do with two of the specific characteristics of the scholarship that has been scrutinised here. These are the conflation of ethnicity, race, minority and culture, and the lack of clarity regarding the understandings of ethnicity and race that inform our scholarship. Although these two obstacles are related, I think it is important to disentangle why it is that they are, in fact, two different obstacles. The conflation of ethnicity and race has to do with the fact that the vast majority of studies reviewed while writing this book conflate not only ethnicity with race, but also ethnicity and race with minority status, and ethnicity and race with culture. As was shown in the previous chapters, it was not uncommon for the articles reviewed to rely on samples, within one and the same inquiry, that are sometimes drawn from ethnic categories and sometimes from racial ones. Moreover, most of the articles reviewed use the constructs of ethnicity and race inconsistently more often than one might expect if one is to understand the theoretical and conceptual debates on ethnicity and race that Chapter Three presented. The fact that so many articles deduce what the identification grounds and/or social positions that constitute ethnicity and race mean for the results they present, even though they use ethnicity and race as crude proxies ‘for location in varying social contexts’ (Williams, 2005: 56), or as nothing more than descriptive level labels (Magai et al., 2003) was also mind boggling to say the least, and is, of course, related to the obstacle of analytical clarity being addressed here. The conflation of ethnicity and race documented through the scoping review remind us of Dick and Wirtz assertion that

161

Ethnicity and old age

in the United States, concepts of race circulate in an uneasy and confused collocation with concepts of ethnicity. The terms ‘race’ and ‘ethnicity’ function as what Urciuoli (2008) describes as ‘strategically deployable shifters’: purposefully nebulous terms whose semantic ambiguity serves the pragmatic function of constructing particular social spaces and speaker alignments rather than specifying a fixed referent. (Dick and Wirtz, 2011: E4) From this it follows that the conflation of ethnicity with race witnessed in a sizeable proportion of the literature reviewed should not be easily disregarded as a mix-up of terminology since such mix-ups – even if unintentionally so – accomplish something in our writing (and more importantly in our imagination) about ethnic and racial groups. Thus, through the conflation of ethnicity with race on which scholarship on ethnicity and old age so often relies, this scholarship is – in the words of linguistic anthropologists Dirk and Wirtz (2011) – ‘semantically ambiguous’ as it tries to ‘specify the fixed referents’ that ethnic and racial minorities are constantly depicted as ‘being’. Related to this is, of course, the arguments put forth by race scholars Elias and Feagin, to which I have referred in Chapter Three. They have argued that failing to recognise that race is not the same as either culture or ethnicity can end up hindering us from not only recognising but adequately analysing the significance that ‘racial meaning, racial grouping, and systematic racism play in greatly shaping contemporary society and human relations’ (Elias and Feagin, 2016: x). This is the case, I would argue, because when we fail to design studies that aim to carefully disentangle if and how ethnicity on its own, and race on its own, and minority status on its own, and culture on its own, as well as how all of these parameters are related to one another, we are in fact failing to advance our understandings of when the racialisation of minority ethnic ‘status’ (Grosfoguel, 2004) may be ‘responsible’ for the findings that our inquiries bring to the fore. Related to all of this is the fact that a focus on racialisation – which the scholarship in focus in this book has yet to utilise as an angle of investigation – would allow us to interrogate ‘the investments that social actors have in racialization and help us to understand why racializing discourse [and I would add practices] has proven so flexible, so insidious, and so durable’ (Dirk and Wirtz, 2011: E9). However, racialisation – or the practices, processes and discourses of the hierarchisation of ethnic groups along continuum-like degrees of superiority and inferiority create - is not on the radar of the scholarship of ethnicity

162

A new agenda

and old age. It is for this reason that, in Chapter Three, I alluded to the ‘construction site’ that is scholarship on ethnicity and old age as a site that gives the impression of being oblivious to racialisation. Thus, by conflating ethnicity with race, and using ‘Whiteness’ as the master category against which ethnic and racial groups are compared, this scholarship is inadvertently contributing to ‘the material construction and maintenance of a racial hierarchy by dominant white groups in modern societies, wherein different groups are labelled, ordered and rewarded or penalized according to a racial classification system developed and substantially maintained by whites’ (Elias and Feagin, 2016: 95). The obstacles that lack of analytical clarity pose to our imagination on ethnicity and old age are also related to the lack of reliance on explicit definitions of ethnicity and race and/or on explicit allusions to the kinds of understandings that inform the inquiries that this scholarship engages in. Most of the articles reviewed while working on this book are based on studies that are informed by either the essentialist/primordialist, the structuralist/circumstantialist understanding of ethnicity and race or a combination of these perspectives. This is not something that is stated explicitly by this literature but rather a conclusion I have drawn when reading, rereading and painstakingly coding the articles reviewed on an array of issues. The fact that the literature does not make explicit which understanding of ethnicity and race informs the inquiries that this scholarship reports on means that, taking just a quick glance at the findings, one can never grasp that the conclusions sometimes drawn about the impact of ethnicity and race are, in fact, conclusions that the study design employed does not allow one to make. Here it seems important to remind the reader that the articles included in this scoping review were chosen because they claim – through their use of the terms ethnicity/race and ageing/old age in their titles, abstracts and keywords – to contribute to our understandings of the impacts that ethnicity and race have for the research questions they have posed. In spite of this, because of the lack of clarity about which understanding of ethnicity and race informs the design they employ, most of them end up with concluding remarks that say something along the lines of ‘we started out wanting to study the impact of ethnicity and race, but cannot in fact say what it is about ethnicity and race that prompts our findings’. Such observations make clear that when the perspectives that inform our research are not spelled out, one easily ends up in a state of uncertainty as to which ‘factors’ one claims one needs to study (that is, whether it is ‘essentialism-based variables’ having to do with ethno-cultural values, for example; or

163

Ethnicity and old age

‘structure-based variables’ having to do with resources). Thus, taken as a whole, the scholarship that I have had in my sights while conducting the theorising exercise I have engaged in through a scoping review is scholarship that, despite its obsession with justification, is actually fumbling about what exactly it wants to discover about ethnicity and race (not to mention the relationship between these constructs and the construct of minority and culture). Drawing attention to what we learned in the introduction about what Mills (1959) and Abbott (2012) have claimed about how one can go about expanding one’s scholarly imagination, it seems necessary to note that the sense of bafflement while working on the scoping review was ever-present, even though I had read a considerable number of the articles this review focused on when they first came out. Back then, I confess to not really having reflected on the fact that this literature was not, in fact, as much about ethnicity and race as it was about the assumptions that this scholarship makes and takes for granted about these identification grounds and/or social positions. My contention now that I have not only read, reread and coded all of these articles using the magnifying glass that the perspectives of ethnicity and race alluded to in Chapter Three offers (and after having had a chance to ponder at length on what we think we know, actually know and need to find out about the intersection of ethnicity, race and old age) is that by failing to define how ethnicity and race are understood in these studies; and by failing to explicitly refer to the understandings of ethnicity and race that guided these inquiries, this scholarship ends up raising all sorts of questions not only about how ethnicity and race are actually operationalised in this literature, but also about why we – social gerontologists and ethno-gerontologists alike - insist on collecting this type of data in the unsophisticated fashion we seem to insist on doing. As I stated in passing in one of the previous chapters, it was not uncommon for me to feel that this scholarship is more interested in rehashing all the taken-for-granted but extremely faulty ‘truths’ about the implications of ethnicity and race for an array of topics than in addressing these topics in ethnicity- and race-astute ways. In order to elucidate why the obstacles caused by lack of analytical clarity need to be addressed, it is necessary to draw attention to what we learned in Chapter Two about what the globalisation of international migration and transnationalism means to the study of culture, migration, ‘periphery’ and inequality. With regard to culture, for example, that chapter noted that the globalisation of international migration has forced ethnicity (and migration) scholars to abandon the assumption – which the studies reviewed in this scoping review are

164

A new agenda

still based on – that ethno-cultural values can be thought of as values one learns based on the localities in which one has been immersed due to the ethnicity and race that one identifies with. From this it follows that one of the many questions that should be considered for an ethnicity- and race-astute future agenda for studies on the intersection of ethnicity and old age is why ‘mixed ethnicity’ or ‘mixed race’ is not included in surveys and studies as a category. Surely the category ‘Other’, which is apparently available as an alternative in some studies, can be selected by people who have a mixed background, but that category can also be selected by those whose ethnic and racial group is not mentioned in these studies. The point I am trying to make here is that in spite of the fact that the globalisation of international migration and transnationalism has challenged the imagination of ethnicity and race scholars when it comes to diversity, the scholarship reviewed in this book does not seem to have grasped that revising and updating the ethnic and racial categories most studies depart from might be something we ought to do, since the ethnic and racial categories we are relying on may not be in tune with the categories that people deemed to be of minority ethnic and racial status identify with. In other words, virtually all of the studies reviewed while working on this book depart from the assumption that people ‘belong’ to one ethnic and/or racial category and do not acknowledge that people’s backgrounds in this regard can be deemed to be more mixed (that is, both this and that rather than either/or); and/or that people themselves may not find the categories that we make available to them meaningful enough. Surely they are complying with our expectation to pick an alternative (or self-identify as some articles claimed that people were doing). But the question is whether the categories we are working with are sufficient to capture the diversity that Chapter Three acknowledged that the globalisation of international migration and transnationalism has brought about. The fact that some people may not necessarily identify with the categories that they are nowadays ‘forced’ to pick from in surveys, for example, is thus not something that scholarship on the intersection of ethnicity and old age at this present point in time takes into account. If Hannerz is correct in his assertion that in globalised times such as ours we need to think of the autonomy and boundedness of culture ‘as a matter of degree’ (Hannerz, 1992: 261), then a future agenda for research on the intersection of ethnicity, race and old age needs to take into account that some people neither regard themselves as people who ‘belong’ to an ethnic and/or racial category, nor do they identify with any single one of the available categories that studies assume to be relevant. From this it follows that the identification

165

Ethnicity and old age

grounds and/or social positions that are ethnicity and race need to be thought of as much more atypical than the normative (and obsolete) understanding of these constructs that we are relying on at present. In other words, a mixed category may be more relevant to some of the people we regard as being in minority ethnic and racial groups. But until we give them such a choice, we will not know if the categories we are using are in fact relevant to them or not. Related to this, of course, is also the fact that a future agenda for research on this intersection needs to make serious attempts to differentiate between the impact that ethnicity has, and the impact that race has; the impact that minority status has, and the impact that culture has, without assuming that all of these angles are one and the same. This means that an ethnicity- and race-astute agenda for future research needs to take into account that the designs of our future inquiries should tap into the array of sources of identification with which ethnicity and race are associated, as well as the array of ‘sources of subordination and oppression’ that these social positions sometimes entail.

Unleashing our imagination In the introduction to this book I argued that time had come for scholarship on the intersection of ethnicity and old age to engage in a theorising exercise to identify what it thinks it knows, what it in fact knows, and what it needs to find out about ethnicity and race. I argued also that engaging in such an exercise could potentially lead to the expansion of the imagination of this scholarship. This I did while alluding to Mills’ idea of the sociological imagination, which is characterised by ‘the capacity to shift from one perspective to another, and in the process to build an adequate view of a total society and of its components’ (Mills, 1959: 211). Although this book has not aimed ‘to build an adequate view of a total society’, it has indeed tried to propose a more adequate understanding of what the identification grounds and/ or social positions that are ethnicity and race mean while arguing that in globalised times such as ours, when international migration and transnationalism are increasing the diversity of our older populations to the extent that these societal trends have, we cannot – in social gerontology and ethno-gerontology – relegate the advances made in ethnicity and race scholarship to the periphery of our scholarship’s imagination. I hereby acknowledge the fact that, as a project, this book and the scoping review conducted while writing it was inspired by Emirbayer

166

A new agenda

and Desmond’s proposition that reflexivity is key to advancing our understandings of the ethnic and racial order that informs our inquiries and their claim that ‘our analytic gaze [needs to be turned] back upon ourselves ... [so that we can] critically inquire into the hidden presuppositions that shape our thought’ (Emirbayer and Desmond, 2012: 574). These race theoreticians argue not only that the ‘more that race scholars uncover the hidden assumptions in their scientific unconscious, the more they can strive to undo their effects, thereby making it possible to develop ever-deeper insights into the workings of the social order’ but also that ‘reflexive analysis is to be considered not a goal to pursue for its own sake but an ineliminable means of scientific advance’ (2012: 590). Thus, in arguing that the expansion of our imagination is necessary, I have been thinking all along – although I have not made this point explicitly – not only that the scientific unconscious of the scholarship on ethnicity and old age needed to be interrogated but also that the concept of ‘social imaginaries’, coined by Cornelius Castoriadis in his 1987 book The Imaginary Institution of Society (see also Castoriadis, 1994) was a concept that could inform how to move forward while interrogating the scientific unconscious of the scholarship under scrutiny in this book. The concept of social imaginaries alludes to ‘ways of understanding the social’ (or in this case the ways in which we make sense of ethnicity and race in relation to ageing and old age) and the fact that these are often imaginary precisely because ‘they exist by virtue of representation or implicit understandings, even when they acquire immense institutional force; and they are the means by which individuals understand their identities and their place in the world’ (Gaonkar, 2002: 4; see also Stoetzler and Yuval-Davis, 2002). From this it follows that the idea of the imagination I have used to drive the arguments put forth in this book is intimately related to the idea that the ways in which we write about groups (which is one of the ways through which representation is accomplished) actually help certain implicit understandings about these groups ‘to acquire immense institutional force’ while making other imaginaries inaccessible to us. This is, of course, related to my argument in Chapter Three that scholarship can be regarded as one of the construction sites in which ideas about ethnic and racial groups and ethnicity and race as identification grounds and/ or social positions are built and rebuilt and where the dismantling of such ideas can take place. Taylor’s (2007: 23) definition of social imaginaries as ‘the ways that people imagine their social existence, how they fit together with others, how things go on between them and their fellows, the expectations

167

Ethnicity and old age

that are normally met, and the deeper normative notions and images that underlie these expectations’ is relevant to the theorising challenge I took on and the scoping review I have conducted to interrogate the scientific unconsciousness of the scholarship on ethnicity and old age. This is the case because this scholarship influences how we think about older people’s social existence; how we think older people from minority ethnic and racial groups fit with those who are not deemed to be ‘ethnic and racial beings’; the expectations we have on what ethnicity and race mean for ageing and old age; and how this scholarship influences gerontological policy and practice for minority ethnic groups. As such, this scholarship, albeit implicitly, is in fact one of the scholarships that convey ‘truths’ about the racial order to which Emirbayer and Desmond (2012) refer. According to Gaonkar (2002: 5), in order to understand why social imaginaries are powerful ideas with which social scientists ought to reckon is that modernity relies on ‘a special form of social imaginary that is based on relations among strangers’ and the notion of a national people ‘is a paradigmatic case of modern social imaginary’ that relies on the representation of the ‘we’ and the ‘Other’ (to which I referred in Chapter Three). Moreover, he argues that national people live amid many other social imaginaries, penumbral to them. Other modern social imaginaries— such as the ethnos, the mainstream, the public, and humanity—differ from the national model in important ways. Some are not articulated as a we but are third-person objectifications of society; these include the market, the mainstream, and ethnic and census categories. (Gaonkar, 2002: 6) The reason why all of this is important to note as this book draws to an end is that the literature reviewed for this book was very much concerned with the social imaginary that is constituted by an array of assumptions about minority ethnic and racial groups and take for granted certain ways in which ethnicity and race are believed to be meaningful to some older people but not to others (see also Vertovec, 2012, who discusses the imaginary in relation to diversity). This book has tried to challenge the premise of that social imaginary by arguing that the societal trends referred to in Chapter Two (population ageing, the globalisation of international migration and transnationalism) are urging us to rethink the assumptions that this imaginary makes about who ethnic and racial ‘Others’ are, what questions are worth posing

168

A new agenda

to them, and what questions we ought to pose to ourselves (as the previous sections have tried to argue we need to do). In the imagination of the scholarship of ethnicity and old age (as it stands today and based on what we have found out about it by drawing attention to the literature published in peer-reviewed journals in English over the past two decades and the major trends observed in it), older people from minority ethnic and racial groups come from a limited number of socio-cultural contexts (that is, the US) and have limited ethnic and racial ‘backgrounds’ (for example, African-American and Hispanic). These groups are interesting objects of study because they are assumed to be not only different from but also disadvantaged when compared with their majority ethnic counterparts (that is, White people), whose ‘privileged race’ need not be interrogated. These groups’ ethnic and racial backgrounds are believed to be relatively fixed and to determine either who they are or the circumstances in which they find themselves. Their agency is therefore seldom acknowledged and neither are their claims (nor the claims of others for that matter) about who they are and what they need and/or prefer deemed to be worthy of any major interrogation. The imagination of the scholarship of ethnicity and old age is content with shedding light on the inequalities that minority ethnic and racial populations experience but lacks a commitment to combating the injustices that these groups are believed to face. The imagination in question does not presume that minority ethnic and racial groups can experience privilege and neither does it acknowledge that majority ethnic and racial groups can oppress. This scholarship’s imagination does not deem the interrogation of the ways in which the privilege of majority ethnic and racial groups is reproduced as an angle of investigation worthy of our attention. This book has exposed and questioned all of these assumptions about who ethnic and racial ‘beings’ are (whether they are regarded as a minority or deemed to be a part of the majority) and why it is that studying them in their old age is necessary. In doing so, and in pointing out and arguing why this imagination needs to be expanded (which is what this last chapter has been about), this book hopes to be able to contribute to unleashing a new imaginary about the role that ethnicity and race plays in ageing and old age.

169

References Abbott, A. (2012) ‘Surprise! Some comments on Richard Swedberg’s Pierce paper’, Sociologica, 2: 1–4 Ackers, H.L. and Dwyer, P. (2002) Senior citizenship: Retirement migration and welfare in the European Union. Bristol: Policy Press Adler, S.R., McGraw, S.A. and McKinlay, J.B. (1998) ‘Patient assertiveness in ethnically diverse older women with breast cancer: challenging stereotypes of the elderly’, Journal of Aging Studies, 12(4): 331–50 Ajrouch, K.J. (2017) ‘A social constructionist approach to diversity and social relations among Muslim Americans’, Journal of Cross-Cultural Gerontology, 32: 131–46 Ajrouch, K.J., Antonucci, T.C. and Janevic, M.R. (2001) ‘Social networks among Blacks and Whites: the interaction between race and age’, Journal of Gerontology: Social Sciences, 56B(2): S112–18 Albert, S.M., Musa, D., Kwoh, K. and Silverman, M. (2008) ‘Defining optimal self-management in osteoarthritis: racial differences in a population-based sample’, Journal of Cross-Cultural Gerontology, 23: 349–60 Alley, D.E., Putney, N.M., Rice, M. and Bengtson, V.L. (2010) ‘The increasing use of theory in social gerontology: 1990–2004’, Journal of Gerontology: Social Sciences, 65B(5): 583–90 Alpass, F., Pond, R., Stephens, C., Stevenson, B., Keeling, S. and Towers, A. (2013) ‘The influence of ethnicity and gender on caregiver health in older New Zealanders’, Journal of Gerontology: Series B, 68(5): 783–93 Ammann, E.S. and van Holten, K. (2013) ‘Getting old here and there: opportunities and pitfalls of transnational care arrangements’, Transnational Social Review: A Social Work Journal, 3(1): 31–47 Andreasen, R.O. (1998) ‘A new perspective on the race debate’, British Journal for the Philosophy of Science, 49(2): 199–225 Anthias, F. (1998) ‘Rethinking social divisions: some notes towards a theoretical framework’, Sociological Review, 46(3): 505–35 Appadurai, A. (1990) ‘Disjuncture and difference in the global cultural economy’ in M. Featherstone (ed) Global culture: Nationalism, globalization and modernity. London: Sage Archer, K., Bosman, M.M., Amen, M.M. and Schmidt, E. (2007) ‘Hegemony/counter hegemony: imagining a new, post-nation state cartography of culture in an age of globalization’, Globalizations, 4(1): 115–36

171

Ethnicity and old age

Archer, M. (1990) Foreword. In M. Albrow and E. King (eds) Globalization, knowledge and society. London: Sage Arcury, T.A., Chen, H., Savoca, M.R., Anderson, A.M., Leng, X., Bell, R.A. and Quandt, S.A. (2011) ‘Ethnic variation in oral health and social integration among older rural adults’, Journal of Applied Gerontology, 32(3): 302–23 Arcury, T. A., Grzywacz, J. G., Neiberg, R. H., Lang, W., Nguyen, H., Altizer, K., Stoller, E. P., Bell, R. A. and Quandt, S. A. (2012) ‘Older adults’ self-management of daily symptoms: complementary therapies, self-care and medical care’, Journal of Aging and Health, 24(4): 569–97 Arcury, T. A., Nguyen, H. T., Sandberg, J. C., Neiberg, R. H., Altizer, K. P., Bell, R. A., Grzywacz, J. G., Lang, W. and Quandt, S. A. (2015) ‘Use of complementary therapies for health promotion among older adults’, Journal of Applied Gerontology, 34(5): 552–72 Armstrong, M. J. (2000) ‘Older women’s organization of friendship support networks: an Afr ican Amer ican-White Amer ican comparison’, Journal of Women and Aging, 12(1/2): 93–108 Aspinall, P. J. (2007) ‘Approaches to developing an improved crossnational understanding of concepts and terms relating to ethnicity and race’, International Sociology, 22(1): 41–70 Austin-Broos, D. (2003) ‘Globalization and the genesis of values’, The Australian Journal of Anthropology, 14(1): 1–18 Ayalon, L. and Gum, A. M. (2011) ‘The relationships between major discrimination, everyday discrimination, and mental health in three racial and ethnic groups of older people’, Aging and Mental Health, 15(5): 587–94 Aysan, M. F. and Beaujot, R. (2009) ‘Welfare regimes for aging populations: no single path for reform’, Population and Development Review, 35(4): 701–20 Baer, R. D., Arteaga, E., Dyer, K., Eden, A., Gross, R., Helmy, H., Karnyski, M., Papadopoulos, A. and Reeser, D. (2013) ‘Concepts of race and ethnicity among health researchers: patterns and implications’, Ethnicity and Health, 18(2): 211–25 Bairot, R. and Bird, J. (2001) ‘Racialization: the geneology and critique of the concept’, Ethnic and Racial Studies, 24(4): 601–18 Bakk, L., Cadet, T., Lien, L. and Smalley, A. (2017) ‘Home modifications among community-dwelling older adults: a closer look at race and ethnicity’, Journal of Gerontological Social Work, 60(5): 377–94

172

References

Baldassar, L. (2007) ‘Transnational families and aged care: the mobility of care and the migrancy of aging’, Journal of Ethnic and Migration Studies, 33(2): 275–97 Banton, M. (1998) Racial theories (2nd edn). Cambridge: Cambridge University Press Banton, M. (2004) ‘Race: as classification’ in E. Cashmore (ed) Encyclopedia of race and ethnic studies. London/New York: Routledge Banton, M. (2016) ‘Race, changing historical conceptions of ’ in J. Stone., R. Dennis., P. S. Rizova., D. Smith and X. Hou (eds) (2016) Encyclopedia of race, ethnicity, and nationalism. West Sussex, UK: WileyBlackwell Barnes, L. L., Wilson, R. S., Hebert, L. E., Scherr, P. A., Evans, D. A. and Mendes de Leon, C. F. (2011) ‘Racial differences in the association of education with physical and cognitive function in older Blacks and Whites’, Journal of Gerontology: Series B, 66(3): 354–63 Barressi, C. M. and Stull, D. E. (eds) (1993) Ethnic elderly and long term care. New York: Springer Publishing Company Barth, F. (1969) Ethnic groups and boundaries: The social organization of culture difference. Oslo: Universitetsförlaget Barth F. (1989) ‘The analysis of culture in complex societies’, Ethnos, 54(3–4): 120–42 Bauman, Z. (1998) Globalization: The human consequences. New York: Columbia University Press Baxter, J., Shetterly, S. M., Eby, C., Mason., L., Cortese, C. F. and Hamman, R. F. (1998) ‘Social network factors associated with perceived quality of life: the San Luis Valley Health and Aging Study’, Journal of Aging and Health, 10(3): 287–310 Bécares, L., Stafford, M. and Nazroo, J. (2009) Fear of racism, employment and expected organizational racism: their association with health. European Journal of Public Health, 19(5): 504–10 Beck, U. (2000) What is globalization? Cambridge: Polity Behnken, B. D. and Wendt, S. (eds) (2013) Crossing borders: Ethnicity, race, and national belonging in a transnational world. Plymouth, UK: Lexington Books Beissner, K., Parker, S., Henderson, C. R., Pal, A., Papaleontiou, M. and Reid, M. C. (2012) ‘Implementing a combined cognitivebehavioral + exercise therapy protocol for use by older adults with chronic back pain: evidence for a possible race/ethnicity effect’, Journal of Aging Physical Activity, 20(2): 246–65

173

Ethnicity and old age

Bengtson, V. L. (1979) ‘Ethnicity and aging: problems and issues in current social science inquiry’, n D. E. Gelfand and A. J. Kutzik (ed) Ethnicity and aging: Theory, research and policy. New York, NY: Springer, pp. 9–31 Bengtson, V. L., Burgess, E. O. and Parrott, T. M. (1997) ‘Theory, explanation, and a third generation of theoretical development in social gerontology’, Journal of Gerontology: Social Sciences, 52B(2): S72–88 Bengtson, V. L., Gans, D., Putney, B. M. and Silverstein, M. (eds) (2009) The Handbook of theories of aging, (2nd edn). New York: Springer Publishing Company Benn, E. K. T., Fox, A., Fei, K., Roberts, E. and Boden-Albala, B. (2015) ‘Moving towards a more comprehensive investigation of racial/ ethnic differences in cognitive disability among US adults’, Journal of Immigrant Minority Health, 17: 1105–13 Binstock, R. H. and George, L. K. (eds) (2006) Handbook of aging and the social sciences. California: Academic Press Birren, J. E. and Bengtson, V. L. (eds) (1988) Emergent theories of aging. New York: Springer Publishing Company Blakemore, K. (1997) ‘From minorities to majorities: perspectives on culture, ethnicity and ageing in British social gerontology’, in A. Jamieson, S. Harper and C. Victor (eds), Critical approaches to ageing and later life. Buckingham, UK : Open University Press Blakemore, K. and Boneham, M. (1994) Age, race and ethnicity: A comparative approach. Buckingham, UK/Philadelphia: Open University Press Blankson, A. N. and McArdle, J. J. (2013) ‘Measurement invariance of cognitive abilities across ethnicity, gender, and time among older Americans’, Journal of Gerontology: Series B, 70(3): 386–97 Bloom, D. E., Canning, D. and Lubet, A. (2015) ‘Global population aging: facts, challenges, solutions and perspectives’, Daedalus: the Journal of the American Academy of Arts and Sciences, 144(2): 80–92 Boaz, T. L., Becker, M. A., Andel. R. and McCutchan, N. (2017) ‘Rehospitalization risk factors for psychiatric treatment among elderly Medicaid beneficiaries following hospitalization for a physical health condition’, Aging and Mental Health, 21(3): 297–303 Bonilla-Silva, E. (2012) ‘The invisible weight of whiteness: the racial grammar of everyday life in contemporary America’, Ethnic and Racial Studies, 35(2): 173–94 Booth, W. C., Colomb, G. C. and Williams, J. M. (1995) The craft of research. Chicago/London: The University of Chicago Press

174

References

Botev, N. (2012) ‘Population aging in Central and Eastern Europe and its demographic and social context’, European Journal of Aging, 9: 69–79 Bowen, M. E. and González, H. M. (2008) ‘Racial/ethnic differences in the relationship between the use of health care services and functional disability: the Health and Retirement Study (1992–2004)’, The Gerontologist, 48(5): 659–67 Bowman, K. F., Landefeld, S. S., Quinn, L. M., Palmer, R. MM Kowal, J. and Fortinsky, R. H. (1998) ‘Strain in African American and White American caregivers of hospitalized elderly: implications for discharge planning’, Research on Aging, 20(5): 547–68 Boyington, J.E.A., Howard, D.L. and Holmes, D.N. (2008) ‘Self-rated health, activities of daily living, and mobility limitations among Black and White stroke survivors’, Journal of Aging and Health, 20(8): 920–36 Bradby, H. (2003) ‘Describing ethnicity in health research’, Ethnicity and Health, 8(1): 5–13 Bradley, E.H., Curry, L. A., McGraw, S. A., Webster, T. R., Kasl, S. V. and Andersen, R. (2004) ‘Intended use of informal long-term care: the role of race and ethnicity’, Ethnicity and Health, 9(1): 37–54 Braun, K. L., Tanji, V. M. and Heck, R. (2001) ‘Support for physicianassisted suicide: exploring the impact of ethnicity and attitudes toward planning for death’, The Gerontologist, 41(1): 51–60 Brewer, J. D. (2004) ‘Imagining the Sociological Imagination: the biographical context of a sociological classic’, The British Journal of Sociology, 55(3): 317–33.’ Brewer-Lowry, A., Arcury, T. A., Bell, R. A. and Quandt, S. A. (2010) ‘Differentiating approaches to diabetes self-care management of multi-ethnic rural older adults at the extremes of glycemic control’, The Gerontologist, 50(5): 657–67 Browne, C. V., Mokuau, N., Ka’opua, L. S., Kim, B. J., Higuchi, P. and Braun, K. L. (2014) ‘Listening to the voices of Native Hawaiian elders and ‘Ohana caregivers: discussions on aging, health and care preferences’, Journal of Cross-Cultural Gerontology, 29: 131–51 Brubaker, R. (2015) ‘Grounds for difference. Cambridge, MA: Harvard University Press Bryant, A. N. and Kim, G. (2012) ‘Racial/ethnic differences in prevalence and correlates of binge drinking among older adults’, Aging and Mental Health, 16(2): 208–17 Buckley, C., Angel, J. L. and Donahue, D. (2000) ‘Nativity and older women’s health: constructed reliance in the health and retirement study’, Journal of Women and Aging, 12(3/4): 21–117

175

Ethnicity and old age

Burgio, L., Stevens, A., Guy, D., Roth, D. L. and Haley, W. E. (2003) ‘Impact of two psychosocial interventions on White and African American family caregivers of individuals with dementia’, The Gerontologist, 43(4): 568–79 Bürkner, H-J. (2011) ‘Intersectionality., how gender studies might inspire the analysis of social inequality among migrants’, Population, Space and Place, 18(2): 181–95 Burton, L.M. and Dilworth-Anderson, P. and Bengtson, V. L. (1992) ‘Creating culturally-relevant ways of thinking about diversity and aging: theoretical challenges for the twenty-first century’, in E. Percil Stanford and F.M. Torres-Gil (eds) Diversity: New approaches to ethnic minority aging. New York: Baywood Publishing Cagney, K. A. and Agree, E. M. (1999) ‘Racial differences in skilled nursing care and home health use: the mediating effects of family structure and social class’, Journal of Gerontology: Social Sciences, 54B(4): S223–36 Cagney, K. A. and Agree, E. M. (2005) ‘Racial differences in formal long-term care: does the timing of parenthood play a role?’ Journal of Gerontology: Social Sciences, 60B(3): S137–45 Calderón-Rosado, V., Morrill, A., Chang, B-H. and Tennstedt, S. (2002) ‘Service utilization among disabled Puerto Rican elders and their caregivers’, Journal of Aging and Health, 14(1): 3–23 Cantu, P. A., Hayward, M. D., Hummer, R. A. and Chiu, C-T. (2013) ‘New estimates of racial/ethnic differences in life expectancy with chronic morbidity and functional loss: evidence from the National Health Interview Survey’, Journal of Cross-Cultural Gerontology, 28: 283–97 Carling, J. (2008) ‘The human dynamics of migrant transnationalism’ Ethnic and Racial Studies, 31(8): 1452–77 Carter, B. and Fenton, S. (2010) ‘Not thinking ethnicity., a critique of the ethnicity paradigm in an over-ethnicised sociology’, Journal for the Theory of Social Behavior, 40(1): 1–18 Cashmore, E. (ed) (2004) Encyclopaedia of race and ethnic studies. London/ New York: Routledge Castles, S. (2000) Ethnicity and globalization: From migrant worker to transnational citizen. London/Thousand Oaks/New Delhi: Sage Publications Castles, S. and Davidson, A. (2000) Citizenship and migration: Globalization and the politics of belonging. London: Macmillan Press Ltd Castles, S. and Miller, M. J. (1998) The age of migration: International population movements in the modern world. London: Macmillan Press Ltd

176

References

Castora-Binkley, M., Peronto, C. L., Edwards, J. D. and Small, B. J. (2013) ‘A longitudinal analysis of the influence of race on cognitive performance’, Journal of Gerontology: Series B, 70(4): 512–18 Castoriadis, C. (1987) The imaginary institution of society. London: Polity Castoriadis, C. (1994) ‘Radical imagination and the social instituting imaginary’, in G. Robinson and J. Rundell (eds) Rethinking imagination: Culture and creativity. London: Routledge Chan, A., Malhotra, R., Matchar, D. B., Ma, S. and Saito, Y. (2016) ‘Gender, educational and ethnic differences in active life expectancy among older Singaporeans’, Geriatrics and Gerontology International, 16: 466–73 Chen, F., Mair, C. A., Bao, L. and Yang, Y. C. (2015) ‘Race/ethnic differentials in the health consequences of caring for grandchildren for grandparents’, Journal of Gerontology, Social Sciences, 70(5): 793–803 Chiu, C-J. and Wray, L. A. (2011) ‘Physical disability trajectories in older Americans with and without diabetes: the role of age, gender, race or ethnicity, and education’, The Gerontologist, 51(1): 51–63 Cohen, C. I., Colemon, Y., Yaffee, R. and Casimir, G. J. (2008) ‘Racial differences in suicidality in an older urban population’, The Gerontologist, 48(1): 71–8 Coleman, E. A. and O’Sullivan, P. (2001) ‘Racial differences in breast cancer screening among women from 65 to 74 years of age: trends from 1987–1993 and barriers to screening’, Journal of Women and Aging, 13(3): 23–39 Coles, R. L. (2001) ‘Elderly narrative reflections on the contradictions in Turkish village family life after migration of adult children’, Journal of Aging Studies, 15: 383–406 Connell, C. M. and Gibson, G. D. (1997) ‘Racial, ethnic and cultural differences on dementia caregiving: review and analysis’, The Gerontologist, 37: 355–64 Cornell, S. and Hartmann, D. (1998) Ethnicity and race: Making identities in a changing world. Thousand Oaks/London/New Delhi: Pine Forge Crenshaw, K. W. (1991) ‘Mapping the margins: intersectionality, identity politics and violence against women of colour’, Stanford Law Review, 43(6): 1241–99 Crespo, N. C., Yoo, E. J. and Hawkins, S. A. (2011) ‘Anthropometric and lifestyle association of bone mass in healthy pre-menopausal Mexican and Asian American women’, Journal of Immigrant Minority Health, 13: 74–80 Cylwik, H. (2002) ‘Expectations of inter-generational reciprocity among older Greek Cypriot migrants in London’ Ageing & Society, 22(5): 599–613

177

Ethnicity and old age

Dannefer, D. (2003) ‘Cumulative advantage/disadvantage and the life course: cross-fertilizing age and social science theory’, Journal of Gerontology: Social Sciences, 58(6): S327–S337 Dannefer, D. and Phillipson, C. (eds) (2010) The SAGE handbook of social gerontology. London/Thousand Oaks/New Delhi/Singapore: Sage Publications Davies, A. and James, A. (2011) Geographies of aging: Social processes and the spatial unevenness of population aging. Farnham, UK: Ashgate Publishing Denis, A. (2008) ‘Intersectional analysis: a contribution of feminism to sociology’, International Sociology, 23(5): 677–94 Denzin, N. K. (1990) ‘Presidential address on the sociological imagination revisited’, The Sociological Quarterly, 31(1): 1–22 Dick, H. P. and Wirtz, K. (2011) ‘Racializing discourses’, Journal of Linguistic Anthropology, 21(S1): E2–E10 Dilworth-Anderson, P., Williams, I. C. and Gibson, B. E. (2002) ‘Issues of race, ethnicity, and culture in caregiving research: a 20-year review (1980–2000)’, The Gerontologist, 42(2): 237–72 Dilworth-Anderson, P., Brummett, B. H., Goodwin, P., Williams, S. W., Williams, R. B. and Siegler, I. C. (2005) ‘Effects of race on cultural justifications for caregiving’, Journal of Gerontology: Social Sciences, 60B(5): S257–S262 Dilworth-Anderson, P. and Hilliard T. S. (2014) ‘Social networks and minority elders’, in K. E. Whitfield and T. A. Baker (eds) Handbook of minority aging, New York: Springer Publishing Company Dong, X., Simon, M. A. and Evans, D. A. (2012) ‘Prevalence of selfneglect across gender, race, and socioeconomic status: findings from the Chicago Health and Aging Project’, Gerontology, 58: 258–68 Dornelas, E. A., Stepnowski, R. R., Fischer, E. H. and Thompson, P. D. (2007) ‘Urban ethnic minority women’s attendance at health clinic vs. church based exercise programs’, Journal of Cross-Cultural Gerontology, 22: 129–36 Dowd, J. J. and Bengtson, V. L. (1978) ‘Ageing in minority populations: an examination of the double jeopardy hypothesis’, Journal of Gerontology, 33: 427–36 Dulin, P. L., Stephens, C., Alpass, F., Hill, R. D. and Stevenson, B. (2011) ‘The impact of socio-cultural contextual, physical and lifestyle variables on measures of physical and psychological well-being among Maori and non-Maori: the New Zealand Health, Work and Retirement Study’, Ageing & Society, 31: 1406–24

178

References

Dunlop, D. D., Manheim, L.M., Song, J. and Chang, R. W. (2002) ‘Gender and ethnic/racial disparities in health care utilization among older adults’, Journal of Gerontology: Social Sciences, 57B(3): S221–33 Dupree, L. W., Watson, M. A. and Schneider, M. G. (2005) ‘Preferences for mental health care: a comparison of older African Americans and older Caucasians’, Journal of Applied Gerontology, 24(3): 196–210 Dwyer, P. (2000) ‘Movements to some purpose? An exploration of international retirement migration in the European Union’, Education and Aging, 15(3): 353–77 Dwyer, P. (2001) ‘Retired EU migrants, healthcare rights and European social citizenship’, Journal of Social Welfare and Family Law, 23(3): 311–27 Dwyer, P. and Papadimitriou, D. (2003) ‘The social security rights of older international migrants in the European Union’, Paper presented to the European Science Foundation Scientific Network on International Migration in Europe: Welfare Policy and Practice Implications for Older People. 23–26 October, York, UK Early, D. R., Widaman, K. F., Harvey, D., Beckett, L., Park, L. Q., Farias, S. T., Reed, B. R., DeCarli, C. and Mungas, D. (2013) ‘Demographic predictors of cognitive change in ethnically diverse older persons’, Psychology and Aging, 28(3): 633–45 Elias, S. and Feagin, J. R. (2016) Racial theories in social science: A systemic racism critique. New York/London: Routledge Ellins, J. and Glasby, J. (2016) ‘You don’t know what you are saying “Yes” and what you are saying “No” to: hospital experiences of older people from minority ethnic communities’, Ageing & Society, 36: 42–63 Emirbayer, M. and Desmond, M. (2012) ‘Race and reflexivity’, Ethnic and Racial Studies, 35(4): 574–99 Essed, P. (1991) Understanding everyday racism. Newbury Park, CA: Sage Estes, C. L., Binney, E. A. and Culbertson, R. A. (1992) ‘The gerontological imagination: social influences on the development of gerontology, 1945–present’, Int’l. Journal of Aging and Human Development, 35(1): 49–65 Faist, T. (2000a) ‘Transnationalization in international migration: implications for the study of citizenship and culture’, Ethnic and Racial Studies, 23(2): 189–222 Faist, T. (2000b) The volume and dynamics of international migration and transnational social spaces. Oxford: Oxford University Press Feagin, J. R. (2014) Racist America: Roots, current realities, and future reparations. New York: Routledge

179

Ethnicity and old age

Feld, S., Dunkle, R. E. and Schroepfer, T. (2004) ‘Race/ethnicity and marital status in IADL caregiver networks’, Research on Aging, 26(5): 531–58 Fiori, K. L., Consedine, N. S. and Magai, C. (2008) ‘Ethnic differences in patterns of social exchange among older adults: the role of resource context’, Ageing & Society, 28: 495–524 Fiori, K. L., Consedine, N. S. and Magai, C. (2009) ‘Late life attachment in context: patterns of relating among men and women from seven ethnic groups’, Journal of Cross-Cultural Gerontology, 24: 121–41 Forrest, K. Y. Z., Bunker, C. H., Sheu, Y., Wheeler, V. W., Patrick, A. L. and Zmuda, J. M. (2012) ‘Patterns and correlates of grip strength change with age in Afro-Caribbean men’, Age and Ageing, 41: 326–32 Fraser, N. (1996) Social justice in the age of identity politics: Redistribution, recognition and participation. The Tanner Lectures on Human Values, 30 April–2 May, Stanford University, Fraser, N. (1997) Justice interrupts: Critical reflections on the ‘postsocialist’ condition. New York: Routledge Fraser, N. (2009) Scales of justice: Reimagining political space in a globalizing world. New York: Columbia University Press Friedemann, M-L., Buckwalter, K. C., Newman, F. L. and Mauro, A. C. (2013) ‘Patterns of caregiving of Cuban, Other Hispanics, Caribbean Black and White elders in South Florida’, Journal of CrossCultural Gerontology, 28: 137–52 Fuller-Thomson, E., Nuru-Jeter, A., Minkler, M. and Guralnik, J. M. (2009) ‘Black-White disparities in disability among older Americans: Further untangling the role of race and socioeconomic status’, Journal of Aging and Health, 21(5): 677–98 Furner, S. E., Giloth, B. E., Arguelles, L., Miles, T. P. and Goldberg, J. H. (2004) ‘A co-twin control study of physical function in elderly African American women’, Journal of Aging and Health, 16(1): 28–43 Gallagher-Thompson, D., Coon, D. W., Solano, N., Ambler, C., Rabinowitz, Y. and Thompson, L. W. (2003) ‘Changes in indices of distress among Latino and Anglo Female caregivers of elderly relatives with dementia: site-specific results from the REACH national collaborative study’, The Gerontologist, 43(4): 580–91 Gallant, M. P., Spitze, G. and Grove, J. G. (2010) ‘Chronic illness self-care and the family lives of older adults: a synthetic review across four ethnic groups’, Journal of Cross-Cultural Gerontology, 25: 21–43 Gaonkar, D. P. (2002) ‘Toward new imaginaries: An introduction’, Public Culture, 14(1): 1–19 Geertz, C. (1973) The interpretation of culture. New York: Basic Books

180

References

Gelfand, D. E. (2003) [1994] Aging and ethnicity: Knowledge and services (2nd edn). New York, NY: Springer Publishing Company Gerst-Emerson, K. and Gray, J. (2017) ‘Physical activity and cardiovascular disease among older adults: the case of ethnicity and race’, Journal of Aging and Physical Activity, 25: 505–9 Giddens, A. (1994) ‘Living in a post-traditional society’, in U. Beck, A. Giddens and S. Lash (eds) Reflexive modernization: Politics, tradition and aesthetics in the modern social order. Stanford, CA: Stanford University Press Gille, Z. and Riain, S. O. (2002) ‘Global ethnography’, Annual Review of Sociology, 28, 271–95 Glass, A. P. and Samuel, L. F. (2011) ‘A comparison of attitudes about cremation among Black and White middle-aged and older adults’, Journal of Gerontological Social Work, 54: 372–89 Glazer, N. and Moynihan, D. P. (1963) Beyond the melting pot: The Negroes, Puerto Ricans, Jews, Italians, and Irish of New York City. Cambridge: MIT Press Glick-Schiller, N., Basch, L and Szanton-Blanc, C. (eds) (1992) Towards a transnational perspective on migration: Race, class, ethnicity, and nationalism reconsidered. New York: New York Academy of Science Glick-Schiller, N. Basch, L. and Szanton-Blanc, C. (1995) ‘From immigrant to transmigrant: theorizing transnational migration’, Anthropological Quarterly, 68(1): 48–63 Green, J. (1989) ‘Ageing and ethnicity: an emergent issue in social gerontology’, Journal of Cross-Cultural Gerontology, 4: 377–83 Greenfield, P. M. (2014) ‘Sociodemographic differences within countries produce variable cultural values’, Journal of Cross-Cultural Psychology, 45(1): 37–41 Grosfoguel, R. (2004) ‘Race and ethnicity or racialized ethnicities: identities within global coloniality’, Ethnicities, 4(3): 315–36 Gustafson, P. (2001) ‘Retirement migration and transnational lifestyles’ Ageing & Society, 21(4): 371–94 Haas, S. A., Krueger, P. M. and Rohlfsen, L. (2012) ‘Race/ethnic and nativity disparities in later life physical performance: the role of health and socioeconomic status over the life course’, Journal of Gerontology: Series B, 67(2): 238–48 Hamelink, C. J. (1999) ‘The elusive concept of globalization’, Global Dialogue, 1(1): 1–9 Hannerz, U. (1992) Cultural complexity: Studies in the social organization of meaning. New York: Columbia University Press

181

Ethnicity and old age

Hardill, I., Spradbery, J., Arnold-Boakes, J, and Marrugat, M. L. (2005) ‘Severe health and social care issues among British migrants who retire to Spain’, Ageing & Society, 25(5): 769–83 Hawkley, L. C., Thisted, R. A., Masi, C. M. and Cacioppo, J. T. (2010) ‘Loneliness predicts increased blood pressure: a 5 year crosslegged analyses in middle-aged and older adults’, Psychology and Aging, 25(1): 132–41 Heikkilä, K. and Ekman, S-L. (2003) ‘Elderly care for ethnic minorities: wishes and expectations among elderly Finns in Sweden’, Ethnicity and Health, 8(2): 135–46 Heo, G. J. and Koeske, G. (2011) ‘The role of religious coping and race in Alzheimer’s disease caregiving’, Journal of Applied Gerontology, 32(5): 582–604 Hilgeman, M. M., Durkin, D. W., Sun, F., DeCoster, J., Allen, R. S., Gallager-Thompson D., Burgio, L. D. (2009) ‘Testing a theoretical model of the stress process in Alzheimer’s caregivers with race as a moderator’, The Gerontologist, 49(2): 248–61 Ho, C. J., Weitzman, P. F., Cui, X. and Levkoff, S. (2000) ‘Stress and service use among minority caregivers to elders with dementia’, Journal of Gerontological Social Work, 33(1): 67–88 Horn, V. and Schweppe, C. (eds) (2016) Transnational aging: Current insights and future challenges. New York/London: Routledge Horn, V., Schweppe, C. and Um, S-G. (2013) ‘Transnational aging: a young field of research’, Transnational Social Review: A Social Work Journal, 3(1): 7–10 Hughes, E. C. (1994) On work, race and the sociological imagination. (ed) L.A. Coser, Chicago: University of Chicago Press Isaac, H. (1975) Idols of the tribe: Group identity and political change. New York: Harper and Row Jackson, J.S., Brown, E., Antonucci, T. and Daatland, S. O. (2005) ‘Ethnic diversity in ageing, multicultural societies’, in M. L. Johnson (ed) The Cambridge handbook of age and ageing. Cambridge, UK: Cambridge University Press Jackson, P.B. (2005) ‘Health inequalities among minority groups’, Journal of Gerontology: Series B, 60B (Special Issue II): 63–7 Jackson, P.B. and George, L. K. (1998) ‘Racial differences in satisfaction with physicians’, Research on Aging, 20(3): 298–316 Janevic, M. R. and Connell, C. M. (2001) ‘Racial, ethnic, and cultural differences in the dementia caregiving experience’, The Gerontologist, 41(3): 334–47

182

References

Jang, Y., Park, N. S., Chiriboga, D. A., Yoon, H., An S. and Kim, M. T. (2015) ‘Social capital in ethnic communities and mental health: a study of older Korean immigrants’, Journal of Cross-Cultural Gerontology, 30: 131–41 Jenkins, R. (1983) Lads, citizens and ordinary kids: Working-class youth life-styles in Belfast. London: Routledge and Kegan Paul Jenkins, R. (1986) Racism and recruitment: Managers, organizations and equal opportunity in the labour market. Cambridge: Cambridge University Press Jenkins, R. (1997) Rethinking ethnicity: Arguments and explorations. London/Thousand Oaks/New Delhi: SAGE Publications Jenkins, R. (2000) ‘Categorization: identity, social process and epistemology’, Current Sociology, 48(3): 7–25 Jenkins, R. (2008) Social identity (3rd edn). London/New York: Routledge Jolley, D., Moreland, N., Read, K., Kaur, H., Jutlla, K. and Clark, M. (2009) ‘The ‘Twice a Child’ projects: learning about dementia and related disorders within the black and minority ethnic population of an English city and improving relevant services’, Ethnicity and Inequalities in Health and Social Care, 2(4): 4–9 Jones, A. C., Kwoth, C. K., Groeneveld, P. W., Mor, M., Geng, M. and Ibrahim, S. A. (2008) ‘Investigating racial differences in coping with chronic osteoarthritis pain’, Journal of Cross-Cultural Gerontology, 23: 339–47 Karl, U. and Torres, S. (eds) (2016) Ageing in contexts of migration. London/New York: Routledge Karlsen, S. and Nazroo, J. Y. (2002a). Agency and structure: the impact of ethnic identity and racism on the health of ethnic minority people. Sociology of Health & Illness, 24(1): 1–20 Karlsen, S. and Nazroo, J. Y. (2002b). Relation between racial discrimination, social class and health among ethnic minority groups. American Journal of Public Health, 92(4): 624–31 Karter, AJ., Laiteerapong,, N., Chin, MH., Moffett, H.H., Parker, M.A., Sudorem R., Adams, A.S., Schillinger, D., Adler, N. S., Whitmer, R.A., Piette, J. D. and Huang, E. S. (2015) ‘Ethnic differences in geriatric conditions and diabetes complications among older, insured adults with diabetes: The diabetes and aging study’, Journal of Aging and Health, 27(5): 894–918 Kastoryano, R. (2000) ‘Settlement, transnational communities and citizenship’, Int’l Social Science Journal, 52(16): 307–12

183

Ethnicity and old age

Katz, R. and Lowenstein, A. (1999) ‘Adjustment of older Soviet immigrant parents and their adult children residing in shared households: an intergenerational comparison’, Family Relations, 48(1): 43–50 Katz, S. (1992) ‘Alarmist demography: power, knowledge and the elderly population’, Journal of Aging Studies, 6(3): 203–25 Kearney, M. (1995) ‘The local and the global: the anthropology of globalization and transnationalism’, Annual Review of Anthropology, 24, 547–65 Keefe, J., Rosenthall, C. and Béland, F. (2000) ‘The impact of ethnicity on helping older relatives: findings from a sample of employed Canadians’, Canadian Journal of Aging, 19(3): 317–42 Kelley-Moore, J. A. (2006) ‘Assessing racial health inequality in older adulthood: comparisons from mixed-mode panel interviews’, Journal of Gerontology: Social Sciences, 61B(4): S212–20 Kelley-Moore, J. A. and Ferraro, K. F. (2004) ‘The Black/White disability gap: persistent inequality in later life?’, Journal of Gerontology: Social Sciences, 59B(1): S34–43 Kelley-Moore, J. and Huang, W. (2017) ‘The “good times” cohort in later life: Black-White differences in pathways to functional limitations’, Research on Aging, 39(4): 526–48 Kessler, C. S. (2000) ‘Globalization: another false universalism?’, Third World Quarterly, 21(6): 931–42 Khaltar, A., Priyadarshani, N. G. W., Delpitiya, N. Y., Jayasinghe, C., Jayasinghe, A., Arai, E, and Tamashiro, H. (2017) ‘Depression among older people in Sri Lanka: with special reference to ethnicity’, Geriatric Gerontology Int’l, 17: 2414–50 Khan, M. M., Kobayashi, K., Vang, Z. M. and Lee, S. M. (2017) ‘Are visible minorities “invisible” in Canadian health data and research? A scoping review’, Int’l. Journal of Migration, Health and Social Care, 13(1): 126–43 Kim, G., Shim, R., Ford, K. L. and Baker, T. A. (2015) ‘The relationship between diabetes self-efficacy and psychological distress among older adults: do racial and ethnic differences exist?’, Journal of Aging and Health, 27(2): 320–33 Kim, H-J. and Fredriksen-Goldsen, K. I. (2017) ‘Disparities in mental health quality of life between Hispanics and non-Hispanic White LGB midlife and older adults and the influence of lifetime discrimination, social connectedness, socioeconomic status, and perceived stress’, Research on Aging, 39(9): 991–1012

184

References

Kim, H-J., Jen, S., Fredriksen-Goldsen, K. I. (2017) ‘Race/ethnicity and health-related quality of life among LGBT older adults’, The Gerontologist, 57(S1): S30-S39 Kim, J. and Choi, N. G. (2010) ‘Twelve-month prevalence of DSM-IV mental disorders among older Asian Americans: comparisons with younger groups’, Aging and Mental Health, 14(1): 90–9 Kim, J-H. and Knight, B. G. (2008) ‘Effects of caregiver status, coping styles and social support on the physical health of Korean American caregivers’, The Gerontologist, 48(3): 287–99 King, A. D. (ed) (1991) Culture, globalization and the world-system: Contemporary conditions for the representation of identity. Binghamton: SUNY Press King, R. and Vullnetari, J. (2006) ‘Orphan pensioners and migrating grandparents: the impact of mass migration on older people in rural Albania’, Ageing & Society, 26(5): 783–816 Kivisto, P. (2001) ‘Theorizing transnational immigration: a critical review of current efforts’, Ethnic and Racial Studies, 24(4): 549–77 Koehn, S. (2009) ‘Negotiating candidacy: ethnic minority seniors’ access to care’, Ageing & Society, 29: 585–608 Koehn, S., McCleary, L., Garcia, L., Spence, M: Jarvis, P. and Drummond, N. (2012) ‘Understanding the Chinese-Canadian pathways to a diagnosis with dementia through a criticalconstructionist lens’, Journal of Aging Studies, 26: 44–54 Koehn, S., Neysmith, S., Kobayashi, K. and Khamisa, H. (2013) ‘Revealing the shape of knowledge using an intersectional lens: results of a scoping review on the health and health care of ethnocultural minority older adults’, Ageing & Society, 33: 437–64 Kofman, E. (2004) ‘Family-related migration: a critical review of European studies’, Journal of Ethnic and Migration Studies, 30: 243–62 Kolb, P. (2014) Understanding aging and diversity: Theories and concepts, Abingdon, Oxon/New York:Routledge Krajewski-Jaime, E. R. (ed) (2014) Aging: Ethnicity and gender issues. Champaign, IL: Common Ground Publishing Kramer, J.B. and Barker, J.C. (1994) ‘Ethnicity in the elderly: book review essay’, Journal of Cross-Cultural Gerontology, 9(4): 403–17. Krause, N. (2006) ‘Social relationships in later life’, in R. H. Binstock and L. K. George (eds) Handbook of aging and the social sciences. California: Academic Press. Kuchibhatla, M. and Fillenbaum, G. G. (2002) ‘Assessing risk factors for mortality in elderly White and African American people: implications of alternative analyses’, The Gerontologist, 42(6): 826–34

185

Ethnicity and old age

Kwak, J. and Haley, W. E. (2005) ‘Current findings on end-of-life decision making among racially or ethnically diverse groups’, The Gerontologist, 45(5): 634–41 Kwak, J., Haley, W. E. and Chiriboga, D. A. (2008) ‘Racial differences in hospital use and in-hospital death among Medicare and Medicaid dual-eligible nursing home residents’, The Gerontologist, 48(1): 32–41 Laditka, J. N. and Laditka, S. B. (2001) ‘Adult children helping older parents: variations in likelihood and hours by gender, race, and family role’, Research on Aging, 23(4): 429–56 Laditka, J. N. and Laditka, S. B. (2006) ‘Race, ethnicity and hospitalization for six chronic ambulatory care sensitive conditions in the USA’, Ethnicity and Health, 11(3): 247–63 Laditka, J. N. and Laditka, S. B. (2015) ‘Associations of educational attainment with disability and life expectancy by race and gender in the United States: a longitudinal analysis of the panel study of income dynamics’, Journal of Aging and Health, 28(8): 1403–25 Laditka, S. B., Laditka, J. N., Liu, R., Price, A. E., Friedman, D. B., Wu, B., Bryant, L. L.., Corwin, S. J. and Ivey, S. L. (2013) ‘How do older people describe others with cognitive impairment? A multiethnic study in the United States’, Ageing & Society, 33: 369–92 Lahaie, C., Earle, A. and Heymann, J. (2012) ‘An uneven burden: social disparities in adult caregiving responsibilities, working conditions and caregiver outcomes’, Research on Aging, 35(3): 243–74 Lambe, S., Cantwell, N., Islam, F., Horvath, K. and Jefferson, A. L. (2011) ‘Perceptions, knowledge, incentives and barriers of brain donation among African American elders enrolled in an Alzheimer’s research program’, The Gerontologist, 51(1): 28–38 Latham. K. (2012) ‘Progressive and accelerated disability onset by race/ ethnicity and education among late midlife and older adults’, Journal of Aging and Health, 24(8): 1320–45 Latham. K. (2014) ‘Racial and educational disparities in mobility limitation among older women: what is the role of modifiable risk factors’, Journal of Gerontology: Series B, 69(5): 772–83 Lawrence, V., Samsi, K., Banerjee, S., Morgan, C. and Murray, J. (2011) ‘Threat to valued elements of life: the experience of dementia across three ethnic groups’, The Gerontologist, 51(1): 39–50 Lee, H. B ., Richardson, A. K ., Black, B. S., Shore, A. D., Kasper, J. D. and Rabins, P. V. (2012) ‘Race and cognitive decline among community-dwelling elders with mild cognitive impairment: Findings from the Memory and Medical Case Study’, Aging and Mental Health, 16(3): 372–7

186

References

Levkoff, S., Levy, B. and Weitzman, P. F. (1999) ‘The role of religion and ethnicity in the help seeking of family caregivers of elders with Alzheimer’s disease and related disorders’, Journal of Cross-Cultural Gerontology, 14: 335–56 Li, L. W. and Fries, B. E. (2005) ‘Elder disability as an explanation for racial differences in informal home care’, The Gerontologist, 45(2): 206–15 Liang, J., Xu, X., Bennett, J. M., Ye, W. and Quinones, A. R. (2009) ‘Ethnicity and changing functional health in middle and late life: a person-centered approach’, Journal of Gerontology: Social Sciences, 65B(4): 470–81 Lin, J. and Kelley-Moore, J. (2017a) ‘Intraindividual variability in late-life functional limitations among White, Black, and Hispanic older adults: implications for the weathering hypothesis’, Research on Aging, 39(4): 549–72 Lin, J. and Kelley-Moore, J. A. (2017b) ‘From noise to signal: the age and social patterning of intra-individual variability in later-life health’, Journal of Gerontology: Social Sciences, 72(1): 168–79 Lincoln, K. D. (2014) ‘Social relationships and health among minority older people’, in K. E. Whitfield and T. A. Baker (eds) Handbook of minority aging. New York: Springer Publishing Company Litwin, H. (2004) ‘Social networks, ethnicity and public home-care utilisation’, Ageing & Society, 24: 921–39 Loveman, M. (1999) ‘Is race essential?’, American Sociological Review, 64(6): 891–8 Lowenstein, A. (1999) ‘Caring for parents with Alzheimer’s: comparing perceptions of physical and mental health in the Jewish and Arab sectors in Israel’, Journal of Cross-Cultural Gerontology, 14: 65–76 Lum, T. Y. (2005) ‘Understanding the racial and ethnic differences in caregiving arrangements’, Journal of Gerontological Social Work, 45(4): 3–21 Lunt, N. (2009) ‘Older people within transnational families: the social policy implications’, International Journal of Social Welfare, 18: 243–51 Magai, C., Kerns, M-D., Consedine, N. S. and Fyffe, D. (2003) ‘Depression in older ethnic groups: a test of the generality of the social precursors model’, Research on Aging, 25(2): 144–71 Mahoney, D. F., Cloutterbuck, J., Neary, S: and Zhan, L. (2005) ‘African American, Chinese, and Latino family caregivers’ impressions of onset and diagnosis of dementia: cross-cultural similarities and differences’, The Gerontologist, 45(6): 783–92

187

Ethnicity and old age

Mand, K. (2006) ‘Gender, ethnicity and social relations in the narratives of elderly Sikh men and women’, Ethnic and Racial Studies, 29(6): 1057–71 Markides, K. S. and Eschbach, K. (2005) ‘Aging, migration and mortality: current status of research on the Hispanic paradox’, Journal of Gerontology: Series B, 60(2): 68–75 Markides, K. S. and Gerst-Emerson, K. (2014) ‘Introduction: Minorities, Aging and Health’, in K. E. Whitfield and T. A. Baker (eds) Handbook of minority aging. New York: Springer Publishing Company, pp. 105–9 Marsella, A. J. (2009) ‘Diversity in a global era: the context and consequences of differences’, Counselling Pychology Quaterly, 22(1): 119–35 Martin, D., Metzger, J-L, and Pierre, P. (2006) ‘The sociology of globalization: theoretical and methodological reflections’, International Sociology, 21(4): 499–521 Martin, L. G., Schoeni, R. F., Freedman, V. A. and Andreski, P. (2007) ‘Feeling better? Trends in general health status’, Journal of Gerontology, Social Sciences, 62B(1): S11–S21 Martinez, I. L., Kim, K., Tanner, E., Fried, L. P. and Seeman, T. (2009) ‘Ethnic and class variations in promoting social activities among older adults’, Activities, Adaptation and Aging, 33: 96–119 Massey, D. (1994) Space, place and gender. Cambridge: Polity Mayeda, E. R., Glymour, M. M., Quesenberry, C.P. and Whitmer, R. A. (2016) ‘Inequalities in dementia incidence between six racial and ethnic groups over 14 years’, Alzheimers and Dementia, 12: 216–24 McDougall, G. J., Becker, H., Pituch, K., Acee, T. W., Vaughn, P. W. and Delville, C. L. (2010) ‘Differential benefits of memory training for minority older adults in the SeniorWise study’, The Gerontologist, 50(5): 632–45 McFarland, M. J., Smith, C. A., Toussaint, L. and Thomas, P. A. (2012) ‘Forgiveness of others and health: do race and neighborhood matter?’, Journal of Gerontology: Series B, 67(1): 66–75 McGovern, P. and Nazroo, J. Y. (2015) Patterns and causes of health inequalities in later life: a Bourdieusian approach. Sociology of Health & Illness, 37(1). 143–60 Mehrotra, C.M. and Wagner, L. S. (2009) Aging and diversity (2nd edn). New York/London: Routledge Mehta, N. K., Sudharsanan, N. and Elo, I. T. (2014) ‘Race/ethnicity and disability among older Americans’ in K. E. Whitfield and T. A. Baker (eds) Handbook of minority aging. New York: Springer Publishing Company, pp.111–29

188

References

Mendes de Leon, C. F., Barnes, L. L., Bienias, J. L., Skarupski, K. A. and Evans, D. A. (2005) ‘Racial disparities in disability: recent evidence from self-reported and performance-based disability measures in a population-based study of older adults’, Journal of Gerontology: Social Sciences, 60B(5): S263–S271 Meshefedjian, G., McCusker, J., Bellavance, F. and Baumgarten, M. (1998) ‘Factors associated with symptoms of depression among informal caregivers of demented elders in the community’, The Gerontologist, 38(2): 247–53 Miles, R. (1989) Racism, Routledge Miller, N. A., Kirk, A., Kaiser, M. J. and Glos, L. (2014) ‘Disparities in access to health care among middle-aged and older adults with disabilities’, Journal of Aging and Social Policy, 26: 324–46 Mills, C. W. (1959) The sociological imagination. New York: Oxford University Press Mills, T. W. and Edwards, C. D. (2002) ‘A critical review of research on the mental health status of older African-Americans’, Ageing & Society, 22: 273–304 Miltiades, H. B. (2002) ‘The social and psychological effect of an adult child’s emigration on non-immigrant Asian Indian elderly parents’, Journal of Cross-Cultural Gerontology, 17(1): 33–5 Min, J. W. and Barrio, C. (2009) ‘Cultural values and caregiver preference for Mexican American and non-Latino White elders’, Journal of Cross-Cultural Gerontology, 24: 225–39 Mitchell, U. A. and Aneshensel, C. S. (2017) ‘Social inequalities in inflammation: age variations in older persons’, Journal of Aging and Health, 29(5): 769–87 Mittleman, J. H. (2000) ‘Globalization: captors and captive’, Third World Quarterly, 21(6): 917–29 Miyawaki, C. E. (2015) ‘Association of social isolation and health across different racial and ethnic groups of older Americans’, Ageing & Society, 35: 2201–28 Miyawaki, C. E. (2016) ‘Caregiving practice patterns of Asian, Hispanic, and Non-Hispanic White American family caregivers of older adults across generations’, Journal of Cross-Cultural Gerontology, 31: 35–55 Miyawaki, C. E. (2017) ‘Association of filial responsibility, ethnicity, and acculturation among Japanese American family caregivers of older adults’, Journal of Applied Gerontology, 36(3): 296–319 Momtaz, Y. A., Hamid, T. A., Yusoff, S. and Ibrahim, R. (2013) ‘Do depression and educational attainment mediate the association between ethnicity and dementia’, Gerontology, 59: 206–12

189

Ethnicity and old age

Montoro-Rodriguez, J., Kosloski, K. and Montgomery, R. J. V. (2003) ‘Evaluating a practice-oriented service model to increase the use of respite services among minorities and rural caregivers’, The Gerontologist, 43(6): 916–24 Mungas, D., Reed, B. R., Farias, S. T. and DeCarli, C. (2009) ‘Age and education effects on relationships of cognitive test scores with brain structure in demographically diverse older people’, Psychology and Aging, 24(1): 116–28 Mutchler, J. A. and Burr, J. A. (2011) ‘Race, ethnicity, and aging’, in R. A. Settersen and J. L. Angel (eds) Handbook of the sociology of aging. New York: Springer, pp. 83–101 Mutran, E. J., Sudha, S., Desai, T. and Long, K. (2001) ‘Satisfaction with care among elderly Africa n American and White residents of adult care facilities’, Research on Aging, 23(1): 61–82 Nagel, J. (1994) ‘Constructing ethnicity., creating and recreating ethnic identity and culture’, Social Problems, 41(1): 152–76 Navaie-Waliser, M., Feldman, P. H., Gould, D. A., Levine, C., Kuerbis, A. N. and Donelan, K. (2001) ‘The experiences and challenges of informal caregivers: common themes and differences among Whites, Blacks, and Hispanics’, The Gerontologist, 41(6): 733–41 Nazroo, J. Y. (1998) Genetic, cultural or socio-economic vulnerability? Explaining ethnic inequalities in health. Sociology of Health & Illness, 20(5): 710–30 Nazroo, J. Y. (2003) The structuring of ethnic inequalities in health: economic position, racial discrimination, and racism. American Journal of Public Health, 93(2): 277–84 Nederveen, P.J. (1994) ‘Globalization as hybridization’, International Sociology, 9(2): 161–84 Nguyen, D. (2012) The effects of sociocultural factors on older Asian Americans’ access to care. Journal of Gerontological Social Work, 55: 55–71 Nicklett, E, J. and Taylor, R. J. (2014) ‘Racial/ethnic predictors of falls among older adults: The Health and Retirement Study’, Journal of Aging and Health, 26(6): 1060–75 NIH (National Institute of Health) (2011) Global health and aging, Report by the National Institute of Health, National Institute of Aging and the World Health Organization (NIH Publication 11–7737) Noelker, L. S., Ford, A. B., Gaines, A. D., Haug M. R., Jones, P. K., Stange, K. C. and Mefrouche, Z. (1998) ‘Attitudinal influences on the elderly’s use of assistance’, Research on Aging, 20(3): 317–38

190

References

Nyunt, M. S. Z., Fones, C., Niti, M. and Ng, T-P. (2009) ‘Criterionbased validity and reliability of the Geriatric Depression Screening Scale (GDS-15) in a large validation sample of the community-living Asian older adults’, Aging and Mental Health, 13(3): 376–82 O’Reilly, K. (2000) The British on the Costa del Sol: Transnational identities and local communities. London: Routledge Olson, L. K. (2001) Age through ethnic lenses: Caring for the elderly in a multicultural society. Boston/Oxford: Rowman & Littlefield Publishers Osman, A. and Walsemann, K. M. (2017) ‘Ethnic disparities in the onset and progression of functional limitations among Israeli middleaged and older adults: socioeconomic and health-related pathways’, Journal of Gerontology: Social Sciences, 72(1): 140–50 Ozawa, M. N. and Yeo, Y. H. (2008) ‘Race/ethnicity and socioeconomic class as correlates of disability in old age’, Journal of Gerontological Social Work, 51(3–4): 337–65 Padilla-Frausto, D. I., Wallace, S. P. and Benjamin, A. E. (2014) ‘Structural and cultural issues in long-term care services and supports for minority populations’, in K. E. Whitfield and T. A. Baker (ed) Handbook of minority aging. New York: Springer Publishing Company, pp. 221–36 Palmberger, M. (2017) ‘Social ties and embeddeness in old age: older Turkish labour migrants in Vienna’, Journal of Ethnic and Migration Studies, 43(2): 235–49 Pan, S., Stutzbach, J., Reichwein, S., Lee, B. K. and Dahodwala, N. (2014) ‘Knowledge and attitudes about Parkinson’s disease among a diverse group of older adults’, Journal of Cross-Cultural Gerontology, 29(3): 339–52 Pang, E.C., Jordan-Marsh, M., Silverstein, M. and Cody, M. (2003) ‘Health-seeking behaviors of elderly Chinese Americans: shifts in expectations’, The Gerontologist, 43(6): 864–74 Park, M., Unutzer, J. and Grembowski, D. (2014) ‘Ethnic and gender variations in the associations between family cohesion, family conflict and depression among older Asian and Latino adults’, Journal of Immigrant Minority Health, 16: 1103–10 Parker, M. W., Bellis, J. M., Bishop, P., Harper, M., Allman, R. M., Moore, C. and Thompson, P. (2002) ‘A multidisciplinary model of health promotion incorporating spirituality into a successful aging intervention with African American and While elderly groups’, The Gerontologist, 42(3): 406–16 Peek, M K. and O’Neill, G. S. (2001) ‘Networks in later life: an examination of race differences in social support networks’, Int’l. Journal of Aging and Human Development, 52(3): 207–29

191

Ethnicity and old age

Peek, M.K., Coward, R. T. and Peek, C. (2000) ‘Race, aging, and care: can differences in family and household structure account for race variations in informal care’, Research on Aging, 22(2): 117–42 Pelcastre-Villafuerte, B. E., Meneses-Navarro, S., Ruelas-Gonzales, M. G., Reyes-Morales, H., Amaya-Castellanos, A. and Taboada, A. (2017) ‘Aging in rural, indigenous communities: an intercultural and participatory health care approach in Mexico’, Ethnicity and Health, 22(6): 610–30 Peng, T. R., Navaie-Waliser, M. and Feldman, P. H. (2003) ‘Social support, home health service use, and outcomes among four racialethnic groups’, The Gerontologist, 43(4): 503–13 Phillipson, C. (2002) ‘Transnational communities, migration and changing identities in later life’, Paper presented at the 34th EBSSRS Symposium on Aging and Diversity, August 29–31, Bergen, Norway Phillipson, C. (2015) ‘Placing ethnicity at the centre of studies of later life: theoretical perspectives and empirical challenges’, Ageing & Society, 35: 917–34 Phoenix, A. (2006) ‘Editorial: intersectionality’, European Journal of Women’s Studies, 13(3): 187–92 Pinquart, M. and Sörensen, S. (2005) ‘Ethnic differences in stressors, resources, and psychological outcomes of family caregiving: a metaanalysis’, The Gerontologist, 45(1): 90–106 Polivka, L. (2000) ‘Postmodern aging and the loss of meaning’ Journal of Aging and Identity, 5(4): 225–35 Polivka, L. (2001) ‘Globalization, population, aging and ethics’, Journal of Aging and Identity, 6(3): 147–63 Pope, H., Watkins, K. W., McKeown, R. E., Friedman, D. B., Simons, D. B. and Miller, M. C. (2013) ‘Church-based health promotion program impact on ethnically diverse older adults’ social support, religiosity, and spirituality’, Journal of Religion, Spirituality and Aging, 25: 238–57 Portes, A., Guarnizo, L. E. and Landolt, P. (1999) ‘The study of transnationalism: pitfalls and promise of an emergent research field’, Ethnic and Racial Studies, 22(2): 217–37 Preston, S. H. and Stokes, A. (2012) ‘Sources of population aging in more and less developed countries’, Population and Development Review, 38(2): 221–36 Prince, M. J., Wu, F., Guo, Y., Robledo, L. M. G., O’Donnell, R., Sullivan, R. and Yusuf, S. (2014) ‘The burden of disease in older people and the implications for health policy and practice’, The Lancet, 6736(14): 100–11

192

References

Quine, S. (1999) ‘Health concerns and expectations of Anglo and ethnic older Australians: a comparative approach’, Journal of CrossCultural Gerontology, 14: 97–111 Richmond, A. H. (2002) ‘Globalization: implications for immigrants and refugees’, Ethnic and Racial Studies, 25(5): 707–27 Robert, S. A. and Ruel, E. (2006) ‘Racial segregation and health disparities between Black and White older adults’, Journal of Gerontology: Social Sciences, 61B(4): S203–S211 Robertson, R. (1992) Globalization: Social theory and global culture. London: Sage Robertson, R. (1995) ‘Globalization: time-space and homogeneityheterogeneity’, in M. Featherstone, S. Lash and R. Robertson (eds) Global modernities. London: Sage Rodriguez-Galán, M. B. and Falcón, L. M. (2010) ‘Patterns of social activity engagement among older Hispanics and their relationship to sociodemographic and health variables’, Activities, Adaptation and Aging, 34: 251–75 Rote, S., Angel, J. L. and Markides, K. (2014) ‘Health of elderly Mexican American adults and family caregiver distress’, Research on Aging, 37(3): 306–31 Roth, D. L., Haley, W. E., Wadley, V. G., Clay, O. J. and Howard, G. (2007) ‘Race and gender differences in perceived caregiver availability for community-dwelling middle-aged and older adults’, The Gerontologist, 47(6): 721–9 Sabik, N. J. (2013) ‘Ageism and body esteem: associations with psychological well-being among late middle-aged African American and European American women’, Journal of Gerontology: Series B, 70(2): 189–99 Sanders, J. (2002) ‘Ethnic boundaries and identity in plural societies’, American Review of Sociology, 28: 327–57 Santoro, M. S., van Liew, C., Holloway, B., McKinnon, S., Little, T. and Conan, T. A. (2016) ‘Honor thy parents: an ethnic multigroup analysis of filial responsibility, health perceptions, and caregiving decisions’, Research on Aging, 38(6): 665–88 Satre, D. D. and Areán, P. A. (2005) ‘Effects of gender, ethnicity, and medical illness on drinking cessation in older primary care patients’, Journal of Aging and Health, 17(1): 70–84 Schans, D. and Komter, A. (2010) ‘Ethnic differences in intergenerational solidarity’, Journal of Aging Studies, 24: 194–203 Scharlach, A. E., Giunta, N., Chow, J. C-C. and Lehning, A. (2008) ‘Racial and ethnic variations in caregiver service use’, Journal of Aging and Health, 20(3): 326–46

193

Ethnicity and old age

Schmidtke, O. (2001) ‘Transnational migration: a challenge to European citizenship regimes’, World Affairs, 164(1): 3–16 Schoenberg, N. E., Traywick, L. S., Jacobs-Lawson, J. and Kart, C. S. (2008) ‘Diabetes self-care among a multi-ethnic sample of older adults’, Journal of Cross-Cultural Gerontology, 23: 361–76 Schuler, P. B., Vinci, D., Isosaari, R. M., Phillip, S. F., Todorovich, J., Roy, J. L. P and Evans, R. R. (2008) ‘Body-shape perceptions, body mass index of older African American and European American women’, Journal of Cross-Cultural Gerontology, 23: 255–64 Shah, A., Banner, N., Newbigging, K., Heginbotham, C. and Fulford, B. (2009) ‘The early experience of consultant psychiatrists in application of the Mental Capacity Act: issues for black and minority individuals’, Ethnicity and Inequalities in Health and Social Care, 2(2): 4–10 Sherkat, D. E., Kilbourne, B. S., Cain, V. A., Hull, P. A., Levine, R. S. and Husaini, B. A. (2007) ‘The impact of health service use on racial differences in mortality among the elderly’, Research on Aging, 29(3): 207–24 Sherzai, D., Sherzai, A., Babayan, D., Chiou, D., Vega, S. and Shaheen, M. (2016) ‘Dementia in the oldest old: a nationwide inpatient sample database study’, Journal of Aging and Health, 28(3): 426–39 Shils, E. (1957) ‘Primordial, personal, sacred and civic ties: some particular observations on the relationships of sociological research and theory’, British Journal of Sociology, 8: 130–45 Silveira, E.R. and Ebrahim, S. (1998a) ‘Social determinants of psychiatric morbidity and well-being in immigrant elders and Whites in East London’, Int’l. Journal of Geriatric Psychiatry, 13: 801–12 Silveira, E.R.T. and Ebrahim, S. (1998b) ‘A comparison of mental health among minority ethnic elders and whites in East and North London’ Age and Ageing, 27: 375–83 Simmons, L. (1945) The role of the aged in primitive society. New Haven, CT: Archon Books Simonsick, E. M., Kasper, J. D. and Phillips, C. L. (1998) ‘Physical disability and social interaction: factors associated with low social contact and home confinement in disabled older women (The Women’s Health and Aging Study)’, Journal of Gerontology: Social Sciences, 53B(4): S209–S217 Slany, K., Kontos, M. and Liapi, M. (eds) (2010) Women in new migrations: Current debates in European societies. Cracow, Poland: Jagiellonian University Press

194

References

Slotman, A., Snijder, M. B., Ikram, U. Z., Schene, A. H. and Stevens, G. W.J. M. (2017) ‘The role of mastery in the relationship between perceived ethnic discrimination and depression: the HELIUS study’, Cultural Diversity and Ethnic Minority Psychology, 23(2): 200–8 Small, J., Chan, S. M., Drance, E., Globerman, J., Hulko, W., O’Connorm D., Perry, J., Stern, L. and Ho, L. (2015) ‘Verbal and nonverbal indicators of quality of communication between care staff and residents in ethnoculturally and linguistically diverse long-term care settings’, Journal of Cross-Cultural Gerontology, 30: 285–304 Smart, B. (1993) Postmodernity. London/New York: Routledge Smedley, A. and Smedley, B. (2005) ‘Race as biology is fiction: racism as a social problem is real: Anthropological and historical perspectives on the social construction of race’, American Psychologist, 60(1): 16–26 Smith, M. P. and Guarnizo, L. E. (eds) (1998) Transnationalism from below. New Jersey: Transaction Publishers Söderman, M. and Rosendahl, S. P. (2016) ‘Caring for ethnic older people living with dementia: experiences of nursing staff’, Journal of Cross-Cultural Gerontology, 31(3): 311–26 Solway, E., Estes, C. L., Goldberg, S. and Berry, J. (2010) ‘Access barriers to mental health services for older adults from diverse populations: perspectives of leaders in mental health and aging’, Journal of Aging and Social Policy, 22: 360–78 Spoelstra, S., Given, B., von Eye, A. and Given, C. (2010) ‘Fall risk in community dwelling elderly cancer survivors: a predictive model for gerontological nursing’, Journal of Gerontological Nursing, 36(2): 52–60 Stanaway, F. F., Cumming, R. G., Naganathan, V., Blyth, F. M., Handelsman, D. J., Le Couteur, D. G., Waite, L. M., Creasey, H. M., Seibel, M, J. and Sambrook, P. N. (2011) ‘Ethnicity and falls in older men: low rate of falls in Italian-born men in Australia’, Age and Ageing, 40: 595–601 Standford, E. P. and Torres-Gil, F. M. (eds) (1992) Diversity: New approaches to ethnic minority aging. Amityville, NY: Baywood Publishing Company Staunaes, D. (2003) ‘Where have all the subjects gone? Bringing together the concepts of intersectionality and subjectification’, NORA, 11(2): 101–10 Stephens, C., Alpass, F., Towers, A. and Stevenson, B. (2011) ‘The effects of types of social networks, perceived social support, and loneliness on the health of older people: accounting for the social context’, Journal of Aging and Health, 23(6): 887–911

195

Ethnicity and old age

Stoetzler, M. and Yuval-Davis, N. (2002). Standpoint theory, situated knowledge and the situated imagination. Feminist Theory, 3(3): 315333. Stoller, E. P. (1998) ‘Informal exchanges with non-kin among retired Sunbelt migrants: a case study of a Finnish American retirement community’, Journal of Gerontology: Social Sciences. 53B(5): S287–S298 Stoller, E. P. and Perzynski, A. T. (2003) ‘The impact of ethnic involvement and migration patterns on long-term care plans among retired Sunbelt migrants: plans for nursing home placement’, Journal of Gerontology: Social Sciences, 58B(6): S369–76 Stone, J., Dennis, R. M., Rizova, P. S., Smith A. D. and Hou, X. (eds.) (2016) Encyclopedia of race, ethnicity, and nationalism. West Sussex, UK: Wiley-Blackwell Sudha, S. and Mutran, E. J. (1999) ‘Ethnicity and eldercare: comparison of attitudes toward adult care homes and care by families’, Research on Aging, 21(4): 570–94 Sun, F., Durkin, D. W., Hilgeman, M. M., Harris, G., Gaugler, J. E., Wardian, J., Allen, R. S. and Burgio, L. D. (2012) ‘Predicting desire for institutional placement among racially diverse dementia family caregivers: the role of quality of care’, The Gerontologist, 53(3): 418–29 Swedberg, R. (2012a) ‘Theorizing in sociology and social science: turning to the context of discovery’, Theory and Society, 41: 1–40 Swedberg, R. (2012b) ‘On Charles S. Pierce’s lecture “How to theorize” (1903)’, Sociologica, 2: 1–27 Swindler, A. (1986) ‘Culture in action: symbols and strategies’, American Sociological Review, 51, 273–88 Szinovacz, M. E., DeViney, S. and Davey, A. (2001) ‘Influences of family obligations and relationships on retirement: variations by gender, race, and marital status’, Journal of Gerontology: Social Sciences, 56B(1): S20–S27 Tajfel, H., Billig, M. G., Bundy, R. P. and Flament, C. (1971) ‘Social categorization and intergroup behaviour’, European Journal of Social Psychology, 1(2): 149–78 Taylor, C. (2007) Modern social imaginaries. Durham: Duke University Press Taylor, M.G. (2008) ‘Timing, accumulation, and the Black/White disability gap in later life: a test of weathering’, Research on Aging, 30(2): 226–50 Tennstedt, S. and Chang, B-H. (1998) ‘The relative contribution of ethnicity versus socioeconomic status in explaining differences in disability and receipt of informal care’, Journal of Gerontology: Social Sciences, 53B(2): S61–S70

196

References

Tennstedt, S. L., Chang, B-H. and Delgado, M. (1998) ‘Patterns of long-term care: a comparison of Puerto Rican, African-American, and non-Latino White elders’, Journal of Gerontological Social Work, 30(1–2): 179–99 Thrasher, A. D., Clay, O. J., Ford, C. L. and Stewart, A. L. (2012) ‘Theory-guided selection of discrimination measures for racial/ethnic health disparities research among older adults’, Journal of Aging and Health, 26(4): 1018–43 Tomlinson, J. (1999) Globalization and culture, The University of Chicago Press Torres, S. (1999) ‘A culturally-relevant theoretical framework for the study of successful aging’, Ageing & Society, 19(1): 33–51 Torres, S. (2001) Understandings of successful aging in the context of migration: the case of Iranian Immigrants to Sweden’, Ageing and Society, 21(3): 333–55 Torres, S. (2002) ‘Relational values and ideas regarding ‘successful aging’, Journal of Comparative Family Studies, 33(3): 417–30 Torres, S. (2003) ‘A preliminary empirical test of a culturally-relevant theoretical framework for the study of successful aging’, Journal of Cross-Cultural Gerontology, 18: 79–100 Torres, S. (2004) ‘Making sense of the construct of successful aging: the migrant experience’, in S-O. Daatland and S. Biggs (eds) Ageing and diversity: Multiple pathways and cultural mgrations. Bristol: Policy Press Torres, S. (2006a) ‘Culture, migration, inequality and ‘periphery’ in a globalized world: challenges for the study of ethno- and anthropogerontology’, in J. Baars, D. Dannefer, C. Phillipson and A. Walker (eds) Aging, globalization and inequality: The new critical gerontology. Amityville, NY: Baywood Publishing Company Torres, S. (2006b) ‘Different ways of understandings the construct of successful aging: Iranian immigrants to Sweden speak about what aging well means to them’, Journal of Cross-Cultural Gerontology, 21: 1–23 Torres, S. (2006c) ‘Elderly immigrants in Sweden: otherness under construction’, Journal of Ethnic and Migration Studies, 32(8): 1341–58 Torres, S. (2009) ‘The age of migration: what does it mean and why should European social care?’, Retraite et Societé (Best of selection 2008): 67–90 Torres, S. (2011) ‘Cross-cultural differences in ageing’, in I. StuartHamilton (ed) An introduction to gerontology. Cambridge: Cambridge University Press

197

Ethnicity and old age

Torres, S. (2012) ‘International migration: patterns and implications for exclusion in old age’, in T. Scharf and N. C. Keating (eds) From exclusion to inclusion in old age: A global challenge, University of Bristol: The Policy Press Torres, S. (2013) ‘Transnationalism and the study of aging and old age’, in C. Phellas (ed) Aging in European societies. New York: Springer Torres, S. (2015a) ‘Ethnicity, culture and migration’, in J. Twigg and W. Martin (eds) Handbook of cultural gerontology. Routledge Torres, S. (2015b) ‘Expanding the gerontological imagination on ethnicity: conceptual and theoretical perspectives’, Ageing & Society, 35(5): 935–60 Torres, S. (2018) ‘Ethnicity, race and care: what the social justice framework can offer’, in S. Westwood (ed) Ageing, diversity and inequality: Social justice perspectives, Routledge Torres, S. and. Karl, U. (2016) ‘A migration lens on inquiries into aging, old age, elderly care: carving a space while assessing the state of affairs’, in U. Karl and S. Torres (eds) Aging in contexts of migration. Abingdon, Oxon/New York: Routledge Treas, J. (2008) ‘Transnational older adults and their families’, Family Relations, 57: 468–78 Treas, J. and Mazumdar, S. (2002) ‘Older people in America’s immigrant families: dilemmas of dependence, integration and isolation’, Journal of Aging Studies, 16: 243–58 Tsunokai, G. T. and McGrath, A. R. (2011) ‘Baby boomers and beyond: crossing racial boundaries in search for love’, Journal of Aging Studies, 25: 285–94 Tung, H-J. and Mutran, E. J. (2005) ‘Ethnicity and health disparities among the elderly in Taiwan’, Research on Aging, 27(3): 327–54 Turner, L. W., Taylor, J. E. and Hunt, S. (1998) ‘Predictors of osteosporosis diagnosis among menopausal women: results from a national survey’, Journal of Women and Aging, 10(3): 79–96 Twigg, J. and Martin, W. (eds) (2015) Handbook of cultural gerontology. Abingdon, Oxon/New York: Routledge Umberson, D., Thomeer, M. B., Williams, K., Thomas, P. A. and Liu, H. (2016) ‘Childhood adversity and men’s relationships in adulthood: life course processes and racial disadvantage’, Journal of Gerontology: Social Sciences, 71(5): 902–13 UN (United Nations) (2002) World population aging: 1950–2050. New York: United Nations, Department of Economic and Social Affairs, Population Division Usui, W. (1989) ‘Challenges in the development of ethnogerontology’, The Gerontologist, 29(4): 566–8

198

References

Vallin, J. (2002) ‘The end of the demographic transition: relief or concern?’, Population and Development Review, 28(1): 105–20 van den Berghe, P. L. (2004) ‘Race: as signifier and Race: as synonym’ in E. Cashmore (ed) Encyclopedia of race and ethnic studies, London/ New York: Routledge van Liew, C., Santoro, M., Kothari, D., Wooldridge, J. and Cronan, T. A. (2016) ‘“Experience keeps a dear school”: the effects of ethnicity and caregiving experience on hiring a healthcare advocate’, Journal of Cross-Cultural Gerontology, 31: 409–26 Van Oudenhoven, J. P. and Ward, C. (2013) ‘Fading majority cultures: the implications of transnationalism and demographic changes in immigrant acculturation’, Journal of Community and Applied Social Psychology, 23: 81–97 Vertovec, S. (1999) ‘Conceiving and researching transnationalism’, Ethnic and Racial Studies, 22(2): 447–62 Vertovec, S. (2012) ‘Diversity’ and the social imaginary’, European Journal of Sociology, 53(3): 287–312 Wallace, D. C., Fields, B. L., Witucki, J., Boland, C. and Tuck, I. (1999) ‘Use of home and community-based services by elderly black and white females’, Journal of Women and Aging, 11(4): 5–20 Wallman, S. (ed) (1979) Ethnicity at work. London: Macmillan Warnes, A.M., Friedrich, K., Kellaher, L. and Torres, S. (2004) ‘The diversity and welfare of older migrants in Europe’, Ageing & Society, 24(3): 307–26 Weber, M. (1961) ‘Ethnic groups’, in T. Parsons et al. (eds) Theories of society. Glencore, IL: The Free Press Weber, M. (1978) Economy and Society (ed. G. Roth and C. Wittich). Berkeley: University of California Press White, T. M., Townsend, A. L. and Stephens, M. A. P. (2000) ‘Comparisons of African American and White Woman in the parent care role’, The Gerontologist, 40(6): 718–28 White-Means, S. I. (2000) ‘Racial patterns in disabled elderly persons’ use of medical services’, Journal of Gerontology: Social Sciences, 55B(2): S76–S89 White-Means, S. I. and Rubin, R. M. (2008) ‘Parent caregiving choices of middle-generation Blacks and Whites in the United States’, Journal of Aging and Health, 20(5): 560–82 Whitfield, K. E. and Baker, T. A. (ed) (2014) Handbook of minority aging. New York: Springer Publishing Company

199

Ethnicity and old age

Whitfield, K. E., Ford, M. E. and Edwards, C. (2014) ‘What does knowing about genetics contribute to understanding the health of minority elders?’ in K. E. Whitfield and T. A. Baker (eds) Handbook of minority aging. New York: Springer Publishing Company, pp. 153–71 Wilding, R. (2007) ‘Transnational ethnographies and anthropological imaginings of migrancy’, Journal of Ethnic and Migration Studies, 33(2): 331–48 Williams, D. R. (2005) ‘The health of US racial and ethnic populations’, Journal of Gerontology: Series B, 60B (Special Issue II): 53–62 Williams, D. R. and Wilson, C. M. (2001) ‘Race, ethnicity, and aging’, in Binstock, R. H. and George, L. K. (eds) Handbook of aging and the social sciences (5th edn). San Diego, San Francisco, New York, Boston, London, Sydney and Tokyo: Academic Press, pp. 160–78 Willis, R. (2012) ‘Individualism, collectivism and ethnic identity: cultural assumptions in accounting for caregiving behavior in Britain’, Journal of Cross-Cultural Gerontology, 27: 201–16 Willis, R., Price, D. and Glaser, K. (2013) ‘Ethnicity as a determining factor for instrumental support in mid and later life in England and Wales’, Journal of Gerontology: Series B, 68(2): 278–89 Wilson, G. (2002) ‘Globalization and older people: effects of markets and migration’, Ageing & Society, 22(5): 647–63 Wimmer, A. (2013) Ethnic boundary making: Institutions, power, networks. New York: Oxford University Press Winker, G. and Degele, N. (2011) ‘Intersectionality as multi-level analysis: dealing with social inequality’, European Journal of Women’s Studies, 18(1): 51–66 Woodward, J. L., Auchus, A. P., Godsall, R. E. and Green, R. C. (1998) ‘An analysis of test bias and differential item functioning due to race on the Mattis Dementia Rating Scale’, Journal of Gerontology: Psychological Sciences, 53B(6): P370–P374 Yancey, W.L., Ericksen, E. P. and Juliani, R.N. (1976) ‘Emergent ethnicity: review and reformulation’, American Sociological Review, 41(3): 391–403 Yenilmez, M. I. (2015) ‘Economic and social consequences of population aging: the dilemmas and opportunities in the twenty-first century’, Applied Research Quality Life 10: 735–52 Young, T. L. and Janke, M. C. (2013) ‘Perceived benefits and concerns of older adults in a community intergenerational program: does race matter?’, Activities, Adaptation and Aging, 37: 121–40 Yuval-Davis, N. (2006) ‘Intersectionality and feminist politics’, European Journal of Women’s Studies, 13, 3, 193–209

200

References

Yuval-Davis, N. (2010) ‘Theorizing identity: beyond the ‘us’ and ‘them’ dichotomy’, Patterns of Prejudice, 44(3): 261–80 Zahodne, L. B., Manly, J. J., Smith, J., Seeman, T. and Lachman, M. (2017) ‘Socioeconomic, health, and psychosocial mediators of racial disparities in cognition in early, middle and late adulthood’, Psychology and Aging, 32(2): 118–30 Zechner, M. (2008) ‘Care for older persons in transnational settings’, Journal of Aging Studies, 22(1): 32–44 Zsembik, B. A. and Peek, M. K. (2001) ‘Race differences in cognitive functioning among older adults’, Journal of Gerontology: Social Sciences, 56B(5): S266–S274 Zuckerman, I. H., Ryder, P. T., Simoni-Wastila, L., Shaffer, T., Sato, M., Zhao, L. and Stuart, B. (2008) ‘Racial and ethnic disparities in the treatment of dementia among Medicare beneficiaries’, Journal of Gerontology: Social Sciences, 63B(5): S328–S333

201

Appendix: how the scoping review was conducted This Appendix is intended to provide detailed information on how the database searches used to identify the articles reviewed in Chapters Four to Six were conducted and how the identified literature has been analysed. To facilitate navigation in this Appendix, I will address each of the questions which I assume most readers who are interested in methodology will have in the order in which I made these decisions. I take for granted that most readers would be interested in the actual process I followed, even if not all of them will necessarily want to know the nitty gritty of each of the decisions I made along the way. Thus, by dividing this Appendix into sections that each answer specific questions, I hope to make it easier for readers to orient themselves, not only as far as the process as a whole is concerned, but also in terms of the specific questions they might have about each step.

Selecting the databases used to identify the peerreviewed articles As stated in the Introduction, delineating the parameters for a theorising exercise such as the one on which this book is based requires that one identifies the scientific communities that generate the research to be reviewed. Ageing and old age is a huge field (much more so than ethnicity and race) so the first decision I had to make was to decide what angle to pursue when it comes to the array of angles from which ageing and old age research can be launched. My own expertise as a social scientist led me to decide against journals specialising in geriatrics, medical and/or health sciences, and to opt instead for journals specialising in gerontology and/or ageing. In other words, this was the first sampling-related decision I made. With regard to health sciences, it must be mentioned that the reason why I opted not to include journals specialising in this field is that these journals do not specifically aim to be the publication channels par excellence for research on ageing and old age. Although there is indeed research published on ageing and old age, and on ethnicity and race, in such journals I opted to focus on journals that – by virtue of their own aims and scope – specifically aim to publish research on ageing and old age as well as on ethnicity and race. This means that this book does not focus on what could inform scholarship on the

203

Ethnicity and old age

intersection in focus here, but rather on what the scholarship which aims to be about this intersection claims to be about. This distinction is crucial to understanding what is in focus and what is not. Something else that needs to be pointed out is that I chose databases that index a sufficiently comparable number of journals in each of the two fields in focus here. This I did in order to make sure that the growing interest in old age and ageing that I have witnessed among ethnicity and race scholars received the attention it deserved. The number of articles published in such journals turned out to be much less than I had anticipated. This is probably so because the interest seems to be mostly in older migrants rather than older minority ethnic groups as such, and most of what has been published on the former does not claim to be a contribution to research on ethnicity and old age (at least not in the title, abstracts and keywords sections, which are the sections I chose to focus on when identifying the literature to be reviewed). The second decision I made concerned the actual databases that could potentially be used when searching for articles. This decision was made after having taken closer looks at the journal title lists of a dozen databases and assessing whether or not these databases had a sufficiently comparable number of journals in both of the fields in focus (that is, ethnicity/race and ageing/old age). The assessment led me to choose the ASSIA (Applied Social Sciences Index and Abstracts) database and the Web of Science: Core Collection. The ASSIA database lists the following journal titles on gerontology (in alphabetical order): Activities, Adaptation and Aging Age and Aging Aging and Mental Health Alzheimer’s and Dementia Archives of Gerontology & Geriatrics Journal of Gerontological Social Work Journal of Housing for the Elderly Journal of Population Aging Journal of Religion, Spirituality & Aging Journal of Religious Gerontology Journal of Gerontology: Psychological & Social Sciences Psychology and Aging Quality in Aging, Policy, Practice & Research

204

Appendix

Quality in Aging and Older Adults Working with Older People ASSIA also lists the following titles in what is often, in database terminology, referred to ethnic studies (in alphabetical order): Diversity & Equality in Health Care Diversity in Health Care Diversity in Health & Social Care Ethnicity & Inequalities in Health and Social Care Immigrants & Minorities International Journal of Migration, Health & Social Care International Migration Review Journal of Cross-Cultural Psychology Journal of Ethnicity in Criminal Justice Journal of Ethnicity & Substance Abuse Journal of Immigrant & Minority Health Web of Science: Core Collection lists the following journals on gerontology (in alphabetical order): Advances in Life Course Research Age & Aging Ageing & Society Aging & Mental Health Canadian Journal of Aging Dementia: International Journal of Social Research and Practice Educational Gerontology European Journal of Ageing Generations: Journal of the American Society of Aging Geriatrics & Gerontology International The Gerontologist International Journal of Aging & Human Development Journal of Aging & Social Policy Journal of Aging and Health Journal of Aging and Physical Activity Journal of Aging Studies Journal of Applied Gerontology Journal of Gerontological Nursing Journal of Women & Aging

205

Ethnicity and old age

Journal of Gerontology: Psychological and Social Sciences1 Psychology and Aging Research on Gerontological Nursing Research on Aging Web of Science: Core Collection lists (in alphabetical order) the following journals in their ethnic studies category: Journal of Postcolonial Writing Cultural Diversity & Ethnic Minority Psychology Ethnic and Racial Studies Ethnicities Ethnicity & Health Ethnos Global Networks: A Journal of Transnational Affairs Globalization and Health Identities: Global Studies in Culture & Power International Journal of Intercultural Relations International Migration International Migration Review Journal of Ethnic and Migration Studies Journal of Immigrant and Minority Health Race & Class Race, Ethnicity and Education In addition to all of these journals, I manually searched the titles and abstracts for the Journal of Cross-Cultural Gerontology during the period chosen (1998–2017), which is not indexed in either of these databases but which I deemed to be a must.

Sampling criteria: deciding which articles to include The third decision I made concerned the sampling criteria to be used and this decision was comprised of a series of deliberations. First, the articles had to have been published during the 20-year period decided on (January 1998–December 2017). Second, I used the following keywords when searching the databases chosen (as well as the website of the Journal of Cross-Cultural Gerontology): ethnicity, race, ageing, old age, elderly and all possible combinations of these terms. Only articles that used these terms were downloaded for inclusion in the scoping 1

Underlined journals can also be found in the ASSIA list.

206

Appendix

review. Third, while searching for the literature I had to impose limiting criteria to make the searches manageable, since it was not uncommon for some of these keywords to generate between 1,000 and 4,000 titles. Thus, only articles published in the journals mentioned in the previous section were chosen since these are articles that have been published in journals that specifically aim to contribute to scholarship on either ethnicity/race or ageing/old age. Once an article had been identified as having the potential to become ‘data’, I asked the following three questions in order to narrow down which articles to focus on: 1. 2. 3.

Does the article claim in its abstract to be about ageing/old age and ethnicity/race? Does the article use ethnicity and/or race in its keywords list? Does the article use ageing, old age, ageing, elderly and/or older people in its title?

If the answer was yes to any of these questions, then the article was printed out to be included in the review. It is worth noting that these terms were not only mentioned in the methods section of the abstract, since it is not uncommon for allusions such as ‘we have controlled for age, gender, race’ and so on to be used in an article even if the article does not end up reporting results that are about ethnicity/race. Articles that were about specific ethnic groups but did not mention ethnicity and/or race, and/or ageing, old age, elderly, senior, nursing home resident and/or older people in their abstracts, keywords or titles were not included, since they were deemed to be about the group as opposed to a contribution to the ethnicity/race debate. The same holds true for articles that were about older migrants but did not mention ethnicity and/or race, and/or ageing, old age, elderly and/or older people. Such articles were also not included since they were not claiming to be contributions to the intersection of ethnicity and old age, which is what this book is about, but were about the intersection between migrancy/migrantship and old age, which is, of course, a related topic but not the actual focus of this book. Literature review exercises such as this one must have explicit and transparent criteria. Consequently, an author whose work is deemed to be informative for the intersection in question but does not meet the inclusion criteria is not included. This is why most of my own work was not picked up in the literature searches used to identify the literature to be reviewed in this book. Most of my previous work is about the intersection between migrancy and old age and not necessarily about ethnicity and/or race. In other words, the focus of Chapters Four to

207

Ethnicity and old age

Six is not literature that informs the intersection between ethnicity/race and old age/ageing per se but rather literature that claims to be about this intersection because it chooses to make such a statement in its abstract, keywords or title. There is, in other words, more literature available on the intersection in question than what I have chosen to focus on, but that will always be the case when trying to systematically appraise a field. Limitations must be put in place and these cannot be chosen randomly, which is why I opted to review only articles that explicitly claimed to contribute to the intersection in focus here.

Analysing the literature: sorting out and coding The first step in reviewing the literature entailed sorting it out into themes as the book’s synopsis was quite open as regards what angles would be covered in Part 2 of the book. This first step uncovered the following themes (with the number of articles found in parentheses): Health inequalities (n=117) Health and social care (n=55) Social relations and caregiving (n=52) Attitudes (n=15) Methods-related (recruitment, retention and sampling) (n=14) Quality of life, life satisfaction, successful ageing, well-being (n=14) Financial issues (jobs, insurance, economic status) (n=11) Religiosity and spirituality (n=9) Experiences (n=9) Housing (n=7) Identity (n=6) Loneliness (n=3) Coping (n=3) Work related (n=3) Volunteering (n=3) Life expectancy (n=2) Victimisation (n=1) Nursing theft (n=1) Language proficiency (n=1) Personal control (n=1) Emotional expression (n=1) Storytelling (n=1) Black gerontologists (n=1) Social workers (n=1) Elder abuse (n=1)

208

Appendix

Gaming (non-digital) (n=1) Social participation (n=1) Preferred activities (n=1) Life-space constriction (n=1) The second step entailed deciding which themes to focus on in the chapters that were going to present the results of the scoping review. The sheer number of articles listed on every topic was what determined that the book’s second part would focus on health inequalities, health and social care, and social relations and caregiving since these were the topics that received the most attention. The third step necessitated sorting the literature into the sub-themes covered by each topic. The reason I did this was that writing chapters on topics as broad as the ones chosen would have been virtually impossible, not to mention reader-unfriendly. Sheer volume had to be turned into coherent and manageable themes that could be tackled with a readable narrative, and so sub-themes became the mechanism for transforming the material into a coherent whole that tells us something about not only the underlying understandings of ethnicity and race in the literature, but also about the variety of themes that each of the chosen research topics draws attention to. The fourth step entailed reading and coding each and every one of the articles on the chosen research topic. The articles were coded using Microsoft Excel tables on the basis of 36 criteria. Information on sample characteristics was coded under the following headings: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14.

Author, title and abbreviation of journal and volume/number information Publication year Published in an ethnicity/race journal Quantitative methods used Qualitative methods used Systematic or scoping review used North American study Based on an Anglo/White or a majority sample Based on Black/African-American sample Based on Hispanics Based on an Asian sample Based on an Arab sample Based on another ethnic group Focuses on differences and/or compares with the ethnic majority

209

Ethnicity and old age

15. Informants’/respondents’ own views in focus 16. Concluding statement from abstract (written out in a column of its own) Ethnicity/race-related information was coded under the following headings: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20.

Ethnicity and/or race is defined Race is used instead of ethnicity Ethnicity and race are used synonymously Ethnicity/race assigned or self-reported (i.e. picked from existing alternatives) Ethnicity/race accepted (i.e. interviewees talk about their own identification) Ethnicity/race assumed to be associated with specific attitudes or behaviours Ethnicity/race understood in essentialist/primordialist way Ethnicity/race understood in structuralist/circumstantialist ways Ethnicity/race understood in constructivist ways Ethnicity/race used as an explanation for the findings Uses/explores other social positions as explanations Explores or alludes to sex/gender as an explanation Explores or alludes to class or education as an explanation Explores or alludes to economic resources as an explanation Explores or alludes to family structure or informal networks as an explanation Explores or alludes to geographical aspects as an explanation Ends up suggesting that ethnicity/race matters nonetheless Measures discrimination Alludes to discrimination playing a role without studying it Alludes to attitudinal or behavioural factors as explanations without measuring them

In other words, Chapters Four to Six were conceived primarily on the basis of these 36 codes, even if the chapters also describe the angles that the articles reviewed focus on by virtue of their being based on the sub-themes that they address. Thus, although Chapters Four to Six are titled as they are, it is what the research reviewed tells us about the intersection on ethnicity/ race and old age/ageing that is their main focus. The chapters are not about health inequalities, health and social care, and social relations and caregiving per se but rather about what research on these areas

210

Appendix

suggests about the intersection between ethnicity/race and old age/ ageing as published in journals focusing on either social gerontology/ ageing or ethnic/racial studies. It is worth noting also that although these chapters draw specific attention to three topics and utilise 224 articles, all 336 articles are used when drawing the conclusions in Chapter Seven, since these are not only based on the literature that Chapters Four to Six look more closely at, but all of the articles coded.

Deciding which references to allude to explicitly Last but not least, I take for granted that some readers may wonder how exactly I have chosen the articles I refer to in Chapters Four to Six since some of them are based on a scoping review that has included a sizeable number of articles. Listing all of the references used is not possible considering that a book contract always comes with a pre-determined maximum number of words to be delivered, and I am using more references than the ones listed in these three chapters. Thus, the references chosen are those I have deemed to be valid illustrations of the points I make in these chapters; points that stem from the scoping review. These points have not been decided a priori but are the result of the painstaking coding exercise described in the previous sections. In all chapters and in all sections based on one of the sub-themes, I have chosen to mention not only the trends observed but also the ‘exceptions to the rule’, so to speak, so that the reader is able to gain a good sense of what characterises the literature and what the exceptions are.

211

Index

Index

A

Benn, E.K.T. 97 ‘biographical discontinuity’ of migrants 40 biological race 54–5, 61–2 Birren, J.E. 8, 146 Blakemore, K. 4, 12n1, 13 Blankson, A.N. 97 Bloom, D.E. 26–7 Boneham, M. 12n1, 13 Bonilla-Silva, E. 150 Booth, W.C. 51 boundary making 57, 58 Bowman, K.F. 131 Brewer-Lowry, A. 118 Browne, C.V. 88, 89 Brubaker, R. 59 Burgio, L. 139 Burton, L.M. 8

Abbott, A. 15, 16, 164 Ackers, H.L. 38, 46, 47 Adler, S.R. 106, 114 age, as a social construct 24 ‘ageing-as-leveller’ hypothesis 83 Agree, E.M. 91 Ajrouch, K.J. 126, 128, 132 ‘alarmist demography’ 24, 25, 27, 48 Albert, S.M. 118 Alpass, F. 127, 128 analytical clarity, lack of 161–6 Anthias, F. 57 anthropo-gerontology 8, 152 anthropological legacy 158 anthropology 62, 75–6 Appadurai, A. 38 Archer, M. 28 Arcury, T.A. 118 Armstrong, M.J. 126, 131 atheoretisation 8, 146 Australia: health inequalities studies 89, 91n1, 93, 94 Austria: social relations and caregiving studies 126, 127, 133 Ayalon, L. 88, 96

C

B background variables, ethnicity and race as 53, 68 Baker, T.A. 12n1, 13, 83 Banton, M. 53, 54 Barker, J.C. 159 Barnes, L.L. 97 Barresi, C.M. 12n1 Barrio, C. 134–5 Barth, F. 62, 70 Bauman, Z. 37 Baxter, J. 131 Beck, U. 28, 31, 37 Behavioural Model of Health Services 113, 134 Bengtson, V.L. 8, 9, 146

Cagney, K.A. 91 Canada: health and social care studies 106, 107, 114, 115 health inequalities studies 85, 89, 91n1, 96, 97 social relations and caregiving studies 127, 129, 130, 133 capitalism 28 caregiving see health and social care studies; social relations and caregiving studies caregiving stress 138–9 Carter, B. 73–4 Cashmore, E. 53, 78, 87, 99, 141 Castles, S. 35 Castora-Binkley, M. 97 categorisation: and ethnicity/race 7, 52, 57, 58, 77 see also classification, race and ethnicity as ‘centre and periphery’ 36–7 Chan, A. 85, 91n1 Chen, F. 90 Choi, N.G. 88, 96

213

Ethnicity and old age circumstantialist/structuralist perspective on ethnicity and race 65–70, 71, 77, 87, 97, 108, 130, 159, 160, 163 citizenship policies 47 claims of ethnicity 6 classification, race and ethnicity as 54, 55, 56–7, 63, 74, 77, 82, 87, 99, 141 cognitive functioning, health inequalities studies 96–98 Cohen, C.I. 95 Comte, Auguste 59 Connell, C.M. 139, 140 construction sites 74, 163 context of discovery 8, 9, 10, 23, 50, 146, 147 context of justification 8, 9, 10, 11, 50, 146, 147 Cornell, S. 6, 21, 57, 61, 62, 63, 64–5, 66–7, 68, 69–70, 71–2, 73, 74, 75, 76, 77, 78, 160 cultural domination 150 Cultural Justifications Caregiving Scale 137 culture, study of 29–32, 39–40 culture irrelevance 146 culture-obliviousness, obstacles resulting from 151–4 ‘cumulative advantage-disadvantage’ perspective 83, 91

D demographic transition, population ageing as 25, 26, 27, 48 demography 24–7 see also population ageing Denzin, N.K. 12 depressive symptomology, health inequalities studies 95 Desmond, M. 59, 167, 168 ‘diasporic consciousness’ 33 Dick, H.P. 161–2 Dilworth-Anderson, P. 124, 128–9, 130, 137, 140 disability, health inequalities studies 92–3 discourse analysis 54 discovery, context of 8, 9, 10, 23, 50, 146, 147 discrimination 154–5 health and social care studies 113, 121 health inequalities studies 88–9, 91–2, 96, 100 social relations and caregiving studies 142 dissemination outlets, choice of 157–8 diversity within minority ethnic groups 41–2, 45

Dong, X. 95 Dornelas, E.A. 116 ‘double jeopardy hypothesis’ 83 Dulin, P.L. 85, 94 Dupree, L.W. 114 Durkheim, Émile 59 Dwyer, P. 38, 46, 47

E Early, D.R. 97 East Asia, life expectancy 25 Ebrahim, S. 85, 94, 95 edited collections see handbooks, encyclopaedias and edited collections Edwards, C.D. 95–6 Ekman, S.-L. 106, 107, 114, 115 Elias, S. 58–9, 59–60, 69, 76–7, 150, 161, 162, 163 Ellins, J. 106, 107, 114, 115 Emirbayer, M. 59, 166–7, 168 encyclopaedias see handbooks, encyclopaedias and edited collections Eschbach, K. 92 Essed, P. 60 essentialist/primordialist perspective on ethnicity and race 61–5, 66, 68, 69, 70, 78, 87, 97, 108, 130, 159–60, 163 ‘ethnic aged’ 104–5 ethnicity: claims of 6 as a classification 54, 55, 56–7, 63, 74, 77, 82, 87, 99, 141 as identification ground 5–6, 53, 71 definition 5–7, 13, 14 differentiation from minority status 7 differentiation from/relationship to race 5, 7, 13, 14, 51–61, 74–8, 159–63 health and social care studies 108, 109–10 health inequality studies 86–8 social relations and caregiving studies 126, 129–31, 134–5, 140, 142 diversity within minority ethnic groups 41–2, 45 essentialist/primordialist perspective 61–5, 66, 68, 69, 70, 78, 87, 97, 108, 130, 159, 160, 163 and genetics 54–5, 63 and globalisation 39–48 ‘mixed ethnicity’/’mixed race’ 165 negotiable nature of 71 scholarship obstacles caused by stagnating understanding of 159–61

214

Index scholarship on 3, 4, 7–8, 14, 16, 19, 145, 158 social constructionist perspective 62, 65, 70–4, 78, 97, 108, 130, 159, 160 structuralist/circumstantialist perspective 65–70, 71, 77, 87, 97, 108, 130, 159, 160, 163 ethno-gerontology 4, 8, 152, 158 avoidance of as a term 16 cultural assumptions in 30 importance of globalisation in 38–9 Europe, health inequalities studies 85–6

F Faist, T. 32, 45, 47 Falcón, L.M. 90 families, provision of social care 43–4, 45–6 see also social relations and caregiving studies family reunification, and immigration law 45–6 Feagin, J.R. 58–9, 59–60, 69, 76–7, 150, 161, 162, 163 Feld, S. 133 Fenton, S. 73–4 Fiori, K.L. 132 Forrest, K.Y.Z. 85, 93 Fraser, N. 98–9, 120, 141, 150 Fredriksen-Goldsen, K.I. 88–9, 91, 95, 96 French School of Sociology 27–8 Friedemann, M.-L. 136 friendships, impact of ethnicity and race on 142

G Gallagher-Thompson, D. 139 Gaonkar, D.P. 168 GDS-15 (Geriatric Depression Screening Scale) 107, 117 Geertz, C. 61, 62, 63 Gelfand, D.E. 6, 12n1, 13, 57, 104–5, 109, 113, 124 gender, lack of analysis of in research 155 general health, health inequalities studies 90–2 genetics, and ethnicity and race 54–5, 63 Geriatric Depression Screening Scale (GDS-15) 107, 117 German sociology 27–8 Gerontological Society of America, Task Force on Minority Issues 4 Gerst-Emerson, K. 83 Gibson, G.D. 139 Giddens, A. 31

Gille, Z. 30 Glasby, J. 106, 107, 114, 115 Glass, A.P. 106, 114 Glazer, N. 67 globalisation 23, 27–9, 48–50, 147 and inequality 35, 36–9, 47–8 of international migration 3, 13, 14, 19, 23, 28, 31–2, 34–9, 44–5, 147, 148, 152, 164–5, 168 implications for intersection of ethnicity and old age 39–48 and localisation 37 and the study of culture 29–32 see also transnationalism Green, J. 159 Greenfield, P.M. 42 Grosfoguel, R. 61 Gum, A.M. 88, 96 Gustafson, P. 49

H Haley, W.E. 114, 116 handbooks, encyclopaedias and edited collections 17–18 health and social care studies 103–5 health inequalities studies 81–3 social relations and caregiving studies 123–5 Hannerz, J. 30, 165 Hartmann, D. 6, 21, 57, 61, 62, 63, 64–5, 66–7, 68, 69–70, 71–2, 73, 74, 75, 76, 77, 78, 160 Hawkley, L.C. 95 health and social care studies 10, 15, 103–5, 119–21 main trends 105–11 access and usage 111–13 attitudes, preferences and experiences 113–16 programmes, interventions and services suitability 116–17 self-care practices 117–18 methodological issues 106, 121 health inequalities studies 10, 15, 81–3, 98–102 main trends 84–90 cognitive functioning 96–8 disease specific 93–4 general health 90–2 mental health 94–6 physical functioning, disability and mobility 92–3 methodological issues 89–90, 102 Heikkilä, K. 106, 107, 114, 115 Heo, G.J. 139 Hilgeman, M.M. 138 Hilliard, T.S. 124 ‘Hispanic paradox’ 92

215

Ethnicity and old age Ho, C.J. 138 Hughes, E.C. 56–7, 67

Kim, J. 88, 96 Kim, J.-H. 128 King, A.D. 29 Knight, B.G. 128 Koehn, S. 85, 89, 90, 91n1, 96, 97, 98, 106, 107, 114, 115 Koeske, G. 139 Kofman, E. 45 Kolb, P. 12n1 Komter, A. 127, 133 Krajewski-Jaime, E.R. 12n1, 13 Kramer, J.B. 159 Krause, N. 123 Kwak, J. 113–14, 116

I identification grounds, ethnicity and race as 5–6, 53, 71 identity, importance of 5–6 imagination, expansion of 11–12, 163, 166–9 see also ‘sociological imagination, the’ immigration law 45–6 inequality: and globalisation 35, 36–9, 47–8 see also health inequalities studies; social justice information and communications technology 28, 38 intellectual craftsmanship in social sciences 11–12, 146 interest groups, ethnic and racial groups as 67 international migration, globalisation of 3, 13, 14, 19, 23, 28, 31–2, 34–9, 44–5, 147, 148, 152, 164–5, 168 implications for intersection of ethnicity and old age 39–48 see also transnationalism international trade 28 intersectional analysis 155–6 intimate relationships, impact of ethnicity and race on 142 Isaac, H. 61–2, 63 Israel: health and social care studies 107, 112 health inequalities studies 85, 92–3 social relations and caregiving studies 127, 137–8

L

J Jackson, J.S. 104 Jackson, P.B. 90, 96, 101 Janevic, M.R. 139, 140 Jang, Y. 95 Janke, M.C. 117 Japan, life expectancy 25 Jenkins, R. 5–6, 7, 62, 64, 71, 75–6 Jolley, D. 107, 117 justification, context of 8, 9, 10, 11, 50, 146, 147

K Katz, S. 24, 25 Kearney, M. 40 Keefe, J. 127, 129, 130, 133 Kelley-Moore, J. 89 Khaltar, A. 85, 94 Khan, M.M. 85, 91n1 Kim, H.-J. 88–9, 91, 95, 96

labour supply, and population ageing 26–7 Laditka, J.N. 132 Laditka, S.B. 89, 97, 132 Lahaie, C. 136 Lambe, S. 106, 110, 114 Lawrence, V. 85, 89, 96, 97 LDCs (less developed countries), and demography 25 Lee, H.B. 97 legacy 158 Levkoff, S. 126, 129, 139 life expectancy 24–5 life satisfaction concept 40–1 Lincoln, K.D. 123–4 Litwin, H. 107, 111–12 localisation, and globalisation 37 localities, and culture 29, 30, 31, 39–40 locations, health inequalities studies 91 Loveman, M. 59 Lowenstein, A. 127, 137–8 Lum, T.Y. 133–4 Lunt, N. 46–7

M MacArthur Scale of Subjective Social Status 101 Mahoney, D.F. 126, 136–7 majority cultures 29 Malaysia: health inequalities studies 85 Mand, K. 126, 127, 133 Markides, K.S. 83, 92 Marsella, A.J. 28, 36 Martin, D. 27 Martin, L.G. 90 Martinez, I.L. 126, 132 Marx, Karl 28, 59 mass media, and globalisation 28 Mayeda, E.R. 97 McArdle, J.J. 97 McDougall, J.G. 116

216

Index McFarland, M.J. 91 McGovern, P 101 McGrath, A.R. 132 MDCs (more developed countries), and demography 25 Mehrotra, C.M. 12n1 mental health, health inequalities studies 94–6 Meshefedjian, G. 127, 137 methodological issues: health and social care studies 106, 121 health inequalities studies 89–90, 102 implications of reliance on small number of methods 154–7 narrow samples, perspectives and reference categories 148–51 social relations and caregiving studies 125–7, 141 see also obstacles to scholarship Mexico: health and social care studies 107, 109, 112 migration, globalisation of 3, 13, 14, 19, 23, 28, 31–2, 34–9, 44–5, 147, 148, 152, 164–5, 168 implications for intersection of ethnicity and old age 39–48 see also transnationalism Miller, M.J. 35 Mills, C. Wright 11–12, 146, 164, 166 Mills, T.W. 95–6 Min, J.W. 134–5 minority status, differentiation from ethnicity 7 Mittleman, J.H. 31 ‘mixed ethnicity’/’mixed race’ 165 Miyawaki, C.E. 126, 136 mobility, health inequalities studies 92–3 Momtaz, Y.A. 85, 97 Montoro-Rodriguez, J. 116 Moynihan, D.P. 67 Mungas, D. 97 Mutran, E.J. 85, 91n1, 114

N Nagel, J. 73 National Institute of Aging 24–5 National Institute of Health 24–5 Navaie-Waliser, M. 136 Nazroo, J.Y. 101 negotiable nature of ethnicity 71 Netherlands: health inequalities studies 85, 94, 96 social relations and caregiving studies 127, 133 New Zealand: health inequalities studies 85, 94

social relations and caregiving studies 127, 128, 133 Nyunt, M.S.Z. 107, 117

O obstacles to scholarship 147 from choice of dissemination outlets 157–8 from lack of analytical clarity 161–6 from lack of explicit research agenda 147–8 from methodological approaches 154–7 from narrow samples, perspectives and reference categories 148–51 from stagnating understandings of ethnicity and race 159–61 from structure- and cultureobliviousness 151–4 old age: and globalisation 39–48 see also population ageing older migrants: exclusion and deprivation of 42 Warnes’ et al typology of 42–3 Olson, L.K. 12n1, 13 O’Neill, G.S. 131–2 oppression, sources of 156 Osman, A. 85, 92–3 ‘Other, the’ 70, 104, 105, 168

P Padilla-Frausto, D.I. 103–4 Palmberger, M. 126, 127, 133 Pan, S. 89 Pang, E.C. 106, 114 Papadimitriou, D. 38 Park, M. 132 Parker, M.W. 116 Peek, M.K. 97, 131–2, 133 Pelcastre-Villfuerte, B.E. 107, 109, 112 pension systems 27, 46 perceived discrimination see discrimination periphery, the 36–7, 38, 47–8 perspectives, narrowness of in scholarship 149–50 Perzynski, A.T. 114, 115 phenotypical characteristics, and ethnicity/race 53, 54–5, 63 Phillipson, C. 39–40 physical functioning, health inequalities studies 92–3 Pinquart, M. 129, 140 ‘political economy of informal care’ 43, 47 Polivka, L. 48 Pope, H. 116

217

Ethnicity and old age population ageing 3, 13, 14, 19, 23, 24–7, 48–50, 168 and globalisation 39–48 Portes, A. 32–3 positionality of scholars 52, 75–8 Preston, S.H. 25 primordialist/essentialist perspective on ethnicity and race 61–5, 66, 68, 69, 70, 78, 87, 97, 108, 130, 159–60, 163

Q quality of life concept 40–1 Quine, S. 84, 89, 91n1

R race: as a classification 54, 55, 56–7, 63, 74, 77, 82, 87, 99, 141 as identification ground 5–6, 53, 71 differentiation from/relationship to ethnicity 5, 7, 13, 14, 51–61, 74–8, 159–63 health and social care studies 108, 109–10 health inequality studies 86–8 social relations and caregiving studies 126, 129–31, 134–5, 140, 142 essentialist/primordialist perspective 61–5, 66, 68, 69, 70, 78, 87, 97, 108, 130, 159, 160, 163 and genetics 54–5, 63 ‘mixed ethnicity’/’mixed race’ 165 negotiable nature of 71 scholarship obstacles caused by stagnating understanding of 159–61 as a signifier 54, 55, 87 social constructionist perspective 65, 70–4, 78, 97, 108, 130, 159, 160 structuralist/circumstantialist perspective 62, 65–70, 71, 77, 87, 97, 108, 130, 159, 160, 163 as a synonym 54, 55, 87 racial biology 54–5, 61–2 racial groups 59–60 racialisation 60, 61, 67, 162–3 racism 58, 59, 60–1, 67, 100 ‘reciprocal fluxion’ 71 recognition 98, 99 redistribution 98, 99 reference categories, narrowness of in scholarship 150–1 reflexivity 52, 167 religion, and caregivers 139 representation 98–9, 141–2 research: explicit research agenda, lack of 147–8

future ethnicity- and race-astute agenda for 147, 148, 151, 153, 154–5, 157, 160, 166 two phases in 10 see also methodological issues; obstacles to scholarship retirement migration 46–47 Riain, S.O. 30 Richmond, A.H. 35–36, 37 Robert, S.A. 91 Rodriguez-Galán, M.B. 90 Rosendahl, S.P. 106, 107, 109, 114, 115 Rote, S. 128 Roth, D.L. 134 Rubin, R.M. 135–6 Ruel, E. 91

S Sabik, N.J. 88, 94 samples, narrowness of in scholarship 148–9 Samuel, L.F. 106, 114 Santoro, M.S. 137 Schans, D. 127, 133 Scharlach, A.E. 113 Schoenberg, N.E. 118 scoping reviews 10, 15, 18–21 see also health and social care studies; health inequalities studies; social relations and caregiving studies self-identification 157 Shah, A. 107, 117 Sherzai, D. 97 Shils, E. 61, 62, 63 signifier, race as 54, 55, 87 Silveira, E.R.T. 85, 94, 95 Singapore: health and social care studies 107, 117 health inequalities studies 85, 91n1 skin colour 58–9 Slotman, A. 85, 88, 94, 96 Small, J. 106, 114, 115 Smart, B. 28 social care: by families 43–4, 45–6 see also health and social care studies; social relations and caregiving studies social constructionism 6 social constructionist perspective on ethnicity and race 62, 65, 70–74, 78, 97, 108, 130, 159, 160 social gerontology, as an academic discipline 3, 4, 7–8, 14, 16, 19, 39, 75, 77, 145, 150 as dissemination outlet 157–8 ‘social imaginaries’ 167–9 social justice 37, 98–9, 120, 141–2

218

Index ‘social morphology’ 33 social positions: ethnicity and race as 53, 68, 69 narrowness of in scholarship 154, 155 social relations and caregiving studies 10, 15, 44, 123–5, 140–3 main trends 125–33 caregiving and receiving 133–40 social relations and social support/ help 131–3 methodological issues 125–7, 141 social sciences: intellectual craftsmanship in 11–12, 146 methodology and theorising 8 and race theory 58–9 socioeconomic status 155 health inequalities studies 82, 83, 87, 90, 91, 100, 101 ‘sociological imagination, the’ 11–12, 146, 166 Söderman, M. 106, 107, 109, 114, 115 Solway, E. 109 Sörensen, S. 129, 140 Spencer, Herbert 59 Sri Lanka: health inequalities studies 85, 94 Stanaway, F.F. 84, 93 Stanford, E.P. 12n1 Staunaes, D. 156 Stephens, C. 127, 133 Stokes, A. 25 Stoller, E.P. 114, 115, 132 structuralist/circumstantialist perspective on ethnicity and race 65–70, 71, 77, 87, 97, 108, 130, 159, 160, 163 structure-obliviousness, obstacles resulting from 151–4 study designs, narrowness of in scholarship 154 Stull, D.E. 12n1 subordination, sources of 156 successful ageing concept 40–1 Sudha, S. 114 Sun, F. 138–9 Swedberg, R. 8, 9, 10, 11, 19, 23, 50, 146 Sweden: health and social care studies 106, 107, 109, 114, 115 synonym, race as 54, 55, 87 Szinovacz, M.E. 132

T Taiwan: health inequalities studies 85, 91n1 Tanzania:

social relations and caregiving studies 127, 133 Task Force on Minority Issues, Gerontological Society of America 4 Taylor, C. 167–9 theorising 7–10, 15, 19, 23, 81, 146 ‘Thomas theorem’ 3 Thrasher, A.D. 92, 154–5 Tobago: health inequalities studies 85, 93 Tomlinson, J. 31, 37–8 Torres-Gill, F.M. 12n1 transnationalism 3, 19, 23, 32–4, 40, 45, 46–7, 147, 148, 152, 153, 164–5, 168 see also international migration, globalisation of Treas, J. 46, 49 Trinidad: health inequalities studies 93 Tsunokai, G.T. 132 Tung, H.-J. 85, 91n1

U UK: health and social care studies 106, 107, 109, 114, 115, 117 health inequalities studies 85, 89, 94, 96, 97 social relations and caregiving studies 127, 129, 130, 133, 137 Umberson, D. 126, 132 US: health and social care studies 103–4, 106–7, 107–8, 111–12, 114, 115–16, 116–17, 118, 119–20 health inequalities studies 81–2, 84, 86–7, 88–9, 91–2, 93–4, 95–6, 97, 98, 100–1 immigration law 45–6 social relations and caregiving studies 124–5, 127, 131–2, 135–6, 138–9, 141 Usui, W. 8

V Vallin, J. 24 van Liew, C. 114 van Oudenhoven, J.P. 30 Vertovec, S. 32

W Wagner, L.S. 12n1 Wallman, S. 57 Walsemann, K.M. 85, 93 Ward, C. 30 Warnes, A.M. 36, 42–3 Weber, Max 55–6, 59, 67, 69, 76–7

219

Ethnicity and old age welfare systems: and population ageing 26 and retirement migration 46–7 well-being concept 40–1 West, the, impact of globalisation on conceptions of 36 ‘West and the Rest’ 36–7, 48 White, T.M. 138 ‘White framing’ 150 White-Means, S.I. 111, 135–6 ‘Whiteness,’ as the master category 60, 163 Whitfield, K.E. 12n1, 13, 55, 83 Williams, D.R. 82, 86–7, 88, 90, 96, 100, 107, 111 Willis, R. 127, 129, 130, 133, 137 Wilson, C.M. 82, 107, 111 Wilson, G. 43 Wimmer, A. 59 Wirtz, K. 161–2 Woodward, J.L. 97 ‘world culture’ 30–1 World Health Organization 25 World Values Survey 29

Y Yenilmez, M.I. 27 Young, T.L. 117 Yuval-Davis, N. 73

Z Zahodne, L.B. 89, 97 Zsembik, B.A. 97 Zuckerman, I.H. 111

220

“This is the most stimulating book for thinking in different and innovative ways about the relationship between ethnicity, race and old age. Sandra Torres invites us to go beyond traditional categories of analysis and to expand our imagination to face current research challenges.” Claudio Bolzman, University of Applied Sciences and Arts Western Switzerland

Part of the Ageing in a Global Context series, this book proposes a new research agenda for scholarship that focuses on ethnicity, race and old age. It argues that in a time of increased international migration, population ageing and ethno-cultural diversity, scholarly imagination must be expanded as current research frameworks are becoming obsolete. By bringing attention to the way that ethnicity and race have been addressed in research on ageing and old age, and focusing on health inequalities, health and social care, intergenerational relationships and caregiving, the book proposes how research can be developed in an ethnicity-astute and diversity-informed manner. Sandra Torres is Professor of Sociology and Chair in Social Gerontology at Uppsala University, Sweden, and Fellow of the Gerontological Society of America. Her scholarly contributions often aim to expand the gerontological imagination on ethnicity, race and migration.

ISBN 978-1-4473-2811-7

www.policypress.co.uk PolicyPress

@policypress

9 781447 328117

Sandra Torres

“By setting ethnicity and old age in the context of discovery, this book challenges the common views within social gerontology of how these issues will intersect in so many people’s lives. With impressive analytical clarity, Sandra Torres expands a field of knowledge that for such a long time has been neglected within social science.” Erik Olsson, Stockholm University

Ethnicity and old age 

“This book is both ambitious and timely, linking scholarship from the intersection of gerontology and race/ethnicity studies in three domains: health inequalities, health and social care, and social relations and caregiving as the foundation for developing theory and a future research agenda.” Christina Victor, Brunel University London

AGEING IN A

GLOBAL CONTEXT

AGE-FRIENDLY CITIES AND COMMUNITIES ETHNICITY AND OLD AGE A global perspective Expanding our imagination SANDRA TORRES