Care Needs Prioritisation on the Ground: Why Older People in Poverty Are More Likely to be Excluded

Old-age population has been largely discussed as one identical ‘deserving’ group of people who need similar support from the welfare states. In line with this notion elderly care policies have been developed from the perspective of service provisions without considering differential care needs depending on socio-economic backgrounds of older people. Moreover, spatial inequalities and organisational conditions interrelatedly exist on the ground after elderly care policies are implemented. These dynamics at local levels would affect the way street-level bureaucrats interpret differential care needs and prioritise certain group of older people in terms of connecting welfare resources to meet their needs. This study thusly asks under what local and individual conditions older people share similar types of care needs, and why certain care needs and target groups are more prioritised by public officials on the ground. In intertwining policy implementation theories and old-age inequalities on the ground, this paper elaborates why older people in poverty have been excluded despite diversified care services.

In examining the implementation stage of one of elderly care policies in South Korea – Seoul’s Outreach Community Service Project, this paper first explores how care needs of older people are differently formed according to borough disparities and individuals’ socio-economic backgrounds by utilising Seoul Welfare Survey Data in 2022 and adopting a multilevel latent class model. Additionally, in adopting a frame analysis, interview data from 70 public officials involved in the Project will be analysed to investigate what socio-economic characteristics are considered as ‘deserving’ under what frames, and how they vary according to spatial inequalities. Specifically, half of interviewees consist of those working at the wealthiest boroughs and the other half include public officials at the least wealthiest boroughs. The results show the distinctive process of care needs prioritisation across boroughs, which led to exclude the most marginalised older people.