The relationship between frailty, ethnicity and health inequality – a scoping review

Cluley, Victoria; Vanhoutte, Bram; Banerjee, Jay; Pickard, Susan

Abstract

This scoping review highlights the need for research to address the intersectional relationship between racialisation, health inequality and frailty in older age. We map research addressing the relationship between frailty and ethnicity across literature exploring health inequality in order to collate findings, identify trends and highlight research gaps. Our most significant finding is the absence of attention to the role of racism despite the majority of studies identifying a positive corelation between frailty and minority ethnicity. In countries with ageing populations ill health and frailty is generally found to strike earlier and more severely in racially minoritised groups. However, there is a paucity of research addressing ageing and ethnicity. To focus the review, we asked ‘how are frailty and ethnicity/race related in the current literature addressing health inequality?’ We map the existing literature, commenting on terminology, findings, and methodology. While social, economic and cultural factors are speculated as explanations for inequality, there is little analysis of the association between frailty, ethnicity and socio-economic inequality, no explicit attention to the role of racism, and little qualitative research to explore the lived experience of frailty and ethnicity. Despite the contested nature of both frailty and ethnicity, the majority of studies lacked definition of the terms used, particularly with respect to ‘identifying terms’ used for ethnicity. We call for further research to address frailty and ethnicity in the context of racialisation (particularly qualitative research) and health inequality and for critical engagement with ‘identifying terms’ used.

Citation

Cluley, V., Vanhoutte, B., Banerjee, J., & Pickard, S. (2025). The relationship between frailty, ethnicity and health inequality – a scoping review. Journal of Global Aging, https://doi.org/10.1332/29767202Y2024D000000020

• Journal Article Type: Review
• Acceptance Date: Dec 3, 2024
• Online Publication Date: Feb 7, 2025
• Publication Date: Feb 7, 2025
• Deposit Date: Jan 6, 2025
• Publicly Available Date: Feb 8, 2026
• Journal: Journal of Global Ageing
• Electronic ISSN: 2976-7202
• Publisher: Bristol University Press
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1332/29767202Y2024D000000020
• Public URL: https://nottingham-repository.worktribe.com/output/43948031
• Publisher URL: https://bristoluniversitypressdigital.com/view/journals/joga/aop/article-10.1332-29767202Y2024D000000020/article-10.1332-29767202Y2024D000000020.xml
• Additional Information: This is a post-peer-review, pre-copy edited version of an article published in Journal of Global Ageing. The definitive publisher-authenticated version Cluley, V., Vanhoutte, B., Banerjee, J., & Pickard, S. (2025). The relationship between frailty, ethnicity and health inequality – a scoping review. Journal of Global Ageing (published online ahead of print 2025) is available online at: 10.1332/29767202Y2024D000000020