ABSTRACT. This study examined to what degree the income inequality in the use of professional home care by older adults can be explained by differences in three types of determinants: need (physical and mental health related), predisposing (preference and personality characteristics) and enabling (situational characteristics) variables. The data are derived from the 1394 independent living elderly aged between 63 and 94, who participated in the wave 2001/2002 of the Longitudinal Aging Study Amsterdam. Results of logistic regression analysis showed that older adults with low income were more likely to use professional home care compared to older adults with high income (OR = 4,66, 95% CI = 2,98 7,29). Adjusting for the larger health problems, the fewer social resources and the weaker personality of the low income persons, decreased their odds ratio to 1,07 (95% CI = 0,57 1,98). Poor health contributed most to the income inequality in the use of home care. It is concluded that inequality in professional home care is justified as it serves the most vulnerable older adults. Decreasing professional care budgets increases the risk for older persons with low incomes, few social resources and a weak personality to be excluded from the care they need for their severe health problems.
