Index of Wellbeing for Older Australians (IWOA)
Transcription
Index of Wellbeing for Older Australians (IWOA)
RESEARCH & EVALUATION SNAPSHOT Index of Wellbeing for Older Australians (IWOA) Exploring geographic patterns of wellbeing among older people Key Points •The index focusses on five domains of wellbeing participation, education, health, resources, and wealth and housing. The Benevolent Society commissioned the National Centre for Social and Economic Modelling (NATSEM) to develop a geographic index of wellbeing among older people across Australia. Although there are similar indexes for the population as a whole and for sections of the population such as children and youth, currently there is no index which gives a geographic picture of wellbeing among older people. If it is true that we measure what matters, then in the context of an ageing population, the absence of good data on the wellbeing of older people is a striking omission. The index of wellbeing for older Australians (IWOA) is intended to stimulate discussion about how older people are faring. How well are they being served by current policies and programs? And in the context of government concerns about the costs of population ageing, what needs to occur to ensure the wellbeing of older people, both now and into the future? More specifically, the index is a tool for governments, planners and services for monitoring the wellbeing of older people within local areas and for comparing the effectiveness of policies and programs across different areas. It identifies the areas where older people with the lowest level of wellbeing live, and the factors that contribute most to their low wellbeing. The research was undertaken by Professor Robert Tanton, Dr Yogi Vidyattama and Dr Riyana Miranti at NATSEM. •Statistical techniques were used to combine a number of measures of older people’s wellbeing into a single index calculated for local areas − suburbs in metropolitan areas, or larger areas in regional locations. •The largest concentrations of older people experiencing low wellbeing tend to be in outer metropolitan areas. Older people in regional areas of Australia generally have moderate levels of wellbeing, with the exception of some regional towns where wellbeing is low. •The areas of each state with the lowest and the highest levels of wellbeing are almost all located in the major cities. •Housing stress contributed the greatest weight to the overall index. This highlights the importance of housing affordability for older people’s wellbeing. •Limitations in the availability of data at small area level mean that some areas of Australia were not able to be scored. www.benevolent.org.au Research & Evaluation Snapshot INTRODUCTION In recent years there has been increasing interest in measuring the wellbeing of the Australian population as a whole, and of particular sub-groups within the population. In addition, indexes of wellbeing and related concepts such as social exclusion and disadvantage have been developed for small areas. The widely used Socio-Economic Index for Areas (SEIFA) is an index of general disadvantage for areas across Australia calculated every 5 years by the Australian Bureau of Statistics (ABS) from Census data. In many countries, including Australia, indexes of social exclusion have been created at small area level for children and for youth. However, currently there are no similar small area level indexes for older people. This Snapshot summarises research commissioned by The Benevolent Society to develop an index of wellbeing for older Australians (IWOA) at small area level, building on previous work by NATSEM. DEVELOPMENT OF THE INDEX Indicators Labour force participation rates for older people Employment rates for older people Unemployment rates for older people % of older people who provided care to children who were not their grandchildren % of older people who provide care to their children and/or grandchildren (daily) % of older people who provide care to their children and/or grandchildren (daily and several days a week) Annual cost of older people using public transport (bus, ferry, rail or taxi) % of older people who have no Internet in the house % of older people providing care to others % of older people who cannot speak English well or not at all % of older people who are volunteers % of older people who completed Year 12 % of older people who completed Year 10 The indicators used to compile the index are listed opposite. They were limited by the availability of data for small areas across Australia. Poverty Rate for older people The index provides an overall wellbeing summary score for each area, and for five domains of wellbeing which together make up the summary index: Participation, Education, Functional Ability, Resources, and Wealth/ Housing. A sixth domain, Security, was not able to be included because of lack of available data at small area level. The participation domain is about older people’s participation in society and includes indicators such as labour force participation, volunteering, access to a car and access to the internet at home. 2 INDEX OF WELLBEING FOR OLDER AUSTRALIANS (IWOA) Participation % of older people who had no access to a car to drive For the purposes of this index, older people were defined as people aged 65 and older. Indicators were collected or derived for Statistical Area 2 (SA2) as defined by the ABS. These broadly match to suburbs in capital cities, but tend to be larger areas in regional and remote Australia. Any SA2 Areas with fewer than 30 people aged 65 and above were excluded. Domain Education % of older people with post school qualifications % of older people receiving an age pension % of older people with the age pension as their major source of income % of older people who have no superannuation payments Resources % of older people who could not raise a certain amount of money in an emergency within a week. % of older people who pay public/private rent and are in the bottom income quintile of the equivalised household income distribution % of older people who are still paying mortgages % of older people who are private renters % of older people living in public housing % of older people in housing stress % older people who are homeless (Census) % older people who are homeless (modelled from ABS General Social Survey) % of older people receiving rent assistance Wealth and Housing Research & Evaluation Snapshot Indicators Domain % of older people who need assistance with core activities % of older people who use aged care services % of older people who need assistance for 1 to 4 activities of daily living % of older people who need assistance for 5 or more activities % of older people who have an unmet need for assistance for 1 to 4 activities % of older people who have an unmet need for assistance for 5 or more activities Functional ability % of older people who are Home and Community Care clients Hours of assistance for Home and Community Care per older person % of older people with low level community packaged care % of older people with high level community packaged care % of older people in the community with packaged care The education domain includes indicators such as completed year 10, completed year 12 and post school qualifications. The functional ability domain includes indicators on the need for, and use of, assistance at home. Ideally, in a future version of the index this domain would be expanded (and renamed) to include health status and health service usage indicators when such data become available for small areas. The resources domain includes indicators such as poverty rates, financial stress and whether a person is paying rent on a low income thus reducing their disposable income. The wealth and housing domain is about the assets a person holds and their housing situation. The indicators used include those that show the absence of any wealth in the form of housing equity, as well as financial stress due to housing costs (rent or mortgage). The security domain would include indicators such as crime rates affecting older people and whether they feel safe at night. The main source of data was the 2011 Census. The next source of data was from a spatial microsimulation model run by NATSEM. This calculates estimates for small areas from survey and Census data. It has been applied to the ABS Survey of Income and Housing Costs, the ABS General Social Survey and the HILDA survey. Other sources of data included the Australian Urban Research Infrastructure Network and the Department of Social Services (DSS). If there were missing scores (i.e. where data were not available or could not be reliably estimated through modelling) for one or more domains for a particular area, the area is not included in the summary index results. In many parts of remote Australia (and some regional and metropolitan areas) a summary index score could not be calculated for this reason or, in the case of some remote areas, because there were too few older people. As a summary index of wellbeing, the index does not differentiate between sub-groups within the older population on the basis of gender, indigenous status or cultural and linguistic background. Much of the data needed is not available or, if modelled, would have been unreliable. The conceptual framework underpinning the index, the spatial microsimulation model, the statistical techniques and data sources used to develop the index, are described in more depth in the full report of the research. THE RESULTS The maps on page 4 show the results for the summary index in population weighted quintiles of wellbeing for people aged 65 and over. A population weighted quintile splits the population into five equal groups, with the same number of people in each quintile. Areas with higher scores (shown as lighter colours on the map) are ones where higher proportions of older people experience high wellbeing, and areas with lower scores (darker colours on the map) are ones where higher proportions of older people experience low wellbeing. Areas with missing scores are shown as speckled. INDEX OF WELLBEING FOR OLDER AUSTRALIANS (IWOA) 3 Research & Evaluation Snapshot Interactive maps for the summary index and for each domain are available at http://web.natsem.canberra. edu.au/maps/AUS_OSE/atlas.html. Tips for using the online maps To drill down to a particular state, capital city or rest of the state, use Filter. To choose the overall index or one of the domain indexes click on Data, then Index of Wellbeing for Older Australians. Click on Data then Other measure to show the number of people aged 65 and over, or the SEIFA index, for areas. To rank the areas click on Indicator. REGIONAL/URBAN PATTERNS The largest concentrations of older people experiencing low wellbeing are on the outskirts of the capital cities – such as the western and south western suburbs of Sydney, the western and northern suburbs of Melbourne and northern suburbs of Adelaide. Older people living in regional areas tend to have, on average, higher levels of wellbeing, although there are also some areas in regional Australia showing low levels of wellbeing. Regional towns and cities showing lower levels of wellbeing include Port Augusta and Murray Bridge in South Australia; Geelong and Shepparton in Victoria; parts of Wollongong and the Hunter, Nowra and north coast towns in NSW; Coolangatta, Mackay and Innisfail in Queensland; and northern suburbs of Hobart in Tasmania. MAP OF OLDER PERSON’S WELLBEING INDEX, 2011 4 INDEX OF WELLBEING FOR OLDER AUSTRALIANS (IWOA) Research & Evaluation Snapshot In most states, the five areas with the highest levels of wellbeing were suburbs of major cities − such as North Sydney, Wahroonga, St Ives in Sydney, and Southbank and East Melbourne in Melbourne. Conversely, very few of the five areas of each state where older people experience the highest levels of wellbeing are outside a major city. The extremes of low wellbeing are also experienced in cities, but generally in areas distant from the high wellbeing areas. In Sydney these areas include Cabramatta, Liverpool and Fairfield and in Melbourne include Footscray and Broadmeadows. It is notable that in Sydney many of the areas in south west Sydney showing low levels of wellbeing are ones with very culturally and linguistically diverse communities. This warrants further examination. INFLUENCE OF HOUSING Some indicators contributed more weight in the calculation of the final index than others, and so point to the significance of those indicators to older people’s wellbeing. Whether or not people were in housing stress had the greatest impact on the overall index. Receipt of rent assistance also had a high weight. This highlights the importance of housing affordability for older people’s wellbeing. THE SIGNIFICANCE OF PARTICULAR DOMAINS The domain indexes provide a powerful tool for exploring the reasons underlying low wellbeing scores in a particular area. For example, Tamworth West in rural NSW − in quintile 1 in the summary index (lowest wellbeing) − appears in quintile 1 for the education, resources and housing domain indexes, and appears in quintile 2 for the functional ability and participation domains. This suggests that policies focussing on education, resources and housing will be particularly important in this area. Redcliffe in outer Brisbane also shows in quintile 1 (the lowest) in the summary index. It appears in quintile 1 for the housing and resources domains, and in quintile 2 for the participation, education and functional ability domains. This suggests that policies focussing on resources and housing will be particularly important in this area, and/or ones that take into COMMUNITIES (1) WITH THE HIGHEST AND LOWEST WELLBEING BY STATE (2) STATE LOWEST WELLBEING (3) HIGHEST WELLBEING (3) NSW Cabramatta - Lansvale North Sydney - Lavender Bay NSW Liverpool - Warwick Farm Terrey Hills - Duffys Forest NSW Fairfield - East Wahroonga - Warrawee NSW Guildford - South Granville St Ives NSW Lakemba - Wiley Park Pymble VIC Meadow Heights Southbank VIC Footscray East Melbourne VIC Roxburgh Park - Somerton Flinders VIC Braybrook Research - North Warrandyte VIC Broadmeadows South Yarra - West QLD Woodridge Fig Tree Pocket QLD Inala - Richlands Chapel Hill QLD Darra - Sumner Brookfield - Kenmore Hills QLD Riverview Broadsound - Nebo QLD Rockhampton City Brisbane City SA The Parks Coromandel Valley SA Salisbury North Aldgate - Stirling SA Hindmarsh - Brompton One Tree Hill SA Elizabeth Belair SA Smithfield - Elizabeth North Glenside - Beaumont WA Balga - Mirrabooka Nedlands - Dalkeith - Crawley WA Hamilton Hill City Beach WA Willagee Cottesloe WA Calista Gidgegannup WA Nollamara - Westminster Applecross - Ardross TAS Ravenswood Taroona - Bonnet Hill TAS Bridgewater - Gagebrook Mount Nelson - Dynnyrne TAS Mornington - Warrane Bruny Island - Kettering TAS Glenorchy Kingston Beach - Blackmans Bay TAS Invermay Dilston - Lilydale The community names are those given by the ABS for the standard geographies used. In some cases, they may consist of two areas, for example, Liverpool - Warwick Farm. (1) The Northern Territory was excluded from this Table as the index could not be calculated for many areas in NT. The ACT is excluded because there were no areas in the bottom 2 quintiles. (2) Italicised areas are classified as being in Major Cities in the ABS Remoteness Area classification. There are no Major City areas in Tasmania. (3) INDEX OF WELLBEING FOR OLDER AUSTRALIANS (IWOA) 5 Research & Evaluation Snapshot account the low levels of income and assets among local older people. Werribee South in outer Melbourne also shows in quintile 1 in the summary index. It appears in quintile 1 for the participation and education domains and in quintile 2 for the housing, resources and functional ability domains. This suggests that policies and programs that address participation and education and, perhaps, take into account low levels of literacy, may be important in that area. Most areas appear in different quintiles across the five domains showing relative strengths in certain aspects of older people’s wellbeing. However there are some areas that appear in the lowest quintile in the summary index and in all of the five domain indexes. Rockhampton in Queensland, Glenorchy in Tasmania and Penrith in NSW are examples. Areas that scored low in the participation index tend to be in capital cities, large regional cities and remote areas. For example, low participation was found in parts of Perth; in large parts of southern, western and north western Sydney; parts of Wollongong and Newcastle; in northern, western and outer eastern Melbourne and in Adelaide’s northern suburbs. Remote and rural areas generally showed higher scores in the participation domain with the exceptions of some remote areas in northern Australia that appear in quintile 1 (lowest wellbeing). GENERAL DISADVANTAGE VS OLDER PEOPLE’S WELLBEING A comparison of this index with the ABS SEIFA index shows that 10.19 per cent of older people living in areas with a SEIFA quintile of 1 (the most disadvantaged) were also living in areas with the lowest wellbeing among older people, and 12.72 per cent of older people living in the least disadvantaged areas (SEIFA quintile 5) were also living in areas of high wellbeing for older people. Around 76 per cent of older people were in the same quintile or one quintile above or below. Overall, this indicates that the geographical patterns of wellbeing and disadvantage shown by the IWOA index and SEIFA index are similar, but differences do exist and around one in four older people live in an area that is in a very different quintile in the two indexes. This raises interesting questions such as 6 INDEX OF WELLBEING FOR OLDER AUSTRALIANS (IWOA) what influence does the general level of advantage or disadvantage in an area have on older people’s wellbeing. And how do older people experiencing low wellbeing fare in advantaged areas, for example, areas that have become gentrified? DISCUSSION Older people make an immense contribution to our communities in many ways. Yet so much of the public discourse about older people and ageing is unremittingly negative. Older age does bring challenges but it should not be regarded as a failure that people become frail and, of course, eventually die. Nor should older people be regarded simply as an expensive burden on the rest of the community. However, the implications of the ageing of the population must be taken seriously. The Australian Government’s intergenerational reports have highlighted the increasing costs of providing services to an ageing population, especially health services, income support and aged care. State and territory governments are also increasingly focusing on the impact of the ageing of the population and the changes needed to prepare for and respond to it. So we must pay particular attention to ensuring that we have the right policies and services in place to support people through the transitions of older age and to ensuring that policies and services are reaching older people with low levels of wellbeing, wherever they live. Being able to identify areas of low wellbeing for older people, and the factors contributing to low wellbeing in these areas − using the domains and indicators available in this index − allows government policymakers and planners to more effectively target service provision to those areas and to address any weaknesses in the provision of core universal services to older people. It identifies areas where additional resources may need to be allocated and/or policies reviewed. It is a tool for monitoring the wellbeing of the older population within local areas and for comparing the effectiveness of policies and programs across different areas. The index can assist service providers (government and non-government) to better target and tailor services to local older people’s circumstances. For example, areas with low levels on the participation domain may be Research & Evaluation Snapshot ones where improvements to public and community transport will be the most critical, as they allow older people to stay active members of their community. Location has particular importance for older people as they tend to be much less mobile than younger people, especially in the later years when health problems become more common. Older people experiencing low wellbeing cannot easily access services provided in other areas or ones that require significant user fees. The design of programs and services for older people must take account of the location of older people experiencing low wellbeing, who are likely to have poorer access to services due to limitations in health, transport or money. The online provision of government information and services can potentially help but is problematic for many older people, especially those on low incomes and in older age groups, whose use of the internet is much lower than the community average. The influence of the housing stress and rent assistance indicators within the index highlights the importance of housing for older people’s wellbeing. It is difficult to understate the importance of building comprehensive strategies − involving both federal, state and local governments − to address housing affordability among current and future generations of older people. Otherwise we face a crisis of wellbeing among the growing number of older people on low incomes who do not own a home. Older renters on a low income are some of the most vulnerable in our community as a high percentage of their income goes on housing costs. This leaves little to cover other essentials like food, health, transport and energy costs, and/or it means that they are forced to move to areas with lower amenity and poorer access to services. As well as shining a light on the wellbeing of older people, this research also draws out just how important economic resilience/security is in earlier life as older people’s housing status is typically determined well before they reach older age. Australia’s retirement incomes and aged care policies are also largely predicated on an assumption of widespread home ownership in older age. As noted above, the index is somewhat limited by the availability of data at small area level and as a result some areas of Australia were not able to be reliably scored. Future versions of the index would benefit from the inclusion of small area indicators on health status, health service use and safety/security. This research has highlighted the value of a global index of wellbeing among older people but also the richness and complexity of older people’s wellbeing. INDEX OF WELLBEING FOR OLDER AUSTRALIANS (IWOA) 7 ACKNOWLEDGMENTS The research also benefitted greatly from the input and wisdom of an external expert advisory group. However, the analysis and opinions expressed are those of the authors and do not necessarily represent the views of the advisory group, nor their organisations. The group was comprised of: Dr Kirsty Nowlan (Chair) and Sarah Fogg: The Benevolent Society Dr Anthony Brown: Australian Association of Gerontology NSW Dr Helen Kimberley: Brotherhood of St Laurence Professor Yvonne Wells: Lincoln Centre, La Trobe University Sue McGrath: COTA Australia Barbara Squires: Barbara Squires Consulting Kathryn Mandla, Naomi Rogers, Anita Davis, Jenny Phong and Chris Gordon: Department of Social Services (DSS). We also thank the various government and nongovernment organisations, especially DSS, for making available the data on which this index is based. National Centre for Social and Economic Modelling (NATSEM) For over 20 years NATSEM, part of the Institute for Governance and Policy Analysis at the University of Canberra, has been and remains one of Australia’s leading economic and social policy research centres, and is regarded as one of the world’s foremost centres of excellence for microsimulation, economic modelling and policy evaluation. NATSEM undertakes independent and impartial research, and aims to be a key contributor to social and economic policy debate and analysis Australia-wide and throughout the world through expert economic modelling of the highest quality, and supplying consultancy services to commercial, government and not-for-profit clients. Through its research NATSEM is an active contributor to social and economic policy debate. The National Centre for Social and Economic Modelling University of Canberra, University Drive South, Canberra ACT 2601, Australia T 02 6201 2780 E natsem@canberra.edu.au W www.natsem.canberra.edu.au We are The Benevolent Society National office Level 1, 188 Oxford Street Paddington NSW 2021 PO Box 171, Paddington NSW 2021 T 02 8262 3400 F 02 9360 2319 E research.policy@benevolent.org.au ABN 95 084 695 045 Visit www.benevolent.org.au to find out more or connect with us at Published February 2016. LINKS The full report is available at www.benevolent.org.au and www.natsem.canberra.edu.au/publications. Interactive maps of the index are available at http://web.natsem.canberra.edu.au/maps/ AUS_OSE/atlas.html REFERENCE Miranti, R., Payne, A. and McNamara, J, (2010), Towards small area indicators of well-being for older Australians: concepts and issues, NATSEM Discussion Paper DP67 SPA005 We help people change their lives through support and education, and we speak out for a just society where everyone thrives. We’re Australia’s first charity. We’re a not-for-profit and non-religious organisation and we’ve helped people, families and communities achieve positive change since 1813. © 2016 www.benevolent.org.au
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