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
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