How Age Friendly is Bristol? Draft baseline assessment September 2015 Table of Contents Page 1.Introduction 2 2. Some insights into Bristol…. 3 3. What is an age friendly city? 5 4. The Eight Themes of an Age Friendly City 9 5. Theme 1: Outdoor spaces and buildings 10 6. Theme 2: Transport 17 7. Theme 3: Housing 25 8. Theme 4: Social participation 33 9. Theme 5: Respect and social inclusion 42 10. Theme 6: Civic participation and employment 48 11. Theme 7: Communication and information 54 12. Theme 8: Community support and health services 59 1 1. Introduction Bristol wants to become an age friendly city. Bristol Ageing Better, a partnership of over 100 local organisations, (www.bristolageingbetter.org.uk) and Bristol City Council are signed up to making this happen. The World Health Organisation sets out some steps that a city needs to take, if it is to achieve its age friendly objectives. One of the most important is to do a baseline assessment of the age-friendliness of the city in eight key areas: o outdoor spaces and buildings o transport o housing o social participation o respect and social inclusion o civic participation and employment o communication and information o community support and health services. This report starts that process. It is not intended to be comprehensive but rather to start a conversation. What are Bristol’s strengths and areas for improvement, where are the opportunities and challenges that will help and hinder? What progress have we already made, what learning can be shared and what successes can be built on? Although an ageing population will pose challenges for health and care systems, there will also be opportunities to improve the quality of life for Bristol’s citizens as they age. Older people are net contributors to the economy and cities who take an Age Friendly approach can benefit from the contribution of older people locally. This draft baseline assessment is a working document that will require constant updating to reflect change. It needs the input of local residents, service users and providers, professionals, volunteers and community organisations to bring it alive and make it real. The next step will be to develop a city-wide action plan to make sure that progress is being made. If you’d like to contribute to this initiative or to find out more, contact [email protected] 2 2. Some insights into Bristol…. Comparing people over 50 years with those under 50 The following findings, taken from the Quality of Life Survey 2013, compare the experiences of people aged over 50 with those under 50 years of age More over 50s have no educational or technical qualifications: 36% of over 50s compared to 4% of under 50s More have long-term limiting illness or disability: 45% of over 50s compared to 9.5% of under 50s Fewer over 50s participate in active sport: 30% of over 50s compared to 55% of under 50s Fewer report good health: 80% of over 50s compared to 90.5% of under 50s More eat 5 or more portions of fruit and veg a day: 57% of over 50s compared to 46% of under 50s Fewer have been victims of crime: 9% of over 50s compared to 15% of under 50s More feel they ‘belong’ to their community: 69% of over 50s compared to 56% of under 50s More are satisfied with household waste collection: 76% of over 50s compared to 69% of under 50s Comparing people over 65 years with those under 65 Some differences change or become more marked when comparing the experiences of people aged 65+ with people under 65 years of age More over 65s have no educational or technical qualifications: 50% of over 65s compared to 12% of under 65s Fewer are happy using the internet whenever they want: 47% of over 65s compared to 90% of under 65s Fewer talk to friends and family most days: 64% of over 65s compared to 77% of under 65s More feel they belong to the neighbourhood: 75% of over 65s compared to 59% of under 65s More say people are treated with respect in their neighbourhood: 77% of over 65s compared to 66% of under 65s More say poor health prevents them leaving their house as often as they want: 14% vs. 5% More say disability prevents them leaving their house as often as they want: 13% vs. 5% Fewer have had good health in the past 12 months: 77% vs. 87% More have a limiting long-term illness or disability: 54% vs. 23% More have accidentally fallen in the last 12 months: 27% vs. 15% 3 Comparing life satisfaction by ward In the 2013 Quality of Life survey, nearly 70% of all respondents report medium or high ‘Life Satisfaction’, including those aged over 50. However, when broken down by ward this shows a rather different picture. For those over 50, life satisfaction ranges from 48% to 82%, depending on where people live. Map 4: Quality of Life Respondents (over 50) Reporting Medium or High Life Satisfaction 4 3. What is an Age Friendly City? An age-friendly city enables people to actively participate in their community and provides an environment where everyone is treated with respect, regardless of their age. It is a place that makes it easy for older people to stay connected to the people that are important to them. It helps people stay healthy and active even at the oldest ages and provides appropriate support to those who can no longer look after themselves. The World Health Organisation (WHO), describes an age friendly community as an environment where, all actions, buildings and services: “are designed to support and enable older people to ‘age actively’ – that is, to live in security, enjoy good health and continue to participate fully in society”1 Recent national guidance by the Local Government Association has highlighted the need for councils to apply an ageing lens to policy and practice2. “Becoming ‘age-friendly’ is about adopting a particular ‘lens’ through which to view policies and services. It is a way of focussing attention on the issues of particular relevance to older people. Given the huge democratic shift that is taking place and the other changes within this group, it is appropriate to consider their needs, assets and circumstances in quite some detail. That is what adopting an ‘ageing lens’ allows councils to do. As with any lens, it provides a much clearer and more detailed picture.” An age-friendly city supports and enables people to age actively by: recognizing the wide range of skills, abilities and capacities of older people; anticipating and responding flexibly to ageing-related needs and preferences; respecting the decisions and lifestyle choices of older people; protecting those who are most vulnerable; and promoting older people’s inclusion in and contribution to all areas of community life. A person’s health, and their ability to cope with the shocks and stresses that life brings, will change over time (for example, the onset of an illness or disability, divorce, a rapid change in financial circumstances, the death of a partner or close friend). There are a range of complex factors that can have a positive or negative impact on health and wellbeing, for example, lifestyle choices (diet, physical activity, alcohol consumption, use of tobacco); income; and genetic make-up (characteristics inherited from parents). However, individual factors are not the only ones to consider. The work of the WHO Healthy Cities programme acknowledges the importance of wider environmental and social 1 See http://www.who.int/ageing/projects/age_friendly_cities/en/ 2 ‘Ageing: the silver lining. The opportunities and challenges of an ageing society for local government’. Local Government Association, 2015 5 determinants of health. Where someone lives can also have a positive or negative impact on their experience of ageing. Crime and anti-social behaviour within a neighbourhood, for instance, may discourage older people from going out and fully participating in their community. Feeling safe encourages people to be more active as they age. Participation can also be encouraged by easy access to public transport, local facilities and healthcare, traffic calmed streets, clean air and green space, as well as the availability of well-maintained and uncluttered pavements, access to toilets and benches in public areas. Ageist attitudes are still prevalent in society and can have a corrosive impact on how older people feel about themselves and their place in the local community. Challenging ageism is a key strand of any strategy to become more age friendly. The strengths of an environmental approach to ageing well are considerable with benefits beyond the individual. If people can maintain independence through supportive environments, there is less need for them to require services that can reduce autonomy and dignity, and may prove costly for the individual or the public purse. Having insufficient support can limit coping and precipitate premature moves to more restrictive care settings. World Health Organisation – Active Ageing Source: World Health Organisation (WHO), Active Ageing Strategy, 2002 An age-friendly city emphasises enablement rather than disablement; it is friendly for all ages and not just “elder friendly” (WHO: Global Age-Friendly Cities: A Guide) Because active ageing is a lifelong process, an age-friendly city is not just ‘elder friendly’. Barrier-free buildings and streets enhance the mobility and independence of people with disabilities, young as well as old. Secure neighbourhoods allow children to establish a habit of active lifestyles that can stay with them into adulthood. They allow younger women and older people to venture outside in confidence to participate in physically active leisure and 6 in social activities.