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This electronic thesis or dissertation has been downloaded from Explore Bristol Research, http://research-information.bristol.ac.uk Author: Ward, Danielle Title: Resistance and Resilience The Attributes of Healthy Ageing for Older West Indians Living in the United Kingdom General rights Access to the thesis is subject to the Creative Commons Attribution - NonCommercial-No Derivatives 4.0 International Public License. A copy of this may be found at https://creativecommons.org/licenses/by-nc-nd/4.0/legalcode This license sets out your rights and the restrictions that apply to your access to the thesis so it is important you read this before proceeding. Take down policy Some pages of this thesis may have been removed for copyright restrictions prior to having it been deposited in Explore Bristol Research. 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Resistance and Resilience: The Attributes of Healthy Ageing for Older West Indians Living in the United Kingdom Danielle Laurie Ward Centre for Research in Health and Social Care School for Policy Studies January 2018 A dissertation submitted to the University of Bristol in accordance with the requirements for award of the degree of Doctor of Philosophy in the Faculty of Social Sciences and Law Word Count: 63, 527 Abstract The overarching aim of this thesis was to understand how the processes of migration and associated experiences, placed within social and historical context, have contributed to the definition of healthy ageing among West Indian women and men growing older in the United Kingdom. Specific objectives were (1) to explore the post-migration factors influencing the definition of healthy ageing for older West Indians living in the UK and (2) to examine how these identified factors can be used to understand perceptions of healthy ageing for the aforementioned population. Utilising critical race theory and the resilient ageing concept, the current thesis aimed to contribute to the broader literature on the understandings of healthy ageing within ethnic minority communities and to inform the wider network of individuals working within these communities. This thesis used qualitative methodologies to achieve its aim and objectives. One focus group (with five participants) and sixteen interviews were conducted with West Indians living in the wider Bristol and Bath areas. Participants were recruited through letters, emails and phone calls. NVivo was used to organise and code the data, which were then analysed thematically. Findings showed that the participants’ post-migration experiences and construction of healthy ageing can be understood by utilising the concept of resilience, via resilient ageing. Four key factors were identified that can be used to understand perceptions of healthy ageing: social connections, involvement in activities, optimism and belief in a higher power. The findings of the current thesis can be used in a transformative manner by considering how various structures in society, such as an adaptive and supportive environment or public service policies, can be modified to support the needs of this group, thereby contributing to their overall resilience. i ii Author’s Declaration I declare that the work in this dissertation was carried out in accordance with the requirements of the University’s Regulations and Code of Practice for Research Degree Programmes and that it has not been submitted for any other academic award. Except where indicated by specific reference in the text, the work is the candidate’s own work. Work done in collaboration with, or with the assistance of, others, is indicated as such. Any views expressed in the dissertation are those of the author. SIGNED: DATE: iii iv Acknowledgements Thank you to my supervisors, Professor Sarah Payne and Dr. Saffron Karlsen, for their support and advice throughout this process. Thank you for all of the helpful feedback and, especially, the encouragement to keep pressing forward. I would also like to thank the women and men who kindly agreed to take part in my study. Without you, this thesis would not have been possible. To the ENHS crew – thank you for ‘adopting’ me and for making my time here at the university enjoyable. Sarah, Ana, Maria, Sahar, Clare and Laura, you have been amazing officemates. You made my days (and nights) in the office bearable. I would like to give a special thank you to Zoi – your friendship means more than you will ever know. Dr. Debbie Watson, I owe you a huge debt of gratitude. Thank you for recognising when I needed help. Undertaking a PhD can be a lonely and challenging endeavour. Thank you for your support and encouragement. To my family back home in Antigua – Gran, Aunty Gerda, Aunty Heather, Uncle Dick, Aunty Patty, Carol, Daren, Kayla, Jonathan, Ayden, Rebekah and Sarah- Anne. You have given me a lifetime of encouragement; thank you. To my friends Amanda, Andrea, Shyan, Carina, Sally, Aoife and Rosina– thank you for being amazing cheer leaders! I am truly lucky. To Gryffindor, thank you for making me smile every day. And finally, to my mother and step-father, Judith and John, I owe you the biggest thank you. This endeavour would never have been possible without both of you. Mum, you are my inspiration and reason. You taught me the meaning of hard work, kindness and perseverance. This is for you. v vi Table of Contents Chapter 1 Introduction ......................................................................................... 1 1.1 Background to the Thesis ........................................................................... 1 1.1.1 Definition of Key Terms ..................................................................... 2 1.1.2 West Indians in the United Kingdom .................................................. 3 1.1.3 West Indians in Bristol ........................................................................ 5 1.1.4 Who are ‘Older’ People? ..................................................................... 7 1.1.5 Ageing in the United Kingdom ........................................................... 9 1.1.6 Policy Context of Ageing .................................................................... 9 1.2 Conceptual Frameworks Influencing the Study ....................................... 11 1.3 Structure of the Thesis ............................................................................. 11 Chapter 2 Healthy Ageing in Later Life ............................................................ 13 2.1 Introduction to Ageing and Health ........................................................... 13 2.2 Healthy Ageing ........................................................................................ 14 2.2.1 Successful Ageing, Active Ageing and Healthy Ageing .................. 14 2.2.2 Why These Concepts May Not Work ............................................... 17 2.2.3 How Do Older People View Healthy Ageing? ................................. 18 2.2.4 Are Perceptions of Healthy Ageing Different in Ethnic Minority Communities? ............................................................................................... 21 2.2.5 What About Resilient Ageing? ......................................................... 28 2.3 Chapter Summary ..................................................................................... 32 Chapter 3 Theoretical Frameworks .................................................................... 34 3.1 West Indians in the United Kingdom ....................................................... 34 3.1.1 Experiences of and Responses to Racism ......................................... 34 3.1.2 Policy Responses to the West Indian Migrants ................................. 36 3.2 Critical Race Theory ................................................................................ 39 3.2.1 Applicability of Critical Race Theory to the Study .......................... 44 3.3 Ethnic Minorities, Racism and Health ..................................................... 49 vii 3.4 The Life Course Approach to Migration and Health ................................ 52 3.5 Chapter Summary ..................................................................................... 54 Chapter 4 Methodology ...................................................................................... 55 4.1 Research Aim and Methodological Considerations ................................. 55 4.1.1 Theoretical Underpinnings of the Study ............................................ 56 4.1.2 Assessing the Quality of the Study .................................................... 57 4.1.3 Reflexivity ......................................................................................... 57 4.2 Methods .................................................................................................... 60 4.2.1 Sampling ............................................................................................ 63 4.2.2 Gaining Access .................................................................................