STUDY OF AGE FRIENDLY ENVIRONMENTS (SAFE) STUDY REPORT MAY 2019 SCOPING STUDY Prepared by: The SAFE Steering Group 2 THE SAFE STEERING GRGROUPOUP • Denise Cahill, Healthy Cities Coordinator, Cork. • Brenda Barry, Friendly Call Cork, Cork City Partnership. • Judith Purkiss, Assistant Director of Public Health Nursing, South Lee, Health Service Executive. • Gda. Marie O’Neill, Community Garda, An Garda Síochána. • Sgt. Stewart Philpott, Community Garda, An Garda Síochána. • Tríona Scully, Assistant Director of Public Health Nursing, North Lee, Health Service Executive. THE SAFE RESEARCH GROUP • William Henry Smithson, Professor of General Practice, Department of General Practice, University College Cork. • Cormac Sheehan, Research Fellow, Department of General Practice, University College Cork. • Emmy Racine, PhD Candidate, School of Public Health, University College Cork. • Tess Jones, Research Assistant, UCC Health Matters, University College Cork. • Kasturi Chakraborti, Research Assistant, UCC Health Matters, University College Cork. • Sean Hanrahan, Student, School of Medicine, University College Cork. 3 TABLE OF CONTENTS INTRODUCTION ________________________________________________ 4 METHODS _____________________________________________________ 7 RESULTS _____________________________________________________ 9 Attitudes towards Cork City _________________________________________________ 9 City Infrastructure _________________________________________________________ 9 Public Services __________________________________________________________ 11 Crime/ Antisocial Behaviour ________________________________________________ 12 Underlying Themes ______________________________________________________ 14 DISCUSSION _________________________________________________ 16 CONCLUSION AND RECOMENDATIONS __________________________ 18 REFERENCES ________________________________________________ 22 APPENDIX ____________________________________________________ 23 4 INTRODUCTION Ireland’s population has been getting steadily older since the 1980’s. This demographic shift is due to a range of factors including improved diet, better health care, medical and technological advances. As a result of these shifts in the demographics of Ireland there has been a concomitant increase in interest by policy makers, academics, the community sector, and professional organisations, in supporting older persons in Ireland. Just like other areas in Ireland, Cork city is experiencing ageing within its population structure. According to Census 2016 the average age in Ireland has risen to 37.4 years. In 2011 there were 17,950 aged 65 and over age living in Cork City; this amounted to 15% of the city’s population of 119,230. In 2016 this number increased by 9.9% to 19,727, amounting to 5.7% of the city’s population of 125,657 (see table 1). The percentage of the population aged 65 or over in Cork City (15.5%) was higher than the national percentage (13.3%). Table 1: Population by age group, number and percentagepercentage of tthathat population by Cork City population and the National population in 2016 Age range Cork City (n) Cork City (%) National (n) National (%) 656565-65 ---69696969 5,724 4.5% 211,236 4.4% 707070-70 ---74747474 4,906 3.9% 162,272 3.4% 757575 ---797979 4,044 3.2% 115,467 2.4% 808080-80 ---84848484 2,919 2.3% 81,037 1.7% 85 years and over 2,134 1.6% 67,555 1.4% Total 19,727 15.5% 637,567 13.3% Source: Census 2016 [1] The dependency ratio for those aged 65 years and older has increased for Cork City and nationally between 2011 and 2016 (see Table 2). The dependency ratio measures the number of those aged above 65 years (currently defined as old age ) as a share of those between 15 to 64 years (currently defined as working age ). In other words, this ratio tells us how many retired people a potential worker has to sustain. The dependency ratio figure remains higher for Cork City at 22.4% compared to the national average at 20.4%. The increase in the old dependency ratio is indicative of an aging population, which may signify a 5 population who are living longer possibly with more health care needs, increased isolation, and issues of personal safety which is pertinent to this scoping study. Table 2: Old Dependency Ratio for Both Sexes, Cork City 2011 and 2016 65 years and older by 2011 Ratio 2016 Ratio gender Both Sexes 21.4 22.4 Male 18.2 19.7 Female 24.6 25.2 Source: Census 2011 and 2016 [2, 1] According to the Cork City Profile (2018) [4] in 2006 and 2011 one in seven persons was aged 65+ in Cork City. In 2016 the ratio was one in six in Cork City (15.7%) and one in seven for both Cork City and Suburbs and the State. The ED of Fair Hill B was the Electoral Division with the highest proportion of those aged 65+ in Cork City in 2006, 2011 and 2016. With almost a third of its population falling into this age group at each census it was the ‘oldest’ ED in the city. For each census under review, Bishopstown C was the ED with the highest number of those aged 65 and over and, along with Glasheen C, Mahon C and Bishopstown E, numbers increased with each census (Table 3). In 2016, Glasheen C had a high proportion and a relatively high number of older persons. Table 3: Electoral Districts with the highest proposrtions ofof those Aged 65+ (Source: CSOCSO)) 2006 %65+ 2011 %65+ 2016 %65+ Fair Hill B 31.9% Fair Hill B 32.2% Fair Hill B 31.5% Togher B 30.7% Togher B 29.0% Bishopstown D 29.1% Turners Cross D 29.5% TramTramoreore A 28.7% Glasheen C 27.7% Tramore A 28.6% Glasheen C 27.9% Montenotte B 27.1% Browningstown 25.0% TurneTurnerrrrss Cross D 26.8% Bishopstown C 26.4% Source: Census 2006 and 2011 [3, 2] 6 While this increase in longevity is something to be celebrated, an ageing population also brings great challenges. A recent national survey of older people highlighted that 21.3% of older people living in Cork City have had an experience that left them concerned about their personal safety [5] As a result of this national survey and to facilitate healthy, safe and positive ageing, the Cork Age Friendly Alliance requested that Cork Healthy Cities would lead an inter-agency partnership to explore perceptions of safety amongst older people living in Cork and to develop an action plan to address the key issues. The SAFE Project steering group was established with this purpose and began by engaging with University College Cork to conduct a scoping study to explore the issue further. Study Aim To explore older people’s perceptions of safety in Cork City and surrounding areas and establish an evidence base for solutions aimed at addressing any evident safety issues and concerns. This study had three main research questions: 1. Do older people in Cork city feel safe? 2. What are the concerns of older people regarding safety, security and comfort*? 3. What can be done to make Cork city a safer place to live? *Comfort denotes subjective feelings associated with the issues of safety and security, and not restricted to objective issues of safety and security. The research team felt it was important to explore issues that were subjective to the participants, allowing for a more rounded discussion of the issues explored in this scoping study. 7 METHODS The research group conducted a qualitative study to explore older people’s perceptions of safety in Cork City and surrounding areas and establish an evidence base for solutions aimed at addressing any evident safety issues and concerns. To do this we conducted semi-structured interviews and focus groups. Semi-structured means that we used a topic guide to guide the discussions but we were flexible to exploring new perspectives as they came up during the discussions. The topic guide was initially developed based on existing research in the area and then further changed and refined by all project partners (to view the topic guide see Appendix). Data collection Interviews:::: We conducted two interviews with Friendly Call Cork volunteers (4 participants in total). Friendly Call Cork is a free service providing a phone call 5 days a week which is available to older people or individuals who may feel lonely, isolated and vulnerable in Cork city and surrounding areas. Interviews with Friendly Call Cork volunteers took place at the Cork City Partnership offices in Churchfield Cork. Focus groups: We conducted four focus groups with people aged 65 and over living in Cork city and surrounding areas ( 40+ participants in total). These focus groups took place with at Nano Nagle Place (11 participants), Mahon Community centre (4 participants), Turners Cross Day Centre (5 participants) and NICHE Community Health Project (20+ Participants). All interviews and focus groups were co-ordinated and facilitated by experienced UCC researchers. Written consent was obtained from all participants prior to taking part. All interviews and focus groups were audio-recorded with the permission of the participants. The interviews and focus groups were transcribed, and formed the basis of the results and discussion sections of this report. 8 Participants Friendly Call volunteers were recruited through the Friendly Call development worker Brenda Barry. Brenda Barry is a member of the SAFE project steering group. Focus group participants were geographically and socially diverse. They were recruited through the Friendly Call Cork service and a wide variety of local community initiatives and groups in the relevant areas. These include but are not limited to the Lantern Project, local residents associations, local day centres run by the Health Service Executive (HSE) and community health initiatives. Every effort was made to recruit widely, and therefore capture data that was representative of all of Cork City. Data analysis All audio recordings were transcribed verbatim. Two UCC researchers (TJ & K) conducted the data analysis with input from an experienced qualitative researcher (CS). Data were managed using Nvivo software. Each UCC researcher coded the interviews separately (to reduce bias) and identified themes and subthemes. Both researchers discussed their findings before deciding on the final version of results.