Purpose
Toi Hau Tāngata The Social Wellbeing Agency (SWA) has worked in partnership with Te Manatū Whakahiato Ora Ministry of Social Development (MSD) and Manatū Hauora Ministry of Health (MoH) to build an evidence base on the needs of older people aged 65 or older across five life domains. This report uses the Integrated Data Infrastructure (IDI) to estimate and characterise the needs of older people in health, housing, finance, social connection, and accessibility. This report supports commitments by MSD and MoH under the Better Later Life Strategy Action Plan 2021 – 2024 - He Mahere Hohenga.
This study measures the needs of older people in multiple life domains using the Integrated Data Infrastructure (IDI). It addresses an important knowledge gap on experiences of older New Zealanders across these domains. Through this work, we have established a more nuanced understanding of the experiences of older New Zealanders who are often characterised as a homogenous group that experiences better outcomes than the rest of the population.
This work provides an overview of need, including the size and the characteristics of older people experiencing vulnerability. It provides insights into where the overlapping vulnerabilities (or multiple disadvantages) across domains are most prevalent; and where the most acute need may lie.
Our objective was to create a preliminary evidence base using the IDI that measures and characterises older people’s experiences of vulnerability and multiple disadvantage, with the ultimate aim of ensuring that services for this group are fit for purpose.
Methodology
This analysis focussed on estimating and characterising older people’s experiences of vulnerability. We were particularly interested in understanding people’s experiences of vulnerability across multiple domains, as this helps us identify overlapping and more complex needs. We defined an experience of overlapping vulnerabilities or vulnerability in two or more domains as multiple disadvantage.
We use the terms ‘vulnerability’ and ‘multiple disadvantage’ as they help capture the complexity and unique nature of older people’s needs. While these terms are deficit focussed, our aim is to create an evidence base that will help policy makers asses where the greatest and most complex needs lie. This approach helps us consider the types of circumstances a person might be experiencing that point towards the risk of poor life outcomes. We do not consider vulnerability as a definitive state but rather as an experience. Further, understanding risk factors a person might be vulnerable to (and using our data to determine the size of the need), also helps us understand resilience factors. While we identify older people’s experiences of vulnerability, the Better Later Life (BLL) Strategy identifies features ofresilience for older people in each of the domains (Office for Seniors, 2021).
Our approach was further tested with an Expert Advisory Group for this project which MSD brought together for the purpose of advising on the direction and delivery of this project. This group is made up of sector experts who confirmed that a focus on multiple disadvantage would best capture the complex spectrum of older people’s needs.
We used the Integrated Data Infrastructure (IDI) as our data source for this project. The IDI is a large research database that collects individual level data about people and households. It includes administrative data about education, income, benefits, migration, justice, and health and comes from government agencies, Stats NZ surveys, and non-government organisations (NGOs). The data is integrated at an individual level and de-identified so personally identifying information has been removed (name, day of birth, address). We overlayed the domain data with people characteristics including age, sex, ethnicity, and region.
We developed a set of indicators within the IDI to measure vulnerability aligned with key domains of the BLL Strategy. The indicators were developed as quantitative metrics to measure hardship associated with the MSD and MoH actions of the BLL Strategy.
Key Results
Fifty-four percent of older people are healthy, have liveable housing, are financially secure, and have good social connections and access based on our measures. However, at least 33 percent experience vulnerability and 13 percent experience multiple disadvantage i.e., vulnerability across two or more domains. In this group, we found a complex spectrum of need, including groups of older people experiencing multiple mental health conditions paired with compounding housing and financial vulnerability.
Our findings of varied experiences of vulnerability for older people are consistent with the inequitable experiences and outcomes of Māori and Pacific peoples across the life course. We also know that Māori and Pacific peoples have different life expectancy. The average life expectancy for men of Māori and Pacific ethnicities is 73.4 and 79 years respectively. By contrast, the average life expectancy for men from all other ethnicities is above 80. The data
suggests, therefore, that to improve wellbeing for older adults, there is a need to improve how the system supports outcomes for Māori and Pacific peoples earlier in life.
Older Pacific peoples experience the highest proportions of housing vulnerability compared to all other ethnicities. Asian and MELAA (Middle Eastern, Latin American, and African) older people experience the highest proportions of financial vulnerability. Māori older people experience the highest proportion of health vulnerability and, European older people experience the highest proportion of social connection vulnerability.
Older Pacific peoples, irrespective of sex, were more likely to experience multiple disadvantage at 27 percent compared to all other subgroups we analysed based on sex and ethnicity.
The research was based on the most recent 2018 Census data which includes information on home ownership and other socio-economic variables that are not available elsewhere. These sources do not consider the impacts of the COVID-19 pandemic, the Auckland floods, Cyclone Gabrielle, and the rising cost of living. Hence, the picture of need in this report is likely to be understated.