1. OLDER ADULTS LIVING ALONE IN THE BIRMINGHAM AREA WITH PROJECTIONS TO 2020 Jill Collins & Carol Holland Aston Research Centre for Healthy Ageing Aston University Birmingham B4 7ET http://www1.aston.ac.uk/archa/ http://www1.aston.ac.uk/archa/ To cite this work, please use the following reference information: Collins, J. & Holland, C. (2013) Older adults living alone in the Birmingham area with projections to 2020. Report prepared for Birmingham Ageing Better, available from http://www1.aston.ac.uk/archa/http://www1.aston.ac.uk/archa/

2. Source : 2011 JSNA data Living Alone – Birmingham This shows the percentage of over 65’s living alone in Birmingham in 2011 (JSNA). Labels were added to wards having high concentrations of pensioners living alone. Note: data was available at middle level super output area (MSOA’s are areas having population 5,000- 15,000) Red areas show where over 39.2% of pensioners live alone. Copyright J. Collins & C. Holland, Aston University

3. Living Alone – Birmingham, West Midlands and England Projections (2014-2020) People aged 65 and over living alone, projected to 2020 The number of people aged 65 and over living alone in Birmingham is predicted to increase by around 3,000 (7.5%) by 2020. However, the proportion of those aged 65 and over living alone stays constant over the years and looks consistent with both West Midlands and National values (i.e. around 37% of all aged 65 and over will continue live alone in future years). (Source: POPPI, Projecting Older People Population Information www.poppi.org.uk) Figures are taken from the General Household Survey, ONS. The General Household Survey is a continuous survey which has been running since 1971, and is based each year on a sample of the general population resident in private households in Great Britain. People aged 65 and over living alone, projected to 2020 2014201620182020 Birmingham53,69154,29755,45856,751 West Midlands376,287389,365404,145420,682 England3,482,5423,607,0693,743,8143,900,285 Population aged 65 and over, projected to 2020 2014201620182020 Birmingham143,800146,300149,400152,600 West Midlands1,032,5001,070,0001,104,9001,139,100 England9,536,4009,911,70010,256,60010,603,000 % 65 and over living alone 2014201620182020 Birmingham37.3%37.1% 37.2% West Midlands36.4% 36.6%36.9% England36.5%36.4%36.5%36.8% Copyright J. Collins & C. Holland, Aston University

4. Living Alone – Birmingham Projections to 2020 by Age and Gender (2014-2020) People aged 65 and over living alone, by age and gender, projected to 2020 Numbers living alone predicted to rise steadily each year (and 5.4% by 2020 for those aged 65-75, 5.8% by 2020 for those aged 75+). As expected the largest group living alone in Birmingham are females, aged 75+. (Source: POPPI, Projecting Older People Population Information www.poppi.org.uk) Figures are taken from the General Household Survey, ONS. The General Household Survey is a continuous survey which has been running since 1971, and is based each year on a sample of the general population resident in private households in Great Britain. Copyright J. Collins & C. Holland, Aston University

5. OLDER ADULTS QUALITY OF LIFE INDICATORS

6. Source : 2011 Census Data – Table LC3205EW - Long-term health problems Activity limiting long-term health problems for OP by SOA/ward This shows the proportion of over 65’s having their activities limited either a little OR a lot by long-term health problems. *Lower level Super Output Area (LSOA) is a geographical area designed for the collection and publication of small area statistics. More info at http://www.ons.gov.uk/ons/guide-method/geography/beginner-s-guide/census/super-output-areas--soas-/index.html http://www.ons.gov.uk/ons/guide-method/geography/beginner-s-guide/census/super-output-areas--soas-/index.html Wards with highest proportions severely limited people by Lower Level Super Output area (LSOA) are labelled. Across Birmingham, on average 60.6% of 65+ have their activities limited a little/lot by long term health problems. Copyright J. Collins & C. Holland, Aston University

7. LLTI– Birmingham, West Midlands and England Projections (2014-2020) People aged 65 and over having limiting long-term illness, projected to 2020 The number of people aged 65 and over having a LLTI in Birmingham is predicted to increase by almost 5,000 (6.4%) by 2020. Also, note the proportion of those aged 65+ in Birmingham with LLTI is higher than both the West Midlands and National value at 52.8%. (Source: POPPI, Projecting Older People Population Information www.poppi.org.uk) Base figures are taken from Office for National Statistics (ONS) 2001 Census, Standard Tables People aged 65 and over having a LLTI, projected to 2020 2014201620182020 Birmingham75,91977,18978,88780,769 West Midlands508,651527,447546,483566,351 England4,460,0054,634,4044,807,3454,991,958 Population aged 65 and over, projected to 2020 2014201620182020 Birmingham143,800146,300149,400152,600 West Midlands1,032,5001,070,0001,104,9001,139,100 England9,536,4009,911,70010,256,60010,603,000 % 65 and over with LLTI 2014201620182020 Birmingham52.8% 52.9% West Midlands49.3% 49.5%49.7% England46.8% 46.9%47.1% Copyright J. Collins & C. Holland, Aston University

8. NI 138 - Satisfaction of people over 65 with both home and neighbourhood (2008/09) Source: Place Survey http://www.communities.gov.uk/publications/localgovernment/placesurveymanual0809 Measure satisfaction of how older people live their lives at the local level. Older people were asked 2 questions: How satisfied are you with your home? How satisfied are you with this area as a place to live? The indicator is the percentage of people aged 65 and over who respond that they are fairly satisfied or very satisfied with both their home and the area. NB ‘Area’ is not defined; it is a subjective assessment, which will vary legitimately depending on what area respondents regard as relevant. Copyright J. Collins & C. Holland, Aston University

9. Crimes against Older People (2010/11) Source:2010-2011 Group and Area Crimes against the older person Prosecutions http://data.gov.uk/dataset/cps-hate-crime-and-crimes-against-older-people-report-2010-2011-underlying- data/resource/c4d27761-0250-464f-8cba-99906e8c639a 2010-2011 Crimes against the older person are shown for police areas in England and Wales (note: West Midlands has 2 nd highest number after London). For the West Midlands the successful/unsuccessful convictions rates for these prosecutions was 82.65%/17.35%. This was slightly better than the average value for all England/Wales (80.05%/19.05%). Copyright J. Collins & C. Holland, Aston University

10. INDEX OF DEPRIVATION AFFECTING OLDER PEOPLE (IDAOP)

11. Income Deprivation Affection Older People (IDAOP 2010) Income Deprivation Affecting Older People is a sub-domain of the income deprivation domain that covers adults aged 60 or over living in income deprived households (i.e. the proportion of households where someone in the family is claiming Income Support or income based Jobseeker’s Allowance or Pension Credit [Guaranteed element]). Source : Income Deprivation Affecting Older People Index (www.data.gov.uk)www.data.gov.uk The map (right) shows the proportion of 60+ households in income deprivation at LA level in England in 2010. Birmingham, along with its nearest Geographical neighbours Walsall, Sandwell, Dudley and Wolverhampton exhibit some of the highest rates of IDAOP in England, with around 33% of over 60’s living in income deprivation (on average across the LA). Copyright J. Collins & C. Holland, Aston University

12. Income Deprivation Affection Older People (IDAOP 2010) – Birmingham Drill Down Source : Income Deprivation Affecting Older People Index (www.data.gov.uk)www.data.gov.uk *Lower level Super Output Area (LSOA) is a geographical area designed for the collection and publication of small area statistics. http://www.ons.gov.uk/ons/guide-method/geography/beginner-s-guide/census/super-output-areas--soas-/index.html http://www.ons.gov.uk/ons/guide-method/geography/beginner-s-guide/census/super-output-areas--soas-/index.html Isolating Birmingham in the map and drilling-down to LSOA level(*), we see that the majority of highly deprived areas are the smaller more densely populated urban SOA’s. Note: some of the most deprived SOA’s have up to 96.1% of over 60’s living in income deprivation. This map is repeated on the following slide with 2011 census ward boundaries shown. Copyright J. Collins & C. Holland, Aston University

13. Income Deprivation Affection Older People (IDAOP 2010) – Deprived Birmingham Wards Source : Income Deprivation Affecting Older People Index (www.data.gov.uk)www.data.gov.uk The most deprived wards for older people are highlighted and labelled in the map. The IDAOP score for each LSOA was average across wards, the 10 most deprived wards (2011 census wards) are shown in the table. Ward Name Mean IDAOP Lozells and East Handsworth0.70294 Sparkbrook0.68895 Washwood Heath0.624 Soho0.61 Bordesley Green0.51474 Nechells0.48211 South Yardley0.41833 Aston0.408 Kingstanding0.40588 Springfield0.40133 Copyright J. Collins & C. Holland, Aston University

14. Income Deprivation Affection Older People (IDAOP 2010) – Deprived Birmingham LSOA’s Source : Income Deprivation Affecting Older People Index (www.data.gov.uk)www.data.gov.uk LSOA’s in Birmingham were selected having more than 75% of OP living in deprivation. See YELLOW areas in map. There were 44 LSOA’s in total. More than 75% OP in deprivation Copyright J. Collins & C. Holland, Aston University

15. Proportion of People Aged 60+ (2011 Census) with IDAOP Overlay Source : 2011 Census Data – Age Structure – Table KS102EW (www.nomisweb.co.uk/)www.nomisweb.co.uk/ Income Deprivation Affecting Older People Index (www.data.gov.uk)www.data.gov.uk The map below shows the % of the population in Birmingham aged 60+ by LSOA using dot density on a background thematic map of IDAOP (2010). Deprived areas with high 60+ population are labelled. Copyright J. Collins & C. Holland, Aston University

16. Number of People Aged 60+ (2011 Census) with IDAOP and LLTI Overlay Here the deprivation thematic map has dot density added indicating %60+ living with LLTI. Also, LSOA’s bounded in purple indicate a high number of 60+ in the population (>300). A few postcode sectors have been labelled which demonstrate High number of 60+ High prop living with LLTI High deprivation scores Copyright J. Collins & C. Holland, Aston University

17. OLDER ADULTS POPULATION

18. Proportion of People Aged 60+ (2011 Census) – Birmingham LSOA’s Source : 2011 Census Data – Age Structure – Table KS102EW (www.nomisweb.co.uk/) The map below shows the % of the population in Birmingham aged 60+ by LSOA. Notice, the areas which previously showed the highest levels of deprivation for OP actually have relatively low proportions of OP living there (shown by mostly grey <17%, exception is an LSOA in Handsworth Wood). So could these less affluent OP also feel more isolated living in a younger community? Large red areas are seen towards North Birmingham, i.e. Sutton Coldfield, where the population is generally older.

19. Numbers of People Aged 60+ and 85+ (2011 Census) – Birmingham LSOA’s Source : 2011 Census Data – Age Structure – Table KS102EW (www.nomisweb.co.uk/) The map below shows the numbers the population in Birmingham aged 60+ (left) and aged 85+ (right) by LSOA. More than 500 people aged 60+ More than 50 people aged 85+ Sutton Coldfield wards have a high numbers of older people – particularly the oldest old. As expected there are not many 85+ living in central areas. Copyright J. Collins & C. Holland, Aston University

20. OLDER ADULTS ETHNICITY AND ENGLISH FLUENCY

21. BirminghamWest MidlandsEngland Ethnicity People aged 65- 74 People aged 75-84 People aged 85+ People aged 65- 74 People aged 75- 84 People aged 85+ People aged 65- 74 People aged 75- 84 People aged 85+ White (this includes British, Irish and Other White) 82.33%85.96%93.21%93.95%95.12%97.38%94.66%96.37%98.17% Mixed Ethnicity (this includes White and Black Caribbean; White and Black African; White and Asian; and Other Mixed) 0.41%0.37%0.22%0.19%0.14%0.13%0.31%0.23%0.17% Asian or Asian British (this includes Indian; Pakistani; Bangladeshi; and Other Asian or Asian British) 10.37%7.62%4.04%3.70%2.82%1.53%2.83%1.85%0.87% Black or Black British (this includes Black Caribbean; Black African; and Other Black or Black British) 6.13%5.52%2.23%1.80%1.65%0.73%1.61%1.16%0.50% Chinese or Other Ethnic Group 0.77%0.53%0.30%0.31%0.19%0.09%0.54%0.29%0.13% Ethnicity of Older People in Birmingham, West Midlands and England (2009) Source: ONS Table PEEGC309: LAD 2009 Single Year of Age by Ethnic Group, mid-2009. This table is a commissioned table from the Population Estimates by Ethnic Group (Release 8.0), ONS. The wording used for ethnic groupings are as used by ONS. Birmingham has a much higher proportion of non-white Older People than either the West Midlands or England. This is true across all age groups. In 2009, there were 20,232 non- white Older People living in Birmingham. Copyright J. Collins & C. Holland, Aston University

22. Source : 2011 Census Data – Table LC2105EW - Proficiency in English by age (www.nomisweb.co.uk/) It is worth noting here that OP with little/no English may have been less likely to take part in the Census, so this data may not reflect true numbers. Proficiency in English by Age The map below shows the number of people aged 65+ in each Birmingham LSOA that either… cannot speak English or cannot speak English well Copyright J. Collins & C. Holland, Aston University

23. JSNA HEALTH INDICATORS

24. People aged 65 and over unable to manage at least one mobility activity on their own, by age and gender (2014 values) Activities include: going out of doors and walking As for the living alone data, the worst affected group in Birmingham are females aged 85+. Mobility (JSNA) Source: JSNA Figures are taken from Living in Britain Survey (2001), table 29. The prevalence rates have been applied to ONS population projections of the 65 and over population to give estimated numbers. Copyright J. Collins & C. Holland, Aston University

25. People aged 65 and over predicted to have depression, by age and gender (2014 values) Highest numbers are observed amongst younger groups, as expected more females than males are observed. Depression (JSNA) Source: JSNA Figures are taken from McDougall et al, Prevalence of depression in older people in England and Wales: the MRC CFA Study in Psychological Medicine, 2007, 37, 1787- 1795. Copyright J. Collins & C. Holland, Aston University

26. People registered blind in Birmingham, West Mids and England by age group are shown below. For Birmingham 76.1% of those registered blind are aged 65+ (West Mids, National rates were 73.1% and 73.9% respectively). With respect to partially sight, 77.9% were 65+ in Birmingham (75.8% and 75.4% for West Mids and England). Sight (JSNA) Source: JSNA Figures are from TABLE B1 : Number of Blind people registered with councils by age group, at March 2008 And TABLE PS1 : TABLE PS1 : Number of Partially sighted people registered with councils by age group, at March 2008 Copyright J. Collins & C. Holland, Aston University

27. Three Simple Indicators for Loneliness

28. All data available (at small geography )was aggregated up to ward level using Birmingham’s 40 2011 Census ward areas. Where required %’s were converted to proportions, to ensure all values were in the range [0-1]. Proportion of 65+ Living Alone Proportion of 60+ Living in Income Deprivation (IDAOPI) Proportion 65+ with Day-to-day activities limited a little OR a lot by long-term health problems Proportion 65+ with little/no English + + + Indicator 1: Simply SUMS’s the 4 indicators below This indicator assumes that each component has equal weight and importance in terms of contributing to an OP’s loneliness. There were 11 wards in with indicator value>1.5 (see next). Copyright J. Collins & C. Holland, Aston University

29. Indicator 1: 11 worst wards (Indicator value>1.5). Wards ranked from worst @ top Ward Loneliness Indicator #1 Prop of 65+ Living Alone IDAOP 2010 Prop 65+ with Day- to-day activities limited a little OR a lot Prop 65+ with little/no English Sparkbrook2.0831610.293750.688950.719240.381221 Washwood Heath2.042110.31450.6240.719570.38404 Lozells and East Handsworth2.0187820.28550.702940.703360.326982 Soho1.849870.30750.610.68580.24657 Aston1.816750.4486670.4080.69640.263684 Bordesley Green1.7305430.2340.514740.694420.287383 Nechells1.6930610.3570.482110.66320.190751 Springfield1.5328260.2120.401330.64390.275596 Shard End1.508730.41750.400590.686740.0039 Kingstanding1.501920.4150.405880.670620.01042 Handsworth Wood1.5007440.2886670.370560.643480.198037 Copyright J. Collins & C. Holland, Aston University

30. Indicator 2: Simply SUMS’s the 4 indicators below and add effect of ‘young’ area Indicator 2 tries to represent the added isolation that OP may feel if they live in an area with much fewer 60+ residents than average (<3,500, as opposed to B’Ham average 4,616) Note: New areas of interest here – SELLY OAK and LADYWOOD. See table next slide. Add 0.5 if the ward has a low number of OP resident (<3500) Proportion of 65+ Living Alone Proportion of 60+ Living in Income Deprivation (IDAOPI) Proportion 65+ with Day-to-day activities limited a little OR a lot by long-term health problems Proportion 65+ with little/no English + + + + Copyright J. Collins & C. Holland, Aston University

31. Indicator 2: 13 worst wards (Indicator value>1.5). Wards ranked from worst @ top Ward Loneliness Indicator #2 Prop of 65+ Living Alone IDAOP 2010 Prop 65+ with Day- to-day activities limited a little OR a lot Prop 65+ with little/no English Washwood Heath2.542110.31450.6240.719570.38404 Lozells and East Handsworth2.5187820.28550.702940.703360.326982 Soho2.349870.30750.610.68580.24657 Aston2.316750.4486670.4080.69640.263684 Nechells2.1930610.3570.482110.66320.190751 Sparkbrook2.0831610.293750.688950.719240.381221 Ladywood1.7310260.4950.122860.530060.083106 Bordesley Green1.7305430.2340.514740.694420.287383 Selly Oak1.6597760.34050.208460.58810.022716 Springfield1.5328260.2120.401330.64390.275596 Shard End1.508730.41750.400590.686740.0039 Kingstanding1.501920.4150.405880.670620.01042 Handsworth Wood1.5007440.2886670.370560.643480.198037 Copyright J. Collins & C. Holland, Aston University

32. Indicator 3: Simply SUMS’s the 4 indicators below and add effect of ‘Oldest’ OP Indicator 3 boosts the effect of the ‘oldest’ OP (i.e. those aged 85+). These residents are likely to be the most infirm and isolated. This indicator produces a different set of ‘worst’ wards incl Tyburn and Erdington. See the table (next slide). Add 0.5 if the ward has a high % of ‘Oldest’ OP resident (>15% over 85) Proportion of 65+ Living Alone Proportion of 60+ Living in Income Deprivation (IDAOPI) Proportion 65+ with Day-to-day activities limited a little OR a lot by long-term health problems Proportion 65+ with little/no English + + + + Copyright J. Collins & C. Holland, Aston University

33. Indicator 3: 10 worst wards (Indicator value>1.74). Wards ranked from worst @ top Ward Loneliness Indicator #3 Prop of 65+ Living Alone IDAOP 2010 Prop 65+ with Day- to-day activities limited a little OR a lot Prop 65+ with little/no English Sparkbrook2.0831610.293750.688950.719240.381221 Washwood Heath2.042110.31450.6240.719570.38404 Lozells and East Handsworth2.0187820.28550.702940.703360.326982 Tyburn1.8815320.3633330.3480.657570.012629 Soho1.849870.30750.610.68580.24657 Aston1.816750.4486670.4080.69640.263684 Billesley1.8134570.34860.311180.631310.022367 Erdington1.8081860.45250.245830.600890.008966 Brandwood1.7611910.3670.285330.593820.015041 Kings Norton1.7441070.3503330.290.600640.003134 Copyright J. Collins & C. Holland, Aston University