May 2004 - Ref 564
Black and minority ethnic older people's views on research findings
Consultations with groups of older people from black and minority
ethnic communities found that older people often felt they had been
"researched to death" over the past 15 years. The work by REU
highlighted the need to move beyond traditional research issues and
move into ways about bring change in practice. The study also drew on
a literature review.
The literature review shows that:
- The numbers (and proportions) of older people from black and
minority ethnic communities have risen rapidly, from 60,000 in 1981 to
over 350,000 in 2001. Although the numbers have grown from being quite
small, this is not a new area of research.

- The impact of ageing (in terms of health and support needs) happens
at a comparatively younger age among many minority communities.

- Black and minority ethnic older people are more likely to face a
greater level of poverty, live in poorer quality housing, and have
poorer access to benefits and pensions than 'white' older people.

- Myths about minority ethnic communities need challenging: there is
not necessarily an extended family which "looks after its own".

- Older people from different communities may share experiences of
ageism and racism, but the circumstances of Chinese, Afro-Caribbean or
Asian older people may require different approaches and solutions.

As well as endorsing many of these findings, the consultation
groups raised the following issues:
- Access to majority services for black and minority ethnic older
people remains problematic. Barriers include language issues,
knowledge of what is available, and the attitudes and practices of
service providers.

- Older people felt that community-based voluntary organisations were
more likely to reflect their needs; such organisations are, however,
the least financially secure.

- Older people said that they had been over-researched, with
researchers often asking the same questions (or producing the same
findings) as had been evident 15 years ago. They did not want yet more
research for its own sake. They wanted action that would bring about
change and to be involved in decisions that affected their own lives -
locally and nationally.

Background
The numbers of older people from black and minority ethnic communities
have risen sharply over the past decades - and are projected to
continue to rise. However, service responses to the needs of black
older people have been poor. Often services have either failed to
provide appropriate support within main services or have turned to
community voluntary organisations to provide that support. However,
the funding of community voluntary organisations is precarious at
best. Older people have expressed frustration that the organisations
with the money cannot provide appropriate services, and the
organisations with a better track record in providing services often
do not have the money to exist.
These issues were discussed by older people at the Joseph Rowntree
Foundation's Older People's Steering Group. This group - with members
from a range of majority and minority communities throughout the UK -
defines the scope of the Foundation's Older People's Programme. The
group was clear that the issues of black and minority ethnic older
people were very important among the wider issues of older people more
generally. They felt that it would be important to ask black and
minority ethnic older people themselves about their experiences and
what they felt were the priorities.
The REU undertook a number of consultations with black and minority
ethnic older people in Leeds, Bristol and London. REU staff summarised
the research to date about black older people; presented the findings
to groups of 30 - 40 black older people in each of these
consultations; and discussed the implications for future work.
Consultations included people from different Asian, Afro-Caribbean,
and Chinese groups.
Findings from existing studies
Key findings from existing studies about black and minority ethnic
older people were:
- Both the numbers and proportions of older people from black and
minority ethnic groups within the population are rising and will
continue to rise for the foreseeable future. Numbers are expected to
rise from 60,000 in 1981 to over 350,000 in 2001.
- The census also highlights there are equal numbers of men and
women in this group.
- The impact of ageing (in terms of health and social care needs)
happens at a comparatively younger age within many minority
communities.
- There is evidence that black and minority ethnic older people are
more likely to face a greater level of poverty and have lower incomes
than white older people.
- The numbers of people over 85 from minority communities are also
rising. Although people in this age group are more likely to use
services, there is very little knowledge (or acknowledgement) of the
issues that services need to address.
- Black and minority older people are more likely to live in poorer
quality housing which lacks basic amenities, and this may affect their
health.
- The idea that the extended family will look after their 'elders' may
be a myth and certainly masks the level of true need. Often the
reality is that family networks are spread across continents, not
counties.
- There are common experiences across different communities, but no
single approach will meet the needs of older people from all black and
minority ethnic communities. The circumstances of Chinese older people
may differ from those of Afro-Caribbean older people, for example.
And, as with older people more generally, each person's circumstances
may be different.
The views from the consultation groups
In the consultation groups, older people agreed that these findings
reflected what was known about their own areas and experiences. There
was some frustration that researchers wanted to do yet more research,
rather than making a difference with what was already known. People
said that many researchers were either trying to answer questions that
had been answered years ago, or were looking at research that did not
reflect the lives of older people.
Older people felt there was important work still to be done, but it
was more about applying current research into practice. They
identified a number of key issues.
Mainstream or community services?
There was a great deal of frustration that majority services did not
meet the needs of different minority communities.
Language barriers in services
For some communities language barriers within services caused problems
finding out what services were available or getting services to
respond to the needs of different communities. For example, people
often had problems explaining symptoms of ill health, and felt that
busy GPs did not give sufficient time (or have interpreters in place)
for consulting with patients whose first language wasn't English. As a
result conditions could be misdiagnosed or diagnosis was very late.
Often the problems were about information or advice - locally and
nationally - on what to do or who to approach.
Culture, beliefs and values
Older people felt that majority services often did not meet the needs
of culture and beliefs that are important to different minority
communities. This might range from basics of food to a lack of
knowledge and respect for religious beliefs and practices. Different
communities often have a different view of health and well-being, and
find that their own views of complementary medicine or a holistic
approach to health needs are not seen as being important or relevant.
There were real frustrations here: older people felt that the Western
mindset simply saw communities as "problems" rather than respecting
the fact that different communities had real strengths to be valued.
Who should provide services?
People's experience in different areas had been that the main services
seldom provided what minority communities wanted. Community-based
services were more likely to be accessible and to provide a better
quality service. However, participants disagreed about what should be
done next.
- Some had lost faith in mainstream services and wanted services
from and by their own community voluntary groups. They felt the best
routes to support (and their most positive experiences) had been when
their own community voluntary organisations were adequately funded to
undertake these tasks.
- Others felt that funding community voluntary organisations let the
mainstream services "off the hook". They felt that the main services
should be addressing these issues. They also felt that, when budgets
cuts were on the table, community voluntary services were the first to
lose out.
Money matters
Some older people who had come to the UK during the 1950s and '60s and
had worked in public services said that they had not been properly
advised on the need for pensions. Because of this, they had found
themselves in a poverty trap in later life. Had better advice been
available they may have been able to secure better provision for their
later years.
For some communities poverty was the central issue. Many felt that
it was "their lot" to accept poverty, but did not want their children
or grandchildren to be in the same position. Benefit entitlement was
often poorly understood, not available in appropriate languages, or
there was no one to explain what was available and how they might
apply for it.
Relationships and well-being
Participants felt there were often inappropriate stereotypes about
different communities "looking after their own". In fact, the
discussions in the meetings highlighted that family members were often
more likely to live further away - not closer - than might be true in
Britain as a whole.
There were also issues about changing values between generations.
There could be both a generational gap and a cultural gap between
black and minority ethnic older and younger people. This could leave
older people feeling particularly isolated - often literally, living
alone.
Mental health was also an issue, in particular dementia and
depression. Isolation sometimes led to high levels of depression and
the need for more befriending services. While some participants said
that depression and mental health could be a taboo subject in their
communities, they felt there was a need to discuss these issues - but
not in a way that left people feeling worried or exposed.
Participants also recognised and celebrated the strengths that
could exist in their communities. The networks of support were greatly
valued, and often older people felt that they had important things to
say about a good, balanced, life worth living. However, most of the
time they felt that they were being seen as a problem to be solved
rather than as people with real strengths and wisdom to share.
Common needs for all older people
Participants did also face similar issues to older people more
generally. These included:
- poor access to health care, including having to wait on trolleys
in hospitals. A lack of follow-up from hospital to home was also seen
as a problem;
- sustaining quality of life through preventive measures (healthy
eating, good exercise, a good day out);
- the cost of housing and of living in London and other areas where
housing was expensive;
- pensioner poverty, particularly acute among some minority
communities, but also a concern for many older people;
- housing designed for older people that did not include space for
friends or relatives to stay making it harder to maintain their social
and family lives.
The important message that came from the discussion was that there
was not one specific formula that cut across all groups. Older people
from different minority communities often had specific needs and
specific issues. To emphasise this point some suggested that the idea
of a uniform "majority community" of older people is, itself,
misleading. Older people are different from each other too.
However, it is also important to recognise the need to change
mindsets as much as developing specific services.
Next steps
The consultations with older people from black and minority ethnic
communities have raised a number of issues which are relevant both to
the Foundation's Older People's programme and to the wider situation
nationally.
In particular there is a challenge to move beyond the traditional
research agenda and to develop ideas in practice. At the same time
there is a need to involve older people from black and minority ethnic
communities in bring about this shift. This will require funders,
services and policy-makers to develop their own approaches (in
involving black and minority ethnic older people; in sharing the
setting of agendas; of supporting the development of exemplars of good
practice) to achieve these ends.
About the project
The project was based at the REU (Race Equality Unit). The project
involved 3 key stages:
- An accessible review of research about older people from black
and minority ethnic communities.
- Consultation in three different areas (Leeds, Bristol and London)
with a total of over 100 older people from a range of different
minority communities (African, Bangladeshi, Caribbean, Chinese, Indian
and Pakistani).
- The setting up of a steering group of older people from different
black and minority ethnic communities to define relevant priorities
and activities for the JRF Older People's Programme.
Alex O'Neil, JRF Principal Research Manager with responsibility for
the Older People's Programme, was also involved in writing the report.
How to get further information
The full report, "Let's move on": Black and minority ethnic older
people's views on research findings by Jabeer Butt and Alex O'Neil, is
published by the Joseph Rowntree Foundation (ISBN 1 85935 175 1, price
£11.95).
Click on the 'order report' icon in
the left margin to order online.
Click on the 'report .pdf' icon in the
left margin to download a pdf of the full report free of charge. (File
size is 0.09MB). |