Vulnerability and environmental stress of older adultsFrans Thissen

Department of Geography, Planning and International Development Studies

Outline presentation

� Introduction

� Concepts

� Data and methods

� Results: the cumulative character of vulnerability (a demanding environment)

� Possibilities of (in)formal care (a supportive environment)

� Conclusions

Vulnerability and environmental stress of

older adults

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Vulnerability and environmental stress of

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Introduction � “WHEN I'M SIXTY-FOUR”When I get older losing my hair,

Many years from now

Will you still be sending me the Valentine,

Birthday greetings, bottle of wine

Paul McCartney (1967)

� THE EXPERIENCE OF BEING OLD

(Young) Adults have not ‘been there’.

‘Being old’ creates the potential of empathy,

recognition, sharing and understanding.

Chris Pilo (2003), however about the study of youth.

� GROWING OLD: LOSS� Loss of health (biological)

� Loss of social roles (social-cultural)

� Loss of social capital (functional social

resources) Theo van Tilburg (2005)

Our research about older people

� Older people in villages� Zeeland, Drenthe, Gelderland (1995 &

2009), Noord-Holland

� Old People in Europe’s Rural Areas (OPERA)� Clare Wenger: types of social support

networks

� European study of Adult Well-being (ESAW)� Clare Wenger, Thomas Scharf, Vanessa

Burholt

� PhD Marieke van der Meer

� Multiple disadvantage of older immigrants and non-migrants in deprived neighbourhoods in Amsterdam (Musterd)

� PhD Sabine van der Greft

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Concepts

� Vulnerability

� Neighbourhood (deprivation)

� Environmental stress

� Environmental docility hypothesis

Literature: Meer, M. van der, J. Droogleever Fortuijn & F. Thissen (2008), Vulnerability and

environmental stress of older adults in deprived neighbourhoods in The

Netherlands. Tijdschrift voor Economische en Sociale Geografie, Vol 99, 1, p. 53-

64.

Droogleever Fortuijn, J.C., M.J. van der Meer & F. Thissen (2006). Kwetsbare ouderen

en de kwaliteit van de buurt. Rooilijn, 39 (5): 245-250.

Meer, M. Van der (2006), Older adults and their socio-spatial integration in the

Netherlands, Netherlands Geographical Studies 345, KNAG / UvA, Utrecht /

Amsterdam, Chapter 6Vulnerability and environmental stress of

older adults

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Vulnerability (1)� Definition: “aggregate of all

factors that negatively affect

independent functioning in daily

life”

� Multidimensional concept with

cumulative effects

� Balance between burden vs.

bearing capacity (Deeg)

� Views on vulnerability / frailty

(SCP)

� Result of irreversible

developments (health, social

networks) Vulnerability and environmental stress of

older adults

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Vulnerability (2) Dimensions:

� Individual: personal functional

dependency� Personal health status� Behavioural consequences� (Instrumental) activities of daily

living: (I)ADL, measures of independent functioning

� Household: resources� Presence of other people� Adequacy of household income

� Environmental context

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Neighbourhood (deprivation) (1)

Work of environmental psychology

(Lawton) and environmental

gerontology (Phillipson, Scharf)

Environment:

� Demanding vs. supportive

character of the environment

� Changing character of the (local)

community (Phillipson)�‘Elected’ and ‘Excluded’

� Person-environment fit (Keaton)

� Older people as active agents

� Temporal dimension: place

connectivity (Burholt)Vulnerability and environmental stress of

older adults

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Neighbourhood (deprivation) (2)

� Neighbourhood deprivation:

multidimensional concept

(Musterd) 1. Low income2. Non-participation and non-integration

(social security payments)� Relevant characteristics for social

mobility of (young) adults

� Neighbourhood deprivation

dimensions for older people� Housing and care: quality public

domain and access to services� Self reliance

� Wellbeing (social climate)� Belonging and identity

Vulnerability and environmental stress of

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Environmental stress

� Definition: “process in which

people experience emotional

distress in relationship to

environmental exposures”

(Baum et al 1982; Dupéré &

Perkins 2007)

� ‘Being out of place’ (Rowles &

Walkins, 2007)

� Measuring environmental

stress1. Dissatisfaction with the

neighbourhood2. Feelings of safety

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older adults

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Environmental docility hypothesis (Lawton 1982)

� “the less competent the individual, the greater is the impact

of environmental factors on that individual”

� Older adults without functional limitations and with

adequate household resources are able to live satisfying

lives in a variety of not only favourable, but also

unfavourable environments.

� Frail older adults with few resources are hypothesised to

experience high levels of environmental stress in terms of

neighbourhood dissatisfaction and feelings of unsafety in

deprived neighbourhoods, while feeling satisfied and safe

in non-deprived neighbourhoods.

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older adults

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Data and methods

� Dutch ESAW dataset 2002-2003, structured face-to-face

interview with 1939 older people (50-90 years, non-

institutional)

� Stratified random sample (12 geographical strata)

� Three regions: central, peri-urban, peripheral

� Urban / rural

� Deprived / non-deprived

� Sample proportionate to national distribution of eight age /

gender groups

� Response rate 43 percent

� Descriptive analyses and logistic regression analyses

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Older adults in The Netherlands

Deprived neighbourhood

� 36 % functional dependent

� 45 % low income

� 28 % lives alone

� 30 % Lives whole life in current settlement

� Access to dwelling by stairs: 14 %

Non-deprived neighbourhood

� 25 % functional dependent

� 22 % low income

� 24 % lives alone

� 18 % lives whole life in current settlement

� Access to dwelling by stairs 9 %

Vulnerability and environmental stress of

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Source: Esaw-NL 2002-2003

Cumulative character of vulnerability (1)

14Vulnerability and environmental stress of

older adults

Source: Esaw-NL 2002-2003

15Vulnerability and environmental stress of

older adults

Cumulative character of vulnerability (2)

Source: Esaw-NL 2002-2003

Possibilities of (in)formal care (a supportive environment)

Dependent older people in

deprived neighbourhoods

receiving informal care

experience less

environmental stress than

older people receiving

formal care

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Conclusions

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older adults

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� Most older people:self reliant, feel at home, active agents

� Vulnerable people are more likely to experience negative

effects from environmental deprivation� Risks of socialisation of care

� Accumulation of personal, household and environmental

vulnerability results in environmental stress (cumulative

character of vulnerability)� The importance of the quality of the neighbourhood

� Further research:1. More / Other characteristics of neighbourhoods and older people2. Qualitative studies about the experience of the process of

neighbourhood transitions (urban and rural)3. Person-environment fit of older people in different settings

Vulnerability and environmental stress of older adultsFrans Thissen

Department of Geography, Planning and International Development Studies