Older people (health and wellbeing needs in South Tyneside)

• The State of Ageing Report (2022) highlights there are almost 11 million people aged 65 and over, 19% of the total population. In 10 years', time, this will have increased to almost 13 million people or 22% of the population.
• This comprehensive review of national data on ageing makes clear, that a financially secure and healthy later life is becoming increasingly unlikely for millions of people. With the population ageing rapidly, the number of people at risk is growing at an alarming rate. The latest data shows a sharp increase in pensioner poverty, meaning that almost 1 in 5 people were living in poverty in the 2019 / 20 period.
• There has also seen a recent reduction in life expectancy (of 0.3 years for women and 0.4 years for men). Meanwhile, the number of years we can expect to spend in good health, without a disabling illness, continues to decline; this is now 62.4 years for men and 60.9 years for women.
• The geography of older age in the UK is already highly skewed away from large urban areas and will become more so. A large proportion of people migrate away from cities before they reach older age. The result is that metropolitan areas largely maintain their current demographic, ageing only slowly, while some areas, particularly rural, semi-rural and coastal areas in the periphery, age much faster.
• In a period when the state pension age has risen to 66, the employment rates among people approaching retirement age have fallen to their lowest levels since 2016 and the number of older people renting rather than owning their homes has reached an all-time high.
• These factors have major implications for people's financial security and for the quality of their homes as they age. The number of people in mid and later life who live alone - many without the traditional family structures our approach to ageing has historically relied on - has been increasing steadily, with 1.3 million men aged 65 and over living alone today, up 67% between 2000 and 2019.
• This has implications for housing and for health and social care. These trends confirm that England is becoming a more challenging country to grow old in. We can see in our data that the pandemic has, of course, contributed to many of these problems - but they are ultimately longer-term issues that have been developing for some time. And they will not go away as we return to life as it was before COVID without concerted action.

In terms of health

• 9.1 million people in England are projected to be living with major illness by 2040, 2.5 million more than in 2019. This is an increase from almost 1 in 6 to nearly 1 in 5 of the adult population.
• The number of people living with major illness is projected to increase by 37% - over a third - by 2040, nine times the rate at which the working-age population (20 to 69 year olds) is expected to grow (4%).
• National Institute for Health and Care Excellence (NICE) guidelines and medical research are all optimised for single diseases but that is not the lived reality for the great majority of older adults who often transfer very rapidly from having no significant disease states to several simultaneously. The increasing specialisation of the medical profession runs counter to optimising treatment for older citizens and patients. We must address this seriously as a profession.
• Up to four out of ten people over the age of 65 experience mental health problems. Depression is both the most common and most treatable mental illness in old age, affecting one in five older people in the community. This figure doubles in the presence of physical illness and trebles in hospitals and care homes. Nor should we forget that older people also experience severe mental illnesses.

Age Friendly Communities

• In March 2022, South Tyneside agree to work towards becoming a World Health Organization (WHO) Age Friendly Community.
• This approach encourages local authority areas to undertake a baseline assessment, then develop a strategy and action plan against eight key themes.
• Therefore, the key issues in this JSNAA (2023) are being considered through the lens of the eight-age friendly community themes:  

Outdoor Spaces and Public Buildings

• The outside environment and public buildings have a major impact on the mobility, independence, and quality of life of older people and affect their ability to "age in place". The recurring topics internationally are quality of life, access, and safety.

Transport

• Transportation, including accessibility and affordable public transport, is a key factor influencing active ageing. Being able to move about an area (urban, rural and connections) determines social and civic participation and access to community and health services.

Housing

• Housing is essential to safety and well-being. There is a link between appropriate housing and access to community and social services in influencing the independence and quality of life of older people. Housing and support that allow older people to age comfortably and safely within their community are universally valued.
• Yet almost 1 in 5 homes headed by someone aged 60 or older is in a condition that endangers the health of the people who live there.
• The number of people in mid and later life who live alone - many without the traditional family structures our approach to ageing has historically relied on - has been increasing steadily, with 1.3 million men aged 65 and over living alone today, up 67% between 2000 and 2019.
• Almost 9,000 people died in England and Wales last year because their homes were too cold.

Social Participation

• Social participation and social support are strongly connected to good health and well-being throughout life. Participating in leisure, social, cultural, and spiritual activities in the community, as well as with the family, allows older people to continue to exercise their independence, to enjoy respect and esteem.

Respect and Inclusion

• The respect and inclusion of older people can depend on culture, gender, health status and economic status. The extent to which older people participate in social, civic, and economic life of where they live is closely linked to their experience of inclusion.

Civic Participation

• Older people do not stop contributing to their communities on retirement. Many continue to provide unpaid and voluntary work for their families and communities. Age Friendly provides options for older people to continue to contribute to their communities through paid employment or voluntary work, if they so choose, and be engaged in the political process.

Communication and Information

• Staying connected with events and people and getting timely, practical information to manage life and meet personal needs is vital for active aging. Age Friendly communities have relevant information that is readily accessible to older people with varying capacities and resources.

Communities and Health

• Health and support services are essential for maintaining health and independence in the community. Civil society can provide a role in supporting the health of the community. The WHO checklist focuses on the aspects within the scope of Age Friendly.