Ageing in the Community: Thomond Parish Cluster

Main findings of the social study

Background

• Demographic trends … ageing population … – By 2036, 20%, 65 years and over (11% at present)– Increase in “oldest old” (80 years and older)

• Differences in health – Poorer people have shorter lives, experience worse

health and have less access to services than those who are more affluent

What factors affect health?

• Age, gender, education, income …• Neighbourhoods …(parishes)

– Accessible essential services– Community / social facilities and services– Problems …

• Quality of care & health services.. – GPs, hospital, Public Health Nurses

• Sense of community• Friends and family … contact and support

What the research involved

• The Four Parishes• Snap-shot of the

position in 2007• Collecting data

– Population 65 years and over resident

– Data to describe the parishes (the 2006 Census)

• Social survey • Health screening

– St. Camillus’s Hospital • Sampling

– OL Rosary and St. Munchin’s (larger older population)

– Total coverage in Christ the King and Corpus Christi

Numbers, sample size & response rates

  Male Female TotalResponde

nt No.Sample

size (%)

Corpus C* 58 27 47

Christ the K 132 156 288 146 51

OL Rosary 492 668 1160 218 19

St. Munch's 422 585 1007 151 15

           

Corpus Christi - estimate

Population: Parishes & Thomond Cluster

Parish 2002  2006

  Number % of total Number % of total

Corpus Christi 4020 18.3 3674 17.5

Christ the King 3702 16.9 3865 18.4

Our Lady of the Rosary 6136 28.0 5617 26.7

St. Munchin's 8081 36.8 7863 37.4

Thomond Cluster 21939 100.0 21019 100.0

Age profile in older age groupings, 2006 (by parish)

0

10

20

30

40

50

Christ the K OL of the R St. Munchin's Corpus Christi

parish

% o

f pop

ulat

ion

% 50+

% 65+

Essential services very easy or fairly easy to get to by parish

0102030405060708090

100

Services

% o

f p

op

ula

tio

n

Chris t the K

Holy R

St. Munchins

Corpus Ch

Range: +2 very easy, -2 very difficult

Ac c es s ibility of c ommunity / s oc ial fac ililities s c ore by paris h

0

0.5

1

1.5

C hris t the K Holy R S t Munc hins C orpus C hris ti

P a rish

Scor

e - ra

nge -

2 to

+2

Range: +2 very easy, -2 very difficult

Attendanc e at relig ious s ervic es weekly or more often by paris h

020406080

100

C hris t the K Holy R os ary S t. Munc hin's C orpus C hris ti

P a rish

% o

f pop

ulati

on

Not stat. significant by gender

Stat. sig by age, p=0.05

P ray at leas t daily, by paris h

70

75

80

85

90

C hris t the K Holy R os ary S t. Munc hin's C orpus C hris ti

P a rish

% of

popu

lation

Association with gender, statistically significant p=0.000

Main form of trans port by paris h

020406080

100

C hris t the K Holy R os ary S t.Munc hin's

C orpusC hris ti

P a rish

% o

f pop

ulati

on

C ar

P ublic T

Walking / c yc ling

% s tating public trans port is g ood by paris h

020406080

100

C hris t the K Holy R os ary S t. Munc hin's C orpus C hris ti

P a rish

% of

popu

lation

Types / extent of neighbourhood problems by parish

00.5

11.5

22.5

33.5

4

Problems

Scor

es - r

ange

0 to

4

Christ the King

Holy Rosary

St. Munchin's

Corpus Christi

Range: 0=not at all a problem4=a very big problem

Concentration of neighbourhood problems, by parish (average score)

0

0.5

1

1.5

2

Christ the King Holy Rosary St. Munchin's Corpus Christi

Parish

Aver

age s

core

- ran

ge 0-

4

Range: 0=not at all a problem4= a very big problem

Neighbourhood: good or very good place to live, by parish

020406080

100120

Christ the K Holy Rosary St. Munchin's Corpus Christi

Parish

% of

popu

lation

S ens e of belong ing to c ommunity by paris h

0

20

40

60

80

100

C hris t the K Holy R os ary S t. Munc hin's C orpus C hris ti

P a rish

% o

f pop

ulati

on

Involved in voluntary org anis ations , by paris h

0

20

40

60

80

C hris t the K Holy R os ary S t. Munc hin's C orpus C hris ti

P a rish

% o

f pop

ulati

on

Extent of knowing and trusting people in the neighbourhood by parish

0

20

40

60

80

100

Christ the K Holy Rosary St.Munchin's

CorpusChristi

Parish

% o

f pop

ulati

on

Know most

Trust most

Institutional trust scores - various institutions - by parish

-1

-0.5

0

0.5

1

1.5

2

Institutions

Sco

re -

ran

ge -

2 t

o +

2

Christ the K

Holy Rosary

St. Munchin's

CorpusChristi

Range: +2=trust completely-2=not at all

Institutional trust score by parish

0

0.2

0.4

0.6

0.8

1

Christ the K Holy Rosary St. Munchin's Corpus Christi

Parish

Scor

e - r

ange

-2 to

+2

Range: +2=trust completely-2=not at all

Social networks & interaction

• Networks of family, friends & people to turn to in crisis:– Christ the King (Caherdavin), largest average size &

Corpus Christi (Moyross), smallest– No friends and no-one to turn to

• 12% no friends, 1% no-one to turn to St. Munchin’s• 19% no friends & 3% no-one to turn to Corpus Christi

– In touch by meeting & telephone contact (least in Corpus Christi)

• Age affects regularity of interaction

S elf-rated health, by paris h

0

10

20

30

40

50

E xc ellent V good G ood F air P oor

R a ting

% o

f pop

ulati

on C hris t the K

Holy R os ary

S t. Munc hin's

C orpus C hris ti

Age … not statisticallySignificant in oldest age

Average number of GP visits per annum by self-rated health

0

2

4

6

8

10

12

excellent very good good fair poor

Self-rated health

Ann

ual n

umbe

r of

vis

its

(av)

All: 5.34; CthK=5.86; HR=4.64;St.M=5.93; CC=4.85

Health services utilisation

0

10

20

30

40

50

60

HopsIn-

patient

HospOut-

patient

A&E Rehabclinic

Respite Daycentre

PublicH N

HomeHelp

Health services

% o

f p

op

ula

tio

n

Relationship to parish

Health services utilisation: Evidence factors of association

• Health status .. – People in poor health use services to a greater extent

• Parish (social class)– Average annual GP visits – social pattern…– Home help (gradient) – social pattern..– Public health nursing (almost statistically significant)

• Age (increasing)– Hosp. inpatient (Cramer’s V=0.203, p<0.001)– Respite, (Cramer’s V=0.213, p<0.001)– Day centre, (Cramer’s V=0.356, p<0.001)– PHN (Cramer’s V=0.230, p<0.001)– Home help (Cramer’s V=0.329, p<0.001)

Findings

• Age and gender … physical health … – Men better physical health

• Differences by social class & place (parish)– Oldest old (resilient survivors) … many don’t survive

• “Better” neighbourhoods, better services etc. but– OL Rosary .. poor community-based services– Access to essential services .. Better physical health

• Social networks, trust, participation in voluntary associations .. Follow the social pattern– Regular meeting with friends… physical health

• Age, health, social class .. health services utilisation– Community-based services … low level of provision and higher

take-up disadvantaged• Older population … differences … but a lot in common

Recommendations

• Heavier health services utilisation .. .making up for accumulated disadvantages ..

• Conditions of neighbourhood .. good essential services

• Safe and accessible meeting places …

• Maintain contact with friends

• Contact across the social divide

• Engagement .. building up trust

• Trust in institutions