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
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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
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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
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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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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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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 %
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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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� 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