INPES April 2010 Healthy Ageing in Scotland

1. INPES April 2010Healthy Ageing in Scotland Gary Wilson Employee Director

2. Presentation Outline • Scotland’s Population • Issues affecting older people’s health • Policy Context in Scotland • NHS Health Scotland’s Health in Later Life Programme

3. Scotland 2031

4. Care group of service users adults

5. Older people and diversity Gender • In June 2007, there were 354,174 men over State Pension Age (SPA) in Scotland, compared with 646,483 women over State Pension Age (SPA) in the same year in Scotland. • In 2007, there were over three times as many women as men aged over 90 in Scotland. By 2031 that will drop to below one in two. Minority Ethnic Older People • A total of 9,984 people aged 50 and over are from the Indian, Pakistani, Bangladeshi, other South Asian, Chinese, Caribbean, African, and other minority ethnic communities. Of these, 2,464 are aged 60-74, 787 are aged 75 and over, and 200 are aged 85 and over. • Minority ethnic groups (non-white) made up 2 per cent of Scotland’s population in 2001.

6. Diversity in Scotland continued Older people in LGBT communities (Lesbian, Gay, Bisexual and Transgender) There are no available statistics on sexual orientation or gender identity as data from the Census 2001 did not include a specific question. The UK Government does however estimate that LGBT people account for 6 per cent of the total population. According to UK Government’s estimates this means that approximately 110,000 people in Scotland aged 50 and over are LGBT. Older People with Disabilities 13 per cent of people aged 70 years and over in Scotland have both a long-term illness and disability compared to 2 per cent of 30-39 year olds. Men in the UK can expect to live their last 6.8 years with a disability. For women, the average is 9.1 years.

7. General health of older people in Scotland • The proportion of people with both a long-term illness and a disability increases with age. • Many older people in Scotland still consider themselves to be in good health even if they have a long-term illness which restricts their daily lives. • Healthy life expectancy is increasing. A female born in Scotland in 2000 could expect to live for 78.8 years. 57.5 (73 per cent) of these years could be expected to be lived free from limiting long-term illness, and 67.2 (85 per cent) of these years could be expected to be spent in good or fairly good general health. • Older men aged 65 to 74 in Scotland were more likely to rate their health as ‘very bad’ or ‘bad’ (16 per cent) than younger age groups • 51 per cent of Scottish women aged 75 years and over are slightly less likely than their male counterparts (56 per cent) to rate their health as ‘very good’ or ‘good’. • In Scotland around one sixth of 16 to 24 year olds years report at least one long-standing illness compared to two thirds of the 75 years and over age group.

8. Mental health • I in 10 people aged 60 to 74 in owner-occupier households in the UK had a common mental disorder (such as anxiety, depression and phobias). • Women aged 60-74 were more likely than men in the UK to have a common mental disorder (12 per cent of women compared with 8 per cent of men). • In the UK, depression affects 13-15 per cent of people over 65 living in the community, and 40 per cent of older people in care homes. • 1 in 3 people over 65 in the UK will die with dementia. • In 2007 there were estimated to be approximately 700,000 people with dementia in the UK. By 2051, it is projected to exceed 1.7 million. • Dementia in the UK affects 1 person in 5 over 80, 1 in 4 over the age of 85 and 1 in 3 people over 90. Further Information and Resources “Promoting Mental Health and Wellbeing in Later Life: The UK Inquiry into Mental Health and Wellbeing in Later Life”, Age Concern and the Mental Health Foundation, 2006

9. Access to NHS services, screening and falls • Women aged over 70 are not invited for routine breast cancer screening, despite the higher risk of cancer in older women. • Three quarters of NHS patients are aged 65 and over but they receive only two fifths of the total expenditure. Falls at Home • Falls are common events in the lives of older people in the UK and can result in a range of adverse outcomes, from minor bruises to fractures, disability, dependence and death. • Approximately one quarter of falls result in physical injury and incur high costs in terms of quality of life. • 2.5 million older people across the UK say that they have fallen over on a street pavement at some point during their lifetime. • 2,300 people, aged over 65, fall outside their home every day in the UK.

10. Employment and older people • There are 72,000 people in Scotland of state pension age and over,7.7 per cent of whom are still working. • A quarter of men (25 per cent) and 29 per cent of women in Scotland are permanently retired from work. • Between the ages of 50 and 64, there are 803,000 people in employment in Scotland, of these 575,000 (71.7per cent) are in employment – 22.1 per cent work part-time and 13.5 per cent are self-employed. • There are currently 52,000 people, aged 50 to State Pension Age, in Scotland who are currently economically inactive and who would like to work, and 10,000 people of State Pension Age and over 305,000 people aged 50 or over are unemployed in Scotland. Further Information and Resources: “Employment and Older Workers 50+: A Review of Policy and Practice in Scotland”, Wendy Loretto and Phil White, University of Edinburgh. Commissioned by Age Concern Scotland, 2008.

11. Volunteering • There are approximately 13,000 older volunteers in Scotland. • 48 per cent of all volunteering in Scotland is undertaken by those aged 50 and over in Scotland. • 19 per cent of those aged 50 and over in Scotland gave up time to help as an organiser/volunteer in the past 12 months. • 22 per cent of those aged 60-74 and 13 per cent of those aged 75 and over gave up time to volunteer in Scotland in the past 12 months. • In Scotland, 44 per cent of volunteers aged 60-75 and 45 per cent of those aged 75 and over, give at least 5 hours of their time in an average month. • In large urban areas, 17 per cent of 50-59 year olds volunteer compared to 30 per cent of that age group in remote rural areas of Scotland.

12. Engagement and Participation • A study in 2004 on behalf of the Scottish Government called “Involving Older People: Lessons for Community Planning” showed that older people in Scotland contribute to the community planning process via mechanisms such as: older people’s forums; user panels; older people’s assemblies and older persons’ service planning groups. • The study showed that the involvement of older people (particularly people aged 65 and over) included: • Ensuring access to services; • Supporting community inclusion through access to mainstreamed facilities; • Supporting older people to set an agenda; • Undertaking consultation on topics; • 28 per cent of those aged 65 and over in Scotland feel they are involved ‘a great deal’ or ‘a fair amount’ with their community. This is supported by the Joseph Rowntree Foundation report, “Building a Good Life for Older People in Local Communities: The Experience of Time and Place,” which found that older people in the UK are considered to be “central pillars” of active communities.

13. Mobility and transport Access to transport can influence older people’s well-being. • In 2007, 81 per cent of Scottish single pensioner households had up to a 6 minute walk to the nearest bus stop. • Approximately 855,499 national travel cards have been issued to older people aged 60 and over since the scheme was introduced on 1 April 2006 until 1 October 2007. • This represents 77 per cent of the total population of people aged 60 and over in Scotland • In Scotland, 50 per cent of people aged over 70 have a driving licence. • Scottish drivers aged 70 and over are responsible for just 6 per cent of pedestrian deaths compared to male drivers under 30 years who cause 30 per cent of pedestrian deaths. • 78 per cent of households in Scotland, where the head of household was aged between 50 and 59, own a car compared to just over one-third of households where the head of the household was over the age of 75

14. Leisure • In 2007, those aged 60 and over were more likely to have played bowls in the last four weeks than any other age group in Scotland (7 per cent of those aged 60-74 and 5 per cent of those aged 75 and over). • Older people in Scotland are less likely to undertake the minimum recommended amount of physical activity. In 2003 only 23 per cent of men and 16 per cent of women aged 65-74 years were achieving it. • The largest increase in internet use is in the 75 and over age group with only 1 per cent of that age group using the internet in 1999, rising to 9 per cent in 2005.

15. Six priorities for action Improving opportunities removing barriers Intergenerational links Health and Wellbeing Care, support and protection Housing, transport and planning Lifelong learning opportunities Policy Context: All our Futures Planning for a Scotland with an Ageing Population

16. The aim of Health Scotland’s Health in Later Life Programme is to identify and encourage factors which facilitate and promote healthy ageing, and to promote services and policies that can ensure that the population of Scotland has an equitable chance of attaining a healthy old age. Health in Later Life Programme

17. Dissemination of Mental Health and Well Being in Later Life evidence National Steering Group Meeting Dignity and Respect Research Education for Participation courses Disseminating evidence and policy regarding health improvement in later life in Europe Mental Health and Well Being in Later Life work at local level – bringing the evidence into planning Dementia- national priority Contact fiona.borrowman@health.scot.nhs.uk Mental Health and Well-Being in Later Life Programme 2007-2008