Social inclusion and healthy ageing

Date
Author(s)
Professorial Fellow at the Centre for Public Policy, University of Melbourne and Member of the Advisory Panel on Positive Ageing
Presenter
Professor Brian Howe AO
Location
Sydney

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I would like to acknowledge and thank Margaret Bell AM for inviting me to speak to you today.

The Federal Government established the Advisory Panel on the Economic Potential of ‘Senior’ Australians on 30 March 2011 to ‘examine how Australia can best harness the opportunities that much larger and more active, communities of older Australians bring’.

The principal Ministers initiating the Advisory Panel were the Hon Wayne Swan MP (Deputy Prime Minister and Treasurer) and the Hon Mark Butler MP (Minister for Ageing and now also the Minister Housing and Homelessness). The Ministers’ departments also provided a secretariat to the panel.

The members of the panel were:

  • Everald Compton AM (Chairman): former chair of National Seniors Australia;
  • Professor Gill Lewin: Professor at the Centre for Research on Ageing at the Curtin University of Technology; and
  • Professor Brian Howe AO: Professorial Fellow at the Centre for Public Policy, University of Melbourne;

Professor Simon Biggs (University of Melbourne and Senior Manager of Retirement and Ageing at the Brotherhood of St Laurence) was the Principal Adviser to the Panel.

The terms of reference of our enquiry included:

  • consideration of opportunities inherent in the national broadband network;
  • measures that might be used to combat discrimination;
  • ways of improving work force and community participation through volunteering;
  • measures that might assist in increasing health and wellbeing;
  • increasing the supply of affordable and appropriate housing for older people and creating a stronger commitment to long term planning; and
  • enabling more satisfying lives for older people.

We advertised widely for written and oral submissions responding to our terms of reference.

Our panel visited all Australian states and territories consulting state and territory governments and   a wide range of groups representing older Australians and providing services to older people. In addition, we had the opportunity to hear from many experts on various aspects of the ageing process.

Our Panel published three reports, the first of which was published in August 2011 and followed the theme of the ‘Changing Face of Society”.

Australia has, in recent decades, been changing very rapidly with ageing being one important dimension of what has been multifaceted change affecting almost every aspect of people’s lives. These changes are highlighted by the following statistics:

  • 14 per cent of Australia’s population is 65 and over (up from 8 per cent in 1970);
  • around 23 per cent of Australia’s population will be 65 and over by 2050; and
  • women outnumber men in the older age brackets, 51 per cent of those aged 65-74 years but 67 per cent of those aged 85 and over.

In the Panel’s first report, one of our most important messages emphasized the changing nature of the life course that most people follow or will follow in Australia. One aspect is that people will live longer, as the numbers I have just outlined suggest. However increased longevity is only one dimension of the changes we can expect. People will not only live longer they will also be healthier for longer.

Simon Biggs, our expert adviser, emphasized the importance of what for most people will be an extended or ‘stretched middle age.’

It is then important we argued in our first report that people ‘plan to age well’.

Of course accidents or the onset of a sudden and serious illness can happen but for the most part people can plan to live much longer and more active lives. This makes it very important that people anticipate this stretched life course.

Ageing is only one dimension of changing economy, changing society.

Another aspect is the changing nature of work.

Moving from an industrial age to the information age and a shift to ‘brain power’ which is rapidly replacing ‘muscle power’ in our modern workforce.

In the information or service economy there will be more opportunities for older Australians but realising those opportunities may take anticipatory planning.

In our preliminary look we felt that we needed to emphasize life long learning or skilling for life.

How should we think about this combination of learning and paid or voluntary work?

Discrimination and ageing is one issue which should be considered.

Also there is a feeling that we are losing a sense of community and interdependence.

Realising our potential would involve us thinking about how we would be able to develop policy and strategies that provided inclusive solutions to a very different life course than that lead by earlier generations.

Our second report was titled ‘Enabling Opportunity’ and was released 2 November 2011.

Our attitude to enabling opportunity was optimistic as reflected in a quote from an OECD report included in our second report:

‘Ultimately population ageing is both a challenge and an opportunity. It will put upward pressure on public expenditure while slowing economic growth. But it is a tremendous opportunity for everyone to spend more rewarding years at work and in retirement. Seizing the opportunity will require governments, employers, trade unions and civil society to cooperate in adopting and implementing a new agenda of age friendly employment policies and practices’ (OECD, 2006)

The panel recognised that entering this brave world of positive ageing would require addressing a number of challenges that were alluded to in our first report.

These challenges had not been addressed before basically because we had not grasped as a society that we were in a very different place now than we were in the 1970s. We have a population living in much smaller households, working in service jobs rather than industrial jobs, shopping online rather than in department stores, living in much smaller households in which both parents work and often headed by women  having fewer or no children and yet asking much more of grandparents than in previous generations.

The pace of change is incredible and is exacerbated by the shift in technology (for example banking online), not reading newspapers, working the I Phone on the train of a morning, going to work often with great uncertainty as to work futures, living in housing and suburbs that reflect our post war history but not today’s smaller households and more dynamic life styles.

In this emerging world there is the potential for older people to play important roles although they will face they face significant barriers and hurdles.

Ageism is alive and well in Australian society as employers look for the brightest and best among recent graduates.

The changing character of the workforce means that people need to be both well educated as well as meeting requirements to go through various forms of retraining throughout careers and keeping up with technological change which impacts not only the world of work but many other aspects of the way that we live. 

The housing market in Australia was largely created during a different set of expectations than exists today, a message very slow to get through to the housing industry. Our housing is very expensive to both sell and buy. This is because housing exists in a market where prices are out of kilter with the rest of the world.

As people age they may not for the most part have life threatening illnesses until much later in life but they will often have chronic conditions that restrict activity and that have to be more recognised by the health system. We have built our cities in the 20th century on the assumption that almost everyone will drive whereas for older people driving
may not always be a safe option.  Older people will be safer in pedestrian cities well served by public transport but this message is only heard by the few that have heard of the ‘new urbanists’.

What is to be done?

In this report we suggest possible directions rather than policies. It is important to address discrimination and have it addressed by the Human Rights and Equal opportunity Commission as a high priority.

In health we needed to shift the priorities away from acute health care to giving much greater priority to preventative health and caring from people at the community level.  For example, moving away from health care as a cottage industry controlled by GP’s, more holistic strategies designed to achieve healthier communities,  more emphasis on lifestyle and addressing ageism as a cause of ill health among older people.  It will be important to learn some of the lessons to promote healthy cities programmes over many years by retrofitting our housing and our cities to aim to keep people active and involved and keeping people connected and involved in their communities.

We argue that housing should be at the centre of government strategy especially by increasing the supply of and transition to more sustainable and affordable housing for seniors. The focus with housing should be on ensuring more housing choice for older people and specifically ensuring that their housing reflects universal housing design. Those in greatest housing need are renters and there will be more aged renters in the future. In addition, if people are to age in positively they need to be living in accessible neighbourhoods and of course key facilities need to be within walking distance.

The third report of the panel was published early last year (2012) and titled Turning Grey into Gold.

This report suggested that the federal government develop a national framework to recognise the life course approach to Active Ageing based on World Health Organisation Active Ageing principles and include wellness, age friendly environments, availability and accessibility of effective health care, and active participation in all aspects of community life.  This agenda is to be pursued through the Council of Australian Governments.

Our report sought to pursue aspects of this agenda under various headings: housing; participation; lifelong learning; active ageing volunteering and philanthropy; and finally age discrimination.

On housing we suggested that there were two key problems: one to do with the affordability of housing for many older people (especially renters); and secondly the fact that the choices open to older people for housing were far too limited because the existing housing stock was dominated by bungalow detached housing often not suitable for older people. Of course older people themselves should decide what housing they would like but an unimaginative market offers few choices. There were also affordability issues for both owners and renters and the transfer cost of moving accommodation is too high. Dealing with costs such as stamp duty is a sensitive matter of federal state relations, however it does need to be pursued.

On the issue of workforce participation, there is much talk about flexibility in the workforce but the flexibility cannot only be for employers. Older people who work in a paid or unpaid capacity need to be protected by workers compensation and or insurance arrangements and they also need to be able to get work that recognises their talents. They may also need education and or training to enable them to make a contribution in a world of rapidly changing technology. There is little recognition in Australia of the importance of life course transitions and the importance of supporting transitions to ensure the most successful outcome. 

Lifelong learning has never been more important but for the most part   this term only serves a rhetorical function. Personally, I think it is important that people are able to build capital and money in time, enabling them to access courses that are available so that people can keep growing across the life course. We must recognise and encourage older people to go on making a contribution and not allow them to feel marginalised.

Active ageing needs to be underpinned by best practice community health services that provide specialised services such as dental and podiatry along with access to medial practitioners who can help to anticipate and prevent illness and promote wellness. A key philosophical issue in Australia is the lack of focus on prevention and institutionally we have not yet found the best means of ensuring seamless health and welfare services directed at the needs of older people as well as other high need groups.

On volunteering I thought the most useful sessions we had dealt with the importance of training of volunteers together with matching people with jobs in a way that took account of a person’s aptitudes and skills.

On age discrimination we recommended a vigorous campaign against discrimination and in favour of positive ageing including a community awareness program.

An independent advisory panel, the Advisory Panel on Positive Ageing Panel, is pursuing these recommendations on active ageing for ways to implement the agenda that I have just described. The Committee has had some worthwhile impacts, including Susan Ryan’s appointment as anti-discrimination commissioner in HREOC. This has been an important step forward as has been evident in her vigorous exposure of discrimination especially in the area of employment. In addition, the appointment last year of a Minister with comprehensive responsibility for all aspects of housing policy including industry policy. Also the government agreed last year to incentives for employers who employ people over the age of 55. We are hopeful that there will be further initiatives in the May budget this year, 2013.

In conclusion, recent decades have seen enormous changes at work in Australia. Perhaps too many of these changes have been thought about and discussed through the prism of globalisation and the internationalisation of the Australian economy.  Consequently, too little emphasis has been placed on changes in the way that people are living their lives today as opposed to the way that previous generations have lived.  Changing attitudes to gender is one important example but of course ageing is another. I have emphasised the stretched life course as people live longer but the opportunities associated with more extended lives requires more than a little tweaking of policy. It requires a much more widespread debate about ageism and the various forms of discrimination along with a re-examination of our ideals for the good society. For most of the 20th century women were isolated in their kitchens and then as the result of feminist pressure, significant changes were brought about. Something similar seems to be necessary for older people facing often difficult life course transitions because of our inadequate understanding of both the possibilities and the constraints that face us as we age.