David Jolley, Honorary Reader at the University of Manchester, retired Consultant and Professor of Old Age Psychiatry, reports on a Christians on Ageing webinar:
Issues for older BAME Christians (June 30, 2020).
The session was chaired by the Revd Dr Joseph Cortis and led by Jabeer Butt, Chief Executive of The Race Equality Foundation. David Jolly explained how Jabeer Butt, 'treated us to a detailed, comprehensive and up to date review of the conditions and circumstances of the Black and Minority Ethnic (BAME) populations of the UK, pointing particularly to inequalities and implications for policy and practice:
National data sets have included information on ethnicity since 1991.
These record improving life expectation in the BAME communities: overall half of BAME people aged 55+ are now within the 65+ bracket (1991 the proportion was 34%) (Whole population 2019 proportion of 55+ aged 65+is roughly 60%)
The number of African Caribbeans age 75+ in the UK has increased x 7 1991-2011, Indians 75+ have increased x 4.5 and Bangladeshi 75+ by x 8.
Income from pensions: BAME elders are twice as likely to be in the lowest quintile, than are white elders.
Home circumstances: BAME elders are less likely to be alone or living as an elderly couple than white elders. They are more likely to be part of ‘other’ households – multi-generational.
Housing: Travellers are notable for experiencing housing deprivation compared with all other groups.
Health: Women aged 65+ often live with limiting long-term illnesses: 56% overall, 70% or near for Pakistani. Bangladeshi, Traveller, Arab and Indian women in this age band. Chinese elders report better health than any other ethnic group and Chinese people can anticipate more disability free life years (dfly) than any others: mean being 64.7 years for Chinese men and 67 years for Chinese women. Bangladeshi men have an average of 54.5 dflys and Pakistani women 55 dflys.
Dementia: the prevalence of dementia is higher among Black African Caribbeans and South Asians than their white age and gender equivalents. Average age of onset of dementia is earliest among Black African Caribbeans.
Interaction between socioeconomic status, ethnicity and racism intensify the inequalities in health. Poor health is especially marked on older travellers, Bangladeshis, Pakistanis and Irish.
Covid-19: The risk of infection by the virus is estimated to be 56% higher in BAME people of working age and 69% higher amongst BAME people aged 65+. From hospital death data, death rates have been more than four times the white population for Black African and Caribbean people. Asian people 2.7 times the rate for whites and people of mix race twice the rate for whites. There is discussion about the cause of these differences. Genetic factors may be important, but exposure and practices may also lay their parts.
Actions required as consequence of these features of the Covid crisis include:
· A targeted information campaign
· Urgent implementation of a competent test and trace system
· Additional support for voluntary and community groups
· Help with the issues relating to self-isolation for BAME groups
Contextual considerations:
· Spending on the NHS currently accounts for roughly 24% of government spending
· This is projected to increase considerably with the NHS long-term plan which will encompass social prescribing, reduction of health inequalities and better care for people with multiple morbidities
· There is a challenge and an opportunity to redress some of the unfairness and inequality which has been experienced by the BAME communities
Jabeer’s presentation provided a background for discussion of special issues for older BAME Christians in this country. This was richly informed by the mix of experiences among those contributing.
There was strong appreciation of Jabeer’s presentation – for the facts and figures and for the maps which make clear the non-random distribution of BAME communities – concentrated in city centres and poorer areas with only limited spread to suburbs and beyond. This does mean that Black churches are usually found in city centres and that many longer established churches have limited experience of involvement with people of BAME backgrounds.
The point was made that the Chinese population is more widely and thinly spread, very much associated with their work in the catering trade. This makes it difficult to establish neighbourhood support systems which are language and culture competent.
In general it was said that there is a lack of friendship circles within BAME communities - some of us were surprised to hear this.
Older people are more likely to be alone. They find isolation very difficult. This has been accentuated during the Covid-19 crisis and lockdown. Many are fearful and mistrust the authorities.
The Caribbean and African Health Network (CAHN) based in Manchester goes a long way toward helping people of all ages to get to know about health matters and services – often giving people support in trusting authorities which they have previously distrusted and feared.
The challenge of reaching out – finding people who have become isolated but who would welcome involvement is one which people are aware of and trying to find ways of reaching out.
Special events are helpful and can attract people if they are given good publicity. There was an appeal that BAME religious and information events are given space in calendars, newspapers, and other media. It was commented that special events to attract and engage young people are common within faith communities – special events for older people are rare
There are practical issues with accommodation, including the availability and usage of toilets – all this currently suspended because of the Covid-19 crisis
There is great need for people to volunteer to give their time to visiting and supporting older people and in providing and supporting them with information and activities. Some older people take a view that they have worked hard through their lives and now need to put their feet up – so they are less enthusiastic about volunteering. This is a challenge. Being involved is good for physical and mental health and well-being. Those who try it become convinced.
It is to be remembered that caring is shown in differing ways.
There was brief reference to ‘integration’ – something which we should explore further. There is a need to recognise that people often lack confidence that they will be accepted.
Beware of unhelpful assumptions such as ‘They look after their own, don’t they?’ (There was a Social Services Inspectorate Report with that title 1998)
We were reminded that culture is not static, it changes progressively but at differing rates in different communities and different places. Be sensitive to this.
We heard of the ‘multiple-jeopardy’ of being old, being BAME, using a different language or idiom, being disabled or impaired, being religious, being poor, being unfamiliar or unable to use modern communication devices.
There is currently great awareness of the unequal and unfair treatment of BAME people of all ages and in all places. It is hoped that this awareness can be turned to good and lasting effect.
Racism is a whole society problem – not just a problem for the BAME components of society.
Ageism is as strong as ever – with many unreasonable and hostile comments coming from the media in association with Covid-19 and the lockdown – portrayed as disadvantaging the young to protect the old.
Anna Chaplains are here for people of all backgrounds. They have some but are are keen to recruit more chaplains from the BAME communities. ‘We listen to whoever.’ Anna Chaplaincy is part of The Bible Reading Fellowship, BRF, and is there for people of strong, little, or no faith and is increasingly working in multi-faith contexts.
Some churches or groups of churches provide ministry for older people - see Making a start- developing pastoral care for older people. They will be eager to involve people of any ethnic group – but it will require an informed effort to make this a reality.'
Final reflection:
The presentation and discussion broke new ground for Christians on Ageing. The session was enjoyable and informative and has set us thinking of next steps in exploring and taking useful action for older Christians of the BAME communities. Many thanks to all who contributed.
David Jolley, Christian Council on Ageing, CCOA.