Care implications of an ageing ethnic population

Jill Manthorpe reviews research on the ageing of the black and ethnic minority population in the UK

The research

Key words: Black and minority ethnic older people ❙ populations ❙ diversity ❙ life expectancy

Author: Nat Lievesley, Centre for Policy on Ageing and Runnymede Trust, www.cpa.org.uk; e-mail cpa@cpa.org.uk

Title: The future ageing of the ethnic minority population of England and Wales

Aim: To describe the likely changes in the age structure of black and other minority groups in England and Wales.

Methodology: This report uses data on fertility, mortality and migration to make some projections of the number and profile of older people from ethnic minorities.

Conclusion: Although it is difficult to make population predictions, we can use projections to think about the types and amount of support that may be needed by the growing numbers and proportions of BME older people and the contributions that they may make.

Findings

The ethnic minority population of England and Wales will continue to be younger than the majority white population but by 2051 this difference will be less pronounced.

There are already important differences between minority groups, with the Irish and Indian populations having “mature population structures”, for example, and these differences may increase. In contrast, the Bangladeshi population looks set to keep its comparatively young population profile.

Despite the problems of making predictions, on the basis of this evidence there will be 2.4 million black and ethnic minority people aged 50 and over in 2016 in England and Wales; rising to 3.8 million by 2026 and 7.4 million by 2051.

These are not all older people of course; indeed among them are likely to be many carers. But over the same time spans, there will be just over half a million black and minority ethnic people aged 70 and over by 2016, more than 800,000 by 2026 and that figure escalates to 2.8 million by 2051.

Ethnic transfer

When looking at population predictions, the subject is complicated by a process of “ethnic transfer” whereby young people switch to a white British identity; in other words, they may not describe themselves as having the same ethnic identity as their mothers. This may apply to white Irish people in particular. There will be a net but not very large rise in numbers of people describing themselves as being of “mixed ethnicity”. The implications of this for services that have a strong ethnic or cultural identify are worth debating.

By 2051 the largest ethnic minority group in England and Wales will be the diverse Other white group (coming from several different parts of the world), followed by the Indian, black African and Pakistani ethnic groups.

When considering future population profiles, we need to look at many different aspects, for example, at age of death – with its implications for equalities, disability or illness.

Gender gap

It is likely that life expectancy will generally improve for all ethnic groups, but that men will continue to die earlier on average than women, regardless of their ethnicity. Fertility levels also need to be considered because they influence patterns of family care-giving and the size of the labour market (and therefore the size of the care workforce).

This study suggests that fertility levels, while uneven, may be moving to some stability in the UK. But they too are hard to predict; will the current trend to later maternal age of child birth be sustained?

Currently the BME populations of England and Wales are not evenly distributed because ethnic groups tend to cluster in certain areas. In future this may change. Already there are wide differences in the regional profiles of countries of birth of their populations. India and Ireland are the most common non-UK countries of birth across the UK and in London, but Germany is the most common country of birth in north-east England, the South West and in Wales.

We know little about this composite group of Other white people, although there are local populations that may be highly significant to commissioners, ­providers and community resources (for example, groups of older Polish people; Ukrainians or Italians).

Migration

One further uncertainty in this area is migration. This is very difficult to predict but generally migrants to the UK are from younger age groups. However, some people may choose to return to their countries of origin or they may choose to move countries again, for example to join their family members.

This may affect older populations if they decide to move to live with their adult children or if they decide to return to their former homes. Information and advice about these options may be called for by older people from local councils and voluntary sector groups.

Additionally, and perhaps controversially, the study suggests that, by 2051, the age of 70 may be the new 65 as far as state pensions and economic dependency go. Again this will affect who we think of as older people. This age of 70 may even be a little cautious; many of those whom we think of being “old people” in 2051 might not see themselves in this way.

Analysis

This study is recommended as reading for planners, specialist social workers and third sector groups working with BME users and carers. This is on the grounds that there is a great need to support evidence-based planning as well as practice.

There are unanswered and possibly unanswerable questions about population projections but evidence such as this helps to prompt discussions with local partners so that services are not “surprised” by events.

There is substantial evidence about the links between age and long term needs for support and this may be one element of planning. Another is to investigate the links between awareness of age-related changes and awareness of services. It may be possible to develop ways of improving awareness and uptake of services.

In this context of the transformation of social care, it will be important to monitor the effects of current changes since these may have great impact on younger generations who will learn from the experiences of their friends and parents.

Finally, we know little about the details of the proposed new roles of public health for English councils and adult social care. If there are new statutory responsibilities for public health functions for local councils then these will need to be informed by data that accurately reflect ageing and other diversities.

There is a long tradition of public health work to tackle inequalities and this too needs to inform planning and provision in adult social care.

It is not surprising that this report is part of a larger programme of work looking at financial inclusion and older BME people (funded by the Nationwide Foundation). Data around finance and access to resources will be a further interesting variable to add to the complexities addressed in this report.

Practice implications

For frontline staff:

• Frontline practitioners may be working with older people of great diversity across the UK. The Social Care Institute for Excellence is shortly to produce a practice enquiry on this subject.

For policy makers:

• Local council planners and their colleagues in other public and community services can use this report to analyse and debate the changing profiles of their older populations and to build community capacity to meet the new challenges of changing population profiles.


• Local social care services with little experience of supporting older people from ethnic minorities may need to consider their policies and practices as they move to other areas. This needs the involvement of managers, human resources and training leads.

For managers:

• Customer service sections of local councils may build on local population profiles to re-design their services so that they are accessible to very diverse communities. This requires leadership (for examples of strategies, see Manthorpe et al (2008)). Minority older people should not be seen as solely the responsibility of adult services.

References

Manthorpe, Harris, and Lakey (2008), Strategic Approaches for Older People from Black and Minority Ethnic Groups, Social Care Workforce Research Unit, King’s College London.

About the author:  Professor Jill Manthorpe is director of the Social Care Workforce Research Unit at King’s College London

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This article is published in the 4 November issue of Community Care magazine under the headline Care Implications of an Ageing Ethnic Population