in Quality of Life at Older Ages:
Subjective and Objective Components
Dr James Nazroo
Dr Madhavi Bajekal
Professor David Blane
Ms Ini Grewal
Duration of Research:
May 2000 - May 2002
Dr James Nazroo
Department of Epidemiology and Public Health
University College London
1-19 Torrington Place
London WC1E 6BT
Tel: +44 (0)207 679 1705
Fax: +44 (0)207 813 0280
With one or two exceptions, the circumstances of
older ethnic minority people in Britain, let alone issues relating
to their quality of life (QoL), have not been a key issue for
either policy makers or researchers. This is perhaps because they
are considered to be a small population whose needs will be met
by their families. However, those who migrated to Britain as young
adults in the 1950s and 1960s are now moving into retirement.
They represent a unique generation who, since migrating to Britain
have made a major contribution to Britain's economy working mostly
in arduous low paid occupations in public service and manufacturing
industries. Addressing the needs and perspectives of this generation
is a task of the present.
It has been suggested that ethnic minority older
people face 'multiple hazard'. The implication is that having
an ethnic minority background in addition to being older adds
extra dimensions of disadvantage. It is also possible that this
will interact with both gender differences, given the marked ethnic
differences in family structure and gender roles, and socioeconomic
position. Current evidence suggests that there is some truth to
theories of multiple disadvantage. Across the material and health
dimensions of QoL some ethnic minority groups are considerably
disadvantaged compared with older white people. However, little
empirical evidence has been produced on the factors underlying
such possible inequalities, and the evidence is more equivocal
on disadvantage across other possible dimensions of QoL. For example,
in terms of family contact South Asian people are more likely
to live in households containing two generations of adults, and,
compared with white people, older Caribbean and South Asian people
are much more likely to be living with a child. So, while it seems
to be clear that 'multiple hazard' for ethnic minority older people
exists, ethnic disadvantages in QoL may not be present across
all of its dimensions
It is also likely that the nature and relevance
of particular dimensions of QoL will vary across ethnic groups.
This means that understanding ethnic inequalities in QoL, both
in terms of its extent and its causes, depends on an understanding
of ethnic differences in what might be important to older people.
Aims and Objectives
The research will be concerned with improving our
understanding of ethnic differences in the definitions and experience
of QoL among older people, and the determinants of ethnic inequalities
in QoL among older people.
Specific objectives are:
A description of ethnic differences in older
people's definitions of QoL and the relative importance
they place on particular elements of QoL.
An assessment of ethnic inequalities
in QoL among older people, whether ethnically specific assessments
amplify or narrow formal estimates of inequality in QoL, and
the key determinants of ethnic inequalities in QoL.
To assess how far gender differences
operate in these relationships.
To contribute to the methodological
development of studies of minority groups and the development
of combining qualitative and quantitative methods in a study.
To contribute to theoretical debates
around ageing, particularly the contrasting structured dependency
and third age approaches.
The study will be conducted in two phases, the first
qualitative and the second quantitative. Both phases will be based
on the Fourth National Survey of Ethnic Minorities, which was
a large representative survey of ethnic minority and white people
living in England and Wales, conducted in 1993-94. The aim of
the survey was to describe and explain the experiences of ethnic
minority people, so it collected detailed information on: household
and family structure; socioeconomic position, including economic
activity, sources of income and size of income; perceptions of
the quality of the neighbourhood; education; dimensions of ethnic
identity; experience of crime and harassment; social networks
and participation; both general and specific health outcomes;
and use of health and social services.
The qualitative phase of the study will involve
in-depth interviews with a purposively identified sub-sample drawn
from the Fourth National Survey respondents, focussing on respondents
who were pre-retirement age at the initial interview. This will
allow us to explore issues relating to transitions into retirement.
Respondents will be identified from four ethnic groups, selected
to represent heterogeneity of experience across groups, rather
than comprehensive coverage of all groups. The groups to be covered
will include: white; Caribbean; Indian; and either Pakistani or
Bangladeshi. Twenty respondents will be interviewed in each ethnic
group, giving 80 in-depth interviews in total. The qualitative
interview will cover: exploration of the meaning of QoL; levels
of QoL; changes in QoL over retirement and reasons for changes;
and aspirations for the future. Retrospective data will be collected
to cover migration and employment histories using 'lifegrid' methods.
Interview data will be analysed using 'Framework', a method developed
for the systematic analysis of qualitative data that involves
the indexing and charting of verbatim data within a thematic matrix,
so that associations within and convergence and divergence between
accounts can be determined.
For the quantitative phase we will conduct secondary
analyses of the Fourth National Survey data on those who were
within 10 years of retirement age and those of post-retirement
age. Multivariate techniques will be used to explore the inter-relationships
between dimensions of QoL and how they vary by ethnic group, age
and gender. Importantly, findings on the relative importance of
particular dimensions of QoL at the qualitative phase of the study
will be used to inform and interpret the quantitative analysis.
This means that the quantitative analysis will be sensitive to
the views of those being researched and that we will be able to
determine whether inequalities are greater or smaller once these
subjective accounts are considered.
Understanding ethnic differences in older people's
definitions of QoL, and the value they place on particular aspects
of their lives, will be of great importance to the development
of ethnically sensitive policies to promote QoL for older people.
We anticipate that our findings will, in the long term, feed into
the development of policies concerned with enhancing the QoL of
older people and help ensure that such policies are sensitive
to ethnic diversity. Addressing ethnic inequalities in QoL requires
an understanding of the dimensions and determinants of such inequality.
Our research would contribute to such an understanding, and take
into account the perspectives of older ethnic minority people.
This information will be of direct relevance to policies that
are designed to prolong active life, economic and social participation,
and reduce dependency and social exclusion. It will allow policy
initiatives to be assessed in terms of their probable impact on
different ethnic groups, allow the development of policies that
can be targeted at particularly disadvantaged ethnic groups and
help ensure that policy development is sensitive to ethnic diversity
in experience and aspirations.