Lucy: This is the Ambition for Ageing podcast, episode 1. Why do we address social isolation?
Stephen: I think loneliness and social isolation are important because we shouldn’t really see these as people with an individual problem. I think they’re outliers that give us an indication that what we’re witnessing is the breakdown in civil society. 

[Music]

Kirsty: Hi, I'm Kirsty and welcome to the very first episode of the Ambition for Ageing Podcast: Why Do We Address Social Isolation? Each week I'll be joined by different guests and we'll discuss all aspects of ageing, looking at everything from social isolation and loneliness, to the benefits of ageing and building age-friendly places. We'll be joined by academics and policy makers, researchers, frontline delivery staff, and of course older people themselves.

It feels important to note that the majority of this podcast and all the interviews were recorded pre-COVID. Although we're not going to go into too much detail about the impact of COVID during this series, listening back to these recordings it became clear that everything we're planning on featuring still rings true now in the middle of this pandemic. Despite the need for more physical distancing in this time, our need for social connections are stronger now than ever, which brings us neatly back to the topic for this episode, why do we address social isolation? 

On our programme, we've supported over 1400 small projects, 10 larger projects, and we've involved around 21 000 older people, all with the aim of reducing social isolation. But what have we actually learnt? What have we found out that would be useful to those wanting to address social isolation, whether policymakers or people developing practice? Well, it's not simple. People's lives are complex and interventions to support them must understand and address these complexities. Of course, in the current landscape this is even more complex. How do we increase social connectedness in a world where we're being encouraged to stay physically apart? As we'll hear from our guests there's been a shift in recent years towards looking at social isolation and loneliness as an area of policy. It's moving away from deficit-based models where we link ageing purely to health and social care to looking at assets and supporting older people to continue being active within their communities

We've got a number of guests this episode, including Kate Jopling - one of the foremost voices in ageing at the moment - as well as catching up with a number of our counterparts from across the country. But first, I was joined by our Programme Manager John Hannen to speak to Paul McGarry, the Assistant Director of the Greater Manchester Ageing Hub about his career in ageing and how policies on ageing have developed over the years. Having previously led Manchester City Council's Age Friendly Team, Paul has been working in the ageing world for many years and has a number of insights into ageing well in Greater Manchester and beyond. We spoke to Paul about the impact of cuts and population changes on how we age, the complexities of dealing with social isolation and loneliness and how Greater Manchester are harnessing the good work happening at ground level.

[Music]

Paul: You know, I often say that the first action plan I ever wrote around older people, which was about 1997, for Manchester City Council, one of the actions was to reduce social isolation amongst older people. Kind of fast forward 10 years or so and loneliness became more of an issue really, and I’m never quite sure why it developed in the form it did. It was inspired, I think, by work that had been done in Holland and a kind of coalition around loneliness set up, and there was a mirroring of that in the UK with the campaign to end loneliness, of which I was one of the founding members, amongst other voluntary sector organisations and so on, and in a way it felt like the right thing to do because if you want to grab attention for the ageing agenda talking about loneliness and or social isolation is something that kind of guarantees an audience really. It's a lot easier to kind of do that than to talk about social inclusion or social relationships and so on. I think those are very important points.

The other thing that happened is that loneliness itself, rather than social isolation, started to take on a kind of profiling in kind of national areas. It was mobilised by people like Age UK for the Christmas campaigns and so on. We had a minister for loneliness or against loneliness, and loneliness became something, particularly I think from a kind of healthcare perspective, that was a topic that needed to be fixed in the same way that diseases are fixed and you just need this social socially prescribed intervention, and we can deal with your loneliness, and it seems to me that that past things. It’s probably bound to failure at a population level. Certainly, there may be some examples where it's successful. It kind of shifts the real discussion away from the broader position of older people in society and most importantly the position of those who are disadvantaged as well and the inequalities. 

I think the last thing that is overlaid by all of this is that this kind of fragmenting over the last 10 years of what we call the kind of post-war generational contract, which is that people work until they’re 60 or 65, and then the rest of the population looks after them. So that's started to fragment for all the reasons that we're aware of, so you've got this kind of heavy mix really of issues that have created this environment where these terms loneliness and isolation are bandied about with the best of intentions but not always with a kind of careful approach, which we need.

The last thing I just wanted to say is that there's some of all this work I think quite often takes reform of disempowering different groups of older people, of labelling them as being lonely or isolated, increasingly the language of frailty and all these other things, create a common set of common myths about ageing, which are unhelpful for strategy and for policy, and that's not to downplay those things because they're critically important, but they need to be seen in the round and they need to be seen as part of a broader strategy for kind of social improvements.

Kirsty: You mentioned the fragmentation of the support available for people as you know the age when they retire. Are you talking about things like we've got an ageing population and is that what you're alluding to there?

Paul: It's an easy argument to make but I think it's essentially true is that since 2010/2011, a number of significant decisions were taken nationally and are played at a local level, and if you just think about the cuts in social care and the cuts in supporting people have created significant unmet need in the kind of language that we often use, and this is set out in documents from ONS and others, so you've got a real problem there and I think the local state in general found it more difficult to work out how to support older people who weren't in the top five or ten percent of the kind of needs/care needs triangle, and we were trying to develop these programs around ageing, age-friendly communities, neighbourhoods, whatever it is, at a time where funding and investment in communities and neighbourhoods was being reduced, so this this created a real tension in our work I think. 

More laterally in the last two or three/five years, people have latched on to these concepts of loneliness and isolation, and I’m sure you spoke to colleagues who can give you the kind of clear-cut differences between these things and the impact on certain policy. I think the bottom line on all of this actually is that we need city, or town, or regional and national strategies about improving the quality of life of all older people and improving the quality life of older people who are most disadvantaged. I think if that's your starting point, some of the differences and arguments around isolation and loneliness become less important. 

John Hannen: I think when we talk about fragmentation you need to look at the changing places as well. In the last 10 years, we have seen that change in the nature of the relationship between the state and people, and what can be provided, and what can't be provided, so those difficult questions. But also if you go back another 10/20 years, you see a significant growth in the movement of younger people from places towards higher education, out of towns, and so you have some areas where towns are ageing and people are missing from families, and people missing from neighbourhoods, so the relationship between different generations isn't necessarily changed by a balance of power between young and older, there are geographic changes that are happening as well, and how do then people make connections with strangers who are not family in their place and to build a different kind of relationship, and a different kind of contract between people working and people retired and so on. So I think there's a set of complexities around this, and this makes the issue of loneliness and isolation much more complex and I think some people would like a kind of easy, you know, people are lonely, so let's fix them, to how do we actually look at the kind of places that we live and the relationships we have with each other. There's also been a change that plays out in some of these issues.

Kirsty: And that does connect to a lot of the work that now the Ageing Hub and the Combined Authority a whole are moving towards in focusing on place and focusing on making places age-friendly. 

Paul:  That's right. I reflect on the work that we've done over a long time, principally in Manchester, and then working on a GM footprint. We set up the first … It was called Valuing Older People Network in 2004, I think it was, in central Manchester, and this came actually from a request from elected members to set up a subgroup of ward coordination, I think it was, just to look at ageing populations, and it's often the case it was that kind of what you call innovation, which led to us trying to spread that out throughout the city of Manchester because it felt like the right thing to do. You get people together who work in a place with older people, older people involved, and you identify what the issues are. You gather together the resources you can, and then you set out an action plan and try and achieve it. I mean on one level it’s simple. You then obviously get into broader structural issues about the nature of the housing, the transport systems, how people see themselves, and their roles in families and so on, but I think that kind of approach is hugely dynamic and it's something that we've tried to support in different ways.

So obviously with that Ambition for Ageing Programme, in a way that's another version of these place-based approaches around ageing. There are different variants in Greater Manchester, across the UK, internationally, but they all kind of have the same DNA I think. S
So where we are now is that we're trying to move into a different phase of work and we're trying to build I think initially 11 sites, and try and create an infrastructure in GM, which coordinates activity at that local level for ageing populations, and we're trying to connect those together as well.

The other part of the picture is that through the mayoral challenge and the work that you guys have been doing, we're looking at having over 50 community scale affiliates of the mayoral challenge, and I think this has the possibility to build a real strong bottom-up kind of movement of people who want to take action in their communities, so we're in a really good place for all for all this work and I think you've got to be optimistic and positive about what we can achieve.

Kirsty: Since our conversation with Paul, things have moved on, and despite the interruption caused by covid, the new phase of work Paul mentioned is moving forward, and in February this year the number of age-friendly neighbourhoods awarded by the mayor had reached 53. Our conversation with Paul brought up some really interesting points around how policy has shifted over the years Kate Jopling has been at the forefront of this shift. Amongst her career highlights, she worked on the Jo Cox commission on loneliness, and was previously the director of the campaign to end loneliness. I spoke to Kate at the Ageing Better conference last year about why the difference between loneliness and social isolation is important and how understanding the difference between the two can shape how we support people.

Kirsty: Why is the difference between social isolation and loneliness important?

Kate: Okay so I think it's really important that we do distinguish between loneliness and social isolation because it makes a real difference when we think about what we do about it so if loneliness is that subjective emotion that we feel when there's a mismatch between the relationships that we have and those that we want, so we're not having the relationships that we need sustain us, that tells us something about the ways that we address it. Social isolation, there's lots of different ways you can describe it but it's something objective. We can kind of count how many contacts we have and that's that. When it comes to loneliness, there's really strong evidence that it's very bad for us. It grinds us down over time, but the point is you can't just address it by chucking more contacts at somebody. You can't just address it by saying “well you're in a room full of people,” you really need to make sure that the relationships that people are having are meaningful to them and that they're the kind of relationships that that individual needs, so it's completely individual, and it also relates to how we think and feel about our relationships. So it's not just important to ensure people have contact, although contact is important. It's also vital to make sure that we're thinking about things like how people are experiencing their relationships. Are they having positive experiences? Do they know how to build positive relationships? These things are really significant when we're tackling loneliness.

It's also really important to think about things like the impact of social media on our expectations of our relationships because actually if we have really unrealistic expectations of what it is to have positive relationships then we're never ever going to be able to address loneliness. So I think loneliness is much more complex and nuanced issue. It's very related to social isolation but it's not the same thing, and I do think that matters. 

Kirsty: So you're previously the director of the campaign to end loneliness, and you've also worked with the Jo Cox Foundation as well. Has there been anything that you've learned during those times that you feel it's important moving forward looking at loneliness, looking at social isolation?

Kate: Well I think in the time that the campaign to end loneliness has been around, we really have made a shift from a place where loneliness was something we all felt terribly sad about, but we didn't really think was a big serious public policy issue, to the point we've now got a lonely strategy, and that's massively thanks to the work that Jo Cox started and that was continued as part of her legacy because we really did accelerate progress on loneliness, so we now do see loneliness as a public policy issue. We've got a government strategy. We've had investment from government, so that's really, really important, but I think now is the time we've got to capitalize on that. We need to make sure that we're shifting from sort of pilot programs and activity around thinking that this is something we must do something about to really recognising the potential for acting on things like community infrastructure, acting on things like transport and housing to really start thinking about how well how do we create communities where people can connect and where people can remain connected, and also at the same time how do we put in place the support that people who are deeply, deeply lonely need. And I think sometimes it feels like across those years we've swung the pendulum from one end to the other. We're talking about addressing the needs of the most lonely and then suddenly we're talking about making communities connected, and obviously what we really need is to do those two things in parallel. We need to be working on the things that serve to divide us and making sure that we've got the infrastructure in place that can keep people connected through their lives, but we also need to be putting in place the deep support, which is often one-to-one support that the most lonely people need

Kirsty: Absolutely. I think that with the Ambition for Ageing project, one of the things we found is that a lot of the community work, we’re doing the asset-based work. It's helping people from getting more socially isolated but isn't actually reaching those that are the most socially isolated.  I've realised I’m talking about social isolation here rather than loneliness, but, as you said, there is that interconnecting part as well.

Kate: Yeah, and I think the evidence is that being isolated and being lonely is incredibly bad for us. It grinds us down. And there's really interesting evidence around the fact that people who have been lonely for a long time perceive more threat in social situations. In those circumstances, it doesn't matter how many community groups there are. It doesn't matter how lovely people are to one another. You don't feel that you can join that and you're going to need support to unpick probably the practical but also the emotional barriers that are going to prevent you from being able to take those steps. So I think that absolutely we can't be naive about how loneliness is addressed, and sometimes our public policy messaging is pretty simplistic on this, but I think that there is an opportunity, for example, with the roll out of social prescribing. Done well, that can provide people with that one-to-one support to connect. We need to make sure that we don't miss the opportunities that there are because I think on paper the breadth of these issues is recognised, and what we've got to start doing is kind of weaving together a community response in communities but also making sure that that's supported at a national level in policy terms.

Kirsty: While at the Ageing Better conference where I spoke to Kate, I took the opportunity to speak to our counterparts in other areas, all of whom are working on the Ageing Better programme, like ourselves, looking at what works in reducing social isolation. In order, I spoke to Vic Sterling from Sheffield, Stephen Raybold from Birmingham, and Corinna Hyman from Camden about why we do what we do, and how what we do reduces social isolation. The conference was held at Birmingham botanical gardens, and during Stephen’s interview we were constantly interrupted by a particularly insistent cockatoo. Keep an ear out and see if you can catch the moment. First, Vic.

Kirsty:  I’m speaking to Vic Sterling from Age Better in Sheffield. Why do we do what we do at Ageing Better?

Vic: So I think that before the Age Better programme, isolation and loneliness wasn't really something that people talked about, although now it's become incredibly popular, and so I think that we didn't really understand this difference between social isolation and loneliness, the idea that you can be lonely in a crowd of people or that you can be isolated but you don't particularly feel lonely, so I think that part of the reason why we're doing what we're doing is to understand a lot more and to learn from it as we go throughout the programme, but also I think that we really believe that connections with other human beings, animals, nature, and the rest of it make us happier, healthier people, and so I think there's an element there that if people want that connection, they should have it, that they deserve it, and that if they need a bit of help to get it then they should get that help.

Stephen: Social isolation, so the things that… the physical connection between people is getting harder and harder, and as a consequence, as a society we're becoming more lonely. It's not to say that loneliness at an individual level doesn't occur for lots of different reasons, but there's a there's a wider context to think about it in.

Kirsty: Ageing Better Birmingham and Ambition for Ageing share a similarity in our approaches to reducing social isolation. We both look at asset-based approaches. I wonder if you could talk a little bit about the way that you approach that in Birmingham.

Stephen: So we haven't taken an absolutely purest asset-based model. We're essentially asking communities to, with support, think about how they want to do things and think about how they want to connect to each other, but also to really drive their activity to really get a sense of what it is that other people want to do and what they can do together, and also how to engage people in that activity. So I think one of the critical features of the Birmingham model is it is that we actually use the communities themselves to engage isolated people so that essentially we have about 9000 people now working around the city engaged in sort of very ordinary activities, things that they're interested in, but also attempting to pull people in, attempting to just reach out to the isolated people in their community and get them to take part in the things they take part in.

I think the biggest benefit is it doesn't create a big production line of activity. It's really straightforward and it's really human, so it's just a question of I’m doing something interesting. Would you like to take part? There's no labelling.  There's no working out who's got a problem. There's no working out whether people meet their criteria for participation. We know we're going to pull in some people who aren't isolated and that's great too because they're they are part of the solution so I mean… and it is amazing how many, just taking this quite general approach, amazing how many isolated people that you capture because they're out there. They're amongst everybody else, and that's true for isolation and true for loneliness as well. 

Stephen: I think loneliness and social isolation are important because we shouldn't really see these as people with an individual problem. I think they're outliers that give us an indication that what we're witnessing is a breakdown in civil society, so they are a particularly acute version of something everybody experiences where the chance for connecting to people or the chances to connect to people are getting reduced more and more, and so addressing the challenges they face makes a contribution to everybody.

Kirsty: I just wanted to tell me a little bit about why what we do as Ageing Better matters.

Corinna: Because there are so many older people in the country, but particularly for us in Camden who are lonely and isolated.

Kirsty:  And what kind of stuff does Ageing Better Camden do to help mobilise or help support people who may be at risk of being socially isolated or are socially isolated?

Corinna: So we go out onto the streets and try and find people, or we knock on people's doors on big housing estates in sheltered housing, then we have a team of people that encourage people to be connected and try and work through the barriers they have to going out. So someone who hasn't gone out for ages and ages, there's a reason why not. It might be physical disability, might be nervousness, so they work and help and support them, and then we have groups that try and pull people in who encourage people to come to them. That can be anything from a theatre group to a singing group, to a tai chi group, to a discussion group, anything. 

Kirsty: Why is tackling social isolation so important?

Corinna: Because if people are socially isolated, they almost atrophy in themselves. They go into smaller and smaller sphere of engagement and living, and then people can actually die in a house and no one will know for months on end, so it's just desperately sad.

Kirsty: It's always interesting to hear from others working on the Ageing Better programme. Because of the way it's designed, all of our work looks totally different from each other but ultimately we're all working together to find out what works in addressing and reducing social isolation. So what have we learnt today that can help us make decisions in the future? Kate’s point about being unable to throw contacts at people and expect it to fix loneliness is spot on. You have to understand people on an individual basis. Simplistic assumptions can cause us to create approaches that are not designed to meet people's needs. People's lives are complex. As Paul spoke about, putting loneliness in context as a policy issue means moving from a medical model of things like frailty to a more social one, not to say that medical isn't important, but take a more holistic approach rather than wrapping people in cotton wool will allow us to tackle these issues in a range of ways.

Finally, as our colleagues from Birmingham and Camden spoke about, outreach and pulling people into activities rather than prescribing activities and pushing them into them is important. It's about recognising the complexities of people's lives and designing a range of ways to meet these like with Lee Classic Cinema Club who we've supported in greater Manchester, you can attend, enjoy a cup of tea and a film, and that's it, and that will help some, or you can use that invitation to have conversation, make new friends, and how people use that invitation may differ from person to person, or differ for individuals based on where they are in life at that moment, using invitations rather than pushing people into a room and hoping they'll be good friends, but you do need a broad range of approaches and opportunities to make that work.

Next week we'll be joined by Christina Victor, who's a big name in the world of loneliness. We spoke to her at the British Society of Gerontology last year and you're really in for a treat. 

Thank you to all our guests this episode – Paul McGarry, Kate Jopling, Vic Sterling, Stephen Raybold and Corrina Hyman, and I hope you join us next episode where we'll be asking why are there so many myths around loneliness.

Lucy: Ambition for Ageing is a Greater Manchester-wide cross-sector partnership aimed at creating more age-friendly places and empowering people to live fulfilling lives as they age. Ambition for Ageing is part of Ageing Better, a program set up by the National Lottery Community Fund, the largest funder of community activity in the UK.  Ageing Better aims to develop creative ways for older people to be actively involved in their local communities, helping to combat social isolation and loneliness. Ambition for Ageing is led by Greater Manchester Centre for Voluntary Organisation, the voluntary community and social enterprise sector support and development organisation covering the Greater Manchester city region. The theme tune for this podcast is Air by Ilya Truvenov, and any indents this season are taken from his track Tide. Both are used under a creative commons license from his album Fugue. Thank you for listening to this podcast. For more information about Ambition for Ageing and the work we do, visit ambitionforageing.org.uk.

• Loneliness is not just for Christmas – but by the flurry of charity messages you’d think otherwise, an article written by Christina in 2017.
• During the episode, Christina references champion swimmer, 81-year-old Baz Owen.
• A summary of Joseph Sheldon CBE and his 1948 Wolverhampton survey, as referenced by Christina in the episode.
• Information about the National Lottery Community Fund’s Ageing Better Programme.

Lucy: This is the Ambition for Ageing podcast, Episode 2: Why are there so many myths around loneliness?

Christina: I spend a lot of my time trying to challenge that, that loneliness is not part of normal ageing. Loneliness is probably something we all experience. You would be a very rare person if you’d got to 70 and you’d never been lonely. 

Kirsty: Hello, and welcome to the second episode of the Ambition for Ageing podcast. I’m Kirsty. That was Christina Victor, and today we’re going to talk about why there are so many myths around loneliness. Each week on this podcast, I’m joined by different guests, and we discuss a number of aspects in Ageing. Last week, we spoke to experts in the field about the history of policy around ageing, and the move towards looking to tackle social isolation from a more traditional health-based approach. Today, we’re joined by Professor Christina Victor, Professor of Gerontology and Public Health at Brunel University, and we’ll also be joined later by Richard Dowsett from the National Lottery Community Fund. We’ll discuss the topic of this episode. Why are there so many myths around loneliness? First, we speak to Christina. Christina started her career in medical geography and entered the world of ageing by supporting the professor of geriatric medicine at the medical school in Cardiff, and so began a lifelong career in gerontology. I spoke to Christina, alongside our programme manager, John Hannon during the British Society of Gerontology in 2019. We covered a lot of ground, so we’ll add links to the show notes relating to some of the stuff we discussed. I was genuinely excited to get to speak to Christina. She’s such a big name in the world of ageing, and she has some fascinating insights on social isolation and loneliness. She was a joy to speak to, as you’ll see now. 

Kirsty: So there’s often a lot in the media about loneliness epidemics and particularly with focus to older people, not so much touching on younger people. What does the evidence say about that?

Christina: With regards to older adults, so we can say people age 60 and over, there’s the prevalence of loneliness, so the proportion of the population reporting they are lonely is around 10%, and that hasn’t changed since the first survey in 1948. So for older adults, there is no evidence that the prevalence has increased over time. Obviously, there are more lonely older adults now in 2019 than there were in 1948. 

Kirsty: Because there’s more older adults. 

Christina: When Sheldon did his first survey, but that’s because there are more older people. The definition of an epidemic is generally something has to be increasing. I think it’s a dubious claim. The interesting thing, as a gerontologist, professionally I’m not interested in anybody under about 60. With young adults, so the 16-25s, 16-30 age group, I think we don’t know whether the prevalence has changed because we’ve been so obsessed with loneliness being a problem of old age that we haven’t asked about it in other age groups, so the jury is out for them, but for older adults there’s nothing has changed particularly. 

John: Is there any chance that people answered questions differently in the 1950s?

Christina: Well, the initial survey done by Sheldon, which was in 1948, asked people if they were often or always lonely, sometimes lonely, and never lonely, and the proportion of people who say they were often or always lonely is pretty static. Where there is a difference is in the proportion reporting sometimes. That has increased over time, but that is an interesting discussion. Does sometimes mean something different in 2019 than it did in 1948? But if you’re interested in the people for whom loneliness is a significant problem, that prevalence is flat, but it would be interesting to be able to go back and ask because a lot of these questions, it’s about context and interpretation. 

Kirsty: Why do you think we focus so much on older people when talking about loneliness when the data doesn’t back it up?

Christina: I think first of all… it’s an interesting question, and if anybody would like to fund me to do it, I’d really like to do that. It was why did Sheldon in his survey in 1948, which was called The Social Medicine of Old Age – it’s a great book and I don’t get anything from plugging it – but he included the first question I’ve been able to find in Britain where he asked people to report their loneliness, and I’d love to know why he included it. But from then onwards, it seems that then there was Townsend, then there was various other researchers, and we’ve seen loneliness as being something that is particularly associated with older adults, and perhaps it feeds into the myths and the negative stereotypes about old age. We certainly, particularly at Christmas time, a lot of the charities focus on loneliness at Christmas for older adults. For whatever reason, they may do that. I think it became in a sense a self-fulfilling prophecy that loneliness was something that, as you grew older, like you may have an increase in arthritis symptoms or Chronic Obstructive Pulmonary Disease, loneliness was just another thing that was part and parcel of old age, and it was thought of almost as being a normal part of ageing, and we didn’t step back from that and say is that true, and are there other groups in the community who may experience the same kinds of things. 

Kirsty: If we’re looking at loneliness in comparison to something like social isolation, do you think there’s elements there that are closer to mental health conditions rather than social isolation, which is your lack of connections. 

Christina: The first thing we have to clarify, and of course as an academic it’s my job to make the incredibly simple much more complicated you could ever imagine. It’s really important to differentiate loneliness from social isolation. Loneliness is a subjective evaluation by an individual of their social relationships, and loneliness is the deficit when either the amount you have or the quality you have does not match what you expect, and it’s only we can evaluate our loneliness, whereas social isolation is a more objective measure where we count effectively the numbers of people in your social network. So there are different sorts of social isolation, so it can be just in terms of contacts, so that’s what Peter Townsend did originally. He just counted the number of people you talk to in a week, do a distribution, put it in a cut point and said everybody there is isolated. So that was just about numbers, but you can also think about isolation in terms of not just the number of people in your network, but the type of people in your network. Are they family? Are they friends? Who is your network made up of? And then you can think again in term of isolation, well, it’s all very well having a large number of people in your network. It’s all very well to have a large number of close people in your network, but who would give you support and care if you needed it? Social isolation has its own complexities in terms of how it’s operationalised, but it is distinct, and my reading of the literature for mid-life and older adults is that the risk factor for many negative outcomes, but definitely mental health issues, it’s much more around isolation than it is around loneliness. That can be people may be isolated because they have a mental health problem, but we have to be careful that we don’t mix up association with causation, and that’s a really important thing when we’re trying to think about both loneliness and isolation, and the link to health problems generally. Just because two things are associated, you don’t necessarily know which way the direction is going. If we took older adults with dementia, who probably have a higher level of loneliness than people without dementia, is the loneliness causing the dementia? Possibly not. Or are people lonely because of the way we think about people with dementia but also the impairments they have mean that their relationships are no longer meaningful in the way they were before. It’s complex, and it’s always presented in a rather simplistic manner. 

Kirsty: They’re often used interchangeably. 

Christina: Yes, so we know that…

Kirsty: And they’re really not. 

Christina: Yes. Rats, if you isolate them, don’t do very well. If I was a betting woman, which I’m not, I would probably put my money on isolation, so the not having any contact, as a bigger health risk than perhaps not having the quality of the relationships that you want. 

John: It’s the interesting thing about risk factors because the consumption of caviar is the risk factor for being a billionaire, but it’s not a cause. 

Christina: Yes. Association is not causation, so I have a kind of public health background and it’s really important that people understand that because two things are correlated in a cross-sectional study, you can’t work out which is cause and which is effect. I think there’s a lot of work to do, and somehow the evidence is reported perhaps in a headline grabbing way because we all have to lobby for our particular area of interest. 

Kirsty: In some of your research, you’ve spoken about linking feelings of loneliness to the fear of ageing. Is that common? Do you feel the popular images of loneliness in old age fuel those feelings of loneliness when people reach old age?

Christina: Yes. 

Kirsty: Back to commonality and causation. 

Christina: It’s complicated. We have this massive stereotype that old age is a time of loneliness that the empirical data doesn’t support at all, but nevertheless the myths still continue, and one of the side effects of the ‘loneliness epidemic’ narratives is to propagate that instead of …I spend a lot of my time trying to challenge that, that actually loneliness is not part of ‘normal ageing.’ Loneliness is probably something we all experience. You’d be a very rare person if you got to seventy and you’d never been lonely. It feeds into that general narrative of when you become a certain age you’re going to lose agency, you’ll feel lonely, you’ll lose your mind and lose your place, and those are very dangerous images because it’s probably easier in the health area to have an argument. If older people experience knee pain, they may just say that’s part of ageing when it’s osteoarthritis and, if they want to the GP, they can maybe get a knee replacement and everybody is happy. If you internalise these things as being normal then it means it doesn’t matter whether it’s a physical health problem, a mental health problem, or perhaps enduring loneliness. If you internalise that as normal, you don’t seek help either from your family, or your friends, or online, or from services, or whatever it is, and ultimately that means you’re not going to have a good old age, which is what we’re really interested in because if we know… a lot of the literature around the health effects of loneliness is limited, but we do know that if you experience significance loneliness, your wellbeing suffers, and for no other reason as gerontologists we should be saying we want to combat significant loneliness because it means people have a miserable old age, and none of us want that particularly. 

Kirsty: We’ve got a big challenge ahead of us to start challenging particularly those images you see as adverts of loneliness, and that expectation. 

Christina: I think it’s really interesting because we all have grandparents, and predominantly our grandparents are not like the people in the adverts, or they don’t have those stereotypes, but yet somehow we seem to be able to accommodate. We’ll say ‘well, our gran is an exception. This is what everybody else is like.’ We’ve just got… maybe as a society, we’re afraid of growing old, but, as they say, old age is better than the alternative. I’m not quite sure who that was. Also, it’s about meaning and purpose. If you talk to a lot of older adults, you might think well, they’ve had strokes, or they’ve had this, or they’ve had that. Jill Windells, Masters swimmer was a very good example of that, but yet there was somebody carrying on doing what they loved, which I think is much more typical than the stereotypes would have us believe. It’s like we think all teenage mothers are incompetent and feckless, and so we have whole age groups and we just attribute all sorts of stereotypes to them and don’t challenge them. 

Kirsty: And those you know are the exception to the rule.

Christina: Are nothing like that, yes. Like Jill, I’m a swimmer, and I was a swimmer when I was a kid and I’m a masters swimmer now, so I see quite a lot of 80 and 90 year olds at competitive swim meets, and you see these guys or women come out and some of them have got walkers, and some of them have got physical frailties, and they get to the starting area, so some start on the block, some start in the water. When that gun goes, they want to win. They’re not there to make the numbers up. Older people have a lot more about them than we give them credit for. 

John: It’s the difference between normal perceptions and social norms. 

Christina: Yes. 

John: the things that people do and things people think are common. The things that people think are common can actually influence their behaviour more than the actual social norms. 

Christina: Yes. 

John: It’s what am I expected to do rather than what am I actually doing?

Christina: Yes. I’m just… So I think that masters swimmer… I didn’t know him, but I know quite a lot of ones in the south of England. He was doing what he did, and for many of us we’re the same people when we’re in old age as we were when we were eighteen. 

[Music] 

Kirsty: What do you think is the top myth about loneliness?

Christina: Well, I think the number one thing is it only affects older people, which is clearly not borne out by the empirical evidence. That’s number one. We have to be … Well, the other… I’m not sure if it’s a myth, but it’s loose use of language. We use terms like loneliness, social isolation, living alone, interchangeably when they’re very different concepts, but I’m not sure that’s a myth. To some degree, it’s part and parcel of being human. Most of us experience loneliness, so to experience loneliness is not in and of itself a problem. It’s perhaps how long it lasts and when it starts to have a negative impact on your life, then it becomes a problem. In and of itself, it’s just part of being human. There are lots of other things I could say, but I think it’s important it’s not just a problem of old age. It’s just an experience older adults have in the same way that young adults do, and if you believe the prevalence rate, which shows it’s higher for young adults than older adults, that’s set a question in my mind about why is that? And is it that older people have had loneliness before? They’ve experienced it across their life course. They know for most people it’s a transient experience that’s going to pass or they’ve got strategies for dealing with it, whereas for our young people, maybe this is the first time they’ve had it. Nobody has talked about it. They don’t know what to do about it. And one might speculate that it’s much worse now than perhaps it was in the past when … I guess when I went to school, the only people I knew were the people I went to school with and the people I swam with, and we were all pretty much alike. I didn’t see glamorous eighteen-year-olds on Instagram or Facebook, and pictures of exotic holidays, and them having 500 friends and I’ve only got three…

Kirsty: You have less to compare your life to.

Christina: Yes, so there’s less comparison. I do wonder if we should think about older adults as almost being the experts in managing loneliness, and think about how we could transfer that intergenerationally like don’t worry kids, we all have it. It will pass. It may be a bit whacky but…
Kirsty: I think it’s a great idea. 
Christina: Yes. 

[Music] 

Kirsty: It was so great to speak to Christina, and we only touched the surface. There were a number of things we could have spoken about much longer and in much more detail. As we heard from Christina, data doesn’t support that people get lonelier as they get older, and actually you’re more likely to be lonely as a younger person than as an older person, so that’s the question: if loneliness is part and parcel of just being human, why do we focus so much on loneliness as a problem of older age? If loneliness is an issue that can affect any age group, why do we accept the narrative of the lonely older person as a default? Are we just playing into ageist stereotypes as well as further stigmatising the human feeling of being lonely at times? And what happens to older people who are lonely in a world where we accept that loneliness is an expected circumstance of age? How likely would you be to reach out and ask for help if the world was telling you that the way you were feeling is to be expected for someone of your age? To recognise that loneliness is an issue to be tackled across age groups and is not a natural outcome of getting older can help us to tackle its causes and work towards preventing entrenched loneliness. At Ambition for Ageing, we’re part of the Ageing Better programme, which look to tackle social isolation and loneliness amongst older people. 
Ageing Better is a £78m programme funded by the National Lottery community fund to improve the lives of people aged 50 or over. Richard Dowsett was the Relationship and Contract Manager for the fund, and was our contract manager here at Ambition for Ageing last year. I spoke to Richard at the last Ageing Better partnership conference about how the National Lottery Community Fund identified social isolation and loneliness as an issue, and how the findings of the programme from across the country, and particularly Greater Manchester, have highlighted the importance of viewing these issues with an equalities mindset. 

[Music] 

Richard: the significance of the fund investing in social isolation and loneliness grew out of the recognition that we hadn’t been looking at the issues affecting older people, people over 50 particularly, in communities across England. When the programme started over five years ago, we convened together a group of stakeholders, particularly older people themselves, to talk about the issues that were affecting them in their community, and the issue of loneliness and social isolation were ones they raised that they saw in themselves, in their families, in their friends, and in other individuals that they had contact with in their communities, and I think the nugget of that has grown into something really fascinating because for me it isn’t that social isolation and loneliness are problems in themselves, although they are. They also tend to come along with a lot of the other issues that people in later life face – poverty, ill health, retirement, a change in their social status, and how they see themselves in society, particularly as you go from having worked into a period where you might be expecting to be going on cruises and having big holidays, but actually the reality of that is quite different, and I think what we’re able to do by focusing on particularly social isolation and loneliness is wrap that up in a whole range of other issues that are affecting older people and their perspective on themselves, particularly around the marginalisation that communities feel as they age, and as individuals change their position and place in society, and particularly a society which hasn’t been particularly welcoming or open to the massive contribution that older people make and have made over generations. 

Kirsty: Moving on from social isolation to looking at building age friendly communities and making the environments in which people live, the places in which people live age friendly, looking beyond just other social connections to a whole range of aspects of people’s lives. 

Richard: Absolutely. I think that’s really crucial, and in some ways the approach that Greater Manchester has taken is quite different from some of our other partnerships, and I think it’s a real benefit to the programme to have Greater Manchester’s contribution because you’ve looked at doing work across eight of your local authority areas, funding a huge range of investments, particularly on a smaller scale, which has really spread the message of the programme and the benefits that older people can bring to communities much more broadly than we’ve been able to see elsewhere, and I think it’s very exciting that you combine that with a range of larger initiatives focusing on particular issues, whether that be issues of older men at the margins of society, the issues of carers and their families, and particularly people caring for those with long-term health conditions and how the carer feels can often be quite challenging because they don’t feel like they should be part of society if their partner is experiencing a period of long-term ill health, and I think combining that with cultural activity and arts activity, and the Festival of Ageing has been a really stimulating combination of a range of different delivery approaches that is uniquely linked to Greater Manchester, and I think that you need to reflect the diversities of the communities you’re reaching. 

Kirsty: that diversity in particular has been something that has really come through strongly in all the work we’ve done, and the focus that the programme has moved towards inequalities, and how inequalities can drive social isolation, and we seem to be finding that from across other Ageing Better areas as well. 

Richard: Yes, it is really clear now that issues of marginalisation across the life course can contribute to loneliness, and they’re particularly compounded in the older person community because often they’re first generation migrants that you might have seen who maybe have not learnt English as well as their children may have done. There’s issues of poverty that seem to be exacerbated in those groups as well, and I think that particularly the issues that affect people as they age seem to be even more compounded in marginalised communities because they don’t often have places and social spaces to meet. They often haven’t had ways to express their own cultural interests quite as much as the age. One of the fascinating things that’s starting to come out of the research that I hope we can start to explore more is that some of our conceptions around what is marginalisation and how that links to loneliness are quite different to what the evidence is saying. So we’re actually seeing in some marginalised communities, particularly the Afro-Caribbean and black community, that they experience loneliness far less than other communities, and I’d really like to explore in the future why that might be, and what inoculates them from loneliness, and what about their culture and their approach to ageing might reduce their likelihood of being lonely, and I think that would be a really exciting thing to explore amongst some of the other communities in groups that they look at, so it’s not necessarily just ethnic diversity that’s a challenge, but it’s also particularly older men have been a real challenge to reach and have been really marginalised, and trying to understand what about their lives has prevented them from engaging with some of the projects. I know all the fourteen partnerships have worked really hard at trying to understand and work with older men, and getting out into the community, and getting to pubs, and going to places where they meet, and establishing Men’s Sheds, that’s very exciting. I think in two ways. It’s really important to address the challenges that being part of a marginalised community presents in their own space and their own place, but also bridging those people together across a community, I think that’s really vital as well. So not just working in silos and not being separated, but actually bringing whole communities together, and that’s where you see really exciting social change happening when you’re able to bridge the divides that might on the surface separate people, but when you start to scratch underneath that and look at what people are really interested in, and what they really value, they’re far more similar and far more alike than might first be apparent. 

[Music] 

Kirsty: So that’s the second episode of our podcast ‘Why are there so many myths around loneliness.’ We hope that this episode has given some food for thought, and maybe we might start thinking about why these myths around loneliness exist and what we can do to help tackle them. 
Thank you to both Christina and Richard for featuring on the programme, as well as to John for taking part in the interview with Christina. Our next episode will be ‘How can we work with communities to build capacity.’ We’ll be joined by community development workers from the Ambition for Ageing programme to talk about the work that they’re doing in their local neighbourhoods. 

[Music] 

Lucy: Ambition for Ageing is a Greater Manchester-wide cross-sector partnership aimed at creating more age-friendly places and empowering people to live fulfilling lives as they age. Ambition for Ageing is part of Ageing Better, a program set up by the National Lottery Community Fund, the largest funder of community activity in the UK.  Ageing Better aims to develop creative ways for older people to be actively involved in their local communities, helping to combat social isolation and loneliness. Ambition for Ageing is led by Greater Manchester Centre for Voluntary Organisation, the voluntary community and social enterprise sector support and development organisation covering the Greater Manchester city region. The theme tune for this podcast is Air by Iliya Troyanov, and any indents this season are taken from his track Tide. Both are used under a creative commons license from his album Fugue. Thank you for listening to this podcast. For more information about Ambition for Ageing and the work we do, visit ambitionforageing.org.uk.

• Looking Back Whilst Moving Forward: Ambition for Ageing’s final report and what implications the findings of the programme have for future commissioning
• Julie and Sharon’s conversation about tight knit communities being invisibly socially isolated is further explored in our briefing, What works in tackling social isolation of older people in Bangladeshi Communities, which highlights the importance of working in a culturally sensitive ways with a community’s values to ensure you reach those at higher risk of social isolation within that community.

Lucy: This is the Ambition for Ageing podcast, episode 3: How can we work with communities to build capacity?

Julie: Looking at community capacity is looking at the assets that are available in a community and how communities can make best use of those. 

Kirsty: Hi, welcome to the third episode of the Ambition for Ageing podcast. I’m Kirsty. Each week on this podcast, I’m joined by different guests and we discuss a variety of topics relating to ageing, and this week is no different. Today we’ve invited our guests to think about the question ‘how can we work with communities to build capacity.’ This is the first of two episodes looking deeper at empowering communities to change the places they live. We’ll look at what already needs to exist in a place to begin with, what support to build capacity looks like, how inequalities existing in place can impact on building community capacity, and more. 
In this week’s episode we’re talking to community development workers Yasmin and Julie, both of whom worked with their local communities as part of Ambition for Ageing during our delivery phase to identify, develop, fund, and run a huge number of projects, all in the name of reducing social isolation and increasing age friendliness. In the spirit of cooperation, this episode really is a team effort. We’ve brought in other members of the Ambition for Ageing team, Darren and Sharon, to talk to our local leads in Bolton and Bury to find out about the work they’re doing on building capacity within communities. 
As with most of the interviews featured in this podcast, all of these discussions took place pre-Covid, and, as a result, the pandemic doesn’t feature in the conversations. However, as you’ll hear, a lot of what was discussed can shine a light on what needs to be done post-Covid to help not only with recovery but also with moving forward into the future too. 
Yasmin Holgeth worked for Bolton CVS, one of the hosts for Ambition for Ageing. As with all the Ambition for Ageing areas, Yasmin’s work focused on building age friendly communities, supporting older people to work out what that means for them, and working with residents to allocate small investments to support this. Before they both left for pastures new, Darren caught up with Yasmin over Skype to chat about working with the local community in Bolton and how you can build capacity alongside the communities themselves. The audio quality is a little lower in this section, but hopefully it’s still very listenable. 

[Music] 

Yasmin: Building community capacities all around maximising the strengths of community access, so this can be residents that live within areas that you’re working in, but it can also be some of the local partner organisations and businesses that you’re working with, but it involves giving residents the leading role in participation and encouraging residents to actually identify solutions to issues in the areas where they live, so it isn’t about living in a place where everything is done to you, and if you’ve got an issue, you ask for help and somebody else solves the situation. It’s about residents looking at what are the issues in the place where we live and how can we come to a solution that we can be part of creating together. 

Darren: Why do you think it is important for building community capacity, as that’s what we’re focusing on. The opportunities for funding are more easily accessible. 

Yasmin: Building community capacity enables residents to grow in confidence in raising issues that they might have found in the areas where they live, and by involving residents in raising them issues and coming up with solutions, it might be that we’re introducing small changes that are having a massive impact within neighbourhoods that you might not see as an external body or an external agency, or an organisation looking at a community, and when you’re involving residents and building that capacity and confidence within residents in addressing local issues, it brings meaningful results to the people that live there because they’ve been part of identifying that issue and finding a solution, so it isn’t being done to them. It’s very much they’re involved in finding that solution, and it’s a result for them. It’s important to offer a variety of methods for people to find ways to get involved in things such as Ambition for Ageing and influence change because if you just use one method then we’re risking repeating cycles of marginalisation, which might have happened traditionally where the same people aren’t accessing programmes like Ambition for Ageing, and them same people are getting missed off the picture. I guess as funders, we need to be flexible on how we invest in communities and take that pressure away from people who are applying for funding because the pressure away from them sitting in our boxes, we need to think right, if we genuinely want to see some innovative change and new approaches, we need to be using different methods to engage with people and gather them ideas and invest in communities because, if we’re using the same approach, we’re probably going to get the same people always coming to us. 

Darren: And I suppose historically it’s the people with the loudest voices that have been able to get involved, so it requires creativity as funders to enable others to access it. My next question is about sustainability. In terms of sustainability, how important is building the capacity of individuals and groups, would you say?

Yasmin: Building capacity of people within communities needs to be done using a person-centred approach because we need to understand that some people may quite readily be able to take a leading role within communities to come up with solutions to issues and be quite vocal. Like you were saying before, the louder voices might often be heard. But it doesn’t mean to say that the smaller voices or the people that aren’t confident in speaking out about issues in their area haven’t got important things to say, but we need to find ways to support them people in finding their voice, and we need to be flexible and find methods for people to see their strengths, but try and avoid that sense of dependency on service providers because, when we’re talking about sustainability, we need to think what will happen after initiatives such as Ambition for Ageing go into communities and how can we maintain some of the work we’ve done, and if we’re building a dependency with residents on us as a service provider, we run the risk that when we step away, everything falls down. Within Bolton, our small investment process is focused heavily on supporting groups to establish their projects and then stepping back away from the projects as service providers and letting them deliver the project data with minimal involvement of our staff team, and we’ve always given projects and groups a point of contact so if there is anything that they want to chat about then they don’t feel completely in the wrong because we wouldn’t want people to feel like they weren’t supported, but then we also don’t want people to feel like they can’t survive without us there, and we want people to think about solutions themselves to issues the projects might be facing without straightaway turning to us and saying ‘Can you solve this?’ And if there are any issues, we’ve got that open door relationship but we’re not constantly with the group because we want them to continue and genuinely be empowered to deliver the projects without us. 

Darren: So that when Ambition for Ageing has left the stage, they should have been empowered to know how to navigate some of the systems themselves and maybe pick up some more funding, if necessary, or do what they need to do to keep the good work going. What kind of barriers have you faced, particularly when it comes to reaching and engaging with, and capacity building more marginalised groups?

Yasmin: One of the challenges that we’ve faced would probably be confidence, the confidence of residents, because if people don’t feel like an asset or feel like they’ve got something to offer then they don’t generally feel able to influence change, and they’re not as forthcoming with their ideas for things that they think need addressing, and to try and overcome this, we looked at each of the neighbourhoods that we were working in, and we offered additional support around different things, depending on the local demographic and the support needs within them areas. In some places, we do asset-based community development workshops where we’d meet with the residents and help them look at what are the skills within the local community. What skills have people got that they can bring to the table? They were really supporting people to see actually, I’ve got lots of skills that make me an asset to this neighbourhood. 

I think traditionally people might identify the word asset as something financial, and when you’re working in poorer communities, people might not see themselves as having any assets, but when you explore who they are and what they’ve got to offer the community, they’ve got lots of really strong assets, and it’s about pulling that information out of people and helping them see what they’ve got so that they can build that confidence and engage in programmes like Ambition for Ageing. I think from delivery of the Ambition for Ageing programme, it’s highlighted to us the scale of social isolation and that it’s actually much bigger than we perceived it to be because many older people have engaged in the programme to really build capacity within their neighbourhoods themselves and got involved, so some of our volunteers and the people who lead some of the projects we’ve invested in, when they’ve engaged with the programme, they’ve been quite verbally confident, and we perceived they’d be quite socially connected, but then after getting to know these people, we’d speak about how socially isolated they were out of the group settings and out of these projects. 

So when they go back to their home at night, they were socially isolated, and the programme’s really highlighted that for us that even when we’re perceiving certain people as being quite connected, that they aren’t necessarily as socially connected as we see them. With the programme enabling people to see their strengths, it’s kind of built individuals’ confidence in taking control of their own lives, and given them a sense of worth, which they might have felt like they were lacking, and it’s empowered them to search for things that they want to engage with. I think it’s really encouraged other organisations to use similar approaches because people have seen how well it’s worked, and thought actually why are we not doing that? Why are we not involving service users or client groups, or just groups of residents of any description in the design of what we’re delivering if it’s something that the end product is supposed to be benefiting residents, and that’s a real positive step in the right direction for the future of service delivery. 

[Music] 

Kirsty: it was really interesting to hear Yasmin talk about those small changes having a big impact. It seems that sometimes we miss out on making changes to a place because it feels like it may be an all or nothing situation. Seeing the work Yasmin and the rest of the Ambition for Ageing local leads have done on working with communities to make small changes and the massive impact these changes have had, both to the areas they're working with and also how individuals have grown in confidence with the products they’ve have developed has been really interesting to witness. Yasmin's point about the need to reduce dependency on service providers and supporting people to recognise their own strengths and solutions is really key point to think about, especially looking towards the next few years for the voluntary sector and the impact on the availability of long-term community development funding that the Covid crisis has caused.

[Music]

Kirsty: In the next part of the podcast, we feature a conversation between Julie Bentley, who was the project coordinator for Ambition for Ageing in Bury, working for groundwork, and Sharon Summers who has worked as both a development officer and a contracts officer here at Ambition for Ageing. Julie had a long history of community development and, as with other local leads, groundwork support the local volunteers to act as co-investigators and co-designers as they go into communities and find out what strengths a local community has that can be built upon with small investments 

Sharon has her own history of working in community development and she brought some of her own experience working with communities to the chat with Julie about understanding how inequalities can impact on building community capacity and how sometimes we can find community spaces in places we don't expect.

[Music] 

Julie: It's about looking at what individuals and groups can do, and I think also looking at community capacity is looking at the assets that are available in a community and how communities can make best use of those, also working with individuals and finding individuals who want to support the building of community capacity.

Sharon: So it sounds like getting those kind of key people is really crucial.

Julie: It is yeah. I think without the key people to do it, you need, even if they're not leading something, if they're involved with it, if they're passionate about it, but it's finding those people who can really see why these community places are needed, what can be done with them, and how it affects the community. Also, I think it's about an understanding of what a community means to people. One of the things that I think we've found is a community is a different thing in each ward and also a different thing within different groups within each ward, and all of those communities are valuable, all of those communities are essential to how that area runs, and getting those communities to know each other helps to build the community capacity, and I think that's essential. It's the people that are completely essential to building community capacity, but they need to have spaces to be able to develop community capacity 

Sharon: So in terms of if we're looking at sustainability, how important is building the capacity of individuals and groups to help make things sustainable?

Julie: People themselves are very understanding of things being sustainable. They’re very understanding of not wasting money and things like that, and I think through that, that helps to build the sustainability of an area. Working with a range of different age groups as Ambition for Ageing from people that are over 50, there's a massive generation of people within that that age range itself, and through engaging with people at all the different ages keeps the sustainability going.

Sharon: Right because, as you said, people are living longer aren't they? And so what perhaps someone needs and wants at say 50/51 might be very different from what someone who's 81/91 might need and want.

Julie: Yes, and it's also then looking at sort of the intergenerational thing of that because exactly that, somebody who's 51 may well connect better with somebody who's 45 than they connect with somebody who's 93, and I think it's recognising that, but also getting individuals within the community to share their skills with those people who might not quite be 50 or are just in their 50s so that those community skills don't get lost, and things are built up for a future. For example, when we when we set up the LGBT forum, the group were very adamant that they wanted it to be an intergenerational group because they felt that being a marginalised group, to have a group of over 50s within a marginalised group only isolated them further. So they wanted it to be intergenerational so that everybody was included from the LGBT community in Bury. The other reason they wanted that was quite simply so it would last longer where, if they've got all ages involved, it's got the longevity to carry on running.

Sharon: So they'd actually got almost like a natural understanding of how to make their group and what they wanted to do sustainable.

Julie: Very much so, and I think going back to the start of the project in Bury, a lot of the community libraries were closed, which had a massive impact on a lot of people, and I think your building community capacity is looking for places where you can almost put a large amount of activities and things going on because that will make that place sustainable, whereas if you’ve got lots of activities, one in one centre, one in another, one in another, then there's no sustainability for the actual building, and I think that's important to make sure that people know what they're looking at, and people know the sorts of places nobody can guarantee that somewhere's not going to close, but you can give it its best possible chance of not closing through understanding whose building it is, how involved in it are they, what can they do to support, and working that way because when the libraries closed, areas did lose lots of community groups.

Sharon: So I know that you've kind of sort of alluded to it, but what kind of barriers have you faced, especially when it comes to reaching and engaging with, and capacity building for the more marginalised groups?

Julie: I think in in some cases, it's identifying where the groups are and how, recognising that, depending on the marginalised group you're working with, you can't make a full assumption of where people fit, so whether somebody is part of a marginalised group or not. My experience has been people don't stand out a mile if you go to a community group that's quite inclusive. It may be that there's somebody in that community group that's not shared something that makes them part of a marginalised group. I think identifying people is the first part. I think through capacity building and having the individuals, you can find that out because people will start to share that information. But I think actually approaching the marginalised group, so where there is perhaps an organisation or a distinct group, it's to approach people, build up that trust and relationship with people because that's essential.  If that's not there then trying to explain to somebody what we're trying to do in reducing isolation and things like that doesn't necessarily flow for someone, and also I think understanding the way different cultures work. Some cultures will say ‘well, you know, we … older people within our culture aren't isolated because we look after them, we do this,’ and all these different things, and they don't recognise it in the same way that other cultures recognise it.

Sharon: So it also sounds like there might be sort of key players within certain communities that might kind of be saying it's not an issue or it's not a problem in our community, but actually it might well be, so sometimes it's about getting over that barrier of say key figures within communities to kind of to actually reach those people who might well be isolated but there's all those kind of things about we we don't want to kind of say, or our perception is that they're not.

Julie: Yeah, very much so. 

Sharon: Because from our point of view, we don't think they are, but actually the people on the ground might well be.

Julie: Yeah, and I think it's understanding as well. I think sometimes we we've gone to an older people's community group … we went to an older Asian community group and they were very much ‘no we're not isolated, we don't do this. Our families do these things for us and we don't need that.’ When you talk to their families, their families are now recognising that they need that because their families are working so they can't be there all the time to support them and help, so they're recognising that they need it, and it's about engaging with those families as well so that they can pass the understanding through.

Sharon: Yeah, because it almost sounds like there's a bit of a disconnect between the families and the and the older people.

Julie: Definitely.

Sharon: And there's almost like assumptions perhaps by the older people thinking that this is what our families do, and the families are saying our circumstances have changed now over the years.

Julie: Yeah, we're not able to do that anymore. We can't do the same as you did for your parents because we're doing these things, and that I think helps bring people together. I think one of the other things that I’ve found is actually encouraging groups to set up in places where they perhaps wouldn't have done before. So we have a project that runs out of the Green Café, which is a cafe in a park called the BAME Project, and it actually stands for Believe, Achieve, Motivate, Empower, and they're running out of what is predominantly a white British used café, and they're running out of that, but what that means is they're engaging within the community. So when they have their launch event and when they have their activities, there's now a mix of people going to those because people can see something going on actually in the space that they would usually use. So it's kind of about blurring the lines of kind of unsaid borders where people live there, those people live there, these people live here, and actually blurring those and breaking them, and ‘did you know’, and bringing people into those areas that they can do things in.

Sharon: And that's definitely kind of come out of the programme isn't it? It's about kind of overcoming and sort of challenging that people like me, and that kind of links very much into… because sometimes defaults in any kind of groups and in any ages can be you tend to stick with people like me because it's comfortable.

Julie: Yeah.

Sharon: and it's about… when you talk about blurring, it's about how the you know the work that you've done within Bury, and the work of Ambition for Ageing is also about giving opportunities for connections and networks to be made so people kind of, in a safe and comfortable way, can link in with people who aren't like me.

Julie: Definitely, definitely, and I think as well it's important to recognise that using the people like me, people need to have that identity and they need to blur, and I think it's important to recognise that that's not people working in silos and working individually. There is a need for that, and I think that's evident from all our marginalised groups. We have a member of the LGBT forum who said he was very, very isolated, and now there's the forum he attends the forum and he's also now thinking about attending other things, which previously wouldn't, but he describes the forum as the ‘safe place’. That's where he feels safe, but now he's starting to be able to go to other places because of people he's meeting so I think it's really important to remember that the marginalised groups and anyone really needs to have their own ‘like me’ groups and their own blurred lines groups, just in the same way as people have their own hobby groups where you have like-minded people going fishing or woodworking. It's kind of the same thing and it's getting people to understand. I think it's very much a verbal conversation from people who get it as such that there isn't a difference between people, but people like certain things, and that can be spending time with people like me, or it can be spending time with people who like the same hobby as I like, or it can be spending time with people who you can find things out about and people you've perhaps not come across before and kind of blurring it all up a bit, and actually probably finding that a lot of those people are people like me.

Sharon: Exactly. So the primary aim of Ambition for Ageing programme is to reduce social isolation in older people. How important is building community capacity in achieving this?

Julie: I think it's having the people, and I think it's having those key people who understand that social isolation is a thing. They know their neighbours. They know their residents and can highlight who is isolated, and they can make sure that those people are spoken to. People talk quite a lot about how isolation comes about and how you don't have the milkman anymore who sees that somebody's curtains are closed. You don't have the postman there all the time, so people can't interact with people in the way they did before. People don't feel as safe in their communities, so I think the more community capacity there is, the safer people feel, the more people start to notice things, and I think it's educating people because you can start off with a small group of people who understand it and are building the capacity in their area, and that can be expanding their own community group or setting up a new community group, but then it's about creating a bigger network of people so you've got four or five community groups working together, and then building that so it almost spirals into something where sometimes ‘I’ve not seen such body for ages’ and lots of people know this and this thing's going on, and I think as well, in the community capacity, it's looking at what people are doing and reminding people that if you're out litter picking and every Sunday you go litter picking and somebody across the street says good morning to you, but then suddenly that person's not there, it's checking in, and people are starting to recognise that. I think community capacity lets that happen because people feel like they're part of a community.

Sharon: Sure, and they're looking out for each other.

Julie:  And they look out for each other.

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Kirsty: Hearing Julie talk about how when you look at a community from within you get different results and solutions than looking at it from outside is so important, and to hear her push that point about how the definition of listening to a community must be all perspectives, not just those that fit into our boxes. It links in with the thread running through both conversations around including all people who can make a contribution, not only from an accessibility and inclusivity perspective, but also working with local organisations, local businesses, as part of the community to ensure that what is designed and delivered truly meets the needs to the people who live there. 

Hearing Yasmin, Julie and Sharon speak about how people can do great things but their own confidence can be a barrier is a point I think I’ll take away from these discussions, and how building confidence is as complex as people are. People's lives and experiences are part of it, but how much support is given as another part, and the ability to gain confidence through practice is critical too. I found Julie and Sharon’s discussion about the types of community spaces being used particularly interesting, and it connects in with this wider conversation about the need for safe spaces for marginalised groups. The idea that we can have some places where people can feel safe amongst people similar to themselves but also blur the lines of other spaces where people can meet others who they may traditionally not spend time with such as running a cafe for one group in a space traditionally used by another group, opening up those opportunities for people to learn about each other and those they perceive to be different from them without the pressure of entering a space that may not feel like it's for you.

In our next episode we'll be talking to Sophie Yarker from the University of Manchester, who has carried out research on the importance of these kind of spaces, as well as how we can use places and spaces in our communities to help them survive and thrive, and we'll also feature a conversation between Sharon, who you heard earlier, and a GMCVO researcher Susanne Martikke who discuss what happens when these spaces are not available in local communities.

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Lucy: Ambition for Ageing is a Greater Manchester-wide cross-sector partnership aimed at creating more age-friendly places and empowering people to live fulfilling lives as they age. Ambition for Ageing is part of Ageing Better, a program set up by the National Lottery Community Fund, the largest funder of community activity in the UK.  Ageing Better aims to develop creative ways for older people to be actively involved in their local communities, helping to combat social isolation and loneliness. Ambition for Ageing is led by Greater Manchester Centre for Voluntary Organisation, the voluntary community and social enterprise sector support and development organisation covering the Greater Manchester city region. The theme tune for this podcast is Air by Iliya Troyanov, and any indents this season are taken from his track Tide. Both are used under a creative commons license from his album Fugue. Thank you for listening to this podcast. For more information about Ambition for Ageing and the work we do, visit ambitionforageing.org.uk.

• Sophie’s report, Social Infrastructure: How shared spaces make communities work argues that to reduce social isolation, we need a diversity of social infrastructure to ensure chance social encounters with a diversity of people.
• During the episode, Sophie mentions Klinenberg’s, Heat Wave: A Social Autopsy Of Disaster In Chicago, which pinpoints race, inequality and isolation as causes of death during the 1995 Chicago Heatwave.
• Ray Oldenburg's concept of Third Spaces entered the lexicon through his 1989 book The Great Good Place.
• Camden’s work on Starting conversations with older men on the street in order to increase engagement is mentioned during the episode.
• The Centre for Ageing Better showcased Camden’s work in their blog How services can reach older men.
• Susanne’s overview of Social Capital gives an excellent introduction to the concept for VCSE organisations.
• The first of three researchers mentioned by Susanne, Putman’s Bowling Alone introduction to the concept of social capital.
• Coleman’s theory of a rational choice approach to social theory is the second of three researchers mentioned by Susanne
• Bourdieu arguments that social exchanges are not purely self-interested is the third research referenced by Susanne

Lucy: This is the Ambition for Ageing podcast, episode 4. Why are places and spaces important for communities to survive and thrive.

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Sophie:  If you are just around people who are different from you, that goes someway to breaking down prejudices and preconceived ideas.  It’s not enough on its own for sure. We need policies, strategy, and kind of a bigger societal shift, but it is certainly better than having parallel, or parallel communities where you never see anybody look different from you, who thinks different from you, or has a different life experience than you.

[Music]

Kirsty: Hello, and welcome to episode four of the Ambition for Ageing podcast, I’m Kirsty. This is the second of two episodes, looking deeper at empowering communities to change the places they live.  Last week, we spoke to community development workers about building community capacity, looking particularly about working with individuals.  This week we’ll feature conversations about what needs to exist in a neighbourhood for communities to survive and thrive, and, unusually for this podcast, these were both recorded in February 2021.  So, we’ll also touch on the impact of Covid 19 on our communities.

One thing that is clear from the Ageing Better Work nationally is the importance of social infrastructure, the spaces and opportunities within a community that allow for social interaction to occur anyway you can think of, where you would see other people, speak to other people, be in some form of contact with other people.  Any sort of public space, but also semi-public spaces.  These kinds of spaces include traditional voluntary sector offers, like community buildings, social groups, but move beyond that into places like parks, shops, cafes, and events like community festivals.

All this space allows people to gain social capital, which is the connections and relationships between people, that allow them to trust and support each other.  There’s been a lot of work published about social capital, and its many forms, and we’ll link to some of the studies in the show notes.  Here in Greater Manchester, Doctor Sophie Yarker, a research associate with the University of Manchester, worked with us to explore the role of social infrastructure, and the benefits it brings to building age friendly communities. 

Sophie has a background in human geography and sociology, with research interest in community belonging in civil society.  Prior to working with us Sophie was a research associate at Aberystwyth University, and a teaching fellow at Newcastle University, where she gained her PhD in human geography.  Here’s our conversation.

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Sophie:  I think it’s probably worth saying a little bit about what we mean by social interactions.  It can be somewhere that you go with friends that you already know.  So, if you go to, if you go to a local market for example with your friends, to meet them there for shopping etc, and also to socialise, that’s an example, but also any kind of like fleeting interactions.  So, you know, if you go to the local library quite regularly, you’ll probably get used to seeing the same faces there, more or less every time you go, but you won’t know their names, you might say hello to them, you might not, you might just kind of recognise them, be familiar with them.

So, interaction can be anything from like strong kind of bond connection with people you already know, or develop a friendship with, but it can also be more fleeting, and kind of… also non-verbal communication as well, even just kind of seeing people, and being familiar with them, it doesn’t necessarily have to be talking.  So, there’s a whole kind of spectrum of different types of social interactions that happen in social infrastructure spaces.

Kirsty:  We talk a lot about social capital is important to building social connections.  How can kind of those spaces, those social spaces or that social infrastructure, you know, help us to build those social connections?

Sophie:  There’s quite an interesting idea that when we talk about the social capital that we need as people, and particularly older people need, we can think about it like a vitamin model.  So, it’s not enough to just have one type of vitamin, you need multi-vitamins so to speak, to make… to kind of have a functioning healthy life, and it’s the same with social capital.  It’s not just enough to have really good strong close friendships, you also might need kind of friendships outside your normal circle, or connections outside your circle to kind of… to gain access of different types of information etc.

So, older people particularly need different types of social capital, different types of social relationships to support them, and ageing in place, and different types of social infrastructure will do the job of kind of creating those connections in different ways.  So, kind of an obvious example of a piece of social infrastructure that’s very good for creating bonds between people who have something in common is a religious organisation for example.  So, if you are regularly going to church services in a Catholic church, you have that kind of bond in common that your kind of worshipping, a practicing religion in the same way.  

So that’s a bonding capital.  But then think about parks and green spaces, obviously they are used by a diversity of people.  They’ll be people in the park who have got nothing to do with you at all, from completely different backgrounds, social, economic, cultural backgrounds, but you are still coming into contact with those people and may have different types of interactions with them.  So when we’re thinking about how social infrastructure supports social capital, it’s important to think about the diversity of social capital that we need, and therefore the diversity of different spaces to support those connections and bonds being built up.

Kirsty:  Yeah, and it’s those spaces where there’s that opportunity to meet people different from yourselves, the different ethnic, religious background, gender sexuality, generations etc.  And we know that spending time, even that fleeting time that you mentioned with people, who we perceived as different to ourselves, highlights the similarities between people, and could potentially even help us overcome preconceived notions, prejudices, that kind of thing as well?

Sophie:  Yeah, there’s a lot of work in sociology and human geography around… particularly around inter-cultural connections.  So, we’re talking about culturally diverse communities. 

So, lots of work in that area around what we call everyday multi-culturalism, or everyday conviviality, and there’s also a theory of meaningful contact, and all these things basically mean, that if you are just around people who are different from you, that goes someway to breaking down prejudices and preconceived ideas.  It’s not enough on its own for sure, we need policies, strategies, and kind of a bigger societal shift, but it is certainly better than having parallel societies, or parallel communities when you never see anybody look different from you, who thinks different from you, or has a different life experience than you.

So, we need to be around this difference, and have encounters with difference, on a day-to-day bases for it to build up some understanding of difference, and some understanding of how people live their lives in different ways. 

Sophie:  Another important thing we found with ambitious ageing was the importance of word of mouth for promoting events, activities, etc, for older people to become involved in, and word of mouth only really works if you have spaces where people can talk to each other and share information.  So again, I think that highlights the importance of infrastructure as a space where information can be passed on, and particularly where it can be passed on through different networks, and different circles, because if you are only talking to people in your own social group, or your own cultural background, or your own, you know, people with the same background of experience, etc, to you, information will just be circulated within that group.

The importance of having an everyday space that everybody uses to some extent, is that that information can then be transferred into different networks, and kind of you can spread the word about things happening in the community more widely.

[Music]

Sophie:  I think one of the interesting things that we’ve found from Ambition for Ageing was the role of everyday, or neutral spaces.  I think certainly from a programme that’s come from the community and voluntary sector, there’s obviously huge emphasis on the role of community and voluntary organisations in supporting age-friendly communities, and that is still hugely important, but for some sections of the older population, they aren’t comfortable with community organisations, or community centres.  They’re not familiar with them, they maybe wouldn’t think to visit them, they maybe have certain preconceived ideas of them.

So therefore, looking at what spaces those groups are using, and it tends to be the more neutral everyday spaces.  So, spaces like coffee shops, cafes, restaurants, the kind of unassuming third spaces the older folk talks about, spaces that don’t necessarily have a social remit as their main function, but the do kind of foster those social interactions anyway.  They can be really important in kind of reaching the heart of each if you like, or kind of engaging with section… more marginalized sections of the older population, who might not be coming to community and voluntary spaces as their first port of call.

So, there was some research in Camden as well, that’s been really good at looking at this, and using some outreach work to kind of go to these everyday mundane, ordinary spaces to engage with men particularly, who they found weren’t engaging with the programme when it was coming from a community and voluntary angle.

Kirsty:  Yeah, and it’s almost that the community and voluntary sector have provided kind of a brokering relationships rather than necessarily delivering kind of building those connections maybe outside of the sphere where they would traditionally do so.

Sophie:  Yeah, and I think they are increasingly looking at different spaces that they can use as well.  So different spaces that they can host functions in, and activities, and organise events etc.  So yeah, I think it does demonstrate the change in roles of community and voluntary sector in this, and kind of moving into different spaces that they maybe haven’t worked in so much before, and it also having highlights then the role of other types of social infrastructure, particularly within the commercial sphere to have more connections with community and voluntary sector, and to work in partnership with it more, I think.

Kirsty:  It’s the feeling of belonging to a place where it’s that whole place, not necessarily the areas where you’d get kind of traditional community and voluntary service, but your café, your library, your local park, you know, festivals, things like that, that really build towards that feeling of belonging for a person, and we know how important that sense of belonging is to people, that connection to where they live.  When you feel you belong to a place, you have more impetus to go out, and to contribute to the place.

Sophie:  Yeah, you certainly have… a belonging goes hand in hand with wanting to show a sense of commitment, and a show of care for where you live.  So being in more involved with it, and that doesn’t necessarily have to do formal volunteering, that can be through kind of, kind of helping out with neighbours, and kind of doing more informal kind of care around the community etc.  So, I think the importance of belonging is huge, especially for older people who maybe on more kind of tied, or rooted in their local communities, and to spend more time there. 

If their community changes around them, through regeneration, or gentrification they can feel kind of less attached to where they live, if they feel like its not for them anymore.  So, through them still being involved in social spaces, and still being involved in social infrastructure spaces, that gives them a kind of anchor to place, I think, which then can then kind of go on to other connections, and other spaces as well.

Kirsty:  Yeah, we saw during the pandemic that there were huge numbers of mutual aid groups springing up, and where there were neighbours who were ready and willing to pitch in and help out, but it doesn’t always have to be a crisis to create these kinds of connections.  It feels that there are more organic ways of developing those kinds of links as well.

Sophie:  I think what’s interesting with the kind of community hubs that sprang up, and also the kind of more informal network is, those networks have not come from nowhere, those networks have been able to respond, because those ties were already there, and if those social ties were already there, it suggests that there were some social infrastructure underpinning in the first place, and I think what would be really interesting to do, would be to look at where community hubs have responded to the crisis, and where different informal networks kind of mutual aid groups, things like that. 

Where those networks have formed, and how successful, for want of a better word, they’ve been, and to look at places where they maybe haven’t evolved so much, and to look at maybe what the underlying infrastructure causes are behind that.  I think it’s really similar to Eric Klinenberg’s study of the Chicago heatwave in 1995, when he looked at different death rates to do with the heatwave, and he found that the presence of social infrastructure was a key determinate he felt in how those death rates differed.  

He said that in communities where there were really good social infrastructure, and there were lots of shops, and amenities, cafes, etc, for people to see each other, and kind of have some sense of community, the death rate was much lower in those communities, and he thinks it was because people were much more likely to form these kind of mutual aid networks, and helping each other out, check on neighbours, etc.  So, it would be really interesting to see if there was like a similar picture with the response to the Covid crisis.

I would imagine there would be, but it would be interesting to test it out, I think.

[Music]

Kirsty:  Whenever the topic of social infrastructure, and its role in feelings of belonging comes up, it makes me think about my uncle, who I’ve spoken with about this, and probably listened to this podcast to.  Hi, Uncle Jack.  He’s daily routine includes a number of social connections to where he lives, with very little pressure to develop formal connections.  In normal times he gets the bus to his favourite café, where the staff know his name, they have his cup of coffee ready for him as he sits down.  In his local shop he tends to go to the same cashier each time.

He’ll also take time out of his day to have a sit down in his local community garden, and just watch the world go by.  He’s not the kind of person who enjoys the pressure of social groups.  So, these relationships however fleeting, allow him to feel a connection to where he lives in his community.  Recently, as well as the impact of Covid on things like travel, he’s local shopping centre closed down, so he lost his local shops.  Like many people in his position, this loss is acute, losing places like shopping centres is not only about the loss of business and shops, also about the connections and relationships that are built and maintained in these spaces.

Do you remember a conversation with Sophie, she mentioned the role of voluntary and community sector, in helping to broke relationships within these social spaces?  It was this topic that I spoke to my next guest who is, Susanne Martikke leads on research at Greater Manchester Centre for Voluntary Organisation. GMCVO, or Ambition for Ageing Space.  She has more than ten years of experience in third sector research and is currently a case scholar in sociology at the University of Manchester.  

Susanne also hosts the Greater Manchester third sector research network for academics interested in the third sector, and third sector practitioners interested in research can come together and learn from each other.  Susanne has currently researching community-based organisations in two deprived urban neighbourhoods.  She’s looking at whether these organisations help with the building of social capital, and what types of social capital they facilitate.

I spoke to her about this, how the third sector can use social capital theory to both demonstrate value, and better meet the needs of their local communities, and we also spoke about the dangers of social capital as well as its benefits.

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Susanne:  So social capital, you know, its face value, it’s quite a simple concept, so it basically refers to the value of social relationships, but of course, once you start looking more deeply, there’s actually a lot of controversy around that term, and what it should mean, and you know, the different types of social capital, and broadly speaking kind of three main approaches.  So, the first one is around Putnam’s Bowling Alone, which is quite famous in policy circles, and he says social capital is basically formed when people live in a community, and a geographical community, and who they encounter, and he actually attributes very distinctive role to civic associations, so to voluntary sector organisations. 

So, when people encounter each other in these sorts of organisations and activities, they basically start trusting each other, because they have engaged in these frequent face to face interactions, and because ideally, they have worked on something together on behalf of these organisations… in these organisations.  So, and then there is another theorist, his name is Coleman, and he emphasized that social capital, yeah, it is about relationships, but it matters how people are related, and the way people are related, and to how many… 

To how many people they are related, and how many of these people are related to each other in turn, can influence the individual decisions that people are taking.  So for example, somebody might decide to lend somebody else some money, without , you know, formal contract, just give them some money and have a lot of faith in them giving the money back, because both of these people who are participating in this interaction might know… might be embedded in this whole fabric of relationships, where it really becomes a problem if you are known… if you become known as somebody who doesn’t return money that’s been borrowed to you.

So, this is an example of how trust is created, and norms are enforced in a tightly knit community, where people know each other.  So, and then the last theorist is called Bourdieu, and he focused a lot on the individual outcomes of that sort of relationship.  So, while social capital is a benefit that’s occurs to people as a result of being part of a group, it is definitely as he sees it, a benefit that is an individual benefit.  So, as a result individuals may consciously decide to actually invest in certain relationships, with certain people, because they think that that might bring future benefit.

Yeah, and so as a result, social capital is not only about the relationships that you have, but it’s also about the number of relationships, and the resources that you can require as a result of these relationships.  So, it is actually closely intertwined with your overall social economic position.

Kirsty:  So, do you think that more organisations should pay attention to the concept of social capital?

Susanne:  Social capital is ultimately about the value of social relationships.  So… and that could be either for individuals, or for communities.  A lot of… I mean most voluntary organisations that we kind of encounter in our everyday work for chance,  we all in the business in creating relationships through their work, and so I think, if we think about relationships as something that has value, not only for the individuals involved, but also has a broader community value for the public good essentially, and if organisations can talk about social capital in this way, then that will help them prove the value that their work has, but there is also a second reason why I think that they should be more aware of this.

It’s because social capital as a concept can actually shed a lot of light on how relationships work, and that different relationships should have different advantages, and disadvantages. So, just as an example, understanding the differences between wanting social capital, which is relationships to people who are quite similar to yourself, and bridging social capital, which is roughly speaking relationships to people who are quite different from yourself, so understanding that difference can help organisations understand why they’re for example not reaching the individuals that would most benefit from their services.

For example, a lot of organisations that I’ve come across, often rely on word of mouth, as one of their methods for advertising, or publicising a service.  Really what it does is that essentially those people are most likely going to spread it to people who are like them, in order to reach those that are really socially isolated.  So, they may have a few links to friends and family, but beyond that they may really just be in their home, and not have many connections.

So, in those situations you have to actually come up with a ray of mobilising, you know, bridging capital in some sort of sense, and that could be by using either a service that’s in touch with people like that, and then advertising your service through the networks that this organisation has, you know, who is in touch with some socially isolated people.  You know GPs have been mentioned for example, and some projects have used door knocking as well, talk to people on the doorstep, and try that in order to widen your networks, and yeah, so those sorts of things.

Kirsty:  I think it highlights the importance of social infrastructure in shared spaces, and those shared spaces that are maybe less structured, so parks, and cafes, and those kinds of places that are of benefit.

Susanne:  By definition being inside your home means you are basically only surrounded by people who are either part of the family already, or who have become so close that they are welcome in your home.  So that can be very comforting, comforting space where you have control over what happens, and who comes in, and of course, very much needed, you know, that’s a very important aspect of, you know, life, that you have a space where you are in control, and nobody else can come in unless they are invited, but at the same time it can also be limiting, and I mean it’s I think this is something that we’ve seen through Covid. how it has essentially curtailed people to their own private spaces.

Generally speaking, I think leaving your home means you encounter people who you… well, first of all you have no control over who you encounter, and also, they may not necessarily be part of your inner circle.  So, by definition you broaden your horizon by that.  Yeah, you can observe people, and that’s why I think that spaces like parks, and you know, spaces that kind of invite people to linger a bit, and to just observe other people, because it’s one thing entering into a relationship with somebody, where you know, you might then actually, you know, maybe even move towards friendship, but it’s another thing to have these sorts of casual relationships where, you know, you might see somebody on the street, and you might see them the same time every day, and you may exchange a few words, but you may not actually ever develop that any further, and become friends.

They give you something that, you know, relationships to friends and family don’t give you.  I mean one for this matter is actually unpredictability, you don’t know what’s going to happen, right.  I mean you know with friends and family you have certain patterns, you know, you have routines, you kind of know what to expect.  So, it’s unpredictable, but it also opens up opportunities, you know, because you might learn something new if you encounter different people, you know, they might know things that you don’t know.  So, there’s all a whole lot of, you know, aspects to be gained from that.

Kirsty:  So, do you think it’s a question of ensuring that shared spaces are in place, or is something more needed?

Susanne:  Shared spaces, the existence of shared spaces is definitely already a step forward, but I don’t think that’s enough, just from my own study.  I just found that it’s very much about how those spaces are managed, and how accessible they are.  So, I think, yeah, based on what I’ve found, I would argue that places themselves send out certain clues to potentially users about who they are for, and what they are for.  So, you cannot simply assume that there is, you know, okay, we have the space, there’s no barriers, you know, you just… you’re welcome to just drop in.

That alone won’t actually guarantee that people will use it and envisage way.  So yeah, you might have the community centre, and it has the aspiration to be a shared space, where people genuinely can just, you know, work in no matter who they are, but just be virtue of what goes on there, the types of people that can be seen around there, the timing of things sometimes, and also the layout of the space itself, it just sends certain clues to people, and they will interact with these clues to say, either, yeah, this place is definitely one that I would got to, or they would say, well, no that’s definitely not a place for me.

People generally like to associate with people who are like them, no.  So that is actually a very powerful principle, and that is something that has actually been proven in many different studies, that people with primarily associate with those who they perceive as similar, and so in other words, it’s not enough to provide spaces that are technically accessible, and open to all, but it is actually important to make a deliberate, you know, have deliberate interventions that bring people together, who perceive each other as different.

Kirsty:  And do you think that that contributes to any risks that people may need to be aware of when they are managing shared spaces?

Susanne:  Yes, I think the biggest risk about managing a shared space is mistaking informality for inclusiveness.  So, I’ve seen this in my study, that people generally think that if a space is informal, it is also inclusive, and that’s simply not the case, and that is for the same reasons that I was mentioning about word of mouth, using word of mouth as a way of publicizing your service.  Yeah, the main risk is obviously that the space is not accessible, or inclusive, or that worse, even it is colonized by a number, you know, a certain type of people.

If you rely on informality for people to access the space, then they will automatically sort of revert to their, to that principle I mentioned, which is, you know, they like to be around people who are like them, and they judge places accordingly.  So, if they don’t see people who are like them in that space, then they will shy away from it, and if they see people in that space, they will kind of feel more welcome, and so I think, as somebody… as an organisation that kind of curates this space, you have to be extremely aware of the implications for engagement. 

So, you have to be aware of the space, and what… and those sort of subliminal of messages it sends out, you know, who would feel welcome there automatically, and who would maybe need a more… a little more help to access the space.

[Music]

Kirsty:  It was interesting to hear Susanne talk about how the act of simply leaving your house forces a broadening of horizons.  We know that just walking in a park can reduce isolation.  Perhaps this maybe the mechanism for why.  I’d like to focus on Susanne’s point on how informality does not guarantee inclusivity.  I think back to moments in my own life, where I’ve entered a space, and immediately felt like an outsider, and I’m sure most people can relate to that in one way or another, but spaces designed to be open to everybody, can become exclusive through domination by cliques and more simply, like the layout of the space. 

Your first impressions of the people already using the space, activities run, timings, are useful points to consider.  If we consider the risk of social capital as an oppressive force, allowing power to those who hold the relationships, and by virtue of these relationships, physical space.  You can easily see how marginalization can occur in communities without intervention.  Marginalization and equalities is the topic of our podcast next week, where we’ll be talking about what we know about inequality drives social isolation.  I’ll be joined by Professor James Nazroo from the University of Manchester to talk about the impact of inequality on people as they age, and some of the stark health outcomes related to this.  I will also be chatting to Julie Bentley, one of our local leads for Ambition for Ageing, about how we can work with communities who face marginalization to help breakdown these barriers.

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Lucy: Ambition for Ageing is a Greater Manchester-wide cross-sector partnership aimed at creating more age-friendly places and empowering people to live fulfilling lives as they age. Ambition for Ageing is part of Ageing Better, a program set up by the National Lottery Community Fund, the largest funder of community activity in the UK.  Ageing Better aims to develop creative ways for older people to be actively involved in their local communities, helping to combat social isolation and loneliness. Ambition for Ageing is led by Greater Manchester Centre for Voluntary Organisation, the voluntary community and social enterprise sector support and development organisation covering the Greater Manchester city region. The theme tune for this podcast is Air by Iliya Troyanov, and any indents this season are taken from his track Tide. Both are used under a creative commons license from his album Fugue. Thank you for listening to this podcast. For more information about Ambition for Ageing and the work we do, visit ambitionforageing.org.uk.
 
[Music]

• Fair Society Healthy Lives is the official title of The Marmot Review. Published in 2010, this was an independent review to propose the most effective evidence-based strategies for reducing health inequalities in England.
• Health Equity in England: The Marmot Review 10 Years On looks at the findings of the Marmot Review and analyses what has changed since its publication.
• Public Health England’s review on the disparities in risks and outcomes of Covid-19.
• The Centre for Ageing Better have inequalities as one of their focuses.
• We published a Toolkit for Inclusion in Practice, which provides 24 real case studies illustrating different ways of equalities approach to programme design.
• The National Lottery Community Fund published Engaging Marginalised People Over 50 as their fourth Learning Report, bringing together learning from all 14 partnerships.
• The Ambition for Ageing Equalities Board created a spatial model to support working with marginalised communities.
• The Ambition for Ageing Equalities Board also published a briefing on how to make age-friendly neighbourhoods inclusive.
• The event page for Bury Rainbow Train.

Lucy: This is the Ambition for Ageing podcast Episode 5. What do we know about inequality drives social isolation.

[Music]

James: Over a two-year period, a rich person’s chance, the richest 5th of the population chance of social, becoming socially excluded is only a 5th of that of the poorer, 5th of the population.

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Kirsty:  Hi, I’m Kirsty, and welcome to the 5th episode of The Ambition for Ageing podcast.  That was James Nazroo, one of our guests for this episode, talking about our topic for today.  What do we know about how inequality drives social isolation?  This is the first episode of a two part, looking at this topic.  Inequality has come up time and time again when we’re looking at the causes of social isolation, and we only need to look at how the early impact of Covid 19 replicated existing health in equalities, and in some cases, increased them to see that there are vast differences in the way that we experience life changes, based on our advantages, or disadvantages in life.

When it comes to social isolation, we know that an individual characteristic, such as gender, ethnicity, and sexuality, play a huge part in their experiences, and risk levels, as highlighted by the Centre for Ageing Better.  As we get older, the steady accumulation of a lifetime of advantages, or disadvantages, together with differences, such as our ethnicity, where we live, our income, result in vastly unequal levels of health, wealth, happiness, and security in later life.  Within our own work Ambition for Ageing, we’ve also looked at the barriers people may face in accessing community activities as a result of a lifetime of inequality.

Within this episode we take both the practical, and an academic approach to the subject, featuring interviews with Professor James Nazroo, an expert in ageing and inequalities, and we re-join a conversation between Ambition for Ageing, leading Bury, Julie Bentley, and my colleague Sharon Summers.  Sharon spoke to Julie, who worked on Ambition for Ageing in Bury, back in episode 3, about her working with communities to build capacity.

In this episode we follow up with her, about how inequalities can have an impact on the opportunities people have to have their say in their local communities.  Sharon spoke to her about this, and how an off the cuff suggestion led to a rainbow train, to celebrate pride.

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Sharon:  What issues did you face, when working with groups of marginalized people in Bury.

Julie:  I think there is building, building up trust, building up understanding of what we were trying to do.  I think a lot of people when we talked about micro funding especially, a lot of people from marginalized groups where quite fearful of that, that somebody was coming in and giving them money.  So, building up trust, and building up good relationships with people, and finding where those groups are meeting, because people are meeting and working out how you can kind of work within their communities, where you start off from, where you build up the trust from, and how you get to know people who are doing things.

Sharon:  And I think you also kind of mentioned when we were talking before, about sometimes it’s also about kind of working with volunteers, and perhaps about their assumptions about kind of communities and groups.

Julie:  Very much so, I think, I think, you know, and I think it’s a national feeling giving mainly by the press, and how things are perceived about the fact that, you know, why are we targeting like marginalized groups, why are we looking at marginalized groups, because they have the same opportunities all the way through the project, as anyone else has to apply for funding, or to get involved, and people are a little bit resentful sometimes of the fact that a groups being targeted, and being given something that nobody else was just given.

So, actually managing those sorts of assumptions, and getting people to understand that that’s but why? Why are those marginalized groups not doing it?  So almost turning it on its head, and instead of having this press driven, I think, feeling of…

Sharon: Us and them, and

Julie: ‘We’re being left out’, and us and them, and they’re being treated differently to us.  Actually, look at why, why is that happening, why doesn’t that marginalized group feel like they can do that, because rightly it is there for everyone to apply for, but why don’t they, and it’s finding that out, and engaging with the communities, but letting volunteers, and people find that out as well.

So, bringing them into contact with people, but also putting it in the context of perhaps their, their lives as well.

Sharon:  So it sounds a bit like it’s, it’s having that open dialogue, and conversation in a kind of a supportive way to perhaps challenge people’s assumptions, and to kind of talk through that it isn’t kind of just okay, enough to say, well anyone can come, or anyone can apply, because actually, for some communities and groups it isn’t a level playing field, because people do have additional barriers.  Obviously, you’ve done clever, amazing work within Bury, and can you tell us a bit about the work that’s been done to engage the LGBT community?

Julie:  So, one of the, one of the focus groups that we, we worked on as a marginalised groups was with the LGBT community, and we did something slightly different, we, we, kind of followed a process of trying to engage with what was going on.  When we started Ambition for Ageing, there was Bury Pride, but I think then was in its second year, and there was the LGBT employee group, which was for employees of Bury Council.  There was no age definition on that, and obviously the Bury Pride didn’t… but when we started talking to people, people didn’t know Bury Pride existed locally, and if people did were very much with the assumption that it was for younger people.

Bury Pride started with a rainbow walk, which the younger, it was very much younger people that… So, what we tried to do was, we initially had a meeting about what people wanted, did people want something different, did they not, and who would be willing to support something if we were going to do it.  I think one of the things we found out from that straight away was that, people did want to do something, but they didn’t necessarily want to have a social group, people were quite happy to carry on with their lives, and do what they were doing, but what people wanted was to have somewhere where they were accepted, where it was safe, where they had a voice, and the obvious link to was to link something with Bury Pride.

What we, what we did then, we had an awareness event, and opened up to lots of organisations, services etc, with the idea being that we would get people to come, and actually find out what was available, and if they had got different issues with things, to be able to talk to them.  And I think two things came from the meeting, which were that the phrase of, we treat everyone the same, didn’t work for people, people felt that there is a… and rightly so, there is a huge difference between, we treat everyone the same, and we treat everyone as an individual, and people felt that the same was, well we treat you the same as we treat everyone else, and we have this standard list of questions for the majority population, it were heterosexual.

So, we asked everybody the same question.  Those questions may not be suitable to somebody who’s looking for a carer, or mainly have different needs.  So that was one of the things that came up, which lead to a Pride in Care event, where they offered workshops for carers, people who are being cared for, people who were interested, LGBT people to find out actually how to deal with all this, and it was a great platform for things going on in Bury, and also for people to see that the foundation, or the LGBT foundation already had things in place.

Sharon:  That could almost be used as an additional resource, and a kind of support…

Julie:  And people just don’t know about them in a lot of cases.  So there was that element to it.  So, the other thing that came from the meeting was, we had a conversation about how people could get involved with Bury Pride, where there was a sense of, yes, people really wanted to get involved with it, but they didn’t, for many reasons, and we had an older gentleman who suggested we had a gay train.

Sharon: [laughs] Okay.

Julie:  And people in the room loved it, thought it was great, nobody was offended, it was very much, you know, a fun idea for people to do.  From that meeting that idea kind of shelved itself a little bit, because I think, you know, there was very much… not exactly realistic, great idea, that we’ve got this fantastic East Lancs Railway in Bury, a great idea, but not sure that fits anyway outcome, any anything, and who’s going to do it, but from the back of that they developed an LGBT forum.  So, people then started to take on different roles within that, and supporting different things that were going on, and getting involved in different days, and raising awareness, and a higher profile, and the train came up again, and was renamed the Rainbow Train.

And at that point there was groups of people who were quite committed to doing something with it, so we had volunteers who went to the railway to book the train, and then we had the train on Sunday of Bury Pride.  So, it’s made Bury Pride bigger, but it’s made it very acceptable to older people as well, and some people didn’t come on the Saturday, and did come on the Sunday, some people just because they knew about it, came both days.  So, its opened up a whole awareness of something.  The train was very open, anybody could go on the train.

So it’s, it’s brought a lot of people together through understanding those barriers, and also looking at a marginalized group, and how they can be affected by things.

[Music]

Sharon:  Why do you think targeted equalities work is important?

Julie:  I think simply because it makes sure everyone is involved, and going with this, you know, it’s all inclusive, everyone is involved.  They’re not… if they’re not actively being included, and I think it’s about making sure that everyone feels as included as anyone else.  I think it’s very easy to, for people to get involved with something, and then say, well why are they not.  Well, maybe because they can see that the group is predominantly white British, so they’re not getting involved, because there’s an assumption.  So I think actually actively involving people.

Sharon:  And that’s definitely come out of the work of Ambition for Ageing, that in addition to doing, and a general approach, you also need a targeted approach, there is otherwise you can exacerbate, and kind of highlight kind of isolation if you don’t target, do target some work…

Julie:  And you can create a larger barrier, between them as well, because there’s a focus on one, and not on another, and I think you can break that down by making sure you’re targeting everybody in the community.

[Music]

Kirsty:  I love the idea of a rainbow train chugging its way through Bury, what a brilliant idea.  Hearing Julie talk about how a large part of her role is helping community members understand why others get extra support, is something that will chime with many people working in local communities.  Breaking down those complicated topics like structural inequalities into easy-to-understand conversations is no easy feat, especially when we’re working with people who maybe haven’t had these kind of thoughts and ideas presented to them before.  It’s something that we’ve seen a lot from our community workers, where there’s a need to be highly skilled in working with communities, to navigate the complexities of these conversations, and often gently challenge preconceived ideas.

The fact that not everyone is involved if you don’t actively include them is an important thing to note, when carrying any kind of activity, but particularly community activity work. It simply isn’t enough as Julie said to just say that everybody had the same opportunity to get involved as anybody else.  People’s journeys leading to that same place will differ, and with many facing more difficult barriers to others, to treat everybody the same is going to ignore these barriers.  It was these barriers, and their impact on lifetime opportunities that I spoke to my next guest about.

Professor James Nazroo is a professor of sociology at the University of Manchester and has been the director of the Cathie Marsh Centre for census and survey research since April 2010.  He’s interest in sociology began while he was studying medicine at St George’s Medical School in the early 1980s, when he became aware of a range of sociological enquires into health, and the health professions that problematized much of what we take for granted, such as inequalities in health.  Before coming to Manchester, James had a number of research fellow positions, where he worked on topics ranging from, gender inequalities, and martial violence, to ethnic inequalities in health.

He was also contributor to the Marmot review into health inequalities, which is still used in policy today.  I spoke to James about the impact of inequality on people of the age, and he shared some of the stark health outcomes that are connected to these inequalities.

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James:  So inequalities are a crucial shape for almost everything that older people experience as they grow older, almost everything, not everything, but almost everything as they grow older.  Most strikingly you can see in terms of health outcomes, with the difference between richer and poorer people in relation to health, being very, very large.  So, if you take just something like the top 5th of the population in terms of wealth, compared with the bottom 5th of the population in terms of wealth, in terms of their health, on average there’s a fifteen-year gap between the two.

So, 75-year-old person in the richest 5th, has a similar of kind of health to a 60-year-old in the poorest 5th.  Just say that again, these are 5ths of the populations, so these aren’t extremely rich or extremely poor people.

Kirsty:  So very large amount of people?

James:  Yeah, yeah, so it covers a significant proportion in terms of the comparison, not extremes in terms of the comparison, and show a dramatic difference, and you see the same in terms of live expectancy, so it’s not just in terms of experienced health, also when people die, and there is close to a two fold difference in the chance of dying between the richest 5th, compared with the poorest people, after you’ve taken account of a whole range of other risk factors.

Kirsty:  So your research does focus a lot on that social economic differences, and ethnicity as well.  Could we talk a little bit about that as well?

James:  Yeah, absolutely.  So, we see striking differences in terms of levels of poor health amongst ethnic minority people, compared to the ethnic majority, white people, and again it’s usual of magnitude in terms of comparing people’s health that… at different ages, and these differences grow as people get older.  So, it’s not a static difference, but it’s present across the life course, but a growing difference that becomes huge, once people get into their 60s and 70s, and it’s not just health that matters of course to older people, a whole set of other things matter, and these inequalities shape a whole set of other things as well.

So, it shapes their engagement in the whole set of pairings of life that they think are important.  Their social connections, their engagement in cultural activities, their engagement in social activities.  It affects things like the stuff that connects them to the rest of the world.  So, their digital connection for example varies dramatically across different wealth groups, over and above the differences in relation to age, and continues across generations.  So as digital connectivity increases, increases at not greater rate for poorer people than richer people, which means the cap stays the same.

Kirsty:  What mechanisms are in play there, that cause these stark differences?

James:  So the inequalities in relation to social economic position are driven by a whole range of tightly interrelated factors.  So you can think about the ways in which they shape the housing that you live in, how they shape the area that you live in, how they shape your access to certain important goods, that enable you to do stuff, the computer might be one, or a smart phone might be another, or a car might be another, or easy access to transport, other forms of transport might be another.  They also shape the way in which you perceive yourself in society, and so we know that richer people perceive themselves as higher up in society than poorer people, and poorer people see themselves as lower down in society.

And that perception of yourself, and your standing in the world, then shapes the things you do, and shapes your health.  So it shapes your access to cultural activities, but it also shapes your health.  There’s a whole set of mechanisms that are important there, and these are all present for ethnic minority people as well of course, so social economic disadvantage is a driver for the experiences of ethnic minority people, but for ethnic minority people we also have to think about discrimination, prejudice, and racism, and the ways in which that shapes their life chances.  So how it shapes their access to social economic goods, but also how that impacts directly on them, and there is a suggestion for older ethnic minority people, the disadvantage that they’ve experienced has just accumulated across their life course, leading to widening inequalities as they get into later life.

[Music]

Kirsty:  Yeah, and the research that we’ve done as part of Ambition for Ageing looks at, looks at some of those marginalized and characteristics that goes, you know, on to LGBT, older people, or people with disabilities, it kind of mirrors a lot of the stuff around social economic status, and ethnicity as well.

James:  Yeah absolutely.  So, there are many dimensions of inequality that are operating in our society of course, and, you know, some of the big ones that you’ve identified around disability, around sexuality, but also gender of course, as well as social economic position, and race, and ethnicity, and others.  In detail of course, the ways in which these mechanisms operated different for each of these dimensions of inequality and come together with people who have multiple dimensions of inequality.  So, understanding that may require a different approach for different dimensions of inequality, but fundamentally it really is about how people’s positions in society is challenged.

How they are made to feel uncomfortable in society, or in certain dimensions of society, whether that’s because they haven’t got enough money, or whether it’s because their identity is wrong, or perceived to be wrong.

Kirsty:  And these have an impact on social inclusion?

James:  So those have an impact on a whole range of dimensions of our life, of course, and they can be summarised… many of them can be summarised within a notion of social inclusion.  So, whether it’s access to the cinema, or whether it’s access to a social network, or whether it’s access to shopping facilities, or whether it’s access to the digital world.  They are all things that can be jointly summarised in terms of a notion of social inclusion, you know.

Kirsty:  And you’ve done a lot of work around social exclusion, so why do you choose to focus on social exclusion rather than social inclusion, and how do they differ for you?

James:  Yeah, so that is a very interesting question, and it’s… I guess it’s a question you’re asking someone who does empirical research, and so, the way in which we do our empirical research is, we part shape by the kinds of data we collect.  So, the kinds of data that we would use, or that I would use, say, can we get to a cinema, do you go to the museum or art gallery, can you get to your GP, can you get to your Post Office, and then it becomes very much of binary of yes, no, which then it becomes a measure of social exclusion. You cannot do certain types of things, and that does reveal dimensions of inequality very, very clearly.

And so, we show for example, that over a two-year period, a rich person’s chances, the richest 5th of the populations chance of social… becoming socially excluded is only a 5th of that of the poorer 5th of the population.  So that shows you… so that does become a very powerful tool to illustrate over time how these inequality dynamics impact on social exclusion.  How does it relate to social inclusion, I would argue that these are kind of polar ends of the same concept, and so in policy world, it’s very important to think about, I think it’s very important to think about social inclusion, and I think that for two reasons, so I’ve told you I do social exclusion, because that’s the way our data comes, but for a policy point of view, you want to think about what you can do to get people socially included.

And then you want to think about social inclusion as a continual.  So, some people are able to engage with more things than other people, and then it becomes a lot of binary can I get to it or not, it becomes how much of that good can I have.

Kirsty:  And that links in with social isolation as well for those who are unable to be socially included?

James:  Yeah, I mean social isolation is a complex topic of course, because social isolation in a sense captures someone’s environment, and not the causes of that environment, so their lack of connectivity to any environment, and not the causes of that, so we need to think about the causes of social isolation, in much way as people might want to think about the causes of social inclusion, or social exclusion.  Some people, not many, but some people of course choose to be less engaged than others, and so we need to take that into account as well, which is why I also like the concept of loneliness, which is a subjective lack of wellbeing in affect, which might be driven by social isolation, but it also might be driven by other things of course. So sudden connective people of course feel lonely.

Kirsty:  Yeah. And do think, because it’s quite a, almost a steer towards looking at loneliness amongst older people, you know, it’s on the news a lot, and is there something in that, like why, why do we focus so much on loneliness?

James:  Yeah.  So, loneliness is very good way of getting people motivated, talking about loneliness is a very good way of getting people motivated in any dimension of life, but if you think about the lonely older person, then that is something that I think broadly we will agree is not something that should be happening in our society, but people should be connected, they should not feel lonely.  So from that point of view I think it’s a very good thing to think about, but we also need to think about I guess two difficulties with the idea of talking about loneliness, and particularly in relation t older people, and one thing is that, older people are not becoming more lonely, in fact the opposite is happening, and so if we post our emphasis on loneliness, and on loneliness as something that we want to address, then we can all feel pretty confident that it’s being addressed already, and why bother about all the other dimensions of inequality that are in important.

And so, my emphasis has been primarily on other dimensions of inequality, but I think are crucially important, and if we think about ultimate outcomes in terms of wellbeing, and so on, then those other dimensions alongside those are very, very important.  So how happy someone is, how well they feel they’re developing, how good they feel about, how satisfied they feel about their lives, and so on.  Those things are really very important as well.  And then the second problem is, it’s not clear from conceptual, or an empirical way of thinking, whether loneliness really adds anything to our understanding of inequalities that people face. Importantly loneliness doesn’t explain more in terms of risk of death, than social isolation for example.

[Music]

Kirsty:  Speaking to James about this, with his wealth of knowledge on the topic, really brings home how differently we experience ageing as a population.  Not only in the striking differences that grow larger over time, but in how our perceptions of ourselves, and our own status shapes our health and behaviour as we age. 

In the next episode of this podcast, we’ll be talking to a number of older people who will be sharing their stories.  We’ll talk to them about how it is growing older, and the impact inequalities has had on them, and their friends.
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Lucy: Ambition for Ageing is a Greater Manchester-wide cross-sector partnership aimed at creating more age-friendly places and empowering people to live fulfilling lives as they age. Ambition for Ageing is part of Ageing Better, a program set up by the National Lottery Community Fund, the largest funder of community activity in the UK.  Ageing Better aims to develop creative ways for older people to be actively involved in their local communities, helping to combat social isolation and loneliness. Ambition for Ageing is led by Greater Manchester Centre for Voluntary Organisation, the voluntary community and social enterprise sector support and development organisation covering the Greater Manchester city region. The theme tune for this podcast is Air by Iliya Troyanov, and any indents this season are taken from his track Tide. Both are used under a creative commons license from his album Fugue. Thank you for listening to this podcast. For more information about Ambition for Ageing and the work we do, visit ambitionforageing.org.uk.

• Pride in Ageing was launched by Sir Ian McKellen in June 2019. It aims to help ensure that Greater Manchester becomes one of the best places for LGBT people to grow older.
• Our partners over in Leeds published an excellent two-part podcast titled Diverse Voices, where they spoke to older people from diverse communities about ageism and discrimination.
• Ambition for Ageing led on a national report looking at the importance of social infrastructure for older people from ethnic minority communities.

Lucy: This is the Ambition for Ageing podcast, episode 6. Stories from older people and the impact of inequality and the importance of diversity.

Michael: My grandmother was the Lady in Waiting to the last Emperor’s wife of Imperial China, she was the first, with my mother, that I told that I’m gay, and that was at the age of 9. My grandmother turned around and said, ‘What is so special about that? The many things that happened in the palace behind the scenes is enough to surprise me and shock me,’ so tell her something new so to speak.

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Kirsty: Hi, I’m Kirsty and welcome to the sixth episode of the Ambition for Ageing podcast. As you heard from the small teaser before the opening title today we will be hearing stories from older people on the topic of growing older as a member of a marginalised group. If this is your first time joining us we would recommend checking out the whole series, in particularly the first part of this two-parter on inequalities, last week’s ‘What do we know about how inequality drives social isolation?’ We did record these pre-covid which is why you can hear us all in the same room in some of the discussions.

Anyway, I’m sure you’d rather listen to our guests rather than me giving you a long introduction so let’s jump straight in. Our first guests are all members of Pride in Ageing run by the LGBT Foundation. Launched by Sir Ian McKellen in June 2019 Pride in Ageing has already made huge strides in helping to ensure that Greater Manchester becomes one of the best places for LGBT people to grow older in. 

Pride in Ageing was set up in response to concerns that too many lesbian, gay, bisexual and trans people over the age of 50 are living in isolation and facing discrimination as a direct result of their sexual orientation or gender identity. Laws change but attitudes can be harder to shift. The initiative is ensuring that the voices of LGBT older people over the age of 50 are heard when it comes to ageing policy and activity in Greater Manchester. With an advisory group of 18 LGBT community members at the heart of the project the views of LGBT people in mid and later life are now also directly informing the services and support delivered by the LGBT Foundation.

Pride in Ageing is also set to launch a new quality assurance standard and social prescribing service which will help adult social care services and housing providers to better support the LGBT residents and service users. Pride in Ageing’s varied programme also celebrates being an LGBT person over 50 in Greater Manchester, it’s campaign ‘Come Out With Us’ tackles social isolation and exclusion by creating spaces where over 50s can come together, socialise and learn new skills, helping to build an active and empowered community.

About six months after the programme launched I had a conversation with Pride in Ageing members, Ian Dyer, Tony Openshaw and Philip Harper-Deacon, we started by talking about the inequalities that LGBT older people face and why they got involved in Pride in Ageing.

[Music]

Ian: There is a problem with social isolation for old LGBT people both in the housing sector and in the care sector.

Kirsty: Why did you personally choose to get involved with this project?

Ian: I’m a volunteer with the foundation and I’m 70-plus and as such this was one I was very keen in being involved to represent the older LGBT community.

Philip: From my perspective, I’m now 66, but for years now I’ve been saying, ‘Why the hell aren’t there any gay LGBT rest homes, respite care?’ It’s only now we see this happening. Where I’m coming from is I don’t want to spend the rest of my days in a straight environment, I’ve been gay all my life and I want to be with like minded people who know how the psyche works. There is nothing there at the moment, absolutely nothing. I mean I’m fine at the moment but at some point in my future life I am going to need the benefits of living out in a care home or respite care amongst my own kind.

Tony: A lot of us older people live on our own and we’re concerned about the future.

Philip: The other problem is, of course, you’re living on your own, how do you find all these isolated people? I know no-one in Manchester, my husband died in February and he was the only person who knew me because we were so involved with each other [inaudible], it’s only now, six months after his death, that you think, ‘Hang on a second.’

Tony: Yes, I understand.

Philip: It is actually how do you access these lonely, single people? There is no forum for it at all.

Kirsty: I think that links in with that older LGBT people are more likely to be socially isolated.

Philip: It doesn’t bother me being isolated, I’ve never been lonely in my life, I’m perfectly happy with who I am and what I am, I’ve been like that for the last 66 years, but it would be nice to actually associate with likeminded people.

Tony: I don’t feel lonely but I feel very socially isolated. I don’t know if I can make a distinction there, I was with a partner for 30 years who died, I’m from a generation where I know about 100 people who died through HIV so you don’t expect to lose a lot of friends at a young age, you expect that to happen when you’re in your 80s and 90s. I’ve lost those people, I’m socially ostracised by my family members, I only have one relative who is friendly to me who lives abroad, I see her once a year, and I have family members who live quite close to me, within 15 miles, who don’t speak to me and haven’t spoken to me for 35 years simply because I’m gay. I don’t feel alone because I have a big, gay family but I do feel socially isolated.

Philip: You see I don’t have a gay family, I’ve lost not only my carer, my husband, my travel companion. I love travelling but I’m reluctant to go on my own.

Ian: I feel that as well.

Philip: There should be groups that enable single people to link up with shared common interests. How the hell we do it I do not know.

Ian: I think it depends really again on the individual, I’m fortunate that I’m pretty outgoing, I have not just LGBT interests but straight, like our running club as well where I’ve been a member for many, many, many years. I had a civil for 12½ years but I’d already built up additional outside interests as well, not just the foundation of course, church for example. Again it is very much to the individual.

Kirsty: There is that do you go to activities that are specifically catered towards LGBT people in which maybe it’s a safe space that you feel you can be yourself or whether there are barriers to accessing activities? You referred to straight activities such as where there are a range of people, that maybe you’re not sure what will happen if you approach that group that is maybe made up of not only LGBT people but non-LGBT people as well.

Philip: It’s all very well having the legal society thing, we’ve got to be accepted within these groups, but I don’t want to be going in there because I’m wearing a label saying I’m gay, I want to be accepted because it’s me. 

Ian: Absolutely, yes.

Philip: It’s legal criteria we’ve got to be inclusive, or all inclusive, and it doesn’t hold with me I’m afraid.

Ian: It’s a case of, as it should be, ‘It’s Philip, who just happens to be gay,’ or, ‘Tony, who happens to be gay,’ or, ‘Ian, who happens to be gay.’

Tony: I just think that we identify as gay but we’re more than gay, we have interests like music and theatre and so on. I like to be in a group that is made up of the LGBT community because people just get you and just understand you and know where you’re at. Also I have outside interests as well like the theatre and music and so on and you mix with other people. It’s just about understanding and acceptance. I think during my lifetime things have changed tremendously, I haven’t had eggs thrown at my house for a long, long time, that happened about 40 years ago, and I’ve been beaten up on Sackville Street, that was 30 years ago, things have improved. 

I think we’ve had to fight for our rights over many years but what I feel like, I live in Manchester, I see the tram stops and they’ve got rainbow flags on the tram stops and you see a rainbow tram and you see a rainbow police car, those sorts of things make me feel really proud.

Ian: Yes, absolutely.

Philip: Isn’t it strange though? I’ve been pioneering all my life and here we are again in our later years and we’re still pioneering for the imbalancement of those who are going to follow in our footsteps.

Tony: I feel like I’m an activist all my life.

Philip: Absolutely.

Tony: And I’m always going to get it.

Kirsty: It doesn’t stop.

Tony: It doesn’t stop, no.

[Music]

Kirsty: After speaking to Ian, Tony and Philip I was introduced to Michael Teo, another member of Pride in Ageing, who shared with me some surprising stories from his life and his thoughts on the importance of representing the Chinese community in Pride in Ageing.

Michael: I’m interested to get involved in the Pride in Ageing for two reasons, one is I’m afraid I’m growing older and secondly I would like to represent the Chinese community in this Pride in Ageing. I find that the Chinese community have been ignored, they have been side-lined, for so many years, hence they are reticent of being involved in anything in case they are rejected. That is why they have never put themselves forwards and that is why I am here. Also I would like to encourage, as we are only about 200 yards from the Chinese community, we must be represented, come on, let us come out and be counted.

Kirsty: We know that research talks about how older LGBT people are more likely to be socially isolated and that people from minority communities are more likely to be socially isolated and there is going to be an intersecting part there for Chinese older LGBT people.

Michael: This has not happened to me personally but according to what I’ve been told by various friends of mine LGBT people, when they come out in the Chinese community, are rejected. The reason being that in a foreign place we need to show that we are just as good and to show that we are a member of the LGBT community shows that we are not just as good, there is something lacking in us although we may be professionally much better or on the same par with the indigenous people.

I’ll give you an example, my grandmother was the Lady in Waiting to the last Emperor’s wife of Imperial China, she was the first, with my mother, that I told that I’m gay, and that was at the age of 9. I did tell my grandmother and my mother that I am not going to marry a woman and my grandmother turned around and said, ‘What is so special about that? The many things that happened in the palace behind the scenes is enough to surprise me and shock me,’ so tell her something new so to speak.

Also my aunty is a trans woman, she is the first woman engineer of Malaysia but when she told the Malaysian government that they said to her that if she were to repeat that she would be thrown out of Malaysia or she will be in prison. When she became a trans woman her mother died and she was the only one standing on one side of the coffin because on the opposite side were all her siblings. My mother followed the coffin last and she was surprised and she immediately joined my aunty because she’s a cousin. That is my mother’s family, they are very, very tolerant, they are very open minded, they are very liberal in attitude, because they are from an old family in China, they have seen it all.

Kirsty: What can be done to help remove barriers for people to be able to grow older as they are rather than maybe having to go back into the closet or to never have to come out?

Michael: It’s a very difficult thing because all the time Chinese are confronted with this loss of face. As we are confronted with this of loss of face and this attitude towards society, towards putting on a front, towards trying, endeavouring, attempting, to be better or to be the same as everyone else so as not to look inferior, not to feel inferior, then that is a cultural strain which is very difficult to break. How to go about it? That is why I’m here, I’ve come out, I’m proud.

Just to tell you something, I came from St Paul’s in London, the public school, when I was enrolled there after my friends, classmates, when they were more conversant with me so to speak, when they knew me more, they asked me if I had ever been in a closet. I couldn’t understand what that meant because since the age of 9 I have not considered that I’m different, I haven’t got two heads, I haven’t got four eyes and am just as much a human being except that I am a homosexual and I’m proud of it. 

My father’s family may not be tolerant of me, they are tolerant now but they may not be tolerant of me then, have accepted me for what I am. My friends are their friends and my relatives have got so used to me that they are unable to distinguish me or think of me in any other way. 

So I think to remove barriers is slightly difficult because of the cultural… I think the word is baggage and that they are burdened with that. Otherwise I think the only way to go about it is just to be normal and be myself and to say, ‘Here I am, I can do nothing other.’

[Music]

Kirsty: It was such a joy to get to speak to the Pride in Ageing group and I hope you found our discussions as interesting as I did on the day. The final discussion featured on this episode was between myself, Izetta Enisuoh from the Greater Manchester Older People’s Network and Atiha Chowdhry from the Greater Manchester and Manchester BAME Networks.

As well as being a member of the Greater Manchester Older People’s Network Izetta is a very active member in her local community, in particular her church and African and Caribbean women’s group.

Atiha is chair of the Greater Manchester BAME Network which aims to provide networking opportunities and better access to knowledge, information and support for black and minority, ethnic and refugee, voluntary, community and social enterprise sector organisations across Greater Manchester. Atiha is also chair of the Manchester BAME Network and a deputy lieutenant of Greater Manchester. During our conversation we spoke about the impact of family structures changing, working in intergenerational ways and the importance of taking a neighbourhood approach rather than setting up a big service.

[Music]

Atiha: There is a very growing concern about isolation and loneliness amongst black and ethnic minority communities. Some of it is about the fact that actually the whole family structure for some communities, so if you take the South Asian community that I know quite well but it probably applies to other communities, the family structures are changing a lot. So many people might find themselves no longer living in extended family structures or with family nearby with jobs and opportunities being elsewhere for their families. They might find that children have moved away and they’re left on their own.

So I think that that is quite a big issue in that people may be still thinking that BAME communities have all the support structure and network around them but actually we find more and more that people are living on their own, they’re quite isolated. Then the other factor for them is that they probably hadn’t planned for that change and they relied on their family and friends and children for support and information and things, so they have lots of barriers about accessing services or even having knowledge about where to access services. There is very little information specifically targeted at BME older people that they can understand so that they know how to access services and what to do if they need support and help essentially.

Kirsty: Izetta, does that ring true for you? You’re on the Older People’s Network and you’re part of many different community groups.

Izetta: Yes, and Age Friendly Manchester, we come across quite a lot of older people who are now lonely, as you say the family has moved. They rely on community groups to give them a bit of support and company. Also I think the local churches play a great help with that as well.

Kirsty: Do you think that’s one way you can help tackle social isolation by supporting communities such as those built around churches, built around religious institutions?

Atiha: Yes, I think so. I think as people get older if they weren’t already quite connected to faith I think as they get older the pattern is that people get more into their faith. Some of that is because they have more time as they reduce working, moving to retirement they’ve got more time to spend on that faith. So those places of faith are actually really good places to engage with older people because if they go anywhere, even if they’re not accessing services which they don’t know about or they’ve got language barriers or stuff, they may still be accessing on a daily or weekly or more regular basis their places of faith. So I think we are missing an opportunity by not having targeted support around all of that, which I think is happening in some places now, but I think that places of faith are still doing everything as they see it and they themselves may not be connected to what’s out there and what’s available so they could connect better the people that come to their places. So faith plays quite a large part I think in ageing for people and how they spend their time. 

Kirsty: I see you nodding along there.

Izetta: Yes, that’s true, the community groups as well were a great help but with cutbacks and so forth they’re not as many as they were before, a lot of the community groups have closed down.

Kirsty: Would you say that there is a role for people to self-organise and run groups for themselves?

Atiha: I think you can but you still need some resource and I think space is an issue. I’ve been doing some work in my local area and I think this keeps on coming up about, ‘Where do we meet? Where is the space and space that we don’t have to pay for? Who is going to organise it?’ So I just think that that is quite a lot of work, people want to do that but they still need some sort of a capacity, whether it’s voluntary or resource that’s committed to organising that.

So I kind of keep on thinking that it’s quite a good idea to take an intergenerational approach to some of this as well. So I find that working with younger people in the community, and I don’t mean by that 16 to 24 year olds, but people who are not 50-plus yet. There is an intergenerational thing that we should be doing, that there might be people who are quite keen on supporting services around older people because actually they’re worried about their parents and their grandparents themselves. 

So you quite find when I go to organisations they say, ‘Quite often we get telephone calls from the children because they’re worried about leaving their mum or dad home all day and they’re like, ‘Is there something going on? Can we come and drop them off at a service?’’ So I think we need to think about all of this in an intergenerational and more holistic way, particularly in the BME sector you’ve got quite a lot of generic organisations, you tend not to get organisations that are specifically 50-plus but they’re generic because everybody comes there. So I think that’s where they need to be placed because they’re more likely to meet other people of different ages and all the rest. So that actually on a health and wellbeing issue is much better as well.

Izetta: One of the things that sorts of restricts our elders as well is transportation because there are cutbacks here, there and everywhere, they can’t travel as freely as they would like to, so that needs addressing, transportation.

Atiha: But then people say to me that some communities of interest, for example some Asian women, may still not take a bus, for example. So we’ve seen things that used to be in the community in terms of community transport, ride and dial services, have also gone or they’re very expensive or they don’t suit their timings. So I think we need to think about community transport, you could put all the services in but people can’t get to them.

Izetta: Exactly.

Kirsty: Even looking beyond transport you can’t talk about BME communities and social isolation without looking at discrimination and barriers to participation, whether that’s a fear of discrimination or actual experience that has then impacted on a person’s confidence.

Atiha: You’re absolutely right. On all of those sorts of things the way the system is going because of cutbacks and austerity the idea is that there are other services for older people, or groups, that everybody can go to. Actually if you’ve got language issues, you’ve got cultural concerns, you’ve got food and diet needs and restrictions around your faith, then you’re not going to be able to be comfortably going to any group, you want to be in your own group that caters for your specific needs where you’ll be able to talk to other people and make friendships.

So in areas like Manchester and across GM we have significant BME communities and so it makes sense for them to have that individual provision and everything can’t be general and generic, there has got to be specialist provision.

Izetta: And if you are housebound as well there was a time you could get Meals on Wheels, that’s now gone, there is no more Meals on Wheels, but I know some of the churches again are doing that service and providing meals for people that are housebound.

Atiha: Yes, and some of the luncheon clubs, like the Indian senior citizens do a luncheon club, and for those who can’t come they’ll deliver the food. I find that all of that is done because they are passionate and committed about what they do but nobody is funding that anymore and recognising that. So I feel you are so right on that, that we need to think about how neighbourhoods work, in the past people in the community, your neighbours, would be very happy to go in and help people to cook and do all of that. Sometimes I feel with all the restrictions that that social capital we had has gone, everybody is scared of going in and helping somebody and talking in that way that we used to just freely do before.

Izetta: Do it without any thought.

Kirsty: Do you think anything can be done about that?

Atiha: I think you’ll find there are some kinds of small, innovative things that are going on and I think it can be, especially now, we’re very focused on working at a neighbourhood level, and how difficult would it be at a neighbourhood level to engage different community cafes, luncheon clubs, neighbours who are interested? How difficult is it to identify through that approach where we have deep isolation for BME communities and put the structures in that place? Whether it’s a friend or a neighbour there are other ways and probably more effective and efficient ways of doing that than setting up a big service and then you’re meeting the needs much, much better.

Izetta: We have to remember as well that some of our people are very proud, they won’t accept help when needed, they think it’s charity.

Atiha: That’s very, very true, that’s why sometimes we reach people late because they haven’t done that. Again I think the faith sector really does very good in a very humble way of knowing who those people are and supporting them in a hidden way. I think again it’s really important, so sometimes when I talk to churches or mosques they’ll say, ‘We do know where the help is needed and we try and do that.’ So you have to really reach out in the community and you just won’t know that isolation and loneliness unless you talk to all those people who are kind of anchors in that community.

[Music]

Kirsty: It was great to speak to both Atiha and Izetta about such an important topic and although we covered a lot of ground in our conversation we could have kept on talking for hours. As with every episode we’ll add some resources into the show notes. 

A huge thanks to all our guests, not only those who featured in this episode but everybody across the series of the Ambition for Ageing podcast. We’ve got one final episode to go this series, a bonus episode, asking is a truly accessible evaluation process possible?

[Music]

Lucy: Ambition for Ageing is a Greater Manchester-wide cross-sector partnership aimed at creating more age-friendly places and empowering people to live fulfilling lives as they age. Ambition for Ageing is part of Ageing Better, a program set up by the National Lottery Community Fund, the largest funder of community activity in the UK.  Ageing Better aims to develop creative ways for older people to be actively involved in their local communities, helping to combat social isolation and loneliness. Ambition for Ageing is led by Greater Manchester Centre for Voluntary Organisation, the voluntary community and social enterprise sector support and development organisation covering the Greater Manchester city region. The theme tune for this podcast is Air by Iliya Troyanov, and any indents this season are taken from his track Tide. Both are used under a creative commons license from his album Fugue. Thank you for listening to this podcast. For more information about Ambition for Ageing and the work we do, visit ambitionforageing.org.uk.

[Music]

• The Big Lottery Fund Equality Information Grantholders guide contains lots of information about the importance of collecting equalities information to help guide design, evaluation and research for community projects.
• The Equality and Human Rights Commissioned published Equality Act 2010: summary guidance on services, public functions and associations, to support the implementation of the Equality Act 2010 and discuss how protection from unlawful discrimination is provided by the Act.
• The LGBT Foundation, Monitoring: Sexual Orientation, Gender & Trans Status highlights the importance of monitoring for patients and service users in relation to equality of access to services. improved services more specific to the needs of LGBT people and how monitoring helps to create a culture of inclusivity and openness with the service provider. It is supported by the LGBT Foundation, Good Practice Guide to Monitoring Sexual Orientation, which provides guidance for services on how to implement monitoring.
• The Ambition for Ageing Evaluation: Why take part? document provided those who took part in activities information about why we collect the information we do and the benefits it will have.

Lucy: This is the Ambition for Ageing podcast, bonus episode 7. Is a truly accessible evaluation possible?

Sophie: I think the kind of research that we do is supposed to feel a bit more informal and friendly and then as soon as we put forms into it it introduces that element of professionalism and mistrust for some people I think. So that doesn’t help relationship building.

[Music]

Kirsty: Hi, I’m Kirsty and welcome to the special bonus episode 7 of the Ambition for Ageing podcast: Is a truly accessible evaluation process possible? As you heard from the small teaser before the opening title today we’ll be talking to our guest about how meeting the needs of people in local communities can create a barrier to collecting data for research programmes such as ours.

This episode is a little different to the rest of the series, like all the other episodes we’ll be discussing what we’ve learned whilst working for Ambition for Ageing but in this episode we’re going to look at something a little more practical, the process of evaluation and how to juggle collecting the data you need to run a programme like this successfully whilst avoiding alienating those who may need the support we provide the most.

Like all research programmes we have to collect data from the people who take part in our activities and opportunities, we use this data ourselves in a number of ways. As we are a research programme we want to find out the answer to our research questions, around what kind of interventions work best for which communities. As a test and learn programme we want to evaluate how we are doing and make changes along the way if we are not achieving our aims. 

As a programme that involves communities and designing the places they live we want to be able to identify who may be missing from the data to ensure we run an inclusive programme as we can then put extra work into working alongside these communities the data shows we are missing.

Our programme is part of the National Lottery community funded Ageing Better programme, the information we gather is not only analysed here in Greater Manchester but also on a national level alongside data from the other partnerships to discover the answer to a whole host of questions about delivering interventions for older people. Across all 14 partnerships we asked those involved in the programme to complete questionnaires when they first start taking part, six months into their involvement and then again after a year. We use this information to answer a range of questions from what makes people feel their neighbourhood is age friendly and whether they feel a sense of belonging to their neighbourhood to how involvement in the programme has impacted on their social connections and what they feel about their ability to influence decisions affecting their local area.

The data we collect also lets us compare the experiences of people with different life experiences by collecting demographic data such as ethnicity, sexuality and relationship status and education levels as well as things like digital connectedness and whether they are a carer. If we don’t ask the questions we cannot find out if differences and identity or experience impact people’s perceptions and experiences of the world around them and of the interventions of our programme in particular.

So we know how important collecting this information is however it’s not always easy to get. In this episode I talk to our guest about these difficulties and ultimately if we are wanting to target the most marginalised people in our communities and chart the impact of their involvement how do we do so when their first introduction to the programme is a barrier? Further, if we remove this barrier, say by completing a form with them the second or third time we meet them once we’ve developed a relationship, are we truly able to track progress from the beginning of their journey?

My first guest is Sarah Wilkinson, Sarah support the Ambition for Ageing equalities board in their activities, one of which was carrying out evaluations of our delivery. One of the key ways the equalities board did this was to use the data we collected to identify gaps in representation and offer support to our frontline staff in targeting and working with those who are missing from the data.

I spoke to Sarah about the problems with the form led evaluation approach, alternative ways of collecting information and the need for buy in from those taking part.

[Music]

Kirsty: The evaluation we carry out on Ambition for Ageing is quite an intensive evaluation, particularly forms wise, we have many questions, asking quite personal questions, some around levels of education, whether people feel like they belong in parts of their communities and how often they see people, that’s not even when we start looking at demographic information we ask people as well.

What kind of barriers do you feel that type of evaluation brings to people?

Sarah: There are a lot of different issues really, there are technical barriers in terms of people’s ability to complete the forms and their understanding of the questions and the fact that the information we say is confidential and it’s kept confidentially but if we ask a lot of information and we expect people to fill that in and we’re reaching people who are more socially isolated, who have lower levels of education or who maybe have impairments that mean that they find it difficult to fill in forms then sometimes they’re going to need someone to support them with that.

So that can be one issue, that we construct the forms on the basis that they can be completed by somebody by themselves whereas in practice quite often people need support completing them.

Then there are barriers created by specific questions within the forms, one of them is education that you mentioned. There are a number of issues within the education question, not just that people with lower levels of education may not feel comfortable in expressing that in a form but also if people weren’t educated in the UK, if they’ve come to the UK more recently, the levels of education just don’t match with their experience.

Kirsty: I guess sometimes that means if that’s quite near the beginning of a questionnaire it maybe puts you off with the rest of it because you think, ‘This isn’t for a person like me, these questions aren’t designed for me, why am I continuing to complete this?’

Sarah: Yes, and I think also if people don’t understand a form or understand a question then they might be, understandably, be more tempted just to tick ‘prefer not to say’ for everything because they’ve come across something that is complicated and throws you early on in completing a form.

Then the other obvious area is sexuality, it always comes up, and gender identity, always come up as things that people find difficult to ask as well as difficult to answer. So that’s another big area. 

I think there is a danger really with the number of barriers that are involved in the evaluation, sort of accumulate, it affects how people think about equalities. Equalities is seen as being about a tick box exercise and people are resistant to ticking boxes, for understandable reasons. So I suppose one of my concerns as an equalities research coordinator is about whether it almost does equality a bit of a disservice really about paper monitoring, it’s quite a crude tool in some ways.

Kirsty: How do you think we could better collect that information in order to reach those most socially isolated people who we are aware potentially have many barriers to completing the forms to collect the information to be able to demonstrate that we are reaching those people and to be able to find out from them their experiences?
Sarah: I would say that we have to think really carefully about what information we’re collecting when and what we’re going to do with that information and whether it’s necessary always to collect all the information. As an equalities person that’s a bit of a strange standpoint in some ways but I think there might be ways of doing it where instead of getting people to, for example, tick a box, a long list of questions with lots of boxes to tick, we maybe ask people to describe themselves a bit more in their own words.

So, as you said, if you go straight in with the difficult ones then that’s perhaps not such a good approach, maybe leave some of the ones that are a bit more personal or a bit harder to answer towards the end so that people first of all feel they’re more confident, because they’re completed more of the form, and secondly they feel that they could perhaps skip those at the end without missing out and doing the whole form.

It’s always a struggle in equalities work that you know that people who have a particular identity face a particular discrimination but you also know that everybody is unique individuals. Part of that is around intersectionality, so how having more than one factor combines to not just be an addition of the two factors but to create a new form of discrimination or isolation. 

Part of it is that, so everyone has got a unique combination of different factors that they’ve had in their lives and they have as they’re aging but also just people’s own levels of resilience in coping with change and things can come from things we’re not monitoring at all in the current monitoring system. So we know that even if somebody has seemingly on paper literally the same set of factors or risk factors that actually in the world they might be managing very differently with ageing.

Monitoring is important and one of the messages that we say from the equalities board is we need good quality and quantity of monitoring but I think we need to be learning from Ambition for Ageing really about how to get a bit cleverer with that and a bit smarter with the way that we use it. I think the quantity of what we do is off-putting for people and I think then what it can do is it can make people take the equalities side less seriously because they just think it’s all about the forms, that’s what they see, they go, ‘Those equal opportunities monitoring forms,’ where they don’t see any changes as a result of filling in all these forms. I think for some people it might feel a bit like it’s going into a black hole and they’re not quite sure what happens with it.

Kirsty: I think a lot of the research and a lot of the findings that have come out from the programme so far have been around inequalities that has come from that demographic data. I’ve spoken to people who don’t understand why demographic data is important, ‘Why do I need to give you this information?’ and actually how important it is for a project such as ours to be able to make sure that we’re able to be fully representative and we’re able to reach those who are more traditionally marginalised based on that demographic information.

Sarah: Yes, I think it is important for that but I think there are also other ways of looking at and evaluation and assessing how well we’re reaching the most marginalised people. I think one of the things that we know is that sometimes it takes a lot more work to reach the most marginalised people and so at the time it’s not reflected necessarily in the demographic information in terms of the levels of engagement you’ve had with people. So it might be that it looks like in a particular area that only a small number, six people, have been engaged who meet a particular target group that people are looking at, but it might be that a huge amount of work has been done to engage those six people. So the value of that work may not be reflected by the numbers in the data.

Kirsty: Do you think there is something there as well around, and we might have touched on this a little bit, the fear of or the mistrust of authority and if you’re just going along to an event then it’s seen as one thing whereas as soon as you bring out a paper form and start asking people questions around demographics or even the rest of the form, around how friendly they feel their neighbourhood is, about social contact, about all of that stuff, that they may be stepping back there and feeling, ‘Actually this is more of an authority thing than I’m used to or I feel comfortable with.’

Sarah: In some ways it depends who is doing that, so if, as you say, it is a trusted organisation that people know I think that authority thing may be not such an issue because most people know that for these days for small organisations to get funding or support there is a certain amount of paperwork involved in that. I think in the very informal, some of the much less informal things, that are being supported by Ambition for Ageing I think there will be that mistrust, particularly where people are doing self-organised events or activities and they’ve just had a fairly not light touch support, but they’ve maybe not had a huge amount of involvement with the LDL itself, but suddenly there is an expectation that they are going to be filling in forms. So I think it is all context dependent really.

Kirsty: I think maybe if you’re trying to reach those people who have not got contact with services, those who are the most socially isolated, you’re then bringing them into this environment where maybe they don’t have that knowledge that, ‘This service needs you to complete this,’ and you’re having to start those conversations to begin with. Then there is maybe something there as well about their ability to be able to complete that information, whether that’s emotional or technical.

Sarah: There is and I think for certain groups of people there is almost the opposite, that people are expected to fill out information so often. We’ve been funding some small research projects and there are a couple that are going to work with people who may or may not be refugees and asylum seekers. Talking with colleagues they’re saying that they’re just expected to fill out forms all the time and be researched all the time as well because everyone is interested in researching them.

I think even in health services and things now there is more of that kind of demographic monitoring going on. I don’t know whether that familiarisation with it actually helps people or whether it hinders people, it could work either way. It could be that because when people go to the doctors they now have to fill in something that includes a certain level of fairly personal information that they understand that this is something that organisations are doing now, or it could be the opposite, that people feel more resentful of being asked those questions.

I think it’s a really difficult one, I do think it’s really important that we have that good quality demographic information, I’m talking about from an equalities perspective, but generally information that relates to social isolation in older people. I think there may be more creative ways that we haven’t found yet of getting that information and seeing it as a positive way of people claiming their identity of who they are. We have had a few examples where people have said because they’ve had a discussion about a particular question people have suddenly realised that that is a part of their identity and that can be something that can fill people with, you would hope, pride rather than shame.

I think just all that background works needs to happen so that people know that it’s not judgemental, know that we’re interested in people’s experiences, their life experiences, but that it can be a positive thing to have experienced things in your life that maybe other people haven’t experienced and the richness that can bring, particularly when you’re in a group of people, such as the equalities board. That is how we try and work with the equalities board really, that we see that people’s life experiences and their identities gives people knowledge and strengths that other people don’t have that they can then share with other people, so to value those things. That takes time, you can’t do that by presenting someone with a piece of paper and asking them to tick boxes.

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Kirsty: I think Sarah’s point about how it can take a lot of work to engage with a small number of marginalised people is an important one. We talk about inequalities, we talk about those with less access or experience in involvement with these kinds of programmes and those with less assets in the community to build from. By the nature of being traditionally marginalised or at risk of marginalisation there needs to be more work carried out to reach and earn trust. 

Thinking about in practice compare this, the work it takes to go to an already existing community group of vocal and confident people with experience in taking part in similar activities in the past. Then compare it to the work that needs to be put in first to identify communities of people who have been underrepresented in these types of programmes, to earn their trust, supporting them to learn the processes of such programmes, or the time taken to adapt our processes to their needs, building up self-belief, offering the opportunity to build skills and advocacy, building the confidence to make decisions on behalf of and for their community. The kind of data collection techniques that focus solely on form filling cannot demonstrate the amount of work that goes into engaging with different people and as a result doesn’t show in the data. 

This point about tick box monitoring giving tick box value and the need to support such monitoring with more inclusive and creative ways of collecting data is one of the things I discussed with our second guest. Dr Sophie Yarker featured earlier in this podcast, back in episode 4, where we had a chat about social infrastructure. Sophie is a research associate at the University of Manchester and as a result has a lot of experience in carrying out research like this. 

We were joined in our conversation this time by Jess Thorley, our evaluation office based over at Greater Manchester Combined Authority, whose job it was to analyse the data we collected to both publish what we’re learning from the work we’re doing and she also used the data to evaluate the programme as we progressed. We spoke about the importance of participants understanding why the questions we ask are relevant, the importance of collecting different types of data and the importance of trusting frontline staff in filling in the blanks despite missing data.

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Kirsty: One of the things I spoke to Sarah about was the barriers that lengthy evaluation forms can bring about, how are the barriers represented in the data we collect?

Jess: I think it’s a combination of the fact that for a start we already know that over 13,000 people have been involved in this programme but only 3,000 of those are showing up in our data, so we already know for a start who is being represented in terms of numbers but on top of that we know that that is not a representative sample of the kinds of people involved because of the evaluation design, because people choose to be a part of the programme, it’s all optional whether people choose to get involved. So no-one is randomly allocated to who we get data from and who we don’t.

We do know as well though from anecdotal evidence, from talking to people who are working on the frontline of the programme, that there are considerably barriers for particular groups. We also know as well that even within the people who are filling in the questionnaires there are certain questions that people are deliberately leaving blank. So it may have come up in the other ones, for example, that it’s no surprise that the sexuality question has a lot of missing data, so around a quarter of the people that we even manage to get to fill the forms in are still not choosing to answer that question. 

I think perhaps surprisingly as well the other question that is so frequently unanswered is the question around education which has got very similar levels of missing data, again a quarter of people are choosing not to answer that question. So we know that there are particular groups that are very unlikely to be represented in that kind of data that comes across with that particular style of question as well as that particular method of data collection.

Sophie: I think there is also an issue of some people not recognising or understanding why the questions are being asked, so they don’t see the point of saying what their education level is because they don’t see the relevance, certainly the question on sexual orientation as well, people also don’t see the relevance of being asked that. So there is some resistance there because they don’t understand why they are being asked, they don’t see it is relevant to the activity or the programme that they’ve been visiting.

Jess: I think absolutely, I think the relevant side of it, I think inherently a lot of the times the questions we ask in a questionnaire then put a little bit of a, ‘This is the information we value,’ and the questions that some people might think, ‘I don’t think that my education level and this actually have any bearing here.’ They might be of areas where people feel less confident or more defensive about for various reasons and they might think, ‘Actually there is other information that I think is more valuable to collect in this area and it feels as though you’re making a judgement or assessment about me based on these characteristics that I maybe I don’t identify with in some way, either because I don’t want to tell you…’ or because they might identify as the default anyway and think that it’s not important.

I think there are a lot of reasons behind it and I think, as Sophie says, a lot of it is explaining to people why it’s used because I think the other area as well is the relevance also. At the moment we’re living in a world of GDPR and general data misuse worries, there are a lot of concerns around data protection and what things are being used for. So a lot of people are more suspicious, now more than ever of, ‘Why do you need this particular type of information and what are you going to use it for?’ which I think then also has a bearing on what people choose.

We know as well from some feedback that people have felt that they are happy to give the information but as soon as they have to sign something and put it in writing and give their consent then suddenly it feels a lot more official, it’s, ‘Now my name is attached to it and that’s what I’m not comfortable with.’ There are a lot of those myths and confusions and concerns around, ‘What are you going to be doing with my data? Obviously this is what it says on a sheet but where is it really going?’ and those worries and concerns that I think are just a sign of the times in some ways.

Sophie: I think the kind of research that we do is very much about relationships and communities and informal spaces and the market is outside of the state so to speak, so it’s supposed to feel a bit more informal and friendly. Then as soon as we put forms into it it introduces that element of professionalism and mistrust for some people I think. So that doesn’t help relationship building sometimes.

Anyway, there are obviously ethics you have to follow in research, particularly form the university’s point of view, but I think there are other ways of doing it that don’t create those barriers and don’t create those kinds of suspicions for people.

Kirsty: So we’ve got the one side of things where people may be able to fill out a form or don’t trust it or don’t want to be able to and then we’ve got the other side of things where people may struggle to, whether that’s levels of literacy or whether that’s the language they speak and it not being in the right language or being in a written language whereas they speak a verbal language instead. What kind of things can we do in evaluation to collect that data in a different way?

Jess: I think particularly, as Sophie said for this programme, with a lot of it being around informal activity and relationships, I think the qualitative data is particularly valuable to capture those nuances, to capture what is emerging from the programme and the types of informal relationships and things that are being set up that I don’t think is very easy to capture in a questionnaire and doesn’t reflect it very well. 

So, for example, some of the work that we’ve been doing more recently is we’ve got things like the case studies that are coming through in terms of the local delivery leads, being able to pick up on the things that are going on on the ground in their own time as things emerge and track the stories and different processes that are developing. For that as well we really try and get them, more recently to think about as well, is the story that you’re trying to capture here, is it interesting because it’s unusual or is it interesting because it’s happening a lot? So being able to capture both and being able to identify that as well.

I think on top of that we were also doing some work around focus groups, trying to make sure that the participants’ voices themselves are coming through, particularly because the programme is obviously about coproduction. So having a coproductive approach to developing the programme but then a very prescriptive approach to the evaluation is a little bit jarring in some ways. So I think for us this year we have tried to go back a little bit more to the roots in terms of getting those older people’s voices heard directly. Sophie can talk about some of the work that she’s going to be doing this work as well.

Sophie: Yes, I think I would always advocate the qualitative approach certainly, whether that’s in groups such as focus groups or whether it’s individual in in depth interviews, it depends on the depth that you need and the level of personal reflections that you need. I think certainly you can get all the same information that you would want from an evaluation form in a conversational approach. Typically when I’ve done research with older people before, when their age has been a key factor of what I’m researching, I would never ask them how old they are. During the course of the conversation it usually comes out, people would usually say, ‘I’m in my fifties,’ or, ‘I was born in whatever,’ and you can take it from there. So it requires a little bit more digging and it takes longer but it’s a bit more of a natural and organic way as opposed to directly asking someone when they were born and they kind of volunteer the information themselves. So qualitative approaches I think are always helpful to break down those barriers.

Kirsty: The stats that you quoted at the beginning around the amount of people who have actually been involved and then the amount we’re talking to, how useful is data like that if it’s potentially excluding those that maybe can’t complete forms or can’t get involved in evaluation that way, particularly for a programme that is trying to aim at those more marginalised people?

Jess: I think with any form of data collection every form of data collection only ever gives you a partial picture of what’s going on. I think it’s recognising what that partial picture is and not assuming that you’re seeing everything and recognising the limitations and then trying to come up with other ways to offset that. A lot of the things that we will try do in this programme is advocate a mixed methods approach but also I think it’s making sure you’re working really closely with those frontline staff that really understand what’s going on on the frontline, so it’s from them that we know certain groups aren’t filling things in because they’re the ones that are taking forms out and they can see who is being left out. Trusting those staff as well, if you’re incorporating them into the process, so a lot of them do their own evaluation activities, a lot of them collect their own case studies, it’s trusting them and also giving them the skills to be able to go, ‘You know where there is a gap and you know that then they’re the areas you need to plug,’ whether that’s in terms of service activity or whether that’s in terms of evaluation.

I think with this particular programme, with a very tailored place faced approach, it allows those areas to develop their own solutions but also be able to identify what their own particular issues are, which then, from an evaluation point of view also means that you’re using that kind of insight and intelligence to work out, ‘These people aren’t being represented, is there another way that we can get to them or another way that we can capture their experiences?’

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Kirsty: That final point from Jess is something I think we can really reflect on as this episode comes to an end. We know that collection of data is hugely important in programmes like ours and we need to push for collecting as much as we can and encouraging participants to provide this information. However it will never give us the complete picture, to better measure our impact we need to think beyond ticking boxes, into supporting frontline workers to fill in gaps in our knowledge. As Sarah suggested we need to provide other opportunities for people to provide us with information beyond traditional form filling. 

We certainly don’t have the answers to whether a truly accessible evaluation process is possible but we can recognise some of the steps that we can take to meet that goal.

A huge thanks to Sarah, Sophie and Jess for featuring in this final bonus episode of the Ambition for Ageing podcast. Thanks also to all our other guests who featured in our previous episodes, Paul McGarry, Kate Jopling, Vic Sterling, Steven Raybould, Corinna Hyman, Christina Victor, Richard Dowsett, Yasmin Holgeth, Sharon Somers, Julie Bentley, Susanne Martikke, James Nazroo, Ian Dyer, Tony Openshaw, Philip Harper-Deacon, Michael Teo, Izetta Enisuoh and Atiha Chaudry. 

A huge thanks also to Lucy North for editing a number of these episodes and Viki Lee and John Hannen for giving feedback on the series. 

We hope you have enjoyed this series and if you’ve missed any episodes then please do go out and check them out everywhere good podcasts are available.

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Lucy: Ambition for Ageing is a Greater Manchester-wide cross-sector partnership aimed at creating more age-friendly places and empowering people to live fulfilling lives as they age. Ambition for Ageing is part of Ageing Better, a program set up by the National Lottery Community Fund, the largest funder of community activity in the UK.  Ageing Better aims to develop creative ways for older people to be actively involved in their local communities, helping to combat social isolation and loneliness. Ambition for Ageing is led by Greater Manchester Centre for Voluntary Organisation, the voluntary community and social enterprise sector support and development organisation covering the Greater Manchester city region. The theme tune for this podcast is Air by Iliya Troyanov, and any indents this season are taken from his track Tide. Both are used under a creative commons license from his album Fugue. Thank you for listening to this podcast. For more information about Ambition for Ageing and the work we do, visit ambitionforageing.org.uk

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