Elderly people health profile in the city of Stavropol as the basis for developing social health improvement strategies for elderly people

K. Amlaev, V. Muravyeva

Stavropol (Russia)

Elderly people are one of the largest social groups characterized by certain biological, social, behavioral and juridical features. The number of elderly people is increasing in Stavropol as well as in other regions of Russia. In 2006 the rate of old-aged people in the Russian Federation went up to 24,8%, while in Stavropol it went up to 20 %.

Nowadays we have registered 71 thousand  people older than 50 in the city. Average life expectancy is not high, it’s 69,4 years. Besides, people of more than 80 nationalities live in Stavropol, among them there are a lot of migrants who came to our city after ethnic conflicts in Armenia, Azerbaijan, Chechnya and the earthquake in Armenia. All these factors require a differential approach to the social policy for the elderly people.

A cross-sectoral group on healthy ageing was formed for solving current problems. The members of this group were scientists-sociologists, health care specialists, representatives of NGOs for the, social services workers. This group brainstormed strong and weak points of elderly people municipal policy. The decision was made to publish Elderly people health profile.

The model of Elderly people Health and living standards profile which had been presented and discussed at the Conference on Healthy ageing in June 2005 in Stockholm was taken as a basis.

It was supposed that the profile would contain the following sections:

1. Demography

2. Level of income and social status

3. Social assistance

4. Employment

5. Elderly people’s health

6. Education and physical activity

7. Culture, leisure and public organizations

8. Plans for “Healthy ageing” implementation.

A working group collected and accumulated a lot of information: official statistics data were supplemented with sociological research results. Two public opinion polls were held on the main directions of “Healthy cities” project implementation and quality of life study in Stavropol (1030 people were questioned in their homes, selection of respondents was randomized; 2003 people answered the questions published in the city newspaper). The results of this questionnaire are published in Health profile and Elderly people health profile in the city of Stavropol.

Here are some facts.

Nowadays 71 thousand elderly people live in Stavropol; it’s 20% from the total population. A problem of lower level of men’s life expectancy compared with women’s still exists in Stavropol as well as in Russia. The average life expectancy of men is 63,1 years, and women – 74,6 years. At the present time common problems of older generations refer to the issues of health maintenance, nutrition, housing, getting education in “the third age” and well-being.

Tab.1. The number of people in Stavropol above 50          (thousand people).

The population of Stavropol is 400 thousand people.

Tab.2. Life expectancy in Stavropol (years)

Among the problems of elderly people the most important ones are:

1. Loss of active life position

The main problem of elderly people is transition from active way of life to inactivity in social and industrial spheres. A great number of aged people feel their inadequacy under modern socioeconomic conditions. Besides, elderly people don’t dominate in the family. Responsibility of the family for care and serving needs of aged relatives is reducing. We are not happy that 39,5 % of elderly people don’t identify themselves with part of the city.

2. Health deterioration.

Social living conditions of elderly people are defined by their health first of all. According to sociological research of the own health assessment the elderly people gave the following answers:

37,9 % of elderly people don’t think they are healthy.

37,7% of elderly people say they are unhealthy rather than healthy.

17,3 % feel slightly ill.

Only 7 % of aged people say they are in good health.

It’s necessary to add that respondents who are under 64 years of age are more optimistic about their health.

Among ecological problems which trouble elderly people a high level of noise (more than 60 %) and air pollution (39%) take the first places.

3. Worse living conditions after retiring.

Insufficient provision of elderly people leads to deterioration of nutrition, minimization of expenses on social-cultural needs; vulnerability of aged people in the family is increasing; it results in reducing life expectancy after retiring. Almost half of the pensioners’ families (60,8%) spend half of their income on food, though we can see reduced nutrition.

4. Deterioration of elderly people’s emotional state

The problem of old age is not that a person gets older but that his soul remains young. (O. Wilde) 

Transition of a person to an elderly group changes his relations with society essentially and such valuable concepts as aim and meaning of life. Practice shows that retirement has negative effects on vitality and psychological state of people. 17,7 % of elderly people believe that nobody will help them in a case of helplessness as a result of disease.

Social contacts of elderly people become difficult; this fact has negative consequences not only for elderly people but for people surrounding them. The results of questioning showed that 27,8% of aged people meet their relatives once or twice a month.

In the sphere of health protection, social, cultural, recreational, trade and general services, health and fitness work, tourism there is a lack of attention to elderly people needs. This fact brings to limitation of access to social services and benefits. The attitude to aged people who go on working is not obvious. So, next answers were got to the question of employers’ attitude to elderly people:

“positive”- 22,6%

“more positive than negative”- 27,8%

“more negative than positive” – 27,8 %

“negative” - 4,3 %

it was difficult to answer -17,4 %

Meanwhile 33,8% of retirees  go on working.

Received facts were used while publishing Elderly people health profile of the city of Stavropol; it was the first in Russia. Its aim was not only to find out tendencies in quality of life and health of elderly people but to provide them with information about social services they can obtain, public organizations protecting their interests, where they can find friends in order to get rid of loneliness. The Profile was published by a large circulation (17000 copies) and was distributed to aged people and different groups of community, including the administration.

So, the profile served as social guide for aged people, because it contained useful information about government and public organizations, working with aged people, including their address, services and phone numbers. There was information about activities of 12 public organizations, 23 clubs and artistic groups for elderly people.

During Phase IV of the project a new geriatric department of City clinic hospital № 3, a consulting-diagnostic polyclinic with a centre of surgery on an outpatient basis, a City centre of medical prophylaxis and a center of medical rehabilitation were opened. Specialized educational schools on some diseases in health service establishments such as “Asthma school”, “Hypertension school”, “Stress prevention”, “Crystal age” were opened as well. In 2006 a city action “Stop, hypertension” was carried on in Stavropol, during this action nearly 11562 citizens of all ages took their blood-pressure at 130 health service stations. All these measures are directed to increase access to quality medicine for elderly people who are reflected in the Profile.     

A working group on healthy ageing, consisting of representatives of Health service, social security, pension fund, social insurance fund, public organizations of elderly people developed a city strategy on “Healthy ageing”. We took into account that “Healthy ageing” includes not only social support to elderly people and creation of favorable conditions for moving within the city but their active involvement into social life. Aged people are resources of the society and they can’t be a burden for it and for a family.

The aim of strategy: better health and life quality for the elderly

Objectives:

1.                      Strengthening of aged people physical health. (To increase the number of aged citizens who are fond of physical training and sport by  20 %)

For solving this task it’s planned:

-         to increase aged citizens’ interests to physical training classes and sport through organization of information-educational and propagandistic work on wide development of physical training;

-         to strengthen interaction of social services establishments, public organizations and Department of Physical Culture and sport of Stavropol city administration in the field of sport activities for elderly people;

-         development of material and technical basis for physical training, health and fitness classes for aged people;

-         organization and holding of sport competitions for elderly people.

-         Health-improving activities, training to dotty massage skills and respiratory gymnastics.

2. Involvement of elderly citizens into active life (to reduce the number of socially isolated aged people)

- to open clubs for elderly people;

- to expand elderly people’s possibilities in taking part in cultural activities among the masses and social life of the city;

- involvement of elderly people into work with youth and unfavourable teenagers.

3. Social adaptation of elderly citizens to changing conditions of contemporary life (to increase  by 20% the number of elderly people preserving their independence in family and appropriate place in community).

- organization of additional education for elderly people;

- organization and conducting social-psychological trainings for elderly people.

4. Social assistance to aged citizens (to increase by 30% the number of elderly people receiving different kinds of assistance).

- finding out citizens who need social assistance at home and rendering these services at home by social workers;

- expansion of services list rendering to aged people.

5. Elderly people`s right protection.

- to open consultative centers for rendering juridical services to elderly people.

6. Drawing public attention to elderly people’s problems

- holding conferences and “round tables” with the most active aged citizens of the city to define the problems and needs of the elderly people for organization of city administration work in the field of rendering different kinds of assistance for a such category of citizens;

-celebrating Elderly Person Day;

-interaction with mass media on the issues of covering aged people problems and the examples of active life position;

- holding lectures at schools and higher educational establishments on the theme: “Elderly people relations with children and grandchildren”

Most of the strategic items mentioned above are being implemented during the Phase IV of the project. According to the tasks a specific plan of activities is drawn up. A municipal target programme “Social support of the population in the city of Stavropol” was adopted. It’s being implemented for solving elderly people’s problems. “Activities on social support of elderly people” is one of the parts of this programme.

Conclusion:

-the number of elderly people in a total number of the population is increasing;

- the main problems of the elderly: poor health, lower income, reduced activity, social isolation;

- a group of elderly people isn’t homogeneous due to the different educational level, incomes and social activity. That’s why it’s necessary to find   differential approaches to the work with elderly people. Anatol France said: “There are as many kinds of old age as many old people we have. There is old age tolerable and there is intolerable”.

n      - aged people are insufficiently informed about existing possibilities on health improvement, social and legal consulting, leisure and club activities in the city;

n     - regular questioning of elderly people help to develop social policy maximally corresponding to social needs of aged people;

n     - creation of cross-sectoral group on “Healthy ageing” helps to use resources of different social groups (material, intellectual and others) effectively. The partners are: Stavropol city administration and its departments, public organizations of elderly people;

n     - Elderly people profile is a single informational field and analytical document which gives a basis for developing improvement strategies of health and quality of life of elderly people. It’s a tool of influence on decision-makers and a mean of relations of authorities, population and public organization.

Out of respect to the country hosting the conference I’d like to recite French classical writer: “You have to go forward and forward with life which never stops”. (Emil Zolya)