DOI: 10.1111/ajag.12015
Research Local governance responses to social inclusion for older rural Victorians: Building resources, opportunities and capabilities Rachel Winterton, Samantha Clune and Jeni Warburton John Richards Initiative, La Trobe University, Wodonga, Victoria, Australia
John Martin Centre for Sustainable Regional Communities, La Trobe University, Bendigo, Victoria, Australia
Aim: To explore how local governance enables access to resources, creates opportunities and increases capability for older people in rural communities to experience social inclusion. Method: Twenty-six semi-structured interviews were undertaken with community stakeholders across two rural communities in north-east Victoria. Stakeholders were drawn from local government, and a range of community groups and organisations, as identified in a scoping study. Results: Through the provision of community resources (e.g. physical and human infrastructure, organisational partnerships), local services and supports offer social and productive environments for participation. They also build individual resources (e.g. health, skills, finances, networks) to enable older people to participate within these environments, and provide assistance to allow older people to use individual and community resources. Conclusions: Community resources are integral in facilitating the development of older people’s individual resources, and opportunities and capabilities for participation. These enable greater choice in participation, and contribute to the sustainability of community resources serving ageing populations. Key words: governance, rural, social inclusion.
Introduction Over the past decade, social inclusion has emerged as a policy concern, with the Australian Social Inclusion Board formed in 2008 as an advisory body to government [1]. As a result of rural populations growing older [2], increasing numbers of rural older people are faced with multiple barriers to social inclusion, including poor health and mobility, financial disadvantage and social isolation [3]. While rural communities can be inclusive in terms of community trust, social cohesion and safety [4,5], these benefits are often impeded by poor access to services and limited infrastructure and government assistance. As a result, many communities are struggling to provide resources that support older people [6,7], and thus
Correspondence to: Dr Rachel Winterton, John Richards Initiative, La Trobe University. Email: [email protected] E8
governments are advocating a need to build capacity around local governance, with coordination of activities through community networks and partnerships [8,9]. This is reflected in policy, with the Social Inclusion Board advocating a need for local service coordination and governance to enable location-based social inclusion initiatives [10]. However, while the responsibility for social inclusion is being placed on rural communities, there is little known about how local governance is facilitating this for older residents. This evidence is essential to determine which programs and services work well, in order to inform future policy [11]. Thus, the objective of this paper is to explore how rural communities are currently enabling social inclusion for older residents through locally governed services and supports, from the perspective of community stakeholders. Specifically, it investigates how local governance enables access to resources, creates opportunities and increases capability for rural older people to experience social inclusion. Ageing, rurality and social inclusion: issues and implications From a policy perspective, social inclusion reflects the ability to feel valued and have the opportunity to participate fully in society [11]. In achieving this, the Australian Social Inclusion Board has developed a conceptual framework advocating that participation is contingent on three factors: access to resources, opportunities and capability. Resources refer to the skills and assets individuals and communities possess, which support opportunities and capabilities, allowing people to choose how they wish to participate. Opportunities relate to an environment that enables individuals to use capabilities and resources, and capabilities reflect individual ability or agency to use resources and opportunities to participate. The development of opportunities and capabilities can also build individual and community resources, assisting further participation [11]. However, while social inclusion is a priority area for government, the needs of older people have been largely absent from recent policy debates [12]. This is despite its emphasis in aged care policy, with the recent Productivity Commission inquiry [13] highlighting a need to support social inclusion for older people. This is discussed particularly in the context of providing services, infrastructure and policy that will support older people living in their own homes, that promotes community participation, and that reduces pressure on aged care systems. Social inclusion is particularly important for older people, who are at risk of exclusion because of limited Australasian Journal on Ageing, Vol 33 No 3 September 2014, E8–E12 © 2013 The Authors Australasian Journal on Ageing © 2013 ACOTA
bs_bs_banner
L o c a l
g o v e r n a n c e
engagement with the labour market [6]. In rural locations, this is compounded by poor access to services, transport and infrastructure and reduced government support, largely because of limited population density and distance [5,6]. These issues are exacerbated by the promotion of neoliberal ideologies within rural Australia, which assert that individuals and communities should be responsible for their own welfare [6]. This approach is reflected in social inclusion policy, where a community-based approach is advocated through governments, organisations and communities working together flexibly to meet individual needs and build on community strengths. Further, a locational approach is advocated to target disadvantaged locations [11], which promotes local involvement in determining issues and solutions, capacity development and service coordination across all levels of government, non-profit and business sectors, and governance that is capable of community representation and local engagement [10]. However, while this approach relies on the existence of physical infrastructure, governance capacity, and economic, human and social capital [10], rural deregulation has reduced the resources available to enable these to be produced [14]. Rural local government areas are overrepresented in the Socio-Economic Indexes for Areas (SEIFA) classification of disadvantaged areas [15], and are becoming excluded in response to decreasing access to services and resources, employment opportunities and rural ageing [6]. This lack of resources has been highlighted in recent policy initiatives, with the development of programs aimed at building health and community infrastructure across regional Australia [16,17]. Therefore, in the context of neoliberal approaches to social inclusion and limited health and social infrastructure, older people will be required to actively participate in their rural communities to ensure that they have access to the resources they need. However, this further stigmatises those who cannot actively contribute to society [12]. Thus, given the current population ageing scenario, the lack of policy attention directed towards social inclusion in ageing, and the need for rural communities to provide their own social inclusion solutions, it is critical to identify how local services, supports and infrastructure are catering for the social inclusion of rural older people. Specifically, there is a need to identify capacity-building strategies in regard to social inclusion that respond to the challenges and opportunities of an ageing population [12].
Method This paper uses data from a larger study examining how local health and social infrastructure facilitate social participation for older residents across two rural communities in northeast Victoria. Sites were selected for their high percentages of residents aged 65 and over, small populations (approximately 2000 and 4000 persons respectively) and high levels of retirement migration. While two sites were used to increase the diversity of the sample, comparing the communities was not Australasian Journal on Ageing, Vol 33 No 3 September 2014, E8–E12 © 2013 The Authors Australasian Journal on Ageing © 2013 ACOTA
r e s p o n s e s
t o
s o c i a l
i n c l u s i o n
the objective of the research. However, where appropriate, apparent differences between communities have been highlighted and contextualised in terms of community size. Ethical approval was obtained from the La Trobe University Faculty of Health Sciences Ethics Committee. Across both communities, in-depth interviews were undertaken with stakeholders from a range of community services and supports, including local government, health, social care and community organisations and informal groups (n = 26). Relevant services and supports were identified by undertaking a scoping study of each community, and interviews focused on services and supports that enabled older people to participate, and community barriers and facilitators to social participation. Interviews were tape-recorded with participants’ informed consent, transcribed and analysed thematically using NVivo. Findings are discussed in relation to how locally governed services, supports and infrastructure facilitate social inclusion for older people by enabling access to resources, opportunities and capabilities, in accordance with the Social Inclusion Board framework. In line with ethical procedures, neither individuals nor communities have been identified in representing the data.
Results Stakeholders highlighted numerous ways that their communities facilitated social inclusion for older people through the provision of resources, access to opportunities and increasing capabilities that enabled greater social participation (see Table 1 for a thematic summary). Findings indicate that community resources are influential in developing older people’s individual resources (e.g. health, skills, finances, social networks), opportunities and capabilities. These individual resources, opportunities and capabilities enable greater choice in participation and contribute to the sustainability of community resources that service ageing populations. Community resources First, stakeholders identified a range of community resources that enabled social participation for older people, including local councils, health and social care organisations (e.g. local hospitals, Red Cross), community organisations (e.g. businesses, and not-for-profit, sporting, and religious organisations) and informal activity and support groups. Physical infrastructure (e.g. meeting rooms, transport) was essential in providing places for groups and organisations to meet, and human infrastructure (e.g. skills, volunteers, informal transport) was crucial in providing the workforce and expertise for resources to exist in the rural context. A number of stakeholders, particularly those in health-care and community organisations, highlighted the importance of volunteers and informal networks in tailoring their services to a diversity of older people, in the context of issues presented by geographical isolation and limited funding. However, access to community resources differed between communities, in that the larger community reported a greater number of community organisations and informal groups targeting older E9
W i n t e r t o n
R ,
C l u n e
S ,
W a r b u r t o n
J
e t
a l .
Table 1: How rural communities facilitate social inclusion for older people: stakeholder perceptions Provision of community resources Assets serving older people Partnerships between stakeholders
In a small little country town like this, I mean, it also relies on the volunteers. There's a lot of volunteering goes on here (Stakeholder, informal group). We co-operated with – we formed a partnership with Community Health and Rotary to get the Men's Shed off the ground (Stakeholder, community organisation). As well as ensuring that their facility remains of good standard, it's about working closely with them on any issues. We've done previously a positive ageing strategy. I've worked with them to look at some of the issues that were brought up in that, so addressing some of the concerns that seniors have (Stakeholder, local government).
Opportunities for social participation Social environments
Productive environments
There's a big social activity that happens in our place, which is the medical practice, when they come to see the doctor (Stakeholder, health/social care organisation). Of course the social scene is the supermarket, it's amazing how many conversations go on there (Stakeholder, community organisation). I would say that 80% of our volunteers are over 65. And we've got people who come in and work every Thursday morning, sorting, pricing, setting up the shop, as well as the people who are on the shop rosters so when the shop's open they're serving people (Stakeholder, health/social care organisation).
Increasing capabilities for social participation Building individual resources Assistance to use community/individual resources and opportunities
So yeah, like some of the ones where we've helped people with meals, or put in some aids, if they've lost confidence . . . that's when I think we've done a good job (Stakeholder, health/social care organisation). So it's our role to actually educate people what is actually out there and support them to go on the journey (Stakeholder, local government). I go and have a talk to these guys and tell them what it's all about, leave a flyer with them (Stakeholder, informal group).
people specifically, but had more difficulty accessing physical infrastructure. Another essential resource was the partnerships formed between organisations and groups to facilitate access to resources, funding and leadership. Examples included the auspicing of small groups by larger organisations, partnerships to submit funding applications, and sharing of meeting rooms and buses to transport older people to activities. These partnerships were critical in that they created better access to community resources for stakeholders, and in some cases enabled greater resource production, through the development of new supports catering for older people. In particular, the presence of leadership within the community, particularly that provided by health and community organisations and local councils, was critical in development these partnerships and mentoring arrangements. These community resources were essential in supporting the development of opportunities and capabilities that allowed older people to participate. Opportunities Second, stakeholders discussed the manner in which community resources facilitated environments that enabled older people’s participation, and this was achieved through creating opportunities for older people to interact with others, and use individual resources to participate, which was primarily the domain of local health, community and social care organisations, and informal groups. However, all stakeholders discussed ways that local services, supports and infrastructure provided events, activities, gatherings and sites that enabled older people to participate socially, such as coffee E10
mornings, sporting activities, trivia nights, bus trips and games days. The existence of community infrastructure was also important in facilitating participation, in that the presence of local businesses, medical facilities, shops and community hubs provided opportunities for incidental social interaction, particularly for those who were socially isolated. The ability of community resources to offer opportunities for productive involvement was also mentioned, primarily in the context of volunteering, involvement in groups and activities that allowed older people to use existing skills, civic involvement and community governance. In particular, stakeholders highlighted the role of older people in volunteering in local hospitals, aged care facilities and at community events, delivering meals on wheels, running groups and services, sitting on committees, and providing transport and social visiting to other older people. Thus, as stakeholders acknowledged, this also contributed to the sustainability and development of community resources, while providing opportunities for social participation. In this regard, the wide range of opportunities in terms of interest, activity level and size was seen as beneficial in that it facilitated greater choice for diverse groups of older people, and as suggested earlier, this was more evident in the larger community. Capabilities Finally, local stakeholders indicated that community resources were integral in increasing the ability of older residents to access opportunities for social participation, and thus in increasing their capability. Primarily, stakeholder discussions related to the role of community resources in buildAustralasian Journal on Ageing, Vol 33 No 3 September 2014, E8–E12 © 2013 The Authors Australasian Journal on Ageing © 2013 ACOTA
L o c a l
g o v e r n a n c e
ing individual resources, and in increasing the ability of older people to use these resources. For example, stakeholders highlighted the role of health and social care organisations in facilitating continued health and mobility and access to food and financial assistance, community organisations that offered opportunities for skill development and qualifications (e.g. neighbourhood houses, U3A, Men’s Sheds), and community transport and informal networks in facilitating access to community resources and opportunities. Health and social care organisations also played a key role in building selfsufficiency and targeting social isolation, through building confidence for participation (e.g. home visiting, accompanied shopping trips), providing assistance (e.g. home help and household chores) and provision of tailored assistance plans to maximise social participation (e.g. targeting interventions to cater for specific interests and skills). The adaptation of the Home and Community Care (HACC) Active Service Model across both communities, a state-wide community care initiative which promotes capacity building and social connectedness within service delivery [18], was seen by a number of stakeholders as beneficial in this regard.
r e s p o n s e s
t o
s o c i a l
i n c l u s i o n
assist participation, and provide assistance to use individual and community resources. While these factors were seen to facilitate choice in participation, which has been identified as a benefit of rural living for older people [19], they are also significant in capacity building. As acknowledged by stakeholders, older people play a key role in producing community resources through actively contributing to governance, volunteering and providing expertise, which has been noted in recent Australian studies [20]. Significantly, this research has also highlighted the role that local health-care organisations play in facilitating social participation for rural ageing populations, both in supporting and mentoring smaller community groups, and in providing opportunities and resources to enhance individual and collective capacity.
Discussion
However, it is questioned whether genuine efforts are being made by stakeholders to provide services and supports that are socially inclusive, or whether they are overselling the social component of their services. For example, while stakeholders have highlighted volunteering as an opportunity for social participation, given the pressure placed on volunteers as a response to limited resourcing of rural service providers [21], volunteering may be viewed as a burden rather than an opportunity. As this paper has only explored stakeholder perceptions, the views of older people must be gained to ascertain whether the perceptions of stakeholders reflect older people’s experiences. Further, these findings are highly generalised, and it is doubtful that community resources will be accessible to all older people, or have the ability to build individual resources, opportunities and capabilities. Research must consider which approaches work specifically for diverse groups, which aspects of local services and supports prevent social participation, and what is missing. Given that research has indicated that diversity influences the particular barriers experienced by older people in participating in local governance [22], specific barriers and facilitators for at-risk groups must be identified. Diversity among rural communities should also be explored, as this research has anecdotally noted some differences between communities in terms of access to certain types of resources. While these have been contextualised in relation to community size for the purposes of this paper, these differences must be explored in addition to other community variables (e.g. community type, distance from cities).
While the literature suggests that neoliberalism has been detrimental to service provision in rural communities [7], from the perspective of community stakeholders, it appears that rural communities are devising numerous services and supports that allow older people to participate. Use of a social inclusion framework has highlighted the importance of community resources, which may create opportunities for participation, and both develop older people’s individual resources and increase their capabilities. Through the provision of physical and human infrastructure, and partnerships between local stakeholders to best use these, local services and supports offer social and productive environments for older people to participate, build individual resources to
Lastly, while these findings consider how rural communities are catering for the social needs of older residents, they do not consider the issues that stakeholders from different organisations face in providing community resources to build individual resources, opportunities and capabilities. In particular, this research has alluded to the importance of partnerships as a community resource. This raises questions as to how these partnerships can be fostered and sustained, which other resources community stakeholders require to provide older people with opportunities for inclusion, and barriers to accessing these. Given the diversity among stakeholders, it is likely that there will be differences between organisations in
Stakeholders also suggested that a key component of increasing older residents’ capabilities was the provision of information. In particular, they highlighted the personalised approach to information provision and recruitment to activities and services within their communities (particularly the importance of word of mouth), and the role of community stakeholders in advertising events, services and supports and providing regular information to older people within the communities by means of newsletters. Organisations such as local councils, hospitals and Senior Citizens groups indicated that they acted as essential community hubs for older people to access information on services and supports. As a number of stakeholders noted, a key aspect of building capability for older residents was to keep them living independently within the community, and to enable greater choice in participation. Local government representatives in particular saw that their role was to provide information and educate older people to participate in their communities, rather than being involved in direct service provision, which in a number of cases had been outsourced to community providers.
Australasian Journal on Ageing, Vol 33 No 3 September 2014, E8–E12 © 2013 The Authors Australasian Journal on Ageing © 2013 ACOTA
E11
W i n t e r t o n
R ,
terms of access, which need to be explored. Thus, while this paper has highlighted how rural stakeholders are currently attempting to meet the needs of older residents, it has also identified some issues in delivering local services and supports targeting social inclusion for older people, and highlighted some opportunities for research. This insight is critical to build capacity around locational approaches to social inclusion to cater for the increasing numbers of older people in rural communities.
C l u n e
4 5 6 7 8 9
Acknowledgements This project was funded by the Victorian Department of Planning and Community Development, City of Greater Bendigo, Moira Shire Council, Moira Healthcare Alliance, and the Institute for Social and Environmental Sustainability (La Trobe University). The contents of this article are the responsibility of the authors alone, and do not necessarily reflect the official views of the funding organisations.
10 11 12 13 14
Key Points • Rural communities are using existing human and social infrastructure, as well as partnerships between stakeholders, to provide supports for older residents. • Community resources are integral in enabling social inclusion for older people, through building capacity to participate and providing opportunities for them to do so.
15
16 17 18 19
References 1 2 3
E12
Social Inclusion Unit. Australian Social Inclusion Board. 2011. [Cited 7 March 2012.] Available from URL: http://www.socialinclusion.gov.au/ australian-social-inclusion-board Australian Institute of Health and Welfare. Older Australians at a Glance. Canberra: AIHW, 2007. Saw C. Rural health and ageing. In: Sarantakos S, ed. Quality of Life in Rural Australia. Wagga Wagga: Charles Sturt University, 1998: 10–19.
20 21 22
S ,
W a r b u r t o n
J
e t
a l .
Quine S, Morrell S. Feeling safe in one's neighbourhood: Variation by location among older Australians. Australian Journal of Rural Health 2008; 16: 115–116. Davis S, Bartlett H. Healthy ageing in rural Australia: Issues and challenges. Australasian Journal on Ageing 2008; 27 (2): 56–60. Alston M. Social exclusion in rural Australia. In: Cocklin C, Dibden J, eds. Sustainability and Change in Rural Australia. Sydney: University of New South Wales Press, 2005: 157–170. Alston M. Globalisation, rural restructuring and health service delivery in Australia: Policy failure and the role of social work? Health & Social Care in the Community 2007; 15 (3): 195–202. Hirst P. Democracy and Governance: Authority, Steering and Democracy. Pierre J, ed. New York: Oxford University Press, 2000. Alston M. Social capital in rural Australia. Rural Society 2002; 12 (2): 93–104. Australian Social Inclusion Board. Governance Models for Location Based Initiatives. Canberra: Australian Government, 2011. Australian Social Inclusion Board. Social Inclusion in Australia: How Australia Is Faring. Canberra: Department of the Prime Minister and Cabinet, 2010. Lui C-W, Warburton J, Winterton R, Bartlett H. Critical reflections on a social inclusion approach for an ageing Australia. Australian Social Work 2011; 64 (3): 266–282. Productivity Commission. Caring for Older Australians. Canberra: Final Inquiry Report, 2011. Contract No.: Report No. 53. McKenzie F. The challenges of achieving community self-determination and capacity building in a neo-liberal political environment. Australian Journal of Primary Health 2003; 9 (1): 39–49. Australian Bureau of Statistics. 2033.0.55.001 – Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia – Data only, 2006. 2008. [Cited 9 March 2012.] Available from URL: http://www. abs.gov.au/ausstats/[email protected]/Latestproducts/2033.0.55.001Media %20Release22006?opendocument&tabname=Summary&prodno= 2033.0.55.001&issue=2006&num=&view= Department of Health and Ageing. Community Infrastructure Grants Program. Canberra: Australian Government, 2011. Department of Health and Ageing. National Rural Health Infrastructure Program. Canberra: Australian Government, 2011. Victorian Government Department of Health. Victorian HACC Active Service Model Implementation Plan 2009–2011. Melbourne: Victorian Government, 2010. Winterton R, Warburton J. Ageing in the bush: The role of rural places in maintaining identity for long term rural residents and retirement migrants in north-east Victoria, Australia. Journal of Rural Studies 2012; 28 (4): 329–337. Hodgkin S. ‘I'm older and more interested in my community’: Older people's contributions to social capital. Australasian Journal on Ageing 2012; 31 (1): 34–39. Skinner MW, Joseph AE. The evolving role of voluntarism in ageing rural communities. New Zealand Geographer 2007; 63 (2): 119–129. Petriwskyj A, Warburton J, Everingham J-A, Cuthill M. Diversity and inclusion in local governance: An Australian study of seniors' participation. Journal of Aging Studies 2012; 26 (2): 182–191.
Australasian Journal on Ageing, Vol 33 No 3 September 2014, E8–E12 © 2013 The Authors Australasian Journal on Ageing © 2013 ACOTA
Research Local governance responses to social inclusion for older rural Victorians: Building resources, opportunities and capabilities Rachel Winterton, Samantha Clune and Jeni Warburton John Richards Initiative, La Trobe University, Wodonga, Victoria, Australia
John Martin Centre for Sustainable Regional Communities, La Trobe University, Bendigo, Victoria, Australia
Aim: To explore how local governance enables access to resources, creates opportunities and increases capability for older people in rural communities to experience social inclusion. Method: Twenty-six semi-structured interviews were undertaken with community stakeholders across two rural communities in north-east Victoria. Stakeholders were drawn from local government, and a range of community groups and organisations, as identified in a scoping study. Results: Through the provision of community resources (e.g. physical and human infrastructure, organisational partnerships), local services and supports offer social and productive environments for participation. They also build individual resources (e.g. health, skills, finances, networks) to enable older people to participate within these environments, and provide assistance to allow older people to use individual and community resources. Conclusions: Community resources are integral in facilitating the development of older people’s individual resources, and opportunities and capabilities for participation. These enable greater choice in participation, and contribute to the sustainability of community resources serving ageing populations. Key words: governance, rural, social inclusion.
Introduction Over the past decade, social inclusion has emerged as a policy concern, with the Australian Social Inclusion Board formed in 2008 as an advisory body to government [1]. As a result of rural populations growing older [2], increasing numbers of rural older people are faced with multiple barriers to social inclusion, including poor health and mobility, financial disadvantage and social isolation [3]. While rural communities can be inclusive in terms of community trust, social cohesion and safety [4,5], these benefits are often impeded by poor access to services and limited infrastructure and government assistance. As a result, many communities are struggling to provide resources that support older people [6,7], and thus
Correspondence to: Dr Rachel Winterton, John Richards Initiative, La Trobe University. Email: [email protected] E8
governments are advocating a need to build capacity around local governance, with coordination of activities through community networks and partnerships [8,9]. This is reflected in policy, with the Social Inclusion Board advocating a need for local service coordination and governance to enable location-based social inclusion initiatives [10]. However, while the responsibility for social inclusion is being placed on rural communities, there is little known about how local governance is facilitating this for older residents. This evidence is essential to determine which programs and services work well, in order to inform future policy [11]. Thus, the objective of this paper is to explore how rural communities are currently enabling social inclusion for older residents through locally governed services and supports, from the perspective of community stakeholders. Specifically, it investigates how local governance enables access to resources, creates opportunities and increases capability for rural older people to experience social inclusion. Ageing, rurality and social inclusion: issues and implications From a policy perspective, social inclusion reflects the ability to feel valued and have the opportunity to participate fully in society [11]. In achieving this, the Australian Social Inclusion Board has developed a conceptual framework advocating that participation is contingent on three factors: access to resources, opportunities and capability. Resources refer to the skills and assets individuals and communities possess, which support opportunities and capabilities, allowing people to choose how they wish to participate. Opportunities relate to an environment that enables individuals to use capabilities and resources, and capabilities reflect individual ability or agency to use resources and opportunities to participate. The development of opportunities and capabilities can also build individual and community resources, assisting further participation [11]. However, while social inclusion is a priority area for government, the needs of older people have been largely absent from recent policy debates [12]. This is despite its emphasis in aged care policy, with the recent Productivity Commission inquiry [13] highlighting a need to support social inclusion for older people. This is discussed particularly in the context of providing services, infrastructure and policy that will support older people living in their own homes, that promotes community participation, and that reduces pressure on aged care systems. Social inclusion is particularly important for older people, who are at risk of exclusion because of limited Australasian Journal on Ageing, Vol 33 No 3 September 2014, E8–E12 © 2013 The Authors Australasian Journal on Ageing © 2013 ACOTA
bs_bs_banner
L o c a l
g o v e r n a n c e
engagement with the labour market [6]. In rural locations, this is compounded by poor access to services, transport and infrastructure and reduced government support, largely because of limited population density and distance [5,6]. These issues are exacerbated by the promotion of neoliberal ideologies within rural Australia, which assert that individuals and communities should be responsible for their own welfare [6]. This approach is reflected in social inclusion policy, where a community-based approach is advocated through governments, organisations and communities working together flexibly to meet individual needs and build on community strengths. Further, a locational approach is advocated to target disadvantaged locations [11], which promotes local involvement in determining issues and solutions, capacity development and service coordination across all levels of government, non-profit and business sectors, and governance that is capable of community representation and local engagement [10]. However, while this approach relies on the existence of physical infrastructure, governance capacity, and economic, human and social capital [10], rural deregulation has reduced the resources available to enable these to be produced [14]. Rural local government areas are overrepresented in the Socio-Economic Indexes for Areas (SEIFA) classification of disadvantaged areas [15], and are becoming excluded in response to decreasing access to services and resources, employment opportunities and rural ageing [6]. This lack of resources has been highlighted in recent policy initiatives, with the development of programs aimed at building health and community infrastructure across regional Australia [16,17]. Therefore, in the context of neoliberal approaches to social inclusion and limited health and social infrastructure, older people will be required to actively participate in their rural communities to ensure that they have access to the resources they need. However, this further stigmatises those who cannot actively contribute to society [12]. Thus, given the current population ageing scenario, the lack of policy attention directed towards social inclusion in ageing, and the need for rural communities to provide their own social inclusion solutions, it is critical to identify how local services, supports and infrastructure are catering for the social inclusion of rural older people. Specifically, there is a need to identify capacity-building strategies in regard to social inclusion that respond to the challenges and opportunities of an ageing population [12].
Method This paper uses data from a larger study examining how local health and social infrastructure facilitate social participation for older residents across two rural communities in northeast Victoria. Sites were selected for their high percentages of residents aged 65 and over, small populations (approximately 2000 and 4000 persons respectively) and high levels of retirement migration. While two sites were used to increase the diversity of the sample, comparing the communities was not Australasian Journal on Ageing, Vol 33 No 3 September 2014, E8–E12 © 2013 The Authors Australasian Journal on Ageing © 2013 ACOTA
r e s p o n s e s
t o
s o c i a l
i n c l u s i o n
the objective of the research. However, where appropriate, apparent differences between communities have been highlighted and contextualised in terms of community size. Ethical approval was obtained from the La Trobe University Faculty of Health Sciences Ethics Committee. Across both communities, in-depth interviews were undertaken with stakeholders from a range of community services and supports, including local government, health, social care and community organisations and informal groups (n = 26). Relevant services and supports were identified by undertaking a scoping study of each community, and interviews focused on services and supports that enabled older people to participate, and community barriers and facilitators to social participation. Interviews were tape-recorded with participants’ informed consent, transcribed and analysed thematically using NVivo. Findings are discussed in relation to how locally governed services, supports and infrastructure facilitate social inclusion for older people by enabling access to resources, opportunities and capabilities, in accordance with the Social Inclusion Board framework. In line with ethical procedures, neither individuals nor communities have been identified in representing the data.
Results Stakeholders highlighted numerous ways that their communities facilitated social inclusion for older people through the provision of resources, access to opportunities and increasing capabilities that enabled greater social participation (see Table 1 for a thematic summary). Findings indicate that community resources are influential in developing older people’s individual resources (e.g. health, skills, finances, social networks), opportunities and capabilities. These individual resources, opportunities and capabilities enable greater choice in participation and contribute to the sustainability of community resources that service ageing populations. Community resources First, stakeholders identified a range of community resources that enabled social participation for older people, including local councils, health and social care organisations (e.g. local hospitals, Red Cross), community organisations (e.g. businesses, and not-for-profit, sporting, and religious organisations) and informal activity and support groups. Physical infrastructure (e.g. meeting rooms, transport) was essential in providing places for groups and organisations to meet, and human infrastructure (e.g. skills, volunteers, informal transport) was crucial in providing the workforce and expertise for resources to exist in the rural context. A number of stakeholders, particularly those in health-care and community organisations, highlighted the importance of volunteers and informal networks in tailoring their services to a diversity of older people, in the context of issues presented by geographical isolation and limited funding. However, access to community resources differed between communities, in that the larger community reported a greater number of community organisations and informal groups targeting older E9
W i n t e r t o n
R ,
C l u n e
S ,
W a r b u r t o n
J
e t
a l .
Table 1: How rural communities facilitate social inclusion for older people: stakeholder perceptions Provision of community resources Assets serving older people Partnerships between stakeholders
In a small little country town like this, I mean, it also relies on the volunteers. There's a lot of volunteering goes on here (Stakeholder, informal group). We co-operated with – we formed a partnership with Community Health and Rotary to get the Men's Shed off the ground (Stakeholder, community organisation). As well as ensuring that their facility remains of good standard, it's about working closely with them on any issues. We've done previously a positive ageing strategy. I've worked with them to look at some of the issues that were brought up in that, so addressing some of the concerns that seniors have (Stakeholder, local government).
Opportunities for social participation Social environments
Productive environments
There's a big social activity that happens in our place, which is the medical practice, when they come to see the doctor (Stakeholder, health/social care organisation). Of course the social scene is the supermarket, it's amazing how many conversations go on there (Stakeholder, community organisation). I would say that 80% of our volunteers are over 65. And we've got people who come in and work every Thursday morning, sorting, pricing, setting up the shop, as well as the people who are on the shop rosters so when the shop's open they're serving people (Stakeholder, health/social care organisation).
Increasing capabilities for social participation Building individual resources Assistance to use community/individual resources and opportunities
So yeah, like some of the ones where we've helped people with meals, or put in some aids, if they've lost confidence . . . that's when I think we've done a good job (Stakeholder, health/social care organisation). So it's our role to actually educate people what is actually out there and support them to go on the journey (Stakeholder, local government). I go and have a talk to these guys and tell them what it's all about, leave a flyer with them (Stakeholder, informal group).
people specifically, but had more difficulty accessing physical infrastructure. Another essential resource was the partnerships formed between organisations and groups to facilitate access to resources, funding and leadership. Examples included the auspicing of small groups by larger organisations, partnerships to submit funding applications, and sharing of meeting rooms and buses to transport older people to activities. These partnerships were critical in that they created better access to community resources for stakeholders, and in some cases enabled greater resource production, through the development of new supports catering for older people. In particular, the presence of leadership within the community, particularly that provided by health and community organisations and local councils, was critical in development these partnerships and mentoring arrangements. These community resources were essential in supporting the development of opportunities and capabilities that allowed older people to participate. Opportunities Second, stakeholders discussed the manner in which community resources facilitated environments that enabled older people’s participation, and this was achieved through creating opportunities for older people to interact with others, and use individual resources to participate, which was primarily the domain of local health, community and social care organisations, and informal groups. However, all stakeholders discussed ways that local services, supports and infrastructure provided events, activities, gatherings and sites that enabled older people to participate socially, such as coffee E10
mornings, sporting activities, trivia nights, bus trips and games days. The existence of community infrastructure was also important in facilitating participation, in that the presence of local businesses, medical facilities, shops and community hubs provided opportunities for incidental social interaction, particularly for those who were socially isolated. The ability of community resources to offer opportunities for productive involvement was also mentioned, primarily in the context of volunteering, involvement in groups and activities that allowed older people to use existing skills, civic involvement and community governance. In particular, stakeholders highlighted the role of older people in volunteering in local hospitals, aged care facilities and at community events, delivering meals on wheels, running groups and services, sitting on committees, and providing transport and social visiting to other older people. Thus, as stakeholders acknowledged, this also contributed to the sustainability and development of community resources, while providing opportunities for social participation. In this regard, the wide range of opportunities in terms of interest, activity level and size was seen as beneficial in that it facilitated greater choice for diverse groups of older people, and as suggested earlier, this was more evident in the larger community. Capabilities Finally, local stakeholders indicated that community resources were integral in increasing the ability of older residents to access opportunities for social participation, and thus in increasing their capability. Primarily, stakeholder discussions related to the role of community resources in buildAustralasian Journal on Ageing, Vol 33 No 3 September 2014, E8–E12 © 2013 The Authors Australasian Journal on Ageing © 2013 ACOTA
L o c a l
g o v e r n a n c e
ing individual resources, and in increasing the ability of older people to use these resources. For example, stakeholders highlighted the role of health and social care organisations in facilitating continued health and mobility and access to food and financial assistance, community organisations that offered opportunities for skill development and qualifications (e.g. neighbourhood houses, U3A, Men’s Sheds), and community transport and informal networks in facilitating access to community resources and opportunities. Health and social care organisations also played a key role in building selfsufficiency and targeting social isolation, through building confidence for participation (e.g. home visiting, accompanied shopping trips), providing assistance (e.g. home help and household chores) and provision of tailored assistance plans to maximise social participation (e.g. targeting interventions to cater for specific interests and skills). The adaptation of the Home and Community Care (HACC) Active Service Model across both communities, a state-wide community care initiative which promotes capacity building and social connectedness within service delivery [18], was seen by a number of stakeholders as beneficial in this regard.
r e s p o n s e s
t o
s o c i a l
i n c l u s i o n
assist participation, and provide assistance to use individual and community resources. While these factors were seen to facilitate choice in participation, which has been identified as a benefit of rural living for older people [19], they are also significant in capacity building. As acknowledged by stakeholders, older people play a key role in producing community resources through actively contributing to governance, volunteering and providing expertise, which has been noted in recent Australian studies [20]. Significantly, this research has also highlighted the role that local health-care organisations play in facilitating social participation for rural ageing populations, both in supporting and mentoring smaller community groups, and in providing opportunities and resources to enhance individual and collective capacity.
Discussion
However, it is questioned whether genuine efforts are being made by stakeholders to provide services and supports that are socially inclusive, or whether they are overselling the social component of their services. For example, while stakeholders have highlighted volunteering as an opportunity for social participation, given the pressure placed on volunteers as a response to limited resourcing of rural service providers [21], volunteering may be viewed as a burden rather than an opportunity. As this paper has only explored stakeholder perceptions, the views of older people must be gained to ascertain whether the perceptions of stakeholders reflect older people’s experiences. Further, these findings are highly generalised, and it is doubtful that community resources will be accessible to all older people, or have the ability to build individual resources, opportunities and capabilities. Research must consider which approaches work specifically for diverse groups, which aspects of local services and supports prevent social participation, and what is missing. Given that research has indicated that diversity influences the particular barriers experienced by older people in participating in local governance [22], specific barriers and facilitators for at-risk groups must be identified. Diversity among rural communities should also be explored, as this research has anecdotally noted some differences between communities in terms of access to certain types of resources. While these have been contextualised in relation to community size for the purposes of this paper, these differences must be explored in addition to other community variables (e.g. community type, distance from cities).
While the literature suggests that neoliberalism has been detrimental to service provision in rural communities [7], from the perspective of community stakeholders, it appears that rural communities are devising numerous services and supports that allow older people to participate. Use of a social inclusion framework has highlighted the importance of community resources, which may create opportunities for participation, and both develop older people’s individual resources and increase their capabilities. Through the provision of physical and human infrastructure, and partnerships between local stakeholders to best use these, local services and supports offer social and productive environments for older people to participate, build individual resources to
Lastly, while these findings consider how rural communities are catering for the social needs of older residents, they do not consider the issues that stakeholders from different organisations face in providing community resources to build individual resources, opportunities and capabilities. In particular, this research has alluded to the importance of partnerships as a community resource. This raises questions as to how these partnerships can be fostered and sustained, which other resources community stakeholders require to provide older people with opportunities for inclusion, and barriers to accessing these. Given the diversity among stakeholders, it is likely that there will be differences between organisations in
Stakeholders also suggested that a key component of increasing older residents’ capabilities was the provision of information. In particular, they highlighted the personalised approach to information provision and recruitment to activities and services within their communities (particularly the importance of word of mouth), and the role of community stakeholders in advertising events, services and supports and providing regular information to older people within the communities by means of newsletters. Organisations such as local councils, hospitals and Senior Citizens groups indicated that they acted as essential community hubs for older people to access information on services and supports. As a number of stakeholders noted, a key aspect of building capability for older residents was to keep them living independently within the community, and to enable greater choice in participation. Local government representatives in particular saw that their role was to provide information and educate older people to participate in their communities, rather than being involved in direct service provision, which in a number of cases had been outsourced to community providers.
Australasian Journal on Ageing, Vol 33 No 3 September 2014, E8–E12 © 2013 The Authors Australasian Journal on Ageing © 2013 ACOTA
E11
W i n t e r t o n
R ,
terms of access, which need to be explored. Thus, while this paper has highlighted how rural stakeholders are currently attempting to meet the needs of older residents, it has also identified some issues in delivering local services and supports targeting social inclusion for older people, and highlighted some opportunities for research. This insight is critical to build capacity around locational approaches to social inclusion to cater for the increasing numbers of older people in rural communities.
C l u n e
4 5 6 7 8 9
Acknowledgements This project was funded by the Victorian Department of Planning and Community Development, City of Greater Bendigo, Moira Shire Council, Moira Healthcare Alliance, and the Institute for Social and Environmental Sustainability (La Trobe University). The contents of this article are the responsibility of the authors alone, and do not necessarily reflect the official views of the funding organisations.
10 11 12 13 14
Key Points • Rural communities are using existing human and social infrastructure, as well as partnerships between stakeholders, to provide supports for older residents. • Community resources are integral in enabling social inclusion for older people, through building capacity to participate and providing opportunities for them to do so.
15
16 17 18 19
References 1 2 3
E12
Social Inclusion Unit. Australian Social Inclusion Board. 2011. [Cited 7 March 2012.] Available from URL: http://www.socialinclusion.gov.au/ australian-social-inclusion-board Australian Institute of Health and Welfare. Older Australians at a Glance. Canberra: AIHW, 2007. Saw C. Rural health and ageing. In: Sarantakos S, ed. Quality of Life in Rural Australia. Wagga Wagga: Charles Sturt University, 1998: 10–19.
20 21 22
S ,
W a r b u r t o n
J
e t
a l .
Quine S, Morrell S. Feeling safe in one's neighbourhood: Variation by location among older Australians. Australian Journal of Rural Health 2008; 16: 115–116. Davis S, Bartlett H. Healthy ageing in rural Australia: Issues and challenges. Australasian Journal on Ageing 2008; 27 (2): 56–60. Alston M. Social exclusion in rural Australia. In: Cocklin C, Dibden J, eds. Sustainability and Change in Rural Australia. Sydney: University of New South Wales Press, 2005: 157–170. Alston M. Globalisation, rural restructuring and health service delivery in Australia: Policy failure and the role of social work? Health & Social Care in the Community 2007; 15 (3): 195–202. Hirst P. Democracy and Governance: Authority, Steering and Democracy. Pierre J, ed. New York: Oxford University Press, 2000. Alston M. Social capital in rural Australia. Rural Society 2002; 12 (2): 93–104. Australian Social Inclusion Board. Governance Models for Location Based Initiatives. Canberra: Australian Government, 2011. Australian Social Inclusion Board. Social Inclusion in Australia: How Australia Is Faring. Canberra: Department of the Prime Minister and Cabinet, 2010. Lui C-W, Warburton J, Winterton R, Bartlett H. Critical reflections on a social inclusion approach for an ageing Australia. Australian Social Work 2011; 64 (3): 266–282. Productivity Commission. Caring for Older Australians. Canberra: Final Inquiry Report, 2011. Contract No.: Report No. 53. McKenzie F. The challenges of achieving community self-determination and capacity building in a neo-liberal political environment. Australian Journal of Primary Health 2003; 9 (1): 39–49. Australian Bureau of Statistics. 2033.0.55.001 – Census of Population and Housing: Socio-Economic Indexes for Areas (SEIFA), Australia – Data only, 2006. 2008. [Cited 9 March 2012.] Available from URL: http://www. abs.gov.au/ausstats/[email protected]/Latestproducts/2033.0.55.001Media %20Release22006?opendocument&tabname=Summary&prodno= 2033.0.55.001&issue=2006&num=&view= Department of Health and Ageing. Community Infrastructure Grants Program. Canberra: Australian Government, 2011. Department of Health and Ageing. National Rural Health Infrastructure Program. Canberra: Australian Government, 2011. Victorian Government Department of Health. Victorian HACC Active Service Model Implementation Plan 2009–2011. Melbourne: Victorian Government, 2010. Winterton R, Warburton J. Ageing in the bush: The role of rural places in maintaining identity for long term rural residents and retirement migrants in north-east Victoria, Australia. Journal of Rural Studies 2012; 28 (4): 329–337. Hodgkin S. ‘I'm older and more interested in my community’: Older people's contributions to social capital. Australasian Journal on Ageing 2012; 31 (1): 34–39. Skinner MW, Joseph AE. The evolving role of voluntarism in ageing rural communities. New Zealand Geographer 2007; 63 (2): 119–129. Petriwskyj A, Warburton J, Everingham J-A, Cuthill M. Diversity and inclusion in local governance: An Australian study of seniors' participation. Journal of Aging Studies 2012; 26 (2): 182–191.
Australasian Journal on Ageing, Vol 33 No 3 September 2014, E8–E12 © 2013 The Authors Australasian Journal on Ageing © 2013 ACOTA
