What levels of awareness about services do people from ethnic minority backgrounds in the south of Glasgow have and what practical issues exist in accessing them?
In general, people reported they feel there is a lack of information and awareness about the types of support they can get. If information is not widely known within the community then this knowledge gap will often remain. – Advocacy Connections report
Despite the existence of local authority, Scottish and UK government policies regarding equality of access to services, and despite the existence of a quarter of a century of research material indicating low levels of awareness among this group (S Koehn, 2009; McFarland et al, 1989; Dixon-Woods, 2005; Lindesay et al, 1997; Sadevoy et al, 2004) this study found that awareness of what is available to them is limited among older people from ethnic minority backgrounds. People spoke of not knowing how to access social work, of wanting a home help but having no idea about how to get one and of not knowing what is available.
A very clear and consistent route to accessing information about services was identified. This comprised the use of existing community based services in the area, such as drop-in centres, community halls and day centres, as signposting agencies. Often, these services would be used as intermediaries and would negotiate access to statutory social and health services for people who appeared through their doors.
They acted as informal gateways to a wide variety of services, matching the needs presented by individuals with services that might meet them. In some ways, for those older people who lived near enough or had a means of easy access to one of these places, the need for a high level of awareness of other services was obviated. All they needed to do was visit their “gateway” and present their need. This does not mean they always accessed the service they required. Once signposted, they would be subject to the same vagaries of service provision experienced by the wider population.
This phenomenon is reflected in S. Koehn’s work in Canada in 2009. She found that low levels of awareness of services among ethnic minority older people was mitigated to some degree when they accessed an intermediary type service. The south of Glasgow, despite suffering some cuts in services, is relatively well resourced with these ethno-specific community based services. The fact that people travel from outwith the area to access these services suggests that awareness of services for people from ethnic minority backgrounds in other areas is even worse than in the south of Glasgow.
Koehn also identified a potential difficulty in accessing services specifically for older people:
Other [offspring] choose to keep this information [about services] from their parents because they do not want them to attend programmes outside the home, particularly when they are needed for domestic services and child-care (18)
No evidence for this was found in this study. However, it should be noted that the older people interviewed for this study all already had accessed services, even if only an intermediary type such as a drop-in service. There may be further scope for an examination of whether a “hidden” population of older people exists in Glasgow, whose access to services is restricted by factors such as the one Koehn describes, or whose information networks are lacking to the point where they are living in ignorance of services they could be accessing. Some evidence was found for this latter point:
A number of people who attend the existing day services said that – with the exception of their attendance at the day service – they do not receive any services. Many reported that they don’t know what they could get and have no information about what they are entitled to. A lot of people relied on staff in the day centres or in services like the Well to help them with correspondence and to provide information. People are travelling from across Glasgow and from other local authority areas to attend for advice and information. One person said “It would be difficult to get information without the staff in the centres. – Advocacy Connections Report
If we assume that those who attend day centres in Glasgow, or visit drop in services (of which The Well is one) are a small minority of all the older people from ethnic minorities in the area, this points to the likelihood that many older people from ethnic minorities exist in Glasgow who do not access services at all and that in at least some, if not the majority of cases, this is because they do not have enough information to do so. However, factors affecting identification of candidacy, described above, need to be taken into account here.
Practical issues
The study found that transport to and from services was a significant barrier to access. Many older people rely on family and friends for help with transportation. This can be unreliable and represents a loss of independence (see Dixon-Woods, 2005). In addition, language barriers affected the ability of some to use public transport or taxis. Women, particularly, found the use of public transport to be an issue, due to cultural inhibitions on their being in public places without accompaniment.
The study also found that language barriers for women were more significant than for men due to the home-based role of women in Muslim tradition. Men had improved their language skills through being out in English speaking environments whilst women had not had that opportunity. In later life, this presented women with an additional barrier to accessing services.
People in the study complained that some services were expensive and cited this as a barrier to access. In some cases, state means-based assessment processes have recently resulted in attendees at day centres being asked to pay a contribution towards the service, so this issue was current for a number of people. Chiropody and massage services were mentioned as two desirable services which people did not want to pay for – neither of these is currently available through other means.
(18) Negotiating candidacy: ethnic minority seniors’ access to care, S. Koehn, 2009, Cambridge University Press