© The Family Centre Social Policy Research Unit Sexuality and Discrimination and their Impacts on Health and Wellbeing Symposium

© The Family Centre Social Policy Research Unitwww.familycentre.org.nz

Sexuality and Discrimination and their Impacts on Health and Wellbeing

Symposium Presentation: Dimensions of Ageing and Wellbeing

Presentation to International Federation of Ageing (IFA) 11th Global Conference on Ageing

Prague, Czech Republic,31 May, 2012

Charles Waldegrave, Family Centre Social Policy Research Unit, Wellington, New Zealand

School of Psychology, Massey University: Fiona Alpass, Christine Stephens, Andy Towers & Brendan Stevenson

Family Centre Social Policy Research Unit: Charles Waldegrave & Peter King

University of Otago: Sally Keeling

New Zealand Longitudinal Study of Ageing (NZLSA)

© The Family Centre Social Policy Research Unit www..familycentre.org.nz

School of Psychology, Massey University

Family Centre Social Policy Research Unit

NZLSA Wave 1, 2010


• Sample: National random sample of 3,317 New Zealanders aged between 50 and 84 years

• Oversampling for Māori N = 1,049

• Funded by the Foundation for Research, Science and Technology now Ministry of Science and Innovation

Sample by Age (NZLSA Wave 1)


Frequency PercentValid

PercentCumulative

Percent

Valid 50-54 426 12.8 13.1 13.1

55-59 510 15.4 15.7 28.8

60-64 765 23.1 23.6 52.4

65-69 624 18.8 19.2 71.6

70-74 567 17.1 17.5 89.1

75-79 231 7.0 7.1 96.2

80+122 3.7 3.8

100.0

Total 3245 97.8 100.0

Missing System 72 2.2

Total 3317 100.0

Amartya Sen’s Approach to Wellbeing as Freedom and Capability

• Wellbeing is based on an understanding that emphasises people’s capabilities

• Their ability to create their own wellbeing

• This view of wellbeing is based on the Freedom and Capabilities Approach developed by Amartya Sen

• It emphasizes what people can do, rather than simply how they feel.

Functionings, Capability and Freedom

Functionings•The abilities and skills that people have

Capabilities•Based on ability to apply functionings to the achievement of self-defined goals•Requires freedom•Basis for achieving wellbeing

Instrumental freedoms•Contribute to people’s overall freedom to live life as they would prefer

NZLSA: WHOQoL-85 point scale


How would you rate your quality of life?

How satisfied are you with your health?

How satisfied are you with your ability to perform your daily living activities?

How satisfied are you with yourself?

How satisfied are you with your personal relationships?

How satisfied are you with the conditions of your living place?

Do you have enough energy for everyday life?

Have you enough money to meet your needs?

NZLSA: CASP-12 Wellbeing Scale4 point scale


My age prevents me from doing the things I would like to.

I feel that what happens to me is out of my control.

I feel left out of things.

I can do the things that I want to do.

I feel that I can please myself what I do.

Shortage of money stops me from doing things I want to do.

I look forward to each day.

I feel that my life has meaning.

I enjoy the things that I do.

I feel full of energy these days.

I feel that life is full of opportunities.

I feel that the future looks good for me.

Discrimination and Sexuality: their positive and negative associations with wellbeing


• Projected demographic changes suggest an increasing number of older people will be living in place on their own.

• Primary focus of wellbeing studies on Health, Income and to a lesser extent Participation

• Discrimination is an important human rights issue and older people may be being doubly discriminated

• Sexuality is considered to be a fundamental human need, but older people are often considered to be past enjoyment

• Are these two factors significantly associated with wellbeing?

• How do they relate to other social indicators like loneliness, depression and social support?

Everyday Discrimination Scale6 point scale

The following questions concern your feelings of being discriminated against by others. How often in your day to day life has any of the following happened to you?

•You are treated with less courtesy and respect than other people•You receive poorer service than other people at restaurants and stores•People act as if they think you are not smart•People act as though they are afraid of you•You are called names or insulted•You are threatened or harassed


Everyday Discrimination Scalecontinued

What would you say was the single most important reason for any of these thing above happening to you? Was it your:Race? Sexual orientation?

Gender? Disability?

Age? Religion?

Weight? Health?

Not applicable: I am not discriminated against

Other (Please specify)© The Family Centre Social Policy Research Unit

www.familycentre.org.nz

Discrimination and Wellbeing


• We estimated a correlation between wellbeing and discrimination using Pearson’s r, and we found that the correlation was significant (2-tailed) at the <0.01 level.

• WHOQoL-8 total sample <0.01 (correlation coefficient -.299)

• CASP-12 total sample <0.01 (correlation coefficient -.293)

Discrimination and Wellbeing Māori / Non-Māori


Correlation between wellbeing and discrimination using Pearson’s r was significant (2-tailed) at the <0.01 level for both Māori and non-Māori.

•WHOQoL-8 Māori <0.01 (correlation coefficient -.345)

•WHOQoL-8 non-Māori <0.01 (correlation coefficient -292)

•CASP-12 Māori <0.01 (correlation coefficient -.279)

•CASP-12 non-Māori <0.01 (correlation coefficient -.325)

CASP-12 Wellbeing Sub-Scales


• Correlation between control and autonomy and discrimination using Pearson’s r was significant (2-tailed) at the <0.01 level for the total sample, (correlation coefficient -.345)

Control and Autonomy Sub-Scale

• Correlation between self-realisation and discrimination using Pearson’s r was significant (2-tailed) at the <0.01 level for the total sample, (correlation coefficient -.168)

Self-realisation Sub-Scale

Pleasure Sub-Scale

• Correlation between pleasure and discrimination using Pearson’s r was significant (2-tailed) at the <0.01 level for the total sample, (correlation coefficient -.159)


Discrimination: Single most important reason

Frequency PercentRace or ethnicity 104 3.3

Sexual Orientation 29 .9 Gender 122 3.8 Disability 43 1.3 Age 390 12.3 Religion 36 1.1 Weight 58 1.8 Health 49 1.6 Not applicable (not

discriminated against)

2013 63.2

Other 339 10.7 Total 3182 100.0

De Jong Gierveld Loneliness Scale3 point scale

There is always someone I can talk to about my day-to-day problems.I miss having a really close friend.I experience a general sense of emptiness.There are plenty of people I can lean on when I have problems.I miss the pleasure of the company of others.I find my circle of friends and acquaintances too limited.There are many people I can trust completely.There are enough people I feel close to.I miss having people around.I often feel rejected.I can call on my friends whenever I need them.


CES-D-10 Depression Scale4 point scale


I was bothered by things that usually don’t bother me.

I had trouble keeping my mind on what I was doing.

I felt depressed.

I felt that everything I did was an effort.

I felt hopeful about the future.

I felt fearful.

My sleep was restless.

I was happy.

I felt lonely.

I could not “get going”.

Social Provisions Scale 4 point scale. 24 items - some example questions


There are people who I can depend on if I really need it.

I feel that I do not have close personal relationships with other people.

There is no-one I can turn to for guidance in times of stress.

There are people who depend on me for help.

I feel a strong emotional bond with another person.

There is no-one I can depend on for aid if I really need it.

There are people who admire my talents and abilities.

There is no-one who likes to do the things I do.

No-one needs me to care for them

Discrimination and its Associations with Loneliness, Depression and Social Support


• We estimated correlations between discrimination and 3 variables loneliness, depression and social support using Pearson’s r, and we found that each correlation was significant (2-tailed) at the <0.01 level for the total sample.

• Loneliness <0.01 (correlation coefficient .321)

• Depression <0.01 (correlation coefficient .325)

• Social Support <0.01 (correlation coefficient -.235)

Linear Regression of Discrimination

• To further investigate these three factors and their associations with discrimination we estimated a linear regression using discrimination as the dependent variable, and loneliness, depression and social provisions as the independent variables.

• The results showed:

– F-test statistic had a p-value of <0.001. This tested the whole model.

– T-test of significance of the loneliness and depression coefficients in front of each variable had a p-value of <0.001, but the social provisions coefficient showed no significant relationship.

Loneliness, Depression and Social Provisions Prevalence


Loneliness:42 percent moderately lonely10 percent severely or very lonely

Depression:60 percent depressed at threshold 344 percent depressed at Threshold 4

Social Provisions:A significant relationship was found between greater age and fewer social provisions. F-test statistic had a p-value of <0.01. This tested the whole model.

Sexuality Questions

Taken from the Sexual Functioning Scale LEIPAD questionnaire


• Are you interested in sex? 4 point scale: not at all; a little; quite a bit; very much.

• How often do you have sexual contact?4 point scale: never; occasionally; often, very often

Are you interested in sex by Age


Age Category

Are you interested in sex

TotalNot at all A littleQuite a

bitVery much

50-54 Count 37 188 290 189 704% within Age Cat

5.3% 26.7% 41.2% 26.8% 100.0%


7.3% 33.3% 36.2% 23.1% 100.0%


10.2% 37.7% 36.9% 15.2% 100.0%


12.1% 42.9% 32.9% 12.1% 100.0%


22.4% 40.0% 26.6% 11.0% 100.0%


37.5% 38.9% 15.3% 8.3% 100.0%


41.3% 45.5% 10.5% 2.8% 100.0%

Total

Count 380 991 927 494 2792% within Age Cat

13.6% 35.5% 33.2% 17.7% 100.0%

Are you interested in sex by Gender


Gender

Are you interested in sex

TotalNot at all A littleQuite a

bitVery much

Male Count 71 341 641 402 1455

% within Sex 4.9% 23.4% 44.1% 27.6% 100.0%

Female Count 362 715 383 130 1590

% within Sex 22.8% 45.0% 24.1% 8.2% 100.0%

Total

Count 433 1056 1024 532 3045

% within Sex 14.2% 34.7% 33.6% 17.5% 100.0%

Interest in Sex and Wellbeing


• We estimated a correlation between interest in sex and wellbeing using Pearson’s r, and we found that the correlation was significant (2-tailed) at the <0.01 level. More sexual contact was associated with higher wellbeing

• WHOQoL-8 total sample <0.01 (correlation coefficient .223)

• CASP-12 total sample <0.01 (correlation coefficient .215)

Sexual Contact by Age


Age Category How often do you have sexual contact Total

NeverOccasio

nally OftenVery often

50-54 Count 87 287 287 44 705 % within Age Cat 12.3% 40.7% 40.7% 6.2% 100.0% 55-59 Count 93 263 165 29 550 % within Age Cat 16.9% 47.8% 30.0% 5.3% 100.0% 60-64 Count 115 236 128 24 503 % within Age Cat 22.9% 46.9% 25.4% 4.8% 100.0% 65-69 Count 107 171 88 15 381 % within Age Cat 28.1% 44.9% 23.1% 3.9% 100.0% 70-74 Count 116 118 46 5 285 % within Age Cat 40.7% 41.4% 16.1% 1.8% 100.0% 75-79 Count 131 72 13 0 216 % within Age Cat 60.6% 33.3% 6.0% .0% 100.0% 80-84 Count 99 43 5 0 147 % within Age Cat 67.3% 29.3% 3.4% .0% 100.0% Total Count 748 1190 732 117 2787 % within Age Cat 26.8% 42.7% 26.3% 4.2% 100.0%

Sexual Contact by Gender


How often do you have sexual contact Total Gender Never

Occasionally Often

Very often

Male Count 248 650 487 66 1451

% within Sex 17.1% 44.8% 33.6% 4.5% 100.0%

Female Count 534 630 357 56 1577

% within Sex 33.9% 39.9% 22.6% 3.6% 100.0%

Total Count

%

782

25.8%

1280

42.3%

844

27.9%

122

4.0%

3028

100.0%

Sexual Contact and Wellbeing


• We estimated a correlation between sexual contact and wellbeing using Pearson’s r, and we found that the correlation was significant (2-tailed) at the <0.01 level. More sexual contact was associated with higher wellbeing

• WHOQoL-8 total sample <0.01 (correlation coefficient .308)

• CASP-12 total sample <0.01 (correlation coefficient .259)

CASP-12 Wellbeing Sub-Scales


Control and Autonomy Sub-Scale

• Correlation between control and autonomy and sexual contact using Pearson’s r was significant (2-tailed) at the <0.01 level for the total sample, (correlation coefficient .220)

Self-realisation Sub-Scale

• Correlation between self-realisation and sexual contact using Pearson’s r was significant (2-tailed) at the <0.01 level for the total sample, (correlation coefficient .267)

Pleasure Sub-Scale

• Correlation between pleasure and sexual contact using Pearson’s r was significant (2-tailed) at the <0.01 level for the total sample, (correlation coefficient -.171)

Sexual Contact and its Associations with Loneliness, Depression and Social Support

Wellbeing


• We estimated correlations between sexual contact and 3

variables loneliness, depression and social support using Pearson’s r, and we found that each correlation was significant (2-tailed) at the <0.01 level for the total sample.

• Loneliness <0.01 (correlation coefficient -.187)

• Depression <0.01 (correlation coefficient -.234)

• Social Support <0.01 (correlation coefficient .348)

Linear Regression of Sexual Contact


• To further investigate these three factors and their

associations with wellbeing we estimated a linear regression using sexual contact as the dependent variable, and loneliness, depression and social provisions as the independent variables.

• The results showed:

• F-test statistic had a p-value of <0.001. This tested the whole model.

– T-test of significance of each coefficient in front of the social provisions and depression variables had a p-value of <0.001 whereas the loneliness variable had a p-value 0.003.

Discrimination and Sexuality and their Relationship with Wellbeing


• Gradually losing one’s mobility, friends pass on, health problems may be increasing, etc – Being discriminated against on the basis of age, or worse still doubly discriminated against, could be a living hell.

• If many older people are sexually active or want to be, this raises important issues around the right to privacy, self-determination and agency.

• Both raise important issues about how services are provided and the need for greater public information and awareness.

• These issues could take a central place in the training of service providers, including home help support service workers, nurses, doctors, psychologists, physiotherapists, gerontologists, etc because they impact directly on the lives of older people.


• The use of space, and particularly in residential settings, could consider intimacy as an important human need and ensure there are places for privacy.

• Being alert to all forms of discrimination and disrespect of older people in organisations and discussing it openly when it occurs.

• Public information through journalism and other forms of media to help open public attitudes around discrimination and sexuality among older people. Address the stereotypical myths. Coaching journalists about key messages as we have about smoking and the environment.

• It would help if we saw older people as in many ways the same as the rest of us with similar needs for safety and enjoyment. Disability services, for example, could help people address their sexual needs appropriately as their bodies age.

Documents

© The Family Centre Social Policy Research Unit Sexuality and Discrimination and their Impacts on Health and Wellbeing Symposium