SOCIAL EXCLUSION ON ELDERLY PEOPLE: A STUDY ON THE PERCEPTIONS OF DISABLED OLDER PEOPLE IN SOUTH PARK

Introduction

Social exclusion is a complex and multi-dimensional process by which a section of people in society  are systematically discriminated against because of their poverty, race, religion, gender, disability, HIV status, migrant status, age or similar factors (Levitas et al, 2007). As Levitas et al (2007) rightly defined, ‘Social Exclusion involves the lack of or denial of resources, rights, goods and services, and the inability to participate in normal relationships and activities available to the majority of people in a society’. At the individual level, social exclusion leads to lower level of quality of life, and at the societal level it affects social cohesion as a whole.

Social exclusion is not a new concept or model. The term ‘social exclusion’ was originated in France in the 1970s and René Lenoir is considered as the father of the modern interpretation of social exclusion.  He used the concept in his publication titled, ‘The Excluded, One Frenchman in Ten’ (Menon, 2009). Since then, the concept has been widely used by national governments and multilateral agencies to design policies of social inclusion and poverty eradication.

Initially, the concept of social exclusion was used to denote a group of people who were excluded from conventional social security system. The European Commission began to use the terms since 1980s. In social science literature, the concept has been widely used as a theory and model to approach myriad problems associated with that of discrimination, marginalisation, alienation and lack of resources. Social exclusion has political, economic and cultural implications as well (Walsh, O Shea and Scharf, 2012).

Against this backdrop, the proposed research, attempts to analyse the concept of social exclusion and its diverse implications within the context of disabled elderly population in London.  There are many studies that highlighted ageing as a significant factor contributing to social exclusion (Scharf and Bartlam, 2008; Litwin, 2011). This empirical study would try to understand the extent of social exclusion that the disabled elder people face in their daily life and their own perceptions on the concept of social exclusion. The research would also analyse the risk factors associated with social exclusion of disabled older people and the strategies that can help to decrease social exclusion of the disabled elderly.

Background of the Problem

Though social exclusion is not a new concept, in traditional social science literature, social exclusion was perceived in relation to poverty, deprivation and low level of income (Townsend, 1979). Townsend argued that social exclusion emerges  when “resources are so seriously below those commanded by the average individual that they are, in effect, excluded from ordinary living patterns, customs and activities” (Townsend, 1979; p32). Scholars like Walker and Walker (1997; p.8) also endorsed this narrow view of social exclusion.  But later on, scholars began to identify social exclusion caused by non-economic factors as well. Hence, scholars and practioners began to relate social exclusion with the inability to participate actively in social, cultural, political and economic life due to a variety of reasons resulting from age, disability, race, economic status, mental health, sex etc.  When a section of people are alienated, and distanced themselves from mainstream society due to these risk factors, it is broadly termed as   social exclusion (Nolan and Whelan, 1996).

The question arises what exactly constitute social exclusion?  Using a Comprehensive British Panel Data Survey, Burchardt (1999) identified the following factors as key attributes that represent social exclusion: ‘low standard of living; lack of security; lack of participation in an activity valued by others; lack of decision-making power; lack of support from or contact with family or friends and the wider community’. The UK Social Exclusion Unit (2004) defines social exclusion as ‘deprivation and the lack of access to social networks, activities, and services that results in a poor quality of life’.

Although, there is no dearth of literature on social exclusion, the significance of age as a risk factor evolved only recently. Except in the UK, there was limited research on social exclusion among elderly.  Longer life expectancy due to breakthrough in medical science has increased the number of old people in society. Ageing is associated with vulnerabilities including deteriorating health, lack of mobility and lack of regular income (Walsh, O Shea and Scharf, 2012). Hence, older people need support from others. The risk factors of age affect their ability to participate in social functions meaningfully and thus result in loneliness.  After retirement, the life style of people changes drastically and they prefer to sit at home most of the time. The increase of absenteeism in the social cycle of individual with the rest of society slowly leads to separation from social functions and thus ultimately results in social exclusion (Kahnema and Kruger, 2006). Old people generally depend upon their pensions and are reluctant to participate actively in social and community roles due to financial and health related issues. Most of them suffer from age induced disability as well (Pantaziz, 2000). Fear of crime also affects their engagement in social functions and thus enhances isolation and loneliness (Pantaziz, 2000). Studies show that there is increased risk of depression among those who face social exclusion due to age because they have limited emotional and social support from family and community (Saito et al.2005).

The social exclusion of older people becomes extreme when it is associated with disability. In the case of disabled elder people, exclusion from social engagements emerges from two critical situations. One situation is the lack of mobility due to physical disability. Second situation is the alienation resulting from the lack of resources, lack of emotional support, lack of proper medical care and increasing fear. Thus, disability aggravates social exclusion of older people. Though there is abundance of research studies that examined the role of age in social exclusion, there is relatively limited effort to understand the factors that constitute social exclusion among disabled older people.

The proposed research, therefore, approaches this theme from the perspective of a group of disabled older people in London city. The study analyses their perception, fears and attitude to life and there by construct the meaning and implications of social exclusion for disabled elderly.  Further, the study would also offer recommendations for future policy that can support disabled elderly suffer from social exclusion within an urban context.

Review of Literature

Social exclusion is a widely debated concept. Hence, there is plenty of scholarly literature on the concept and its implications. This review briefly explains definitions and approaches towards social exclusion and various indicators that constitute exclusion from society. After defining the concept, attempt is made to review the existing studies that connect ageing with social exclusion.  Previous research that focuses on the various risk factors of ageing that lead to social exclusion, coping strategies and remedies to reduce the degree of exclusion are also examined.

Definition of Social Exclusion

Earlier research on social exclusion focused on poverty and related it with lack of material resources.  It is evident from Townsend’s (1979) definition that argues that exclusion happens when resources are lower than the expectations. This is supported by Walker & Walker (1997, p8) who stated that social exclusion is “a lack of material resources, especially income, necessary to participate in British society”.  The efforts to define social exclusion outside the realm of poverty debates began with Room (1999) and (Nolan and Whelan, 1996).

Thus scholar began to perceive social exclusion as a process by which a group of people are excluded, segregated and discriminated against the rest of mainstream society due to some risk factors including lack of resources, lack of mobility, lack of health etc. Duffy (1995) defined social exclusion as the ‘inability to participate effectively in economic, social, political and cultural life, alienation and distance from the mainstream society”.

According to the UN (2007) social exclusion implies lack of access to various social protection programs and lack of participation in social life affectively. According to Jehoel–Gijsberg & Vrooman (2008) social exclusion refers to inadequate social integration including lack of participation in leisure activities, insufficient support system from society and the resultant social isolation. Scharf et al (2005) explained social exclusion in terms of loneliness arising out of lesser contact and communication with family, friends and community. These early definitions thus tend to deviate from the economic aspect of exclusion and put more emphasis on its social and cultural dimensions. The Social Exclusion Unit of British Government (2001)defined it as a situation  in which ‘people or areas suffer from a combination of linked problems such as unemployment, poor skills, low incomes, poor housing, high crime environments, bad health and family breakdown’.  Moffatt and Glasgow (2009) perceived it as a process in which people or group disengages from the mainstream society. According to them social exclusion also include the negative consequences of such disengagement on the lives of the excluded groups.

From the above analysis, it is evident that there is no agreed definition of social exclusion. However, it is generally agreed that social exclusion encompasses a process of systematic alienation from key social systems and institutions and its negative impact on the individual or group. Social exclusion is multi dimensional and leads to more than one disadvantages. Understanding the problematic nature of the concept and its implications in different contexts and societies, Levitas et al (2007; p.9) provided a broad definition of social exclusion. According to this definition, Social exclusion ‘is a complex and multidimensional process. It involves the lack or denial of resources, rights, goods and services, and the inability to participate in the normal relationships and activities, available to the majority of people in a society, whether in economic, social, cultural or political arenas. It affects both the quality of life of individuals and the equity and cohesion of society as a whole’.  The proposed research will use this definition as it is broader and can be easily related to the situation of elderly and disabled.

Major Indicators of Social Exclusion     

Previous research on social exclusion shows that different scholars used different attributes to explore the degree and intensity of social exclusion. In his study based on the British Household Panel Survey (BHPS), Burchardt (1999) provides five attributes of social exclusion. They are:  ‘lower standard of living; lack of security; lack of engagement in an activity valued by others; lack of decision-making power; lack of support from or contact with family or friends and the wider community’.

According to Barnes (2005), social exclusion emanates from lower income, non-monetary deprivation, health problems and lack of social participation. Madanipour et al. (1998; p.22) perceive social exclusion as denial of  and  lack of access to participation in decision making and political processes, lack access to labour market and economic resources, and lack of access to social and cultural processes.

Jehoel-gijsbers and Vrooman (2008) features of social exclusion include the following:

1. Economic and structural exclusion: Material resources deprivation and inadequate access to government schemes
2. Social and Cultural exclusion: Insufficient social integration and lack of cultural integration.

Ageing and Social Exclusion

The relationship between ageing and social exclusion was studied by scholars only recently. In 1998, the Government of Britain used some qualitative and quantitative indicators to measure social exclusion and identified key indicators for older people. They are poverty, health and life expectancy fear of crime, poor housing and lack of independence. Agulnik, Burckhardt and Evans (2002) argues that risk of decline in income increases with increasing age and therefore age is an important factor that contributes to social exclusion in any society. Phillipson and Scharf (2004) studied the problem and identified that age induced disability, low income and singe status due to death of partner are important risk factors of social exclusion among older people.

Blackman et al (2001) identified factors like disability, depression, lack of regular income, loss of meaningful social relationships and inadequate old age pensions as the key risk factors associated with old age that led to social exclusion.

Scharf and Bartlam (2008) identified five areas in which older people feel exclusion. They are: exclusion from material relations, exclusion from social relations, exclusion from civic activities, exclusion from basic services and neighborhood and community exclusion.

In a comprehensive study conducted by Barnes et al. (2006), it is identified that there are seven aspects that constitute social exclusion including material resources, social relationships; cultural and leisure activities; participation in civic functions; access to basic services; neighbourhood activities and access to financial services like banking.

Walker (2005) studied risks of social exclusion associated with different category of older people like widows, people living alone, rural elderly, poor elders, elders with lower income etc. They argued that level of exclusion is different in accordance with the context and situation for older people.

Guberman and Lavoie (2004) identified the key domains in which social exclusion is visible among the elderly. They are:

• Symbolic exclusion: lack of representation within a particular group or community
• Identity Exclusion: Different social  identities of a person disappears and narrows down to a single identity- old age
• Socio-political Exclusion: Lack of participation in civic activities lead to declining role in political decision making and participation
• Institutional Exclusion: Absence of participation in social and institutional activities results in lower health and mental state. Lack of communication with institutional care givers also include in this.
• Economic Exclusion: Lack of access to regular income and material resources except pension limits daily life style
• Exclusion from meaningful relations: Lack of access to social networks, groups and facilities affect social relations
• Territorial Exclusion: Geographical isolation and exclusion arising out of lack of mobility.

There are many studies on social exclusion and age that highlight multiple factors as key risk factors of social exclusion among elderly. Gray (2008) focused on decline of social relations as a result of ageing and Pickard (2002) concentrated on declining family care as the key reason for social exclusion. Gray (2009) suggests that older people living alone, widows, and older people without children are some of the categories that face extreme vulnerability in terms of social exclusion. Keady and Watts (2011) focused on the issue of lack of transport and the resultant social exclusion arising out of less mobility among older people. Bartley and O’Neill (2010) also perceived lack of transportation as an important determinant of social exclusion among the older people.

In short, there are plenty of research in the area of social exclusion and ageing. The following table reflects the major conceptual frameworks in this domain.

Guberman and Lavoie (2004)	Barnes et al. (2006)	Scharf and Bartlam (2008)
Economic exclusion Institutional exclusion Territorial exclusion Identity exclusion Symbolic exclusion Socio-political exclusion Exclusion from meaningful relationships	Lack of economic participation Lack of access to material resources Lack of access to public and private services Lack of access to social resources Lack of social participation Lack of political/ civic participation Lack of cultural and educational relations Lack of better health and wellbeing Lack of living environment Fear of crime, harm and criminalization	Lack of access to social relations Lack of access to civic amenities Lack of material resources Lack of service provision and basic services Lack of neighbourhood relations

Table 1(Walsh et, al, 2012)

In short, it is evident that age is a critical factor in social exclusion. Age induced risk factors like disability, health problems, depression, lack of mobility and lack of resources affect the opportunity to interact with people and active in social relations. Social exclusion is a natural effect of these multiple risk factors.

Relevance and Justification of the Study

The review of previous literature shows that there is substantial amount of research that shows the linkage between age and social exclusion. Most of the research focused on the risk factors of old age, need for government intervention etc. However, empirical studies on social exclusion and older people mainly used quantitative survey to measure the degree and extent of exclusion. There is still limited qualitative research that concentrates on the aspirations, preferences and problems of the elderly.  In other words, research studies that focus on the lived in experience of exclusion of the older people are relatively less. Also there are comparatively less empirical studies that focus on the older people with disability. Disability aggravates the chances of social exclusion because it directly affects mobility. While disability itself is a critical risk factor of social exclusion, the situation leads to extreme vulnerability when disabled people become old. Old age related health and other problems along with physical disability is thus a very important condition that contributes to social exclusion. Nevertheless, there is limited research on this aspect. Therefore, the proposed research is expected to fill the gap in existing literature.

The relevance and significance of the research lies in two aspects. Firstly, the proposed study attempts to approach the problem of social exclusion of the older people from their ‘own’ perspective. The study would attempt to narrate the lived experience of social exclusion and related problems associated with disabled elderly in London. Secondly, the study would contribute to existing literature because it focuses on two indicators- age and disability- of social exclusion and analyses the combined effect of both on aggravating social exclusion.

Research Objectives

The main objective of the study is to explore, understand and analyse the ‘lived in experiences’ of disabled older people about the social exclusion that they face in their daily life.  Specific objectives include the following:

1. To understand the meaning and implications of social exclusion for disabled older people
2. To analyse the role of old age and disability in aggravating social exclusion.
3. To explore the perceptions of disabled older people about the risk factors that contribute to the social exclusion they face in daily life.
4. To examine the views of disabled older people about the right types of social support systems that help them to overcome social exclusion.
5. To explore and understand the ‘insider view’ of disabled older people about the need for necessary policies that reduce social exclusion.

Research Questions

The key research questions of the study are:

1. How do the disabled older people perceive social exclusion in terms of their own experience?
2. What are the risk factors that lead to social exclusion of disabled older people?
3. How do age and disability aggravate social exclusion?
4. What are the critical policy recommendations that help to reduce social exclusion of disabled older people?
5. What type of social support system would be ideal for the disabled older people to reduce social exclusion that they face in daily life?
6. Why does the ‘insider’ point of view or ‘lived in experience’ of disabled older people is critically important in making socially inclusive policies?

Research Methodology

As Burns (2000) rightly said, research is a “systematic investigation to find answers to a problem”. Research methodology implies the systematic procedure to investigate the problem of research in accordance with the objectives of the research. The proposed study intends to understand and analyse the perspective, aspirations and insider views of the   disabled older people on the issue of social exclusion.

Since the purpose of the research is to explore the perspective of the elderly, qualitative method is selected as the appropriate research methodology. Qualitative research involves the understanding of behavior pattern, preferences and attitude of the people rather than measuring the numerical data (Flynn, 1990). Qualitative research helps to understand the opinion, preferences, ideas and the lived in experiences of the people on particular social phenomenon (Flynn, 1990). This method is more flexible and helps to understand the problem within the context of a specific social and cultural construct. In this research qualitative methodology is selected mainly for the following reasons.

1. The proposed study intends to understand the lived in experience of disabled elderly rather than quantifying the degree of social exclusion
2. The proposed study is exploratory in nature and attempts to derive inferences from the insider view of socially excluded disabled elderly people on the role of social support systems, public policy framework, risk factors etc.
3. The proposed study doesn’t intend to use statistical tools and quantification of data collected. Rather, it attempts to analyse the views expressed by the respondents and make inferences out of it.

The significance of using qualitative research in understanding human emotions, feeling and opinion about a particular social condition was highlighted by Holloway (1997) as well.  As Burns and Grove (2005; p. 52) argued, qualitative method helps the researcher to understand a social phenomenon more deeply.

Method of data collection

This study involves data collection using both primary and secondary sources. Primary data will be collected through an interview schedule using semi-structured questionnaire to be administered on the selected number of respondents. Secondary data will be collected from books journals, government reports and dissertations. Online data base like JSTOR will be used to collect journals and articles. Books and reports on social exclusion will be accessed from the university library. The detailed desk review using secondary materials forms a major part of the study. The evidences of the review of literature will be substantiated using primary data collected using qualitative technique.

 

Primary Data Collection     

Primary data will be collected using semi-structured interview schedule on a selected number of respondents. The following sections will explain methods of selecting samples, universe of sample and interview techniques.

Location of the Study

The location of the study will be the South Park Resource centre which is a community center for the disabled people in South East London. Due to time and financial constraints it is difficult to identify the disabled elderly within and outside the London city. Apart from that the study attempt to throw light on the role of support systems in reducing social exclusion among disabled elderly.  Hence, it is decided that selecting sample from a care giving center will be extremely helpful in research. Firstly, it provides the access to the respondents easily. Secondly, the respondents will be able to relate the care and support they receive from the center.

Selection of Sample 

The sample size will be 10 disabled elderly visiting the South Park Community Center regularly. Since age and disability are the main indicators, due care will be given while selecting the sample.  All respondents will be above 65 years old and suffering from more than 40 % disability. Attempts would be made to select 5 male and 5 female respondents.  The ability to communicate with the interviewer would be other criteria of selection. In other words, the respondents would be willing to participate and able to share their ideas clearly. The sample will be selected using the following steps.

1. Meeting the coordinator of the resource center and explaining the purpose of the research.
2. Requesting the coordinator of the center to share the list of disabled elderly visiting the center regularly.
3. Selecting 10 samples from the list using age, disability and gender as variables.
4. If there are more than 50 elderly people within the criteria, a simple random sampling will be conducted to select the 10 samples. Simple random sampling will used to avoid the researcher’ own prejudice and judgment in selecting sample and ensuring objectivity.
5. Verifying whether the sample respondents are able to communicate with the interviewer and willing to share their views.
6. If not, replace the samples with other respondents using the same procedure mentioned above.
7. Finalising the list of 10 respondents and confirm the list with coordinator of the center.
8. Fixing the date and time of interview with the help of the coordinator and staff of the center.

Interview Schedule  

The interview schedule is the main tool of data collection in this study. Interviewing is one of the best strategies to gain information in qualitative research (Holloway and Wheeler, 2002; p.79).  A semi- structured questionnaire with open ended questions will be asked to get the response of each respondent. The semi structured questionnaire is used because it provides flexibility to researcher in changing the sequence of the questions in accordance with the answers provided by the respondents. It provides a logical flow and natural feel to the interview process (Holloway and Wheeler, 2002; p.79).

The interview schedule will be conducted at the resource center at a date and time fixed in accordance with the convenience of the respondents. The respondents will be informed about the nature scope and aim of the study.  Open ended questions will be used in the interview. Due care will be taken to avoid sensitive questions. The face to face interview will help to gather detailed information regarding the social and cultural context of the respondents, risk factors that led to social exclusion and their understanding about the extent of social exclusion that they face in daily life. The interviews will be conducted individually.  A tentative list of questions is provided at the end of the proposal. Before conducting the interview schedule with the help of questionnaire, a pre-test will be conducted. The questions will be refined in accordance with the results of the pre-test.

Data Analysis

As rightly stated by Holloway and Wheeler, in qualitative research, data analysis is “a complex, time consuming and difficult procedure” (Holloway & Wheeler 2002, 235). There are different steps in analyzing data. The information collected will be transcribed verbatim and field notes have to be prepared.  After organizing the data, coding and categorization of collected data will be conducted. The categorization of data will be conducted in accordance with the major themes of the research questions. After categorizing the information into different themes and sub themes, it will be analysed and inferences will be drawn.

Ethical Considerations

The ethical considerations are very important in this study as it deals with disabled elderly people.  Due care will be given while preparing the questions and sensitive questions will be avoided. The researcher will ensure confidentiality of the data collected. The interview will be conducted as per the convenience of the respondents. Each question will be asked politely and any kind of arrogance and lack of sensitivity will be strictly avoided. The rights, safety and wellbeing of each respondent will be safeguarded.  Any question that directly affects the dignity of the respondent will be avoided. Due care will be provided if the respondents get emotional while asking questions.

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