E MPOWERING O LDER A DULTS WITH R ESILIENT C OMMUNITIES APA Natl - - PowerPoint PPT Presentation

APA Nat’l Planning Conference @JanaLynott May 6, 2017 #LivIndex

EMPOWERING OLDER ADULTS WITH RESILIENT COMMUNITIES

Speaker Line-Up

• Jana Lynott, AARP Public

Policy Institute

• Joie Acosta, Rand

Corporation

• Lindsay Goldman, New

York Academy of Medicine

Contributor

• Ramona Mullahey, HUD

What is community resilience?

• Look at problems and solutions
• holistically. Address the multitude
• f interconnected risks a community

faces.

• Engage whole community. Bring

together unlike parties across multiple sectors. Break down silos.

• Plan for uncertainty.

The capacity of a community to anticipate, prepare for, and adapt to changing conditions and withstand, respond to, and recover rapidly from shocks.

Source: Resilience AmeriCorps

Older people disproportionately vulnerable

• Chronic illnesses
• Functional limitations
• Sensory, physical, and cognitive disabilities
• Often take multiple medications
• Rely on formal and informal caregivers for assistance
• General “frailty”
• Live alone (many in isolated rural areas)
• Climate change can exacerbate these vulnerabilities

Published 2006 Today

Key Attributes of Community Resilience

Housing Health Economy Access & Functional Needs Community Planning Social Connectedness

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Draft Interagency Concept for Community Resilience Indicators and National-Level Measures, Dept. of Homeland Security, June 2016

Network of Age-Friendly Communities

Updated April 5, 2017

The Built Environment The Social Environment

Our Vision and the “8 Domains of Livability”

AARP’s Network of Age-Friendly Communities

THE LIVABILITY INDEX: GREAT NEIGHBORHOODS FOR ALL AGES

WWW.AARP.ORG/LIVABILITYINDEX

Livability Categories

Housing Neighborhood Transportation Environment Health Engagement Opportunity

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THE LIVABILITY INDEX: GREAT NEIGHBORHOODS FOR ALL AGES

Resilience AmeriCorps

Community volunteers prepare the Chamizal Community Garden for planting as part of the Cities of Service Resilience AmeriCorps VISTA Project in El Paso, TX. Photo Credit: Candace Heins

CLICK HERE FOR PROJECT MAP Improves communities’ capacity to grow in the face of shocks and stresses

Resilience AmeriCorps VISTA projects have five preferred capacity-building strategies

Resilience AmeriCorps VISTA projects address site-specific challenges, solutions, and populations

Challenges

• Extreme

weather

• Threats to

natural/cultural resources

• Energy

insecurity

Solutions

• Safe,

sustainable, affordable housing

• Urban

agriculture

• Microgrids

Populations

• Tribes
• Persons with

limited English proficiency

• Youth

AARP’s Livability Index www.aarp.org/livabilityindex AARP Livable Communities Resources www.aarp.org/livablepolicy www.aarp.org/livable

FOR MORE INFORMATION

NYAM, Resilient Communities: Empowering Older Adults in Disasters and Daily Life, http://www.nyam.org/media/filer_public/64/b2/64b2da62-f4e7-4e04- b5d1-e0e52b2a5614/resilient_communities_report_final.pdf Resilience AmeriCorps https://www.nationalservice.gov/programs/americorps/americorps- initiatives/resilience-americorps

Resilience AmeriCorps VISTA projects use three approaches to anti-poverty work

Looking at problems and solutions holistically Engaging whole community Planning for uncertainty

Resilience AmeriCorps VISTA projects align with five specific community outcomes

Reduced vulnerability Increased preparedness Facilitated long-term recovery Increased risk awareness Improved access to social services

America is Aging

Percent of Population Age 65+ 2010

America is Aging

Percent of Population Age 65+ 2020

America is Aging

Source: U.S Census Bureau – 2008 Census Projections

20 40 60 80 100 120 140 160 180

2010 2020 2030 2040 2050

50+ Population (Millions)

Number of Persons Age 50+ by Race (Percent of Total Population 50+ that Is a Person of Color) Other Asian/PI Black Hispanic White

24% 29% 35% 40% 45%

NATIONAL STUDY OF THE IMPACT OF VILLAGES ON OLDER ADULTS RESILIENCE

Joie Acosta May, 2017

Today’s Presentation

• Brief Overview of the Study
• Purpose
• Partners
• Timeline
• Preliminary Findings
• Interviews with Senior Villages, Age-Friendly staff, and Public

Health Departments

• Survey of Village Members
• Next Steps

Study Purpose (1)

• To document whether villages improve older adults

resilience

• By resilience we mean older adults:
• social connectedness,
• self-sufficiency,
• emotional wellbeing, and
• attention to health needs.

8 Villages with EP activities (n=400) 8 Villages without EP activities (n=400) Older adults not living in villages from 16 similar communities (n=800) COMPARED WITH:

Study Purpose (2)

• Part of a larger project to help improve the alignment

between local health systems and age-friendly efforts

• We are also:
• Interviewing executive directors and other village leaders
• Interviewing local health department staff that work on emergency

preparedness and resilience efforts

Preliminary Interview Findings (1)

• What have we learned about the role of villages in

promoting emergency preparedness?

• Most villages are doing at least one activity to promote emergency

preparedness

• Many villages lack the expertise, staff, time and money to provide

urgent or enhanced emergency preparedness support and resources

COMMON ACTIVITIES Phone tree Daily check-ins List of emergency contacts Medical alert installation (Life Line) Disaster Preparedness Presentations Emergency Department Information Medical/Medication Documentation Personalized call before and after disaster Raising awareness

• Do villages and local health departments (LHDs) have

strong relationships?

• In short-NO
• Villages were not working with LHDs and some perceived LHDs

were just as time/staff/resource constrained as villages

• Few LHDs were aware of villages and none had strong

relationships with them

• Do LHDs provide emergency preparedness activities

aimed at older adults?

• Activities primarily intended to appeal to all populations or tailored

more specifically based on functional limitations (rather than age)

• LHDs not specifically tasked with a focus on older adults—hence

liaising with villages not a high priority

Preliminary Interview Findings (2)

• For AFI leaders, there was variability in the extent to

which emergency preparedness (EP) was prioritized

• Most AFIs did not see EP as a high priority
• Some AFIs could identify other agencies doing EP work and

actively liaised to ensure older adult issues were represented

• Small number of AFIs saw activities as building everyday support

for EP

• AFI’s focus on quality of life issues is driven by consensus
• EP was a less popular topic
• Mandated engagement of city agencies promoted more diverse

agendas

Preliminary Interview Findings (3)

Washington, DC Age-Friendly Initiative: An Exemplar of Collaboration

• Extra domain added to their age-friendly planning
• Strategic plan tasks LHD to lead efforts in partnership with local

villages

Resilience Goals Progress to Date Goal 9.1: Identify and reach vulnerable populations with information on emergency preparedness and resilience. Identify: DOEE is working with partners to produce a heat vulnerability analysis looking at 911 call data. DCOA awarded Foggy Bottom Village funds to work with isolated residents. Reach: AlertDC enrollment increased by 10,709 users in FY16. Goal 9.2: Build individual and community resilience and preparedness for emergencies. Train: Dupont Circle Village members have had CERT training and assigned block captains. Capitol Hill Village members took Hands on Heart CPR training. Network: New village models have begun to develop in affordable housing residences in Ward 8 (Overlook) and Ward 5 (Edgewood).

Preliminary Survey Findings (1)

• To date, 221 village members and 258 of non-village

members have been surveyed

• Villages are older, more female, and more White

Demographics Village Comparison Age 75.0, 8.3 68.5, 10.6 Gender 80.7% female 60.8% female Race 97.8% white 86.7% white 0.9% black 4.6% black 1.3% other 8.7% other

Preliminary survey findings (2)

Select Outcomes Village Comparison Disaster Resilience Reported lacking emergency preparedness* (Max 5) 3.8 4.1 Emergency preparedness behaviors (Max 11) 3.7 3.9 Health Resilience Access to primary care 96.85% 94.30% Length of time since seen a doctor 98.2% <1 year 1.35% 1-5year 0.45% 5 years+ 95.80% <1 year 4.20% 1-5year 0.0% 5 years+

Village members reported lower levels of disaster resilience, but higher levels of health resilience

* T-test found statistically significant differences at p<.01

Preliminary survey findings (3)

Select Outcomes Village Comparison Emotional Resilience Utilize active coping* (Max 5) 4.6 4.5 Emotional wellbeing (Max 5) 4.6 4.7 Social Resilience Social Network (Max 13) 8.8 8.6 Connectedness* (Max 9) 8.1 8.5 Social Support (Max 6) 5.0 5.1

Village members reported using more active coping and having a more active social network, but felt less connected

* T-test found statistically significant differences at p<.05

Sharing Study Results

• All study results will be shared publicly
• Publish a scientific journal article that describes the

findings from the survey

• Are older adults living in villages more resilient than those not living

in villages?

• Develop a web-based toolkit for policymakers in state and

local public health, healthcare, and other service delivery systems relevant to older adults

• Help project need for older adult emergency preparedness
• Provide guidelines for age-friendly and local health systems

alignment

• Include metrics of successful bi-directional engagement and

measures of older adults resilience to disasters

Potential Impact of Study

• Highlight awareness about the village model, and the

social and health benefits of villages to its members

• Inform the public, local government leaders, emergency

management, and public health systems on how to better support village members and Age-Friendly initiatives to increase resiliency across many domains

• Support the business case for funneling more financial,

staffing, and social support to villages if findings show that they increase resiliency and well-being to members and

• ther older adults in the community

Study Partners

• RAND: Lead the research design; Study

administration

• Village-to Village Network: Help recruit members

and disseminate research findings to villages

• NACCHO: Lead the dissemination to public

health departments

• AARP Public Policy Institute: Lead the

dissemination to AARP Age-Friendly Cities

• DC DOH/DOA: Provide feedback on instrument

design and study findings

• CDC: Study funding and oversight

• Contact the Study Principal Investigator:

Joie Acosta jacosta@rand.org (703)413-1100 Ext. 5324

For More Information

Lindsay Goldman, LMSW Director, Healthy Aging The New York Academy of Medicine

APA National Planning Conference I May 2017

Empo Empowering ering Olde Older Adu r Adults lts with with Resilient esilient Communities Communities

(911 (91100 0084 84)

AGEND GENDA A

• NYC Aging Population
• Age-friendly NYC
• Older Adults Disaster Preparedness &

Response Study Methodology

• Study Findings
• What Have We Learned & What Are We

Doing Now?

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605,235 813,827 947,878 951,732 953,317 937,857 1,002,208 1,177,215 1,409,708 200,000 400,000 600,000 800,000 1,000,000 1,200,000 1,400,000 1,600,000 1950 1960 1970 1980 1990 2000 2020 2030 2040

NYC 65+ POPULATION

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54% 46%

Native Foreign born

77% U.S. Citizens 23% Not U.S. Citizens 33% Limited English

NYC 65+ COUNTRY OF ORIGIN

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16% in labor force 37% have retirement income averaging $24,828 84% receive social security averaging $17,297 19% below 100% of poverty & 13% between 100 – 149% of poverty 25% receive SNAP benefits

40% 60% Cost Burden: Renters Less than 30% 30% or more 60% 40% Cost Burden: Owners Less than 30% 30% or more

NYC 65+ INCOME & EXPENSES

80% of Senior Housing Has Elevators

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NYC 65+ LIVING ALONE

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11% 8% 11% 28%

0% 5% 10% 15% 20% 25% 30%

hearing difficulty vision difficulty cognitive difficulty ambulatory difficulty

63% have no reported disability

NYC 65+ DISABILITY PREVALENCE

Source: 2010-2014 American Community Survey 5-Year Estimates

MISSION MISSION

Age-friendly NYC is a one-of-a-kind partnership between the Mayor’s Office, the New York City Council, and the New York Academy of Medicine that works to maximize the social, physical and economic participation of older people to improve their health and wellbeing and strengthen communities.

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MODEL

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2001 WTC Attacks 2003 Blackout 2006 Heat wave 2011 Heat wave 2011 Hurricane Irene 2012 Hurr rrican icane e Sa Sandy dy

RECENT NYC DISASTERS

IOM and NYAM Convening to Identify Post-Storm Research Priorities (11/12) NYAM funded by The New York Community Trust and the Altman Foundation (2/13) NYAM Convenes Older Adults & Disasters Policy Advisory Committee (5/13)

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Methods: thods:

• Literature Review
• Secondary Data Analysis
• Key Informant Interviews (n=55)
• Focus groups (n=138)
• Mapping

OLDER ADULTS & DISASTERS

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“I wasn’t afraid of what could happen worse than what I had already seen in my life… I was able to accomplish a few things and help a few people so I didn‘t think about the misery.” –Focus Group Participant

WHAT DOES LIT SAY?

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WHAT DO OLDER PEOPLE SAY?

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Formal and informal social networks influenced decisions and facilitated access to information, assistance, and resources.

“I didn’t receive a note on my door.

I depend on my neighbors for information, and my neighbors were gone. And I couldn’t use the phone.” –Focus Group Participant (LES)

FINDINGS

Emergency services were often inadequate, inappropriate, or inaccessible.

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FINDINGS

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FINDINGS

Mean age of residents = 72 (age range: 47 to 99) Mean age of responders = 51 (age range: 24 to 83) “So what I did, I’m usually the oldest person in the building, so I cooked for the younger kids so I made [food]… and they came and they ate and we had a plan. If anything happens we go up to the fourth floor. The girl on the fourth floor left and left her door open for

• us. When we saw the water rising, we went up.”

–Focus Group Participant (SI)

Older adults actively supported their communities.

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FINDINGS

Neighborhoods responded.

“No one from FEMA spoke

• Chinese. They were stationed at

the Chinese Benevolent Association, and no one can speak Chinese... I was asked if I could send people down to translate so we did. There should be some thought to these needs before a crisis.”

–Focus Group Participant 73% of responders were local

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OVERALL TAKEAWAYS

• Pre-event functioning predicts response and

recovery

• Community as primary point of intervention
• All sectors/agencies must be engaged
• Preparedness as a function of overall health

and wellbeing

BCID, CIDNY, Bell, & Morales v. de Blasio

• Accessible shelters
• Disability coordinator
• Canvassing operation
• Transportation plan
• High-rise building evacuation task force
• Disability community advisory panel

http://dralegal.org/press/new-york-city-and-disability-advocates-reach- historic-agreement-providing-for-comprehensive-improvements-to-new-york- citys-disaster-planning/

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CLASS ACTION SETTLEMENT

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TOOLS FOR COMMUNITY LEADERS

http://www1.nyc.gov/assets/em/downloads/pdf/Toolkit.pdf

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BUILDING OWNER’S GUIDE

http://www.nyc.gov/html/dfta/downloads/pdf /publications/AIPGuide2016.pdf

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TRAININGS

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MULTIFAMILY HOUSING TOOLKIT

http://www.enterprisecommunity.org/downl

• ad?fid=10019&nid=13356

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IMAGE-NYC MAP

Lindsay Goldman Director, Healthy Aging 212-419-3562 goldman@NYAM.org FOR FOR MORE MORE INFORMA INFORMATION TION

www.AgeFriendlyNYC.org @agefriendlynyc #agechamp

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Kupuna upuna Resilience silience Progr

• gram:

am: Preparedness for

• ld

lder adults - Hawaii

Mission

Facilitator Ramona na Mulla lahe hey Senior Management Analyst Field Policy & Management U.S. Department of Housing and Urban Development Honolulu Field Office ramona.mullahey@hud.gov