Older people's lives in the inner city: hazardous or rewarding?

An exploratory, qualitative study was used to investigate the social health needs of older residents of a low-income inner-Sydney area characterised by multiple social and environmental hazards. The research was conducted to inform the development by the South Eastern Sydney Area Health Promotion Unit of a strategy to promote the health, wellbeing and independence of older people. As part of a needs assessment process, the investigation focused on specific subgroups of the population believed to be highly disadvantaged and neglected. In-depth interviews were conducted with 40 residents aged 60 to 86 years who were recruited through community centres, service providers and neighbours. The interviews were supplemented by observational field notes. We describe key dimensions of the physical and social environment, the many hazards it presented to vulnerable elderly residents and the practices they adopted in meeting their everyday needs in relation to shopping, meals, mobility outside the home and social participation. The description is from the perspectives of residents themselves. Key factors discussed include the neighbourhood, housing, activities of daily living, safety and security, and social participation. We explore the implications of our findings for the development of effective public health practice. The environmental hazards, such as pedestrian safety and traffic management, affect the whole population and require interventions at government level. Others, such as inadequate hygiene and food storage facilities in rented premises, also require an approach at the level of public policy and environmental change, but need to be carefully targetted and implemented.