Ageing at the intersection of diversities

There is growing acknowledgement of how people of diverse backgrounds may experience ageing differently; they may also access—or prefer to access—care and support via different means. The situation becomes more complex when different aspects of diversities and marginalisation intersect.

This project aims to better understand such complexities and intersectionalities via a pilot study on the experiences of Asian-born older males who do not identify as heterosexual and currently living in Sydney, Australia. It acknowledges that:

1. discrimination (e.g. homo/transphobia, racism/xenophobia and ageism) continues to exist within some formal support service settings,
2. some service providers have constrained capacities and/or receive limited support in responding to increasingly complex diversities, and
3. people's sexual and gender identities and/or their migration experiences may have limited access to kinship or other forms of informal support.

In this first project output, we showcase the results of our analysis of the  2021 NSW Gay Asian Men Online Survey  and the  June quarter 2021 GEN Aged Care Data  published by the Australian Institute of Health and Welfare, on:

• where older (aged 50+) gay Asian men currently live in Australia. While the survey took a convenience sampling approach and that the outcome may not be considered representative of the broader gay Asian men communities in Australia, it does provide an indication of where these communities may be living, especially in relation to where appropriate formal services may be located.
• to what extent are Australian Aged Care Providers (ACPs) and Home Care Providers (HCPs) responding to intersections of diversities. Specifically, the maps show the number and percentages of ACPs and HCPs that stated that they provide 'Specific services for people with CALD backgrounds' and 'Specific services for LGBTI people'. For HCPs, the maps show the postcode area of their head offices, but they may each also provide home-based care and support to clients in nearby postcode areas and/or beyond.

These maps may be read in conjunction with the  2021 NSW gay Asian men online survey: key findings report , and the  age-differentiated respondent profile  that we have collated. The latter especially highlights the differences in self-reported health care practices of respondents of different age cohorts, and the challenges they encounter when seeking and/or receiving care and support.

A legend that explains the different coloured categories is included on the bottom left of each map. A search button is included on the top left of each map, where you may search by suburb or street address. Each map may be expanded to full view mode via the top right button.

It can be observed that most of the older survey respondents resided in major metropolitan areas of Australia in 2021 (Map 1). This is especially for the inner city postcode areas of metropolitan Sydney like 2000 (Sydney), 2010 (Darlinghurst) or 2017 (Waterloo, Zetland). Older respondents living in other parts of metropolitan Australia were far less common, and almost completely absent in regional, rural and remote Australia.

These patterns of concentration are largely consistent with that observed in the 2021 Australian Census of Population and Housing data*, in terms of where older (aged 50+) Asian-born persons who were in a same-sex relationship at the time ^#  were residing (Map 1). There were notable concentrations in inner city Statistical Areas Level 2 (SA2s), especially in Sydney and far less so in other parts of Australia, including in other major metropolitan areas.

Within Sydney and outside of the inner city, there were three notable areas of concentration where there were higher numbers of older Asian-born persons who were in a same-sex relationship. These were:

1. in the inner-west suburb of Ashfield
2. in the central-west suburbs of Constitution Hill and Toongabbie
3. in the south-west suburbs of Cabramatta, Canley Heights, Lansvale and Mount Pritchard

These are also areas with high concentrations of Asian-born residents more generally.

 ^{* ABS (2022) TableBuilder Pro (counting persons, place of enumeration), Canberra: Australian Bureau of Statistics.} 

  ^{# This is used as a proxy in the lack of Census data on older Asian-born men who identify as non-heterosexual.} 

The number of Aged Care Providers (ACPs) and Home Care Providers (HCPs) that could meet the support needs of clients of both CALD and LGBTI backgrounds were, likewise, also primarily concentrated in metropolitan areas. There were a higher number of HCPs than ACPs that noted they could meet such an intersection of care and support needs.

Indeed, our analysis of the Australian Institute of Health and Welfare's June quarter 2021 GEN Aged Care Data shows that, while nationally 51% of all HCPs reported they could cater to the intersectional support needs of their CALD and LGBTI clients, only 10% of ACPs responded similarly. Given such a stark disparity, the locationality of these providers is, therefore, quite important when understanding where people of CALD and LGBTI backgrounds wishing to successfully age in place may be able to access relevant care and support.

As the maps below show, and like the distribution of our older gay Asian men survey respondents, the majority of ACPs that could cater to this intersectionality were also primarily concentrated in metropolitan areas (Map 2). As such, there were reasonable overlaps between the spatiality of these two datasets. While HCPs that could cater to this intersectionality were also concentrated in metropolitan areas, there were likewise many such providers located in other parts of Australia (Map 3). This was especially the case in the two states of New South Wales and Queensland, where there were concentrations of services throughout most of these states, particularly in major regional townships in postcode areas like 2450 (Sawtell, south of Coffs Harbour), 2650 (Wagga Wagga), 4350 (Toowoomba), and 4655 (Hervey Bay).

A different way to observing service concentration is to see what percentages of ACPs (or HCPs) in the same postcode area caters to the intersectional needs of CALD and LGBTI clients, as the two maps below show.

Like the two maps above that showed the number of ACPs and HCPs in each postcode area that catered to this intersectionality, there were also higher percentages of ACPs within metropolitan postcode areas that could cater to such intersectional needs (Map 4). Additionally, there were pockets of regional Australia were relatively high percentages of ACPs in those postcode areas also catered to this intersectionality. This, however, were generally the outcomes of having few overall numbers of ACPs in those postcode areas, so that even small numbers of 'specialised' providers may comprise a relatively large percentage. An example is 2347 (Barraba) in northern NSW, where the only ACP in the postcode area reported being able to cater to this intersectionality. This postcode area is, thus, displayed as 100% on Map 4. In contrast, while three ACPs in 2794 (Cowra) in central NSW could cater to this intersectionality, that comprised only 50% of the six ACPs located in that postcode area.

Similar observations can be made of concentrations of HCPs, so that there were more postcode areas where higher percentages of their small numbers of HCPs could cater to this specific intersection of care and support needs (Map 5).

While neither the 2021 gay Asian Men online survey dataset nor the Australian Census accounting of older Asian-born gay men in a same-sex relationship could be understood as broadly representative of the gay Asian men communities in Australia, this set of maps nonetheless does provide an indication of population and service concentrations, and where the two may spatially overlap. Particularly, these maps show how many of each postcode area's local providers could cater to intersectional care and support needs (with CALD and LGBTI used as a case study here), potentially reflecting the availability (or lack thereof) of options for clients when such needs arise.