"In Spain we have regions where ageing is either first or second class," explains Irene Lebrusán, a sociologist, who has focused on the relationship between the vulnerability of the elderly and the conditions of the homes they live in. In Spain, practically 90% of households headed by people over 65 years of age own their homes, but this does not mean that they are in good condition. Not even in the best possible condition.

"When you analyse by tenure regime and compare it with vulnerability, there is more in renting, but owning a flat does not exempt you from it. Having a roof does not mean that it is adequate, because we are talking about a population that does not have the economic capacity to improve the conditions of a property. If you have a flat without a bathroom, with damp or without a lift, it is very difficult to sell it and move to a better one. We are talking about people in a very difficult situation", Lebrusán explains to elDiario.es. 

The sociologist and housing expert has already written a doctoral thesis on the residential vulnerability of the elderly. Now her analysis goes a step further to specify the situation in the different autonomous communities. The conclusion is that the elderly living in the Valencian Community, the Balearic Islands and Andalusia, as well as the autonomous cities of Ceuta and Melilla, are at greater risk of extreme vulnerability and that these communities should accelerate investment in housing so as not to make this situation chronic.

Chained issues

"Vulnerability is when you have housing conditions that do not meet minimum quality standards," he explains, referring to his analysis. "Decent housing is the one that gives you a basic quality of life, but if you live in a room without a lift, it excludes you socially; if you don't have a bathtub, you don't wash yourself; if you have damp, you will have respiratory problems", he enumerates. "At any point in your life you can be in a situation of residential vulnerability. Inequality marks an unbalanced distribution of resources, which leads to vulnerability, lower life expectancy and greater loneliness. These are issues that go hand in hand".

As a starting point for her analysis, Lebrusán bases her analysis on the combination of two indicators: one, on the aforementioned residential vulnerability; the other, on the absence of comfort in dwellings. The first, the sociologist explains in her analysis, is made up of five dimensions: habitability, which refers to the existence of minimum and essential facilities (running water, toilet, sewage disposal, having a bath or shower). Secondly, salubrity, in terms of the state of the building or whether one lives in an overcrowded situation. Thirdly, facilities, such as the availability of a telephone line, which is essential for accessing home telecare services. Finally, physical insulation - for example, whether or not there is a lift - and necessary welfare provisions, such as heating. 

In terms of comfort, this includes aspects such as the availability of hot water, internet or gas in the building, which are not essential variables in determining a person's vulnerability or risk of exclusion, whether or not they are over 65 years of age, but do function as corrective elements for other problems.

With regard to these two analyses, one of the problems is the updating of data from official statistics in Spain. Both are based on data from the 2011 census. A lack of updating is especially relevant in the case of data on the elderly. "The situation of the elderly can change simply because those in a vulnerable situation die, not because they improve," he criticises.

Lebrusán concludes that, "when the majority of the population analysed shows low values for vulnerability and lack of comfort, a subgroup of older people suffer from a combination of deficiencies or serious residential problems in their homes".

Independence and care needs

In his thesis, Lebrusán already found that 20% of the elderly in Spain are at risk from a residential point of view. "In Spain there is a high number of elderly people whose residential needs are not adequately covered. Moreover, there are situations of residential risk that would be preventing their proper integration and participation in society. Residential conditions not only have a determining effect on the quality of life of the elderly person, but are also key to their independence and, therefore, to delaying the need for care", Lebrusán explains in his analysis, especially in situations of dependency.

Based on this premise, the regionalised analysis highlights the geographical disparity in the residential vulnerability of the elderly in Spain. The autonomous cities of Ceuta and Melilla not only have a higher average level of vulnerability than the rest of Spain, but also have a higher percentage of elderly people at extreme risk, more than 53% and 42% respectively. "Despite being young regions, with a very low percentage of people over 65, around half of these people are in an intolerable situation," summarises Lebrusán. 

They are followed by the Valencia region, with 29.6% of people over 65 in a situation of extreme vulnerability, and the Balearic Islands, with 28.1%. The sociologist highlights the situation in the Valencian region, "as one would expect that a region with a high Gross Domestic Product and which is home to one of the largest cities in Spain (Valencia), would have had more resources to fight against substandard housing". In this sense, he points out to elDiario.es the importance of urban development. "In Valencia, there are situations of aggressive urban planning, with a greater concentration of population. For example, urban development plans were developed, with large avenues, but no attention was paid to the conditions of existing housing," he explains. 

Behind, Andalusia, the Canary Islands and Catalonia; all with a higher percentage of elderly people in extreme vulnerability than the national average, above 20%. "These would be the regions that need more urgent measures, and that show a higher incidence of vulnerability," he summarises.

The fact that other autonomous communities fare better in terms of data does not mean that there are no elderly people at risk. "It is worth mentioning the case of Madrid: although it is below the national average score [with 17.4% of elderly people in a situation of extreme risk], its large population means that it is home to almost 11% of the elderly population in a situation of extreme vulnerability. On the other hand, Navarre, with just over 7% of the elderly at high risk, would be the example to be followed by the rest of the communities, says the sociologist in her analysis.

"The truth is that neither regional nor national public policies are providing an adequate response to situations of vulnerability," concludes Lebrusán. "Although Spain, at the national level, has not been able to solve serious problems, the existing regional inequality expresses differences attributable to the territorial administrations", she indicates, given that competences in housing matters have been transferred. "In other words, territorial inequality indicates that some administrations have been more ineffective in implementing housing policies and in creating optimal conditions for households to respond to the needs of the elderly".

And there is a group of older people who are particularly vulnerable and at residential risk. "Being a woman, divorced or never married. Women who were left to care for their parents, who have been able to inherit a home, but which is not in the best condition", she says, and even more so if these women live in the regions most at risk. And for the future, the solution comes from the administrations. "There is a problem in urban, residential and social services policies. Older people in vulnerable situations will die, but those spaces in which they live, which are not in optimal conditions, will once again be left in the hands of people who are in the same situation", Lebrusán points out.