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Amanda Heckelsberg Wolfe, MA Austin Older Adult Quality of Life Study Understanding & Supporting Our Aging Community Overview: Key Players City Partners ◼ City of Austin - Office of Equity and Inclusion, Austin Public Health ◼ Commission on Aging (CoA) ◼ Center for Aging & Community (CAC) – Research lead ◼ Cortez Consulting Services (CCS) – Community engagement team ◼ Community Organizations - 30+ partner organizations across all districts Project Timeline • August 2024 – study planning began • January 2025 – first IRB approval obtained Planning • January-March 2025 - Focus groups conducted (9 groups, Focus Groups 181 useable participants) • February 2025 – second IRB approval obtained • July-September 2025 - Survey distribution period (1,027useable responses) Surveys • Summer 2025 - PhotoVoice sessions at RBJ Residences • September 25, 2025 - PhotoVoice exhibit at RBJ • November 2025 – Study ends Photovoice Why Focus on Older Adult Quality of Life in Austin? The Growing Reality ◼ 25% of Austin's population (243,750 people) are 50 years or older ◼ Residents 65+ are the fastest-growing age group ◼ By 2035, adults 65+ will outnumber children under 18 nationally Austin's Diversity Challenge ◼ 32% Latinx, 9.5% Asian American, 7.5% Black, 48% White ◼ 38% live alone, 11% live with disabilities ◼ 13% live below federal poverty level ◼ Nearly 1/3 speak a language other than English at home The Problem ◼ Previous city surveys successfully reaching white women from limited districts - missing the voices of many of Austin’s residents Ms. Carol August 10th, 2025 - Austin City Hall Let us in! The difference between 55, 75, and up is huge. Every age group of older adults has different needs. Older adults are such a big population in Austin. We should be represented. Our Participant Contributors Populational Inclusion Sample Size Asian or Asian American 262 Black or African American 131 Latino/a/e/x or Hispanic LGBTQIA+ People with disabilities Income at or below 60% MFI 147 134 419 488 All districts proportionally represented D6 = 30 (smallest) D10 = 146 (largest) Caregivers 292 Who Participated ◼ Total Survey Participants: 1,027 older adults ◼ Total Focus Group Participants: 172 older adults ◼ PhotoVoice Participants: RBJ Residences seniors Representation Achieved ◼ 26 languages spoken (18% spoke at least two languages) ◼ All 10 City Council districts and the metropolitan area represented ◼ Intentionally oversampled previously missing groups Participant Demographics Participant Age Distribution (n=1,070) 5.5% 0.4% 3.6% 49 years old or younger 16.7% 23.2% 23.3% 27.3% 50-54 years old 55-64 years old 65-74 years old 75-84 years old 85-94 years old 95+ years old Age Distribution ▪ Majority: 65-74 years old ▪ Range: 50-94+ years Living Situation ◼ 16% currently unhoused ◼ 28% of housed residents worry about losing housing ◼ 26% functionally disabled Participant Demographics Participant Income Distribution (n=657) 7.5% 6.4% 17.2% Less than $9,999 $10,000 to $19,999 $20,000 to $29,999 Household Income ◼ Most common bracket: $50,000-$74,999 ◼ 58% fall below 60% of Austin $30,000 to $49,999 MFI 11.3% $50,000 to $74,999 ◼ Wide range: from under $10,000 to $150,000+ 10.8% 12.8% 20.9% 13.2% $75,000 to $99,999 $100,000 to $149,999 $150,000 or more Our Approach: Data Gathering Methods “There are many things that can be done, and we have the money – federal money, state money. A lot of those funds don’t get used, and we don’t know about them. The lack of information and the lack of access to information is a problem. Here we are, the richest country in the world, and people live on the streets. Some of them are mentally incapacitated. There is help available. We just need to help each other.” Phase 1: Focus Groups ◼ 9 groups with 12 community organizations ◼ Identified 9 key themes from older adults' own voices Phase 2: PhotoVoice and Surveys ◼ PhotoVoice for visual storytelling and inclusion ◼ Electronic, paper, and in-person survey options ◼ Translation services, interpreters, transportation provided ◼ Community Ambassadors as trusted bridges Critical Challenge: ◼ Political climate made participants hesitant to release anonymity or answer government survey Our Methodology: Community-Based Participatory Research What Made This Different ◼ Community as Co-Creators: Older adults shaped what we asked and how we asked it ◼ Paid Community Ambassadors: Trusted members from within the communities ◼ Removed Barriers: Transportation, childcare, refreshments, interpreters, translated materials ◼ Compensated Everyone: Community organizations and participants valued for their time ◼ Met 39 Times: Collaborative workgroup throughout 15-month study period Sequential Exploratory Mixed Methods Design ◼ Qualitative data (focus groups) first to understand priorities ◼ Used findings to design quantitative survey ◼ PhotoVoice for visual narrative alongside surveys Quality of Life Domains Austin’s Older Adults Want Us to Know DOMAIN CITYWIDE SCORE ASSESSMENT Communications 2.6 out of 4 Community Belonging & Access 2.54 out of 4 Moderate Moderate Housing & HCBS 9.6 (lower is better) Concerns Caregivers 19% are caregivers Need support Transportation 7.0 out of 10 Health Services 8.85 (lower is better) Food Access & Utilities 3.82 out of 6 Public Services & Spaces Varied by type Social Life & Recreation 2.1 out of 4 Good Concerns Moderate Mixed Adequate Communications (Score: 2.6 / 4) What This Includes ◼ Access to reliable internet, centralized Most visited places for distribution: ◼ Parks and libraries information, reaching homebound residents, multilingual materials Key Findings ◼ 26 languages represented among participants ◼ Districts 2 & 4 scored significantly lower (modes of 1-2 vs. citywide 3) ◼ Low-income and disabled adults face greater barriers Most trusted sources: ◼ Senior-serving orgs (Austin Senior Services Hub, AGE of Central Texas, CAPCOG) “We don’t get a lot of information from the City of Austin, because it comes on the computer. I have to come to the Center in order to be able to get information.” “How do you get the information out? I heard something about a stop at the shopping center that would take you to the Y and then bring you back, but how do you find out about those programs?” Community Belonging, Access & Empowerment (Score: 2.54 / 4) What This Includes ◼ Employment opportunities, volunteer access, culturally diverse activities, accessible public spaces, affordable housing, safety Key Findings ◼ District 4 lowest score: 2.03 (major geographic inequity) ◼ 19% want to work but can't find jobs - especially lower-income residents ◼ 17% experienced discrimination in places they visit ◼ 13% don't feel safe in their neighborhoods Three Areas Scored Lowest ◼ Culturally diverse activities ◼ Accessible public buildings/spaces ◼ Affordable housing ◼ Insight: Limits belonging for people of color, immigrants, and adults with mobility challenges “I don’t feel included in society.” “We need to be respected, our voices heard – to be engaged in our communities.” Housing & Home and Community-Based Services What This Includes ◼ Housing affordability, accessibility, safety, home Who's Most Affected ◼ People with disabilities: significantly higher modifications, aging in place supports homelessness and housing insecurity The Crisis ◼ 16% are unhoused ◼ 28% of housed worry about losing housing ◼ 41% rate affordability as "fair" or "poor" ◼ 36% rate accessibility as "fair" or "poor" ◼ 13% don't feel safe where they live ◼ Ages 75-84: higher unhoused rates ◼ Ages 55-64: 37% worry about losing housing ◼ District 5: highest proportion unhoused (17%) ◼ Men: higher homelessness rates ◼ Women: higher housing insecurity rates “There is housing in Austin, but not that I qualify for or near my family. The facilities like this [senior living] are always in random places and not in areas for family.” Housing: What Older Adults Need Ms. Judy August 28th, 2025- RBJ Senior Residences The RBJ is one of few affordable senior livings where people feel very safe and feel like a family. This facility was named after President Johnson’s mother, Rebekah Baines Johnson. After 50+ years, the legacy of our founder lives on through the innovative programs we create to meet the evolving needs of Austin’s community. Top Priority Improvements ◼ Pest control (21% have pest problems) ◼ Grab bars & handrails (34% need these) ◼ Ramps (25% need these) ◼ Walk-in tubs/showers (16% need these) ◼ Non-slip flooring ◼ Accessible kitchen cabinetry ◼ Regular maintenance and yard services Housing Score by District ◼ Best: District 8 (mean 7.17) ◼ Worst: Districts 9 & 1 (means 10.90-10.93) ◼ Citywide average: 9.6 (lower is better) Caregivers: The Overlooked Population Who They Are ◼ 19% of our sample were caregivers of older adults ◼ 88% of caregivers are older adults themselves (average age 55-64) ◼ 31% Asian American, 20% Native American (overrepresented) ◼ Nearly even gender split ◼ Most work full-time Their Struggles ◼ 26% are unhoused (vs. 16% of older adults overall) ◼ More likely to feel lonely and socially isolated Their Needs ◼ Lower satisfaction with transportation ◼ Need multilingual information ◼ Want culturally diverse activities “We are missing the caregiver domain. It can fall under people who are taking care of the elderly, young children, or other persons in the home with special needs. They have the same need for access and transportation, because they are taking care of someone else.” Transportation (Score: 7.0 / 10) What This Includes ◼ Reliability, safety, parking, street conditions, traffic signage, accessibility Key Findings ◼ 76% rate reliability positively ◼ Only 58% rate the sidewalks as safe ◼ District 9: highest satisfaction (7.49) ◼ District 4: lowest satisfaction (5.90) ◼ Latinx and Black older adults: lower satisfaction than other groups ◼ Income had little impact - challenges affect everyone What Needs Improvement ◼ Safety (especially pedestrian safety) ◼ Road and sidewalk repairs ◼ Lighting and crosswalks ◼ Accessibility for people with disabilities “Transportation is the toughest one for me. Especially for blind people, of course, there is no way I can jump on a bus and just go anywhere.” Health Services What This Includes ◼ Access to healthcare, medicines, fitness programs, nutrition programs, hospital services The Problem ◼ Only 9% use their healthcare provider as information source ◼ 27% couldn't access medicines or care when needed in past month ◼ Mean Health Insecurity Score: 8.85 (lower is better) Who's Most Affected ◼ Ages 50-64 (before Medicare): scores of 9.61-10.11 ◼ Ages 75+: scores of 7.07-7.66 (Medicare helps) ◼ Below 60% MFI: score 10.14 vs. 8.39 ◼ LGBTQIA+: score 10.66 vs. 8.90 ◼ Native American/Indigenous: score 11.01 ◼ District 8: significantly better outcomes “Outdoor spaces and such become harder to navigate [the older someone gets].” “America wastes so much money, and they should make sure that [we] have insurance regardless of coverage. It should be a problem. It is a matter of life and death, and we are living on a fixed income.” Food Access & Utilities Food Security (Score: 3.82 / 6) ◼ Modal score of 3 (most not severely food insecure) ◼ District 3 has lowest food security (statistically significant) ◼ People with disabilities: score 4.23 vs. 3.64 ◼ 43% used food/meal program in past month (even those not food insecure) ◼ Food programs serve social connection role, not just nutrition Utility Insecurity ◼ 22.9% couldn't afford heat, electricity, or water when needed ◼ People with disabilities: 44.8% faced utility insecurity ◼ Native American/Indigenous: 40.2% ◼ Asian American: 34.5% ◼ White seniors: 13% (disparity is 3x) ◼ Lower-income ($10K-$20K): nearly 40% “Austin isn’t really looking out for my needs.” “We get the feeling that the City is focusing on the young populations and not the elderly. We are the seniors and backbone of the community. What are you doing for us?” Public Services & Internet Access Internet Access (Score: 2.38 / 4 - "Good") ◼ 41% rate internet as fair or poor ◼ Latinx seniors: 2.79 (worst) ◼ Black seniors: 2.68 ◼ White seniors: 2.26 (best) ◼ People with disabilities: 2.54 vs. 2.32 Emergency Services ◼ 22.8% used emergency services in past year ◼ Black seniors: 30.1% (highest) ◼ Suggests gaps in preventive and primary care access The Digital Divide is Real ◼ As services move online, poor internet access excludes older adults from healthcare, supports, and civic engagement. “You know we need people to come by and check on people to see if they are still alive. We had a great man who had been here for 18 years and…he was found 12 days after the day he died.” Social Life & Recreation (Score: 2.1 / 4) What This Includes ◼ Parks, libraries, senior centers, fitness activities, continuing education, cultural activities Key Findings ◼ Social Isolation Risk: average 4.36 out of 9 ◼ People with disabilities: 21% higher isolation risk ◼ LGBTQIA+ older adults: elevated isolation (gay seniors 5.50, lesbian 5.27) ◼ Men: higher isolation than women (4.71 vs. 4.20) ◼ Lower-income ($10K-$50K): nearly 30% higher isolation risk Service Usage is High ◼ 58% use parks, 53% use libraries, 48% use senior/rec centers Mr. Belmer August 18th, 2025 RBJ Residences Cookout Elana, a very caring member of the Rebekah staff, enjoys a barbeque afternoon with a resident. Best Practices: Partnerships What Worked ◼ ✓ Government employees and appointees as invested partners ◼ ✓ Community-based organizations provided planning insight and trust ◼ ✓ Community Ambassadors engendered trust and assisted recruitment ◼ ✓ Compensating organizations and ambassadors for their work ◼ ✓ Community-Based Participatory Research (CBPR) framework Key Lesson ◼ Equalizing the power dynamic between researchers and participants - acknowledging lived experience as expertise “We have amazing places in town like museums, parks, and libraries. We’d love to go and be proud of all these assets but can’t get there.” Best Practices: Planning August 28th, 2025- Art Dilly Drive Mobility Issues for Seniors- When I saw this empty space, I thought it can be better utilized as a pharmacy because we have many seniors who don’t drive, like myself. What Worked ◼ ✓ Started with qualitative data to understand priorities ◼ ✓ Collaborated with potential participants on survey design ◼ ✓ Community ambassadors advised on language, relevance, comprehension ◼ ✓ Non-random sampling (snowball) for hard-to-reach populations ◼ ✓ Phased IRB approval for community feedback throughout ◼ ✓ Planned expanded timeline and budget for true collaboration Key Lesson ◼ Participants are the experts on their own lives - let them shape what questions get asked and how Best Practices: Data Collection What Worked ◼ ✓ Collected data where participants already visit ◼ ✓ Timed with events they'd attend anyway ◼ ✓ Incentivized participation to demonstrate value ◼ ✓ Multi-modal: in-person, online, paper through partners ◼ ✓ Prioritized brevity to prevent cognitive fatigue ◼ ✓ Protected anonymity - crucial for building trust ◼ ✓ Creative incentive technology while protecting privacy ◼ ✓ Mindful of power dynamics in consent ◼ ✓ Offered multiple format options Key Lesson ◼ Many participants have valid reasons to be cautious of government or research institutions - safeguarding privacy demonstrates respect Mr. Willie August 15th, 2025, 1:14 pm - View of Downtown Skyline Thriving Austin Downtown- Austin’s Downtown has lots to offer from trails, biking, and sightseeing for all ages! Best Practices: Sharing Results What Worked ◼ ✓ Layman-friendly language with approachable visuals ◼ ✓ Actionable findings and recommendations ◼ ✓ Co-created solutions with participants ◼ ✓ Specific, hyper-local recommendations ◼ ✓ Comprehensive toolkit: template emails, slide deck, fliers, one-pagers ◼ ✓ Streamlined replication process for annual tracking ◼ ✓ Included participant stories and photos ◼ ✓ Released in non-traditional channels ◼ ✓ Returned information to community partners first Key Lesson ◼ Create resources that make information easy to share and apply - maximize utility for those who will use it Recommendations: Leverage Trusted Community Networks The Strategy ◼ Build on relationships with Austin Public Health, Division of Equity and Inclusion, and expanded community partnerships through regular, meaningful exchanges How ◼ Ongoing engagement NOT tied to specific initiatives ◼ Partner with trusted organizations who have community capital ◼ Use Communications Score to track progress year-over-year Model to Follow ◼ Age-Friendly Seattle partners with population-specific senior centers (Filipino Community Village, East African Senior Center) for community events and conversation ◼ Start With The 30+ community organization partners identified in this study Ms. Martha August 9th, 2025- RBJ Senior Residences Thank you to our first responders who go above and beyond to ensure our safety. Recommendations: Strengthen Economic Access The Strategy ◼ Expand outreach for older adults seeking work and volunteer opportunities to help them pursue productive roles and supplement incomes How ◼ Link SCSEP and Workforce Solutions Capital Area with community organization network Formalize Community Ambassadors program initiated in this study ◼ Develop skills and training programs tailored to older adults ◼ Connect with hyper-local employers Model to Follow ◼ San Diego's aging workforce program provides individualized coaching, job-readiness workshops, and digital- literacy lessons Track Success ◼ Community Access Score & percentage of older adults who want work but can't find it Recommendations: Integrate Older Adults in City Planning The Strategy ◼ Use the community organization network and Community Ambassadors to better integrate older adults into city planning initiatives How ◼ Use regular community conversations as planning feedback opportunities ◼ Community Ambassadors promote attendance and foster trust ◼ Keep residents informed and gather their input continuously Model to Follow ◼ Portland's Age- and Disability-Inclusive Neighborhood (ADIN) project uses working groups to involve older adults and people with disabilities in city planning discussions Track Success ◼ Communications Score developed in this study Recommendations: Promote Energy Relief Programs The Strategy ◼ Improve information dissemination about utility assistance services (like CAP) to older adults not currently accessing them How ◼ Leverage community organization network and Community Ambassadors ◼ Provide materials in multiple languages (key area of feedback) ◼ Distribute through trusted local organizations ◼ Help older adults understand the information provided Track Success ◼ Percentage of older adults who can afford their utilities (year-over-year) Recommendations: Support Aging in Place The Strategy ◼ Invest in home repair and modification programs - less expensive than Medicaid placements in residential facilities How ◼ Expand programs like Housing Department, Meals on Wheels, Rebuilding Together ◼ Partner with hyper-local businesses for economic development ◼ Prioritize most-requested modifications: ◼ Grab bars/handrails (34% need) ◼ Ramps (25% need) ◼ Walk-in showers/tubs (16% need) ◼ Pest control, accessible cabinetry, regular maintenance Model to Follow ◼ City of Rochester's Housing Rehabilitation and Repair programs provide housing repairs explicitly prioritizing seniors 62+ Track Success ◼ Aging in Place Score developed in this study Recommendations: Enhance Recreation & Social Connection The Strategy ◼ Prioritize social connection by allocating City resources and directing funding to community organizations How ◼ Fund what's already working: libraries, parks, senior centers, nonprofits ◼ Expand Aging Services programming ◼ Focus on what older adults prioritize: ◼ Senior-focused activities ◼ Culturally diverse and inclusive programming ◼ Health and mental health-oriented activities Model to Follow ◼ Lifelong Arts Indiana microgrants fund participatory arts programs for older adults, generating significant mental health prevention benefits Track Success ◼ Community Access Score developed in this study Thank You ◼ To Our Older Adult Participants Your invaluable life experience, time, and willingness to share were foundational to this research. You didn't just provide data - you guided the study's direction and ensured its relevance. ◼ To Our Community Ambassadors Your endorsement and enthusiasm played a crucial role in our impressive sample size and authentic engagement. ◼ To Our Community Partners Your trust and support made it possible to reach historically excluded voices. ◼ To Cortez Consulting Services for unparalleled community engagement work. ◼ To City of Austin Office of Equity and Inclusion and Austin Public Health for coordination and support for all the logistics required to make this happen. ◼ To Commission on Aging study workgroup for collaboration and support without which the study couldn’t have existed ◼ Contact Information Amanda Heckelsberg Wolfe, Senior Project Director, awolfe@uindy.edu ◼ For More Information www.uindy.edu/cac