Achieving levelling up health targets could boost employment of older people by 3.7% – and gives more reason to hope

New research published in a report by ILC, the UK’s specialist think tank on the impact of longevity on society, has found that a quarter of a million older people could have stayed in paid employment longer had the levelling up health targets been achieved a decade ago.

The Health and place – How levelling up health can keep older workers working report builds on the earlier findings of the Marmot reviews in 2010 and 2020 led by the UCL Institute of Health Equity, showing that geographical health inequalities are deeply entrenched in England and Wales. The Health of Older People in Places (HOPE) project research led by University College London (UCL) in collaboration with the University of Leeds and the ILC is part of the Health Foundation’s Social and Economic Value of Place programme. The research links these geographical disparities to employment outcomes, finding older people living in the ‘unhealthiest’ areas are 60% less likely to be in paid employment than those from the healthiest.

Between 1991 and 2011 disability-free life expectancy improved in England and Wales. However, there remained a significant gap between the ‘healthiest’ and ‘unhealthiest’ areas. In 2011, disability-free life expectancy at age 50 varied from a low of 13.8 years in the ‘unhealthiest’ local authority to a high of 25.0 years in the ‘healthiest’ local authority; a gap of 11.3 years.

But these significant health and employment outcomes gaps can be turned around. Modelling by the Health of Older People in Places (HOPE) project measured what would have happened if the current levelling up health targets had been achieved between 2001 and 2011 and concluded that this would have increased older people’s participation in the labour market by 3.7%, equivalent to 250,000 older people.

Dr Emily MurrayPrincipal Investigator of the HOPE project and Senior Research Associate, UCL Department of Epidemiology and Public Health commented:

”What this project shows is how closely linked the health of older people in our communities is to the labour market for all in those communities. And how these geographic inequalities in health are long-standing, with the same places that were the ‘Unhealthiest’ in 1991 highly likely to also be the ‘Unhealthiest’ 20 years later.

“Since the onset of the COVID-19 pandemic, almost 400,000 people aged 50-64 years have left the labour market and not returned. The HOPE project shows that if we focus on improving the health of older people in these ‘Unhealthiest’ local authorities, we have a chance to improve the economies of these places as well.”

David Sinclair, Chief Executive of ILC argued:

“Health inequalities are not inevitable, and this Government must not squander any further opportunities through the levelling up agenda to address this long-standing problem. By taking action to reduce health inequalities we could increase labour market participation of older workers in historically ‘unhealthier’ areas, bringing economic benefits to everyone – and give people more reason to hope.”

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Contact

Contact press@ilcuk.org.uk or +44 (0) 208 638 0832 for press queries. Spokespeople are available for interview.

Notes

The full Health and place – How levelling up health can keep older workers working report can be seen here

The Health of Older People in Places (HOPE project) research led by University College London (UCL) in collaboration with the University of Leeds and the ILC-UK seeks to better understand how the health of older people in the place where they live, is associated with people staying in work in later life. This project is part of the Health Foundation’s Social and Economic Value of Place programme. The Health Foundation is an independent charity committed to bringing about better health and health care for people in the UK.

Between 1991 and 2011 disability-free life expectancy (DFLE) improved in England and Wales. However, there remained a significant gap between the ‘healthiest’ and ‘unhealthiest’ areas. In 2011, disability-free life expectancy at the age of 50 varied from a low of 13.8 years in the ‘unhealthiest’ local authority to a high of 25.0 years in the ‘healthiest’ local authority; a gap of 11.3 years.

Modelling by the HOPE project measured what would have happened if the current levelling up health targets had been achieved between 2001 and 2011 and concluded that this would have increased older people’s participation in the labour market by 3.7%.The first Marmot Review into health inequalities in England was published on 11 February 2010. The report, titled ‘Fair Society, Healthy Lives’ proposed an evidence-based strategy to address the social determinants of health, the conditions in which people are born, grow, live, work and age and which can lead to health inequalities. Fair Society Healthy Lives (The Marmot Review) – UCL IHE (instituteofhealthequity.org)

Ten years on, in 2020, Professor Sir Michael Marmot found that for the first time in more than 100 years life expectancy had failed to increase across the country, and for the poorest 10% of women it had declined. Over the last decade, health inequalities had widened overall, and the amount of time people spend in poor health has increased since 2010. The 2020 report confirmed an increase in the north/south health gap, where the largest decreases were seen in the most deprived 10% of neighbourhoods in the North East, and the largest increases in the least deprived 10% of neighbourhoods in London. Marmot Review 10 Years On – UCL IHE (instituteofhealthequity.org)

Key Points from the 2020 Marmot Review:

  • The more deprived the area, the shorter the life expectancy. This social gradient has become steeper over the last decade, and it is women in the most deprived 10% of areas for whom life expectancy fell from 2010-12 and 2016-18.
  • There are marked regional differences in life expectancy, particularly among people living in more deprived areas.
  • Mortality rates are increasing for men and women aged 45-49 – perhaps related to so-called ‘deaths of despair’ (suicide, drugs and alcohol abuse) as seen in the USA.
  • Child poverty has increased (22% compared to Europe’s lowest of 10% in Norway, Iceland and The Netherlands); children’s and youth centres have closed; funding for education is down.
  • There is a housing crisis and a rise in homelessness; people have insufficient money to lead a healthy life; and there are more ignored communities with poor conditions and little reason for hope.

We would like to acknowledge that this publication, which summarises key findings from the HOPE project, uses data obtained from the ONS Longitudinal study.

About ILC

The ILC is the UK’s specialist think tank on the impact of longevity on society, and what happens next.

The International Longevity Centre UK was established in 1997 as one of the members of the International Longevity Centre Global Alliance, an international network on longevity.

Since our inception, we have published over 275 reports and organised over 350 events including the annual Future of Ageing conference.

We work with central government, local government, the private sector, and professional and academic associations to provoke conversations and pioneer solutions for a society where everyone can thrive, regardless of age.

About UCL – London’s Global University

UCL is a diverse global community of world-class academics, students, industry links, external partners, and alumni. Our powerful collective of individuals and institutions work together to explore new possibilities.

Since 1826, we have championed independent thought by attracting and nurturing the world’s best minds. Our community of more than 43,800 students from 150 countries and over 14,300 staff pursues academic excellence, breaks boundaries and makes a positive impact on real-world problems.

We are consistently ranked among the top 10 universities in the world and are one of only a handful of institutions rated as having the strongest academic reputation and the broadest research impact.

We have a progressive and integrated approach to our teaching and research – championing innovation, creativity and cross-disciplinary working. We teach our students how to think, not what to think, and see them as partners, collaborators and contributors.

For almost 200 years, we are proud to have opened higher education to students from a wide range of backgrounds and to change the way we create and share knowledge.

We were the first in England to welcome women to university education and that courageous attitude and disruptive spirit is still alive today. We are UCL.

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About the Health Foundation

We are an independent charity committed to bringing about better health and health care for people in the UK.

Our aim is a healthier population, supported by high quality health care that can be equitably accessed. We learn what works to make people’s lives healthier and improve the health care system. From giving grants to those working at the front line to carrying out research and policy analysis, we shine a light on how to make successful change happen.

We make links between the knowledge we gain from working with those delivering health and health care and our research and analysis. Our aspiration is to create a virtuous circle, using what we know works on the ground to inform effective policymaking and vice versa.

We believe good health and health care are key to a flourishing society. Through sharing what we learn, collaborating with others and building people’s skills and knowledge, we aim to make a difference and contribute to a healthier population.