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Are we ready to make the UK the best country to grow old in? One year ago, the House of Lords Committee on Public Services and Demographic Change produced a hard-hitting report which argued that the Government and society was “woefully underprepared” for a rapidly ageing population. On the first anniversary of the ‘Ready for Ageing?’ report, we are in the unenviable position that sees the United Kingdom ranked unlucky number 13 in a global index of the best countries in the world to grow old in. The principal recommendations in the ‘Ready for Ageing?’ report have not yet been properly addressed or acted on. In his October 2013 speech on ‘The Forgotten Million’, Secretary of State for Health, Jeremy Hunt MP, set down a challenge that the UK should in fact aspire to be best country to grow old in, but the question remains: why are our public services so poorly prepared for major demographic change, and what as a society can we do to ensure future generations of older people thrive in later life? Lord Filkin, Chair of the Committee on Public Services and Demographic Change, hosted a House of Lords breakfast debate looking forward to 2030, a date by which there will be 50% more people aged 65 and over in England and a doubling in the numbers of people aged 85 and over. As a society, we need to prepare for the next 15 years right now and certainly in the next Parliament. At this event, Independent Age and ILC-UK, supported by members of the Ready for Ageing Alliance, launched 2030 Vision: Making the UK the best country to grow old in, which will look to the long term and consider what politicians and policy makers need to now, both in preparation for next year’s General Election, and between 2015 and 2020, to prepare for the long term opportunities and challenges ahead. During the debate, we invited contributions on the economic and societal implications of population ageing and the major policy decisions all the main parties face to ready the UK and its public services for dramatic population ageing. It’s clear that our political, social and cultural approach towards old age today is already hopelessly out of date, so this event will provide Parliamentarians and stakeholders from across civil society with an opportunity to mark the first anniversary of the House of Lords’ Committee report on demographic change and look ahead, so as a society we can seize the opportunities presented by an ageing population.
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One year on:Are we ready to make the UK the
best country to grow old in?
Thursday 13th March 2014
This event is kindly supported by members of the Ready for Ageing Alliance
#future2030
Lord Filkin CBE
ChairCentre for Ageing Better
ChairmanPublic Service and Demographic Change Committee
This event is kindly supported by members of the Ready for Ageing Alliance
#future2030
Julia Unwin CBE
Chief ExecutiveJoseph Rowntree Foundation
This event is kindly supported by members of the Ready for Ageing Alliance
#future2030
Professor Phillip Rees CBE
Professor Emeritus, School of GeographyUniversity of Leeds
This event is kindly supported by members of the Ready for Ageing Alliance
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A Review of Trends in Life and Health Expectancies for the UK, with an International Comparison
Philip ReesSchool of Geography, University of Leeds, Leeds LS2 9JT, UKE: [email protected]
Presentation at the International Longevity Centre/Independent Age Meeting at the House of Lords, Thursday 13th March 2014
Table: Trends and Projections of Period and Cohort Life Expectancy, 1982-2062Life table Gender Years Life Expectancies Annual Change (arithmetic)
1982 2012 2042 20621982-2012
2012-2042
2042-2062
Period MEN Age 0 71.1 79.0 84.7 87.3 0.26 0.19 0.13Age 65 13.0 18.3 22.8 24.9 0.18 0.15 0.11
WOMEN Age 0 77.0 82.7 87.9 90.3 0.19 0.17 0.12Age 65 17.0 20.7 25.2 27.2 0.12 0.15 0.10
Cohort MEN Age 0 85.1 90.6 95.1 98.0 0.18 0.15 0.15Age 65 14.2 21.2 24.7 27.0 0.23 0.12 0.12
WOMEN Age 0 89.2 93.9 98.0 100.7 0.16 0.14 0.14Age 65 18.0 23.9 27.2 29.5 0.20 0.11 0.12
Gaps PERIOD Age 0 5.9 3.7 3.2 3.0 -0.07 -0.02 -0.01Age 65 4.0 2.4 2.4 2.3 -0.05 0.00 0.00
COHORT Age 0 4.1 3.3 2.9 2.7 -0.03 -0.01 -0.01Age 65 3.8 2.7 2.5 2.5 -0.04 -0.01 0.00
Source: ONS (2013) National Population Projections, 2012 BasedPrincipal projection, Mortality assumptions
Trends in life expectancy, past and future, UK
• There is a rapid increase in LEs in the past 2 decades, slows down in the next 50 years
• Men have caught up with women over the past 2 decades, but this catch up will not continue much further in the next 5 decades
• The cohort LEs are better indicators for individuals and social policies but they depend on projections of age-specific mortality
The projected life expectancies are uncertain and so therefore are the projected numbers of older people
How many UK centenarians will there be in 2113?ONS say the number of 2013 babies surviving
to 2113 could be as low as 47k and as high as 530k, based on the lowest and highest life expectancy variants
Rees 2013 said that the 95% confidence interval based on a set of 19 projections of the UK’s population for 100 year olds in 2050 was 59k to 367k
Keilman 2013 said that this confidence interval was too conservative and likely to be ~0k to ~720k, based on a 1,000 simulations using the Uncertain Population of Europe methodology
Table: Time Series of Life and Health Expectancies, Great Britain, 1981-2011 Age, sex Indicator 1981 1991 2001 2000-02 2008-10At birthMen Life Expectancy 70.9 73.2 75.7 75.7 78.1 Notes:
GH3-HE 64.4 66.1 67.0 66.8 IndicatorsGH5-HE 60.4 63.9 GH3-HE = General Health 3 Category Health ExpectancyYNGH (GH3) 6.5 7.1 8.7 8.9 3 Categories = "Good", "Fair", "Poor"YNGH (GH5) 15.3 14.2LLI-HE 58.1 59.1 60.5 60.4 64.4 GH3 Good Health = "Good" and "Fair"YWD 12.8 14.1 15.2 15.3 13.7 GH5-HE = General Health 5 Category Health Expectancy
Women Life Expectancy 76.8 78.7 80.4 80.4 82.1 5 Categories = "Very good", "Good", "Fair", "Bad", "Very Bad"GH3-HE 66.7 68.6 68.8 69.9 GH5-HE Good Health = "Very Good" and "Good"GH5-HE 62.4 66.1YNGH (GH3) 10.1 10.1 11.6 10.5 LLI-HE = Long standing Illness Health ExpectancyYNGH (GH5) 18.0 16.0LLI-HE 60.8 61.6 62.7 62.9 65.4 YNGH= Expected Year Not in Good HealthYWD 16.0 17.1 17.7 17.5 16.7 YWD = Expected Years With Illness, Disability or Infirmity
At age 65Men Life Expectancy 13.0 14.2 15.9 16.0 17.9 Source: Offi ce for National Statistics
GH3-HE 9.9 10.8 11.6 11.9 Health Expectancy StatisticsGH5-HE 9.4 10.2YNGH (GH3) 3.1 3.4 4.3 4.1YNGH (GH5) 6.6 7.7LLI-HE 7.6 7.9 8.8 8.8 10.5YWD
Women Life Expectancy 16.9 17.9 19.0 19.0 20.5GH3-HE 11.9 13.0 13.2 14.0GH5-HE 10.8 11.7YNGH (GH3) 5.0 4.9 5.8 5.0YNGH (GH5) 8.2 8.8LLI-HE 8.5 9.3 10.1 10.3 11.3YWD
1981 to 2001: HEs increase more slowly than LEs2000-02 to 2008-10: HEs increase faster than LEs, at birth
Trends in life and health expectancies and years not spent in good health
Global Burden of Disease 2010 Study Results for the UKSource: Salomon et al. (2012) Healthy life expectancy for 187 countries, 1990–2010: a systematic analysis for the Global Burden Disease Study 2010, Lancet 2012; 380: 2144–62
Sex, indicator 1990 2010 Change
MEN
Life Expectancy 72.9 77.8 +4.9
Healthy Expectancy 62.8 65.7 +2.9
Years without Good Health
10.1 12.1 +2.0
WOMEN
Life Expectancy 78.3 81.9 +3.6
Healthy Expectancy 65.9 67.9 +2.0
Years without Good Health
12.4 14.0 +1.6
GBD2010 estimates for health prevalence rates uses disease incidence data rather than survey data on self-reported health
The GBD2010 results show continuing morbidity expansion but misses detailed changes that could have occurred in the 2000s compared with the 1990s
Figure 1: Age-specific mortality in the UKRanks among 15 EU members + 4 Others (AU,CA,US,NO)B: Men, C: WomenSource:Murray et al. (2013) UK health performance: findings of the Global Burden of Disease Study 2010, Lancet, http://dx.doi.org/10.1016/S0140-6736(13)60355-4
The UK ranks worsen up to ages 50-54. UK ranks poorly in the older ages but ranks for men have improved for ages 65-69 and 70-74
How does the UK compare?
Source:Rees et al 2013 The Implications of Ageing and Migrationfor the Future Population, Health, LabourForce and Households of Northern England,Applied Spatial Analysis and Policy,DOI 10.1007/s12061-013-9086-7
What if favourable trends for 2000-2010 continued?
Study Matthews et al. A two-decade comparison of prevalence of dementia in individuals aged 65 years and older from three geographical areas of England: results of the Cognitive Function and Ageing Study I and II, Lancet 2013: 832: 1405-12, http://dx.doi.org/10.1016/S0140-6736(13)61570-6Interpretation This study provides further evidence that a cohort effect exists in dementia prevalence. Later-born populations have a lower risk of prevalent dementia than those born earlier in the past century.
Study Christensen et al. Physical and cognitive functioning of people older than 90 years: a comparison of two Danish cohorts born 10 years apart Lancet 2013; 382: 1507–13http://dx.doi.org/10.1016/S0140-6736(13)60777-1Interpretation Despite being 2 years older at assessment, the 1915 cohort scored significantly better than the 1905 cohort on both the cognitive tests and the activities of daily living score, which suggests that more people are living to older ages with better overall functioning.
Two recent studies show lower dementia prevalence for British and Danish cohorts
Steve Connor,“Moderate but regular exercise can boost the size of the parts of the brain that shrink with age, according to scientists who believe that light physical activity is one of the best ways of preventing senile dementia.”The Independent, 17 February 2014
Confidence in very old age support ratios (Pop aged 50-64/Pop aged 85+)
YearMedian
projection
Percentile 97.5
Percentile 2.5
95% Percentile Interval
PI as % Median
2010 8.32 8.22 8.59 0.37 4
2020 7.89 6.07 7.60 1.53 19
2030 5.65 4.57 5.78 1.21 22
2040 3.64 3.48 4.28 0.80 22
2050 3.11 2.66 3.68 1.02 33
Source: The Independent, 17 February, 2014
Andrew Kaye
Head of Policy and CampaignsIndependent Age
This event is kindly supported by members of the Ready for Ageing Alliance
#future2030
Rt Hon Paul Burstow MP
Member for Sutton and Cheam
This event is kindly supported by members of the Ready for Ageing Alliance
#future2030
One year on:Are we ready to make the UK the
best country to grow old in?
Thursday 13th March 2014
This event is kindly supported by members of the Ready for Ageing Alliance
#future2030
