how should policymakers respond to the new challenges and opportunities of ageing in scotland

The International Longevity Centre-UK is an independent, non-partisan think-tank

dedicated to addressing issues of longevity, ageing and population change.

“How should policymakers respond to the new challenges and opportunities of ageing in Scotland”

David Sinclair, International Longevity Centre – UK @ilcuk

@sinclairda



ILC-UK Planning Tomorrow, Today

think tank evidence based policy focussed balanced independent respected experts networked international



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Our focus is broad



Summary

Life expectancy continues to grow

4 reasons to worry

Opportunities

6 final trends

Policy priorities for Scotland?



Life expectancy is increasing

In the UK, life expectancy at birth is expected to increase by 7 years for men and 6.7 years for women between 2010 and 2060.

Within the EU, life expectancy at birth is expected to increase by 7.9 years for men and 6.5 years for women between 2010 and 2060.



And we might be underestimating

• The IMF warns that, based on past underestimations, it is possible that current global longevity projections could be underestimated.

• If longevity projections are being underestimated, this could add between 1.5% to 2% of GDP to the annual costs of pensions in countries with advanced economies by 2050



Impact of the global economic downturn

EU GDP growth is expected to be 1.4% per year between 2010 and 2060 compared to 2.5% for the 10 years 1997-2006.

More difficult for the state to pay for longevity: Employment and productivity falling; falling tax intake; more difficult to meet debt obligations; difficulties in funding public pension systems

And for the individual: Unemployment, reductions in wages, or reductions in hours worked, make it more difficult to save adequately for retirement; Falls in value of pension pots; Price inflation has been high.



4 reasons to worry– Oldest old– The cost of ageing– Isolation and exclusion– The squeezed middle aged

But opportunities– Prevention (Vaccination nutrition pa)– Housing– Working longer– Health developments and new technology

Why should we worry?



Challenge 1: Oldest oldGrowth in the number of oldest old



How many centenarians are there?

There are currently 11,800 people in the UK who are currently at least 100 (DWP)

There are fewer than 100 people who are aged more than 110. (DWP)

In 1911 there were just 100 Centenarians living in England & Wales

Growth 7% p/a



Life is not easy for the oldest old

Three quarters of the oldest old suffer from limiting longstanding illnesses, and one out of three perceive themselves as being in poor health.

“almost 50% of men and women aged 80-84 report severe limitations in activities” (IFS, 2010)

Sixty per-cent of over 90s report difficulties shopping for groceries, and 35% report difficulties managing money.

http://www.flickr.com/photos/pondspider/4170990903/sizes/m/in/photostream/



Health of the oldest old

A very high proportion of centenarians use drugs

Some evidence of longer hospital stays 23% of those aged 85 and over had levels

of clinical depressive symptoms 60% of interviewees aged over 90 had had a fall and that of these, 4 in five were unable to get up after at least one fall

Dementia between 50% and 100% 98% of centenarians and near

centenarians consulted a GP



Poverty is a very real challenge

The oldest old (aged 85 and

over) are, as a group, at

greater risk of poverty than

younger older people (aged

65-85). Up to 10% of the

oldest old have total net

wealth of £3,000 or less.



The oldest old remain the most excluded

Almost 38% of those aged 85 or older faced some kind of social exclusion, an encouraging decline of 10% from the 2002 levels



OAP recovering after getting trapped in bath for 5 days



Challenge 2:Cost of ageing

In the UK: age-related spending is projected to rise from an annual cost of 21.3% to 26.3% of GDP between 2016/17 and 2061/62, a rise of 5% of GDP (equivalent to a rise of around £79bn in today’s money).



Trends in healthcare

As a result of a growing older

population, increasing longevity and a

greater coverage of public health care

within the EU the pressure on public

health care funding is likely to continue

growing. Public health spending in the

EU currently accounts for 14.6% of total

government spending, around 7.1% of

GDP.



Healthcare costs

• In the UK: spending on health care is projected to see the largest rise of all elements of age-related spending, rising from an annual cost of 6.8% to 9.1% of GDP between 2016/17 and 2061/62, a rise of 2.3% of GDP (equivalent to a rise of around £36bn in today’s money).

• In the EU: spending on health care is projected to rise from an annual cost of 7.1% to 8.3% of GDP between 2010 and 2060, a rise of 1.1% of GDP.

• Globally: it is difficult to project the costs of health care because of the lack of data from developing countries. But evidence of growing numbers with long term conditions.



Spending on health care will see the greatest increase of all age-related spending over the next 50 years

Projected health care spending as a proportion of GDP



Long term care costs

• In the UK: spending on long term care is projected to rise between 2016/17 and 2061/62 from an annual cost of 1.1% to 2% of GDP, a rise of 0.9% of GDP59 (equivalent to a rise of around £14bn in today’s money).

• EU spending on long term care is projected to rise from an annual cost of 1.8% to 3.4% of GDP between 2010 and 2060



Pension costs

• UK spending on public pensions (state pension, pensioner benefits and public service pensions) is projected to rise from an annual cost of 8.9% to 10.8% of GDP between 2016/17 and 2061/62 (equivalent to a rise of £33bn in today’s money). These assumptions do not include consideration of the impact of a single-tier pension.



Challenge 3: Isolation and ExclusionIncreasingly living alone - isolation

50 per cent of the

1960s cohort will be

living alone at age 75

compared with 37 per

cent for the 1916-

1920 cohort and 41

per cent of the 1940s

cohort

(Evandrou &

Falkingham, 2000).



Living together is good for us

Those who moved from living alone to living as part of a couple (with no children) exhibited a 68% fall in the odds of becoming multiply excluded between 2002 and 2008 compared to those who stayed living alone;

Those who moved from being resident in a couple household to living alone were over three times more likely to become multiply excluded. For this age group (50+), becoming a widow is one of the most common reasons for starting to live alone.

http://www.flickr.com/photos/anabadili/2963913137/sizes/m/in/photostream/



Exclusion from Cultural Activities



Exclusion from Local Amenities



Exclusion from Decent Housing and Public Transport



Challenge 4: The squeezed middle age

People in their fifties increasingly excluded from societyThe number of people aged 50 plus being socially excluded from decent housing, public transport and local amenities has risen sharplyOver one in six people in their fifties (18%) were socially excluded in two of more areas of their life – up from 13 per cent in 2002.



Britons ageing quicker than their parents



Will the baby boomers demand change?

“They have fewer ties to family responsibilities... With their homes paid for their major housing concern is for property taxes and repairs... Being essentially free from obligation, they may spend their income and assets as they wish. Here is a potential market, therefore for those marketers who wish to appeal to it. It is a new market, almost unrecognised which must be developed with care as it depends upon the changing role of older persons in our society and the realisation that they are more free than their predecessors in the past century.”



Will the baby boomers demand change?

“They have fewer ties to family responsibilities... With their homes paid for their major housing concern is for property taxes and repairs... Being essentially free from obligation, they may spend their income and assets as they wish. Here is a potential market, therefore for those marketers who wish to appeal to it. It is a new market, almost unrecognised which must be developed with care as it depends upon the changing role of older persons in our society and the realisation that they are more free than their predecessors in the past century.”

Dodge, 1962



Convenient myth of the elderly hedonist

The elderly have had a recent makeover, as appears in the 70-is-the-new-50 cliche….The impression is one of elderly hedonists – more people in their 60s are getting divorced and starting a new life; line-dancing, gymnastics and dating agencies, going from holiday to holiday; concessions, free passes and cheap tickets. The OAP of yesterday has been transformed into the swinger who refuses to acknowledge ageing.

In other words, the high-profile, fun-loving elderly consumer has become the contemporary emblem of old age. This is profoundly reassuring for the rest of us, and it conveniently dissimulates the image of those who live on into their ninth and 10th decade, consigned to the low-watt penumbra of the nursing home, or worse, the invisible "shut-ins", as they are sometimes called, those too timid to go out, who have lost confidence on the uneven pavements and dizzying shopping crowds; those afflicted by the mysterious paranoias of old age, trembling each time the doorbell rings and frightened of the unexpected telephone call; people whose days are marked by boredom and its twin, loneliness; the companionless meal, the ticking clock and the sound of the electricity meter in the stillness, while the winter dark presses against the windows by 4pm, the only company the school photograph of grandchildren with their cheeky smiles and lost milk teeth smiling against the blue background of a painted summer sky.

Jeremy Seabrook http://www.guardian.co.uk/commentisfree/2010/jan/12/elderly-care-michael-parkinson



Some Opportunities



Dependency is not inevitable

Dependency is not inevitable

and a ”considerable

proportion of the

centenarians maintain a

good level of auto sufficiency

for the basic performance of

the everyday life”. (Antonini

et al, 2008)

http://www.flickr.com/photos/driever/5525684658/sizes/m/in/photostream/



Some of the oldest old become more active



Prevention of ill health

Physical Activity

Smoking and alcohol consumption

Nutrition

Immunisation

(NUDGE, COMPEL OR EDUCATE?)

A move to prevention is vital



Getting housing right

1. Extra care housing is a

home for life

2. Extra care translates

into fewer falls

3. Extra care is

associated with a lower

uptake of inpatient

hospital beds



And how can we make new housing and communities aspirational?



Dependency ratios are increasing (by 2060)

From around four working-age people to around two working-age people for every person aged 65 (UK)



Working longer – a solution?

The longer that people spend in work, the longer

they have to save for retirement and the shorter their

retirement will be, relative to their working life.

A later average age of exit can also increase the

number of people in work, relative to the number who

are retired, making it easier to fund pensions,

benefits and health and care costs from current

taxes.



We are working longer

Labour market participation at older ages (ages 55 to 64) is expected to increase within the EU from around 50% to around 67% between 2010 and 2060.

The average age of exit is also projected to increase from around 62 to around 64 within the EU and from around 64 to around 65 within the UK between 2010 and 2060.



Technology limited by imagination



Fantastic developments in health

I think there’ll be a cure for cancer one day. That we never thought we’d see…and Alzheimer’s.

I would wish for a pill to cure everything…



A significant association between internet use and perceived control in one’s life

Uses the internet

Yes

No

Total

Strongly agree 551 (39.6%) 840 (60.4%) 1391

Moderately agree 1515 (51.6%) 1420 (48.4%) 2935

Slightly agree 1545 (59.4%) 1058 (40.6%) 2603

Slightly disagree 636 (68.2%) 296 (31.8%) 932

Moderately

disagree

593 (77.3%) 174 (22.7%) 767

Strongly disagree 268 (71.8%) 105 (28.2%) 373

Chi-Sq= 422.074, df = 5, P=<0.000

Table 1. Feels what happens in life is often determined by factors beyond control



A strong association between the measure of internet use and measures of loneliness

Uses the internet

Yes

No

Total

Hardly ever or

never

3764 (60.2%) 2489 (39.8%) 6253

Some of the time 1091(51.3%) 1037 (48.7%) 2128

Often 272 (37.4%) 456 (62.6%) 728

Chi-Sq= 166.556, df = 2, P=<0.000Table 5. How often respondent feels lonely



People who reported not using the internet were more likely to say that they ‘often’ felt isolated

Uses the internet

Yes

No

Total

Hardly ever or

never

3683 (59.5%) 2503 (40.5%) 6186

Some of the time 1242 (52.6%) 1118 (47.4%) 2360

Often 198 (37.4%) 331 (62.6%) 529

Chi-Sq= 115.871, df = 2, P=<0.000Table 6. How often respondent feels isolated from others



We must recognise and maximise the contribution of age

• Labour market participation at older ages is on the rise.

• Carers of all ages contribute the equivalent of £119 billion every year in the UK.

• Older consumers (aged 65 and over) spend on average, around £100bn per year.

• Older people volunteer.



6 other challenges to think about

Urbanisation: In the developing world the share of older persons residing in urban areas will rise from about 56 million in 1998 to over 908 million by 2050

The care workforce (role for older people?) Challenges of migration Climate change/environmental change Dementia Affluenza (Debt/Obesity) A growing culture of “othering” (fear of crime)



Priorities for Scottish policymakers?

Prevention of ill health (public health) Get housing right Using technology to improve service delivery Focus on the poorest Create jobs for older and younger people Be proactive on isolation and loneliness (transport) Tackle the “Glasgow city” effect. Respond to the

fairness challenge of increasing State Pension Age?



A question for you

What is the one thing you would do to make

Scotland the best place in the world to grow old?



Many thanks

David Sinclair

Assistant Director, Policy & Communications

International Longevity Centre

[email protected]

02073400440

Twitter: @ilcuk and @sinclairda

how should policymakers respond to the new challenges and opportunities of ageing in scotland

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