Policies for longer working lives: understanding interactions with health and care responsibilities

Lead Research Organisation: Institute for Fiscal Studies
Department Name: IFS Research Team

Abstract

In recent decades, the proportion of older people in the United Kingdom who are in paid work has been steadily rising. In 2000, 60% of 50-64 year olds were employed and by 2015, 70% of them were. The proportion of people aged 65 and over in paid employment has doubled over the same period, from around 5% to 10%. Growth in the size of the older population over this period means the increases in the numbers of older individuals in paid work are even greater. With an ageing population, and policy reforms that are encouraging people to remain in work longer, it is important to understand the broader effects of longer working lives on the older population. Our research focuses on two important factors related to longer working lives.
The first is the effect on health. Do people who work longer into their 60s have lower health because of their extended working life? Or does work (and the income associated with it) allow people to live healthier, more active lives? This question is hard to answer because simply observing that workers are healthier/less healthy than non-workers tells us little about the causal effect of work on health. Health and employment can be related in a complicated way. The fact of working may improve or worsen a person's health. But, at the same time, people may be less likely to work if they are already unwell: for example because pain prevents them from doing the job they used to, or want to, do.
Our research will look directly at the effect of working longer on health by using a reform which increased the employment of older workers, without having any direct effect on health. This reform was the increase in the state pension age for women.
The second factor that we will examine is the interaction between work and caring, using a model that incorporates a large range of factors that affect the health, income and wealth of the older population. We will use this to understand the factors affecting the need for and receipt of social care (informal care, publicly-funded formal care, and privately-funded formal care). We will also model the supply of informal care - that is, who provides care, and how much they provide (in terms of number of hours per week). We will then use the model to understand the interaction between people's decisions to be in paid work and the decision to provide informal care.
Underlying all the research that we do will be the idea of how the effects of working lives can differ for different people, and how they might reinforce or ameliorate existing inequalities in health and income. This means we will not only look at the effect of longer working lives on one type of health, but a range of measures, and understand the behaviours that might have positive or negative impacts on health. We will look at the groups of the population that might be affected differently. In terms of care, we can see whether it is particular types of people who are in greater need of care, and who end up providing care, in particular the differences by income and sex.
All of the research outlined in this proposal is being undertaken in parallel with researchers in France, Germany and Denmark. Together we form one consortium. Our European partners are also academic researchers who have intricate knowledge of the public policies affecting older people in their countries. By studying similar questions in each country, we will be able to increase our understanding of these issues by examining behaviour and outcomes in different policy settings. This will help policymakers understand the impacts of government policies across Europe.

Planned Impact

Concern over some of the impacts of the ageing population has motivated many government policies. This research will help understand the effects of longer working lives on health, caring and inequalities and the potential impact of future policy reforms.

Despite the importance of health and care responsibilities in the lives of older people, there is been relatively little assessment of how a longer working life might affect these, and how recent reforms have impacted them. There is also little systematic evidence as to how different countries are responding to similar challenges. This research will fill this evidence gap, using dynamic microsimulation models to understand the interaction of health, caring and work, exploiting recent policy reforms to understand better the particular relationship between work and the health of the older population.

The proposed research is of clear direct interest to the UK's Department for Work and Pensions (DWP), and HM Treasury, both of whom are engaged in how the ageing population impacts the UK economy. In particular, the work on understanding the impact of longer working lives on health exploits the ongoing increase in the state pension age. Current legislation sets out a path for further increases, with regular reviews of this policy. By understanding what effect it has had on health, the government will be able to take better decisions on the path for future increases and whether other actions ought to be considered to help alleviate any adverse outcomes. Our findings will also be of significant relevance to the Department of Health and local authorities. For the former, it will be important to understand how extending working lives might affect demand for health care. For the latter, it will be important to understand how extending working lives might affect the availability of informal care and thus the need for publicly funded formal care.

As well as being relevant to public policymakers, our findings will also be of significant interest to a number of private and third sector organisations. This includes: employers of older workers, trades unions with older members and charities representing older people; all of whom will be interested in how longer working lives will affect the health, well-being and circumstances of older people.
Our collaboration with three other countries means that we will not only be able to help disseminate our own findings but also the findings of other researchers in the consortium. This means that UK policymakers and civil society will be able to learn lessons from the experience of these countries and understand the different ways in which policies are changing in response to an ageing population. Equivalently it will help disseminate our findings, where relevant, to policymakers in Denmark, France and Germany.

From the earliest stages of the work, we will engage with central and local government, private and third sector organisations to help ensure the work addresses the most relevant questions and to facilitate rapid dissemination of findings. The findings of our research will be made accessible to this audience through non-technical summaries of our results. These will be freely available from the IFS website. The IFS website receives on average over 44,000 visits per month. This will be in addition to more detailed working papers, which will then be submitted to peer-reviewed journals. We anticipate that - at a minimum - the programme of research will generate two academic papers that are publishable in good academic journals.

The publication of our findings will be accompanied by a press release sent to potentially interested journalists that will allow us to disseminate the findings via the broadcast and print media. The key findings will also be publicised through social media, for example via Twitter on which the IFS currently has over 19,000 followers.
 
Description Our research looks at some of the implications of extending working lives on individuals and on the public finances.

We have produced new evidence of the impacts of the rising female state pension age (SPA). We found that it did lead to higher employment for women in their 60s, but this effect was smaller for those women who were unaware of their SPA in advance and was not seen among renters, those not in paid work at age 58 and those who were receiving benefits at age 58. We found no evidence that increasing the SPA increased reported social isolation, self-reported loneliness, measures of depression, or self-reported quality of life.

Utilising the fact that some women were induced into remaining in paid work as a direct result of the rise in the female SPA, we were able to produce new estimates of the casual impact of extending women's working lives on their cognition and physical disability. We found that delaying retirement has significant positive effects on both. Remaining in paid work was found to boost performance in two cognitive test substantially, with this improvement particularly strong for single women. Delaying retirement was also found to increase walking speed and to reduce reports of mobility problems. However we found that for women in sedentary occupations remaining in paid work reduces walking speed due to lower levels of exercise.

We have examined the extent to which changes in the receipt of care across successive birth cohorts might offset (or add to) increasing demand for social care arising from population growth. A first factor is that in future each person might need less care at any given age. We find evidence that the proportion of men aged 65 years and above reporting any difficulties with daily activities has fallen across birth cohorts, though we find no evidence of any change among women. Therefore rates of need for care for men may therefore be falling, but seem less likely to do so for women. A second reason why we might expect to see reduced rates of formal care provision in future is due to the increased availability of informal care provided by partners. We find this is indeed the case for women: for example, women born 1935-44 are 5.8 percentage points more likely to receive care from a spouse at a given age than are women born 1915-24. No statistically significant results were found for men.

If provision of informal care does increase the extent to which this reduces demand for formal care will depend on the degree of substitution between the two. Our research has looked at this directly, exploiting the fact that those who have a daughter are more likely to receive informal care than individuals who only have sons. We find evidence that a 10% increase in hours of informal care received reduces formal care hours by around 5%, with this offset being bigger for publicly funded formal care than for privately funded formal care.
Exploitation Route The findings of our research have already been of interest to policymakers as evidenced by the fact that presentations have been given to civil servants at the Department for Work and Pensions, the Department of Health and Social Care (DHSC) and HM Treasury. We have also contributed to the development of models both inside (DHSC) and outside (Health Foundation) of Government, and continue to discuss with DHSC the best way to model substitution between different types of care. We expect that our research will continue to inform policymakers and the wider public debate: not least as this is an active area of policymaking.

We have also engaged extensively with academics. This includes organising a special session at the 2018 Royal Economic Society annual conference and presentations delivered at conferences in Belfast, Dublin, Paris, Peking and Uppsala. We have just submitted one paper to a peer reviewed journal and further papers are currently in preparation for submission. In particular our use of a reform to identify the impact of retirement on health, and our use of a range of health measures including one that is both objective and independently measured, is something that we hope will be taken forward in subsequent studies.
Sectors Communities and Social Services/Policy,Financial Services, and Management Consultancy,Healthcare,Leisure Activities, including Sports, Recreation and Tourism,Government, Democracy and Justice,Culture, Heritage, Museums and Collections

URL https://www.ifs.org.uk/publications/14164
 
Description Drawing on our research we have contributed to the development of models both inside Government (the Department of Health and Social Care, DHSC) and outside Government (Health Foundation) and continue to discuss with DHSC the best way to model substitution between different types of care. Improvements to these models will improve the assessment of the impacts of different policy settings, helping policymakers and those seeking to scrutinise policymakers. We have also presented the findings of our research to civil servants at the Department for Work and Pensions, the Department of Health and Social Care and HM Treasury, and therefore would expect our work to feed into further public policy impacts in future.
First Year Of Impact 2018
Sector Government, Democracy and Justice
Impact Types Policy & public services

 
Description Discussion at DWP on retirement income adequacy
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
 
Description Discussion with DHSC about spillovers between hospital and social care in England
Geographic Reach Local/Municipal/Regional 
Policy Influence Type Participation in a advisory committee
 
Description Meeting with DHSC to discuss this work and general evidence on hoarding (or not) of assets in older age for social care purposes
Geographic Reach National 
Policy Influence Type Participation in a advisory committee
 
Description Prevalence and dynamics of social care receipt 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Presentation given at IFS, Audience: Academics
Year(s) Of Engagement Activity 2017
 
Description Substitution between informal and formal social care among the older population in England 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other audiences
Results and Impact Presentation given at the IFS, Audience: Academics
Year(s) Of Engagement Activity 2017
 
Description 'State pension age increases and the circumstance of older women' at the ELSA wave 8 launch. 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Neil Amin-Smith presentation at the ELSA wave 8 launch conference at The Royal Society 18/10/2018
Year(s) Of Engagement Activity 2018
URL https://www.ifs.org.uk/about/blog/466
 
Description 'The causal impact of longer working on cognitive function and mobility: Exploiting the increase in the State Pension Age for women in the UK' 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Talk at Peking university 17-18 May 2018.
Year(s) Of Engagement Activity 2018
 
Description BBC News Channel interview 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Andrew Hood interviewed on Adequacy and optimality of retirement provision: household behaviour and the design of pensions.
Year(s) Of Engagement Activity 2018
 
Description BBC news channel interview 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Jonathan Cribb interviewed on Adequacy and optimality of retirement provision: household behaviour and the design of pensions,
Year(s) Of Engagement Activity 2018
 
Description Broadcast: BBC Business Live 
Form Of Engagement Activity A broadcast e.g. TV/radio/film/podcast (other than news/press)
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Public/other audiences
Results and Impact Jonathan Cribb interviewed on Adequacy and optimality of retirement provision: household behaviour and the design of pensions,
Year(s) Of Engagement Activity 2018
 
Description DWP minsterial roundtable on pension income adequacy 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Policymakers/politicians
Results and Impact Adequacy and optimality of retirement provision: household behaviour and the design of pensions,
Year(s) Of Engagement Activity 2018
 
Description Does the older population substitute informal care for formal care in England? 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Industry/Business
Results and Impact George Stoye gave a presentation titled 'Does the older population substitute informal care for formal care in England?' at the Longlives Workshop on 17/04/2019 at the Paris School of Economics.
Year(s) Of Engagement Activity 2019
 
Description Expectations of future care needs and wealth trajectories in retirement 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Industry/Business
Results and Impact Rowena Crawford presented to the Irish Economic Association Conference in Dublin on 11 May 2018.
Year(s) Of Engagement Activity 2018
 
Description Increases in the state pension age, longer working, and links to cognitive function and physical mobility 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Talk at the LONGLIVES meetings in Paris June 2018
Year(s) Of Engagement Activity 2018
 
Description Increases in the state pension age, longer working, and links to health and cognitive function 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Presentation to DWP civil servants on Increases in the state pension age, longer working, and links to health and cognitive function
Year(s) Of Engagement Activity 2017,2018
 
Description Increases in the state pension age, longer working, and links to health and cognitive function 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Increases in the state pension age, longer working, and links to health and cognitive function presented to HMT civil servants
Year(s) Of Engagement Activity 2017
 
Description Increasing the state pension age for women in the United Kindgom 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact presented at a workshop in September (Berlin 12 & 13 September)
Audience: Policymakers/Academics
Year(s) Of Engagement Activity 2016
 
Description LONGLIVES Modules 1 and 2: United Kingdom 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Policymakers/politicians
Results and Impact This presentation was held at the LONGLIVES Meeting, Berlin.
Year(s) Of Engagement Activity 2016
 
Description Modelling Work, Health, Care and Income in the Older Population 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Presented at a workshop in September (Berlin 12 & 13 September)
Audience: Policymakers and Academics
Year(s) Of Engagement Activity 2016
 
Description Modelling Work, Health, Care and Income in the Older Population 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact The IFS retirement simulator (RetSim)

Jonathan Cribb

LONGLIVES Meeting, Copenhagen

May 2017
Year(s) Of Engagement Activity 2017,2019
 
Description Modelling work, health, care and income in the older population: The IFS retirement simulator (RetSim) 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Professional Practitioners
Results and Impact Presentation at Health Foundation away day, 31 October 2018
Year(s) Of Engagement Activity 2018
 
Description Module 3: Caring responsibilities and longer working lives 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact presented at a workshop in September (Berlin 12 & 13 September)
Audience: Policymakers and Academics
Year(s) Of Engagement Activity 2016
 
Description Rising female State Pension Age led to higher employment for women in their 60s - but not for renters and those on benefits before age 60 
Form Of Engagement Activity A press release, press conference or response to a media enquiry/interview
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Public/other audiences
Results and Impact Between 2010 and 2018 the female state pension age (SPA) increased from 60 to 65. This has increased employment among affected women over 60, although not enough to avoid the average incomes of this group falling. New research, using longitudinal data from the English Longitudinal Study of Ageing and published today by the Institute for Fiscal Studies finds that:

Women who were unaware of their SPA in advance were less likely to respond by being in paid work beyond age 60;

Women who were not in paid work at age 58 did not become more likely to re-enter the labour market at age 60 after the SPA had risen;

Women with lower levels of wealth, and those who were not homeowners, were also less likely than others to respond to the reform by being in paid work after age 60.

Speakers: Neil Amin Smith and Rowena Crawford
Year(s) Of Engagement Activity 2018
URL https://www.ifs.org.uk/publications/13544
 
Description Social care receipt: prevalence and expectations 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact Rowena Crawford gave a presentation titled 'Social care receipt: prevalence and expectations' at a conference at Institut National d'Études Démographiques in Paris 18 May 2018
Year(s) Of Engagement Activity 2018
URL https://www.ipp.eu/actualites/18-mai-journee-detude-ined-ipp-defis-socioeconomiques-de-la-perte-daut...
 
Description Substitution Between Health and Social Care: Evidence from England 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Ben Zaranko chaired a session on Empirical Health Studies, and presented the talk titled 'Substitution Between Health and Social Care: Evidence from England'
Year(s) Of Engagement Activity 2018
URL https://editorialexpress.com/conference/RESConf2018/program/RESConf2018.html
 
Description Talk at the 'Elderly Care in France and in Europe', Paris School of Economics 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact Presentation 18/04/2019 Presentation at conference on "Elderly Care in France and in Europe", Paris School of Economics Modelling work, health, care and income in the older English population: The IFS retirement simulator (RetSim) Carl Emmerson
Year(s) Of Engagement Activity 2019
 
Description The Dynamics of Social Care Use in England 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact George Stoye gave a presentation at the Department of Health and Social Care, which was also streamed to NHS England.
Year(s) Of Engagement Activity 2016
 
Description The causal impact of work on cognition and physical disability: exploiting the increase in the state pension age for women in the UK 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Other audiences
Results and Impact David Sturrock presented at "The labour market with an ageing population" conference, hosted by Uppsala University
Year(s) Of Engagement Activity 2018
URL https://www.ifau.se/globalassets/kurser-och-konferenser/2018/program-workshop.pdf
 
Description The dynamics of social care in England 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Professional Practitioners
Results and Impact Presentation of 'the dynamices of social care in England' at the British and Irish Longitduinal Studies Conference, hosted at Queen's University, Belfast, in November 2016.
Year(s) Of Engagement Activity 2016
URL https://www.ifs.org.uk/publications/9766
 
Description The impact of a longer working life on health: exploiting the increase in the UK state pension age for women 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Presentation to the Work, Pensions and Labour Economics study group (WPEG) conference in Sheffield on the impact of longer working on health
Year(s) Of Engagement Activity 2017
 
Description The impact of cuts to social care spending on the use of Accident and Emergency departments in England 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact Presentation the Department of Health and Social Care and NHS England by Ben Zaranko on the impact of cuts to social care spending on the use of Accident and Emergency departments in England.
Year(s) Of Engagement Activity 2018
 
Description Work, Health and Disability 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Policymakers/politicians
Results and Impact IFS hosted an ESRC/DWP roundtable - comprising civil servants from DWP and the Department for Health and a set of academics, in February 2017 as part of the UK Government's consultation on its "Work, Health and Disability" Green Paper.
Year(s) Of Engagement Activity 2017