Tackling health inequalities and extending working lives (THRIVE)

The policy issue: In Europe and Canada, policymakers are facing particular challenges related to rising life expectancy, a shift in the age profile of the population and the consequent increase in the prevalence of chronic illness and disability. But these increases in life expectancy are not experienced equally - there are inequalities that are frequently overlooked in policy-making. Less skilled workers, for example, have a shorter life expectancy, earlier onset of chronic illness and disability, are more likely to suffer from multiple health conditions as they get older. Policymakers in Europe and Canada urgently need to develop strategies that fairly extend working life taking these health inequalities into account. Our aim is therefore to conduct international research that advances understanding of the differential impacts of health inequalities on the opportunity to work later in life and of strategies and policies for extending working life that take these health inequalities into consideration.
Our consortium: The THRIVE project will bring together partners from the UK, Canada, Sweden and Denmark - countries which are all struggling with similar policy problems, but have been experimenting with a variety of strategies to tackle these problems. The THRIVE members are all leaders in health inequalities and employment research and have successfully collaborated with one another over a number of years.
Our research approach: We will analyse population datasets in each country to determine how the pattern of morbidity and co-morbidity with different physical and mental health conditions and caring responsibilities varies over working life by socioeconomic status and gender in different countries and how this is changing over time. We will estimate how the employment consequences of different longstanding illnesses at older ages vary between countries, the reasons for this and the implications for policies that extend working lives. By comparing and analysing policies in the study countries we will elucidate the different policy approaches taken and identify effective strategies. A series of systematic reviews of the quantitative and qualitative evidence will identify which policy approaches are likely to be most effective for extending the working lives of people with longstanding illness, particularly those from more disadvantaged groups. Synthesis of evidence from the reviews and analysis of national datasets will indicate how health inequalities are having an impact on the opportunity to work later in life in each country, how this is likely to develop in the future, and the strategies and policies that are most likely to extend healthy working lives fairly.

Impact summary

Who will benefit from this research?

The main beneficiaries of our research are:
1. Older employees, carers, those they care for and their families, particularly those with low education/disadvantaged circumstances combined with disability.
2. Employment and health policy-makers at local, national and international levels who are striving to formulate age-friendly employment policies, and health, social care and welfare systems that aim to improve health and wellbeing and reduce employment and health inequalities in later life.
3. Public and private sector employers, particularly those with workforces that are engaged in manual or routine/less skilled occupations.
4. Providers of employment, health and social care services
5. Third sector advocacy groups for employees in more precarious positions in the labour market, such as unions, disability rights and carers groups, and those concerned with mental health, ageing and society.

How will they benefit from this research?

Older people themselves, especially those who are in a weak position in the labour market will benefit from policies to extend working lives that are better informed by, and tailored to, the differing realities of people's experiences.

Disadvantaged groups and workers in less skilled/routine occupations, particularly those experiencing the double burden of disadvantage and chronic illness or disability, will benefit the most through greater understanding of their more difficult circumstances and identification of interventions that may be more sensitive to their lives and more effective for improving their life chances.

Older women, particularly those in disadvantaged areas, who are likely to be the major informal care-givers will particularly benefit because their needs will be better understood.

Policy makers will benefit from by a greater understanding of the factors that contribute to more inclusive labour market policies, that offer the best chances for every section of society to participate in the societal goal of working in later life and a healthy ageing workforce. The research findings will be of benefit not only to the UK but also many other countries in Europe and beyond, struggling with similar issues of an ageing population, coupled with inequalities in both health and chances to participate in working life. International efforts to devise strategies to deal with this international policy issue will benefit from the insights that this research gives.

Public and private sector employers will benefit through better-informed policies that help them retain the skills and experience of older workers in their employment, reducing absence from ill health and increasing productivity.

Providers of health, social care and employment services will benefit from using the research to tailor their services to improve the employment prospects of more disadvantaged older people whilst supporting the livelihood and care of those who cannot work, due to ill-health.

Third sector advocacy groups and unions will benefit by being provided with the evidence they need to advocate for policies that promote the social inclusion and employment of the disadvantaged groups that they represent.