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Living Longer – How Our Population is Changing and Why it Matters

The document discusses the significant changes in the UK's population due to ageing, projecting an additional 8.6 million residents aged 65 and over by 2066. It highlights the implications of this demographic shift on various policy areas such as health, social care, and economic structures, emphasizing the need for comprehensive evidence and better statistics. The impact of population ageing is widespread, affecting both urban and rural areas differently and raising concerns regarding dependency ratios and pension sustainability.

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Living Longer – How Our Population is Changing and Why it Matters 1
• The Government Statistical Service’s purpose is to strengthen the evidence that the public and policy makers need for their decision making. • Better evidence is in the public good – this is a crucial time for the UK to respond to an ageing population. • The UK does not have a comprehensive and coherent evidence base. In partnership with the Devolved Administrations and others, ONS wants to change that. “Better Statistics, Better Decisions”
3 Population Ageing - Demography
4 An additional 8.6 million UK residents are projected to be aged 65 and over by 2066 – almost the size of London today. Population pyramids, 1966, 2016 and 2066, (principal projection), UK Source: Population estimates, Principal population projections, 2016-based, Office for National Statistics
The older population is growing faster than younger age groups. 5Source: Population estimates, Principal population projections, 2016-based, Office for National Statistics Population by age group, selected years UK 0 10 20 30 40 50 60 70 80 1966 1991 2016 2041 2066 Millions under 16 16 to 64 65 to 74 75 to 84 85 and over
6 There is variation in the ageing population across local areas. Proportion of the population aged 65 and over, 2016 and 2039, UK Source: 2016 mid-year population estimates for UK, Office for National Statistics, 2014-based subnational population projections for UK, Office for National Statistics, Welsh Government, National Records Scotland and Northern Ireland Statistics and Research Authority. Contains OS data © Crown copyright 2018.
7 Older people are more likely to live in rural areas than younger people… Source: Statistical Digest of Rural England, 2018, DEFRA Contains public sector information licensed under the Open Government Licence v3.0. Average age in rural & urban areas in England, 2002 to 2016 Percentage of population within age bands by rural-urban classification (LSOA) in England, 2016 Source: Statistical Digest of Rural England, 2018, DEFRA Contains public sector information licensed under the Open Government Licence v3.0.
8 …with urban areas ageing less quickly than rural areas. Percentage increase in population between 2016 and 2039 by rural-urban classification (LSOA), England Source: 2014-based subnational population projections for England and Rural Urban Classification (2011) of Lower Layer Super Output Areas in England and Wales, Office for National Statistics The population aged 65+ will grow by around 50% in both urban and in rural areas between 2016 and 2039. However, rural areas will see negligible growth in the population aged under 65, while it increases by 8% in urban areas. The effect of this is an increase in the ratio of older to younger people, particularly in rural areas. 0 10 20 30 40 50 60 Aged 0 to 64 Aged 65+ % Predominantly rural Urban with significant rural Predominantly urban
Global population aged 60 years and over 9 We are not alone - the world’s population is also ageing… Source: Global AgeWatch Index 2015, HelpAge International (projected)
10 …including the rest of Europe. Source: World Population Prospects the 2017 revision, custom data acquired via website, UNDESA Population Division Percentage of population aged 65 years and over, EU countries, 2015 Percentage of population aged 65 years and over, EU countries, 2035 (projected) Percentage of population aged 85 years and over, EU countries, 2015 Percentage of population aged 85 years and over, EU countries, 2035 (projected)
Declining mortality and fertility rates have caused population ageing. 11Source: World Population Prospects the 2017 revision, custom data acquired via website, UNDESA Population Division 0 1 2 3 4 5 6 1960-1965 1965-1970 1970-1975 1975-1980 1980-1985 1985-1990 1990-1995 1995-2000 2000-2005 2005-2010 2010-2015 2015-2020 Total Fertility Rate (children per woman) Global UK 0 10 20 30 40 50 60 70 80 90 1960-1965 1965-1970 1970-1975 1975-1980 1980-1985 1985-1990 1990-1995 1995-2000 2000-2005 2005-2010 2010-2015 2015-2020 Age Standardised* Mortality, Rate per 1,000 population Global UK *Standardised to 1950 global population age structure
12 Life expectancy has increased, and this is expected to continue at a slightly slower rate… Period and cohort life expectancy at birth, UK, males and females Source: Past and projected data from the period and cohort life tables, 2016-based, UK: 1981 to 2066, Office for National Statistics Percentage of people expected to survive to age 100 100 by year of birth, UK, males and females A higher proportion of people can expect to live to age100 – almost doubling in next 50 years 0 10 20 30 40 50 60 1982 1992 2002 2012 2022 2032 2042 2052 2062 % Males Females 70 80 90 100 1982 1992 2002 2012 2022 2032 2042 2052 2062 Male period Female period Male cohort Female cohort years
…but more deprived areas have lower life expectancy. 13 Life expectancy (period) at birth by index of multiple deprivation, England, 2014-16 Source: Health state life expectancies by national deprivation deciles, England and Wales: 2014 to 2016, Office for National Statistics Men born in the most deprived areas can expect to die 9.4 years before men born in the least deprived areas. For women the equivalent figure is 7.4 years. 70 75 80 85 90 Least deprived 9 8 7 6 5 4 3 2 Most deprived years females males
14 Population Ageing – Policy Areas
Ageing is a cross-cutting issue with implications for multiple policy areas. 15 e.g. • Older workers • Labour force structure • Job availability • Pensions • Tax • Financial decisions e.g. • Health requirements • Social care • Transport • Housing needs • End of life • Accessible cities e.g. • Digital inclusion • Wellbeing • Intergenerational issues • Crime • Communities Economy and finance Services and needs Society and the individual
16 Population Ageing – Implications for Economy and Finance
17 There will be increasingly more people of pension age for every person of working age. Source: Population estimates, State Pension age factors, Principal Population Projections, 2016-based, Office for National Statistics Old age dependency ratio, 1966 to 2066 (projected), UK 0 50 100 150 200 250 300 350 400 450 1966 1976 1986 1996 2006 2016 2026 2036 2046 2056 2066 Number of people of State Pension Age per 1,000 of working age
While a larger proportion of older men used to work in 1968 than today… 18Source: IFS Report R98, Retirement in the 21st Century, 2014, Daniel Chandler and Gemma Tetlow, © Institute for Fiscal Studies Employment rates of older men, UK, 1968-2013 Employment rates of older women, UK, 1968-2013
…the number of older workers has risen since the beginning of the century… 200 400 600 800 1,000 1,200 1,400 Nov- Jan 1998 Nov- Jan 2000 Nov- Jan 2002 Nov- Jan 2004 Nov- Jan 2006 Nov- Jan 2008 Nov- Jan 2010 Nov- Jan 2012 Nov- Jan 2014 Nov- Jan 2016 Nov- Jan 2018 Thousands Number of adults aged 65 and over in employment, 1998 to 2018 0 2 4 6 8 10 12 Nov- Jan 1998 Nov- Jan 2000 Nov- Jan 2002 Nov- Jan 2004 Nov- Jan 2006 Nov- Jan 2008 Nov- Jan 2010 Nov- Jan 2012 Nov- Jan 2014 Nov- Jan 2016 Nov- Jan 2018 % Employment rates of adults aged 65 and over, 1998 to 2018 19Source: Labour Force Survey, Office for National Statistics
…the biggest increases in employment rates have been at older ages… 20Source: Labour Force Survey, Office for National Statistics 0 20 40 60 80 100 1993 1995 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 Employment at ages 50 to 64 and 65 & over, Men and Women, 1993 to 2018, UK Men 50-64 Women 50-64 Men 65 & over Women 65 & over % 17.5 percentage points 8.8 percentage points Employment rates doubled for ages 65+ between 1993 and 2018, and increased by almost a third for ages 50-64. Increases in employment rates at ages 50-64 are partly due to increased employment of women over time, as the gap in employment rates between men and women narrows, in line with increases in state pension age for women. Employment by age group, 1993 to 2018, UK 0 10 20 30 40 50 60 70 80 90 100 18-24 25-34 35-49 50-64 65+ 1993 1998 2003 2008 2013 2018 %
21 …with older workers more likely to be self-employed than younger workers and working because they are not ready to stop. Main reason for working beyond State Pension Age, 2015, UK Source: Annual Population Survey, Office for National Statistics 0 10 20 30 40 50 60 Due to opportunities to work more flexible hours To boost pension pot To pay for desirable items (such as holidays) Employer needs your experience or you are needed in the family… Other reason To pay for essential items (such as bills) Not ready to stop work % Women Men Source: Labour Force Survey, Office for National Statistics 0% 20% 40% 60% 80% 100% 16 & over State Pension age & over Self-employed Employees Employee and self-employed split of those working past State Pension Age, 2014, UK Notes: 1. Based on a persons main job 2. State Pension age takes into account the incremental increases in female State Pension age since 2010 3. Dataset used is for April to June 2014 4. Does not include those in “other employment” 5. "Other employment" includes government employment & training programmes, and unpaid family workers
Older people have higher income satisfaction and find it easier to get by financially than younger people. 22 1. Respondents are asked to rate how satisfied they are with their household income using ratings from "completely dissatisfied" to "completely satisfied". Responses for mostly and completely satisfied are included in the chart. 2. 95% confidence intervals are displayed on the chart as error bars. People who report finding it quite or very difficult to get by financially1,2: by age, 2015 to 2016, UK People who were mostly or completely satisfied with the income of their household1,2: by age,2015 to 2016, UK 1. Respondents are asked to rate how they were coping financially from "finding it very difficult" to "living comfortably". 2. 95% confidence intervals are displayed on the chart as error bars. Source: Measuring National Well-being: Domains and Measures (data from Understanding Society, the UK Household Longitudinal Study), Office for National Statistics 0 1 2 3 4 5 6 7 8 9 10 16 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 & over % 0 10 20 30 40 50 60 70 16 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 & over %
Incomes for retired households are lower than for non-retired households… 23Source: Household disposable income and inequality in the UK: financial year ending 2017, Office for National Statistics Median equivalised disposable household income by household type, UK, financial year ending 2017 Note: Estimates have been adjusted to take account of inflation
…and income inequality for retired households is also lower. 24 Average disposable incomes with and without private pensions, UK, 1977 to financial year ending 2016 Despite income being £10,000 higher for retired households with a private pension. Gini coefficients for disposable income by household type, UK, 1977 to financial year ending 2017 Lower Gini coefficient indicates more equality. Source: Household disposable income and inequality in the UK: financial year ending 2017, Office for National Statistics
The next generation of retirees are more likely to have a personal pension because of auto-enrolment. 25 Auto-enrolment since October 2012 has boosted uptake of workplace pensions. This means pensions for future retirees are likely to be defined contribution. Source: Annual Survey of Hours and Earnings pension tables, UK: 2017 provisional and 2016 revised results, Office for National Statistics Proportion of employees with workplace pensions by type of pension, UK, 1997 to 2017
Pensions are the biggest welfare outgoing. 26Source: How is the welfare budget spent?, Office for National Statistics Welfare budget spending items, UK, 2016-17 Pensions £111bn 42% Incapacity, disability & injury benefits £44bn 16% Unemployment benefits £2bn 1% Housing benefits £25bn 10% Family benefits, Income support & tax credits £46bn 18% Personal social services and other benefits £35bn 13%
As the population has aged, public expenditure on state pensions and health have gone up. 27 Source: Expenditure on health care (figure 17) and GDP, ONS **Figures refer to government healthcare expenditure only and exclude private spending. Seasonally adjusted GDP was used. Estimates from the “Expenditure on Healthcare in the UK” series are used here as the time series available stretches back to 1997. However, it should be noted that these estimates differ from the headline measure for healthcare expenditure as a percentage of GDP in the UK health accounts, which is produced to the latest internationally-standardised definitions. Source: Expenditure on state pension and GDP, ONS *State pension expenditure (also called social security benefits in cash) excluding other benefits Seasonally adjusted GDP was used. UK public spending on health as a percentage of GDP, UK, 1997-2016** UK public spending on state pensions as a percentage of GDP, UK, 1997-2016* Public spending on state pensions increased from 3.6% to 4.6% of GDP between 1997 and 2016 while public spending on health increased from 4.4% to 6.9% of GDP. 0 1 2 3 4 5 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 % of GDP % of GDP 0 1 2 3 4 5 6 7 8 9 10 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016 % of GDP % of GDP
Tax revenues and government expenditure on welfare and public services are influenced by the population age structure. 28Source: OBR Fiscal sustainability report, January 2017Contains public sector information licensed under the Open Government Licence v3.0. Tax revenue predominantly comes from middle age groups. Spending on health, long- term care, and welfare (including pensions, disability benefits, and attendance allowance) is higher at older ages. Representative profiles for tax, public services, and welfare spending, UK, 2021-2022
0 20,000 40,000 60,000 80,000 100,000 120,000 140,000 160,000 180,000 July 2006 to June 2008 July 2008 to June 2010 July 2010 to June 2012 July 2012 to June 2014 July 2014 to June 2016 Net Household Property Wealth (£) 30 to 32 60 to 62 Wealth increases with age until around age 65… 29 Median household wealth by age and wealth component by age of household reference person, Great Britain, July 2014 - June 2016 0 50,000 100,000 150,000 200,000 250,000 300,000 350,000 400,000 450,000 16 - 24 25 - 34 35 - 44 45 - 54 55 - 64 65 - 74 75 - 84 85 and over Property Wealth (net) Financial Wealth (net) Physical Wealth Private Pension Wealth (£) Median household net property wealth of those aged 30 to 32 years and aged 60 to 62 years based on the age of the household reference person, UK Source: Wealth and Assets Survey, Office for National Statistics Source: Economic Well-being, UK: October to December 2017, Office for National Statistics Over time, the wealth of younger people (in their early 30’s) has declined. Note: The Household Reference Person is defined as the sole householder in one person households, the person with the highest income in joint person households and in households where householders have the same income, the oldest is taken as the HRP
…but younger generations have less wealth than those that came before them. 30Source: Resolution Foundation, The Generation of Wealth, 2017, C. D'Arcy & L. Gardiner (resolutionfoundation.org) Up until the late 50’s, adults on average do not accumulate as much wealth as those who were born five years before them had done by the same age. However, this trend is reversed for those aged 60 and over. Those aged 25 are worst affected, accumulating 84% less wealth than those aged 25, five years previously. Median family total net wealth per adult in 2012-14, as a proportion of the preceding cohort’s wealth in 2006-08, GB
Future retirees may be less likely to own a home in retirement. 31 16 21 26 31 36 2003-04 2005-06 2007-08 2009-10 2011-12 2013-14 2015-16 Years Average age of first time buyers England, 2003-04 to 2016-17 First time buyers by age, England, 1995-96, 2005-06 and 2015-16 Percentage of families (singles or couples) owning their own home, 1961 – 2017, by age group, UK Lower levels of home ownership and later age at first purchase in pre-retirees may result in more future retirees renting or paying off a mortgage into later life. Source: Resolution Foundation, Housing data (resolutionfoundation.org) Note: There is a change of data source in 1984, resulting in small inconsistencies. Prior to 1980, housing association renters are included in the private rented sector. Prior to 1984, full-time students in parents’ homes are included as single adults in parents’ homes. Source: English Housing Survey, Ministry of Housing, Communities and Local Government Contains public sector information licensed under the Open Government Licence v3.0. The average age of first time buyers is increasing. This has largely been driven by decreases in the percentage of first time buyers aged 16-24. Younger generations (<65) have seen a decrease in home ownership rates in recent years, with bigger decreases at younger ages.
Renting has become more common for all ages apart from the oldest… 32 1.1 2.7 7.5 18.8 49.0 71.0 69.4 13.3 48.7 59.6 55.3 30.0 6.5 2.5 27.5 17.5 17.2 16.5 14.0 18.3 22.9 58.1 31.0 15.6 9.4 7.0 4.2 5.2 0% 20% 40% 60% 80% 100% 16-24 25-34 35-44 45-54 55-64 65-74 75 & over own outright buying with mortgage all social renters all private renters Tenure by age of household reference person, England, 2008-09 3.4 3.5 7.5 19.0 45.4 71.9 74.6 6.8 34.7 48.7 47.8 26.5 6.3 2.8 25.5 15.7 17.4 18.4 16.5 15.4 17.6 64.3 46.1 26.4 14.8 11.6 6.4 5.1 0% 20% 40% 60% 80% 100% 16-24 25-34 35-44 45-54 55-64 65-74 75 & over own outright buying with mortgage all social renters all private renters Tenure by age of household reference person, England, 2015-16 Source: English Housing Survey, Ministry of Housing, Communities and Local Government,2015-16 Contains public sector information licensed under the Open Government Licence v3.0. People aged 25 to 34 in England are now more likely to be ‘privately renting’ than ‘buying with a mortgage’.
…and in early adulthood private renting has now overtaken owner occupation… 33 Source: English Housing Survey, 2016 to 2017, Ministry of Housing, Communities and Local Government Contains public sector information licensed under the Open Government Licence v3.0. Over the last decade, the proportion of households where the Household Reference Person (HRP) is aged 25 to 34 and 35 to 44 years old, which are owner- occupied, decreased by 34% and 27% respectively. Trends in tenure, households with a HRP aged 25-34 or 35-44, 2006-07 to 2016-17
…as houses have become more expensive. 34 House prices have doubled relative to average earnings in the last 20 years. This is due to house prices increasing faster than earnings. 0 1 2 3 4 5 6 7 8 9 10 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 Ratio of median house price to median annual earnings, England and Wales, 1997 to 2017 Affordability ratio 0 50 100 150 200 250 300 350 400 1997 1999 2001 2003 2005 2007 2009 2011 2013 2015 2017 Median price paid for property and annual earnings indices England and Wales, 1997 to 2017 House Prices Earnings Index (1997 = 100) Source: Housing affordability in England and Wales: 2017, Office for National Statistics
Trends in tenure, England, 1980 to 2016-17 0 10 20 30 40 50 60 70 80 1980 1981 1982 1983 1984 1985 1986 1987 1988 1989 1990 1991 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2008-09 2009-10 2010-11 2011-12 2012-13 2013-14 2014-15 2015-16 2016-17 percentage owner occupiers private renters social renters For those renting, private has become more common than social renting… 35 Source: English Housing Survey 2016-17, Ministry of Housing, Communities and Local Government Contains public sector information licensed under the Open Government Licence v3.0. Renting is the main option for people who do not own a home in retirement. The private rental sector is now larger than the social rented sector.
…with increases in private renting across all income groups. Home ownership levels have declined and private renting has increased. For middle and higher income groups, this has mainly be driven by reductions in owner-occupiers. For low income groups, increases in private renting are associated with reductions in social renting. 36 Change in percentage of British population in each housing tenure, 1994-1996 to 2013-2015 Source: Institute for Fiscal Studies, The cost of housing for low-income renters, Robert Joyce, Matthew Mitchell, Agnes Norris Keiller, © Institute for Fiscal Studies
Population Ageing – Services and Needs 37
Older adults tend to live in more rural areas, where access to services is more difficult… 38 Source: Journey time statistics: access to services 2014, Department for Transport. Contains public sector information licensed under the Open Government Licence v3.0.Source: 2014 mid-year population estimates, Office for National Statistics Proportion of the population aged 65 and over, 2014 Average minimum travel time for 8 key local services (minutes), 2014 % 65+ Travel time (minutes)
..and where there is less public transport available, people could be more reliant on cars. 39 Source: Department for Transport, National Travel Survey Contains public sector information licensed under the Open Government Licence v3.0. Source: Department for Transport, National Travel Survey Contains public sector information licensed under the Open Government Licence v3.0. There is less bus availability in smaller rural settlements in England and in these areas car ownership is much higher than in urban areas. Bus availability indicator by settlement type, in England, 2002 to 2012 Household car availability by settlement type, in England, 2014/15
However, car use declines with age, as health deteriorates… 40 These factors can leave older people in rural areas isolated, particularly those who cannot afford to pay for taxis, or do not have family members/neighbours who can help with transport, - 10 20 30 40 50 60 70 80 90 100 17-20 21-29 30-39 40-49 50-59 60-69 70+ Percentage Age Full car driving license holders by age and gender, England, 2016 Source: Department for Transport, Driving licence holding and vehicle availability (NTS02) Contains public sector information licensed under the Open Government Licence v3.0.
…and without access to a car, inadequate public transport makes it harder to access health services. 41 Proportion of older people who can travel to the hospital easily, by age group, 2008 to 2012, England Source: Future of Transport in an Ageing Society, (ELSA data), ILC-UK and Age UK Reasons for not using public transport given by those over 65, 2012-13, England
Around half of remaining life is spent in poor health at age 65. 42 9.3 10.1 10.0 10.5 10.4 10.6 11.2 10.7 11.3 11.2 9.0 7.3 8.2 8.2 8.2 10.0 8.5 9.8 9.8 9.7 0 5 10 15 20 25 Males: Northern Ireland Males: Scotland Males: Wales Males: England Males: United Kingdom Females: Northern Ireland Females: Scotland Females: Wales Females: England Females: United Kingdom Years'In good health' 'Not in good health' Proportion of life spent ‘in good health’ 53.6 53.4 52.2 56.7 51.3 56.0 56.0 54.8 57.9 50.6 Source: Health state life expectancies, UK: 2014 to 2016, (Data from Annual Population Survey), Office for National Statistics Life expectancy and the proportion of life spent in good health at age 65 years, by sex, 2014 to 2016, UK and constituent countries There is regional variation in how long someone can expect to live at age 65, and how much of this will be in good health. A larger proportion of remaining life in good health does not automatically mean a higher life expectancy. Scotland is the country with the highest proportion in good health, but the lowest life expectancy at age 65.
Those on lower incomes and in the poorest health find it most difficult to access health services. 43 Source: Future of Transport in an Ageing Society, (ELSA data), ILC-UK and Age UK Contains public sector information licensed under the Open Government Licence v3.0. Prevalence of multimorbidity by age and socioeconomic status, England, 2018 Ease of travelling to healthcare facilities among those 65 and over, England, 2012-13 On socioeconomic status scale, 1=most affluent and 5=most deprived Source: The epidemiology of multimorbidity in primary care: a retrospective cohort study. Cassell A, Edwards D, Harshfield A, Rhodes K, Brimicombe J, Payne R, Griffin S. British Journal of General Practice. 2018 Apr; 6(669): e245–e251.Copyright License (http://creativecommons.org/licences/by- nc/4.0/).
Healthcare demand increases with age… 44 0 500 1,000 1,500 2,000 2,500 Est. spend per person per year £s Age NHS General and acute care age-cost curve, 2013 to 2014, England Males Females Source: Trends in the number of English NHS hospital admissions, The Health Foundation Source: Technical Guide to Allocation Formulae and Pace of Change, 2016/17, NHS England. Contains public sector information licensed under the Open Government Licence v3.0. Trends in number of NHS hospital admissions in England, 2006/07 to 2015/16
…because the number of health conditions increase with age… 45 Having several health conditions increases the complexity of treatment. Some common health conditions associated with older age are: - Hearing impairment - Visual impairment - Heart disease - Dementia - Stroke - Rheumatoid arthritis - Diabetes - Cancer Number of grouped health conditions by age, 2016, England Source: Health Survey for England, 2016, NHS Digital Contains public sector information licensed under the Open Government Licence v3.0. 0 10 20 30 40 50 60 70 80 90 100 16-17 18-19 20-24 25-29 30-34 35-39 40-44 45- 49 50- 54 55-59 60-64 65-69 70-74 75-79 80-84 85-89 90+ Percentage Age group (years) 6 conditions 5 conditions 4 conditions 3 conditions 2 conditions 1 conditions 0 conditions
...particularly age-related health conditions such as dementia… 46 Diagnosed Dementia Prevalence (%) by age group, England, 2016 Source: House of Commons Library, Dementia: policy, services and statistics Contains public sector information licensed under the Open Government Licence v3.0. The prevalence in this chart is likely to be underestimated, as it only shows diagnosed cases. Source: Dementia: applying All Our Health, Public Health England and Diagnosis in the UK, Alzheimers Research UK and Dementia Statistics Hub It is estimated that 850,000 people in the UK are living with dementia but only around two-thirds have been given a dementia diagnosis by their GP or memory service. £
…while satisfaction with health decreases with age. 47 Source: Measuring National Well-being: Domains and Measures (data from Understanding Society, the UK Household Longitudinal Study), Office for National Statistics Percentage who were mostly or completely satisfied with their health1,2: by age, 2015 to 2016, UK 0 10 20 30 40 50 60 70 16 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75 and over % 1. Respondents were asked to rate their health from "Completely dissatisfied" to "Completely satisfied". Responses for mostly and completely satisfied are included in the chart. 2. 95% confidence intervals are displayed on the chart as error bars.
Disability prevalence increases with age… 48 Source: Family Resources Survey 2015/16, Department for Work & Pensions Contains public sector information licensed under the Open Government Licence v3.0. Percentage of people reporting a disability by age group, 2015/16, UK 0 5 10 15 20 25 30 35 40 45 50 State Pension age adults Working-age adults Children All people %
0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 18-24 25-34 35-44 45-54 55-64 65-74 75-84 85 and over % Age (years) Males Females …while the ability to self-care decreases with age… Percentage of males and females who reported “I have no problems washing or dressing myself”, England, 2017 Source: NHS England / Ipsos MORI, GP Patient Survey The proportion of adults able to provide self care decreases at older ages. This is particularly noticeable in females aged 85 and over, where 42% have at least some problems washing or dressing. 49
…with those on lower incomes more likely to need help and less likely to receive it. 50 Overall, about a quarter of people aged 65 and over need help with daily activities. Those on low incomes are more likely to require help. Although they are more likely to receive it than those on higher incomes there is a bigger gap between the need for help and help received for those on lower incomes. Source: Health and Social Care Funding explained, The Health Foundation Gap in provision between receipt of and need for help with daily activities, by income bracket among those aged 65 and over, 2014, England
Social care demand increases with age, but Local Authority provision of adult social care has not increased as the older population has grown… 51 Change in Gross Current Expenditure on Adult Social Care by Local Authorities, in cash and real terms, 2005-06 to 2016-17 Source: Adult social care activity and finance report, England 2016-17, NHS Digital Contains public sector information licensed under the Open Government Licence v3.0. Source: Personal Social Services: Staff of Social Services Departments, England, 2017, NHS Digital. Contains public sector information licensed under the Open Government Licence v3.0. Percentage change in Local Authority adult social services jobs, by job role group from 2011 (baseline) 13 14 15 16 17 18 19 2005-06 2007-08 2009-10 2011-12 2013-14 2015-16 £ billion Cash Terms Real Terms
…but overall, the adult social care jobs market is increasing Estimated number of adult social care jobs in England and percentage change on previous year 52Source: The size and structure of the adult social care workforce in England, 2017, Skills for Care The decline in local authority adult social care spending and jobs, taken alongside the increase in overall adult social care jobs, suggests an increase in private provision of formal social care.
There have been roughly the same number of care home beds in recent years, despite an ageing population... 53 Over the period 2010 to 2017 the number of nursing home beds increased, while the number of residential home beds decreased, leading to the same overall number of beds. With an ageing population, this has resulted in more older people per care home bed. Over the same period there has been an increase in the number of domiciliary (home) care agencies. Adult social care market trends, England, 2010-2017 Source: The state of adult social care services, Care Quality Commission (CQC registration data, March 2017) Contains public sector information licensed under the Open Government Licence v3.0. Note: Arrows show movement since March 2015
…and the number of people receiving publicly funded home care has declined. 54 There has been a decrease in the number of people receiving local authority / HSCT funded domiciliary care. This decreased by 20% in the UK as a whole between 2009 and 2015 (with a larger decrease of 24% in England). This is highly pertinent to the care of older people - most recipients of domiciliary care are aged 65 or over. UK weighted average of people using domiciliary care services in 2015, by age Total people receiving domiciliary care funded by a local authority of Health and Social Care Trusts (HSCT) across the UK in sample week, 2009-2015 Source: An Overview of the Domiciliary Care Market in the United Kingdom, 2016, United Kingdom Homecare Association
Any decline in access to formal care increases the need for informal care, most commonly provided by adult children… 55 Percentage of people receiving informal care by age and gender, 2016/17, UK Source: Family Resources Survey, Department for Work and Pensions Contains public sector information licensed under the Open Government Licence v3.0. Family members who were main recipients of informal care, 2016/17, UK 0 10 20 30 40 50 0-15 16-24 25-34 35-44 45-54 55-64 65-74 75-84 85+ Males Females Percentage of people Source: Family Resources Survey, Department for Work and Pensions Contains public sector information licensed under the Open Government Licence v3.0.
…and these adult children may have their own child caring responsibilities. 56 Average number of live-born children by age 30 and completed family size, by year of birth of women, England and Wales, 2016 Source: Childbearing for women born in different years, England and Wales: 2016, Office for National Statistics As age at childbearing increases, adult children may have their own child caring responsibilities at the time that their parents also need care. This results in a ‘sandwich generation’ who provide care for both their own children, and their parents, at the same time. People are also having fewer children than in the past, so there are fewer children who could potentially provide care for their parents in the future. There are also other potential barriers to future informal care provision, such as geographical distance between family members, and women working until later on in life.
Older people themselves are also often informal carers… 57 Source: Family Resources Survey, Department for Work and Pensions Contains public sector information licensed under the Open Government Licence v3.0. Percentage of people providing informal care by age and gender, 2016/17, UK Care is often provided by an older person for their spouse.
…who in turn may then be more likely to require health services. 58 Source: Survey of Carers in Households 2009/10, The Health and Social Care Information Centre. Contains public sector information licensed under the Open Government Licence v3.0. Source: Full story: The gender gap in unpaid care provision: is there an impact on health and economic position?, Office for National Statistics Percentage of males and females with ‘Not Good’ general health: by extent of unpaid care provision per week, England and Wales, 2011 The effect of caring upon carer’s health1, England, 2009/10 Being an informal carer is associated with negative health impacts.
Healthcare and social care are also linked by transfers of patients between these services. 59 Source: Delayed Transfers of Care Statistics for England, 2017/18, NHS England Contains public sector information licensed under the Open Government Licence v3.0. Delayed Transfer of Care (DTOC) occurs when a patient is medically ready to depart from their current care setting but is unable to do so because of non-clinical reasons. Delays where the patient was awaiting a care package in their own home was the most common reason for DTOC in 2017/18. Total number of delayed days by reason for delayed transfer of care, England, 2010-2011 to 2017-2018 Note: Grey lines represent the other reasons for delayed transfer of care for comparison purposes
Population Ageing – Society and the Individual 60
Older people are not a homogeneous group. 61Source: Annual Population Survey, Office for National Statistics Average personal well-being ratings: by age, 2012 to 2015, UK Wellbeing is highest around early retirement age, before decreasing with advanced age.
Many older people were born outside the UK. 62 UK residents not born in the UK, by age and country of birth, 2014 Around 8 percent of UK residents aged 65 and over, were not born in the UK % Source: UK population by country of birth and nationality grouping, by sex and age: 2014, Office for National Statistics 0 2 4 6 8 10 12 14 European Economic Area non-European Economic Area 0 - 4 5 - 14 15 - 44 45 - 64 65 - 74 75 - 84 85 +
Older people are more likely to live alone, particularly women. Source: Families and Households, 2017, Office for National Statistics and Annual mid-year population estimates 1996 to 2016 0 10 20 30 40 50 60 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016 % of age group People living alone UK, 1996-2016, females 16-24 25-44 45-64 65-74 75 and over 0 10 20 30 40 50 60 1996 1998 2000 2002 2004 2006 2008 2010 2012 2014 2016 % of age group People living alone UK, 1996-2016, males 16-24 25-44 45-64 65-74 75 and over 63
This is because women live longer, and women tend to marry men who are older than themselves. This results in more women than men being widowed… Source: Expectation of Life, Principal Projection, 2016-based, Office for National Statistics Period life expectancy at age 65, by sex England and Wales, 2004 to 2017 Proportion of adults over the age of 65, marrying someone under the age of 65, by sex, 2015 England and Wales 0 10 20 30 40 50 60 Men Women % Source: Marriages data, Office for National Statistics 64 More than half of men aged 65 and over who married in 2014 married someone under 65, compared to 1 in 5 women. 15 16 17 18 19 20 21 22 23 2004 2006 2008 2010 2012 2014 2016 years Men Women
…although widowhood is declining due to faster increases in life expectancy for males than females. Source: National Life Tables, Office for National Statistics Life expectancy at birth for males and females, UK, 1980-1982 to 2014-2016 Marital status* of adults aged 70 and over, 1986 and 2016, England & Wales Source: Population estimates by Marital Status, Office for National Statistics 64 66 68 70 72 74 76 78 80 82 84 1980 to 1982 1984 to 1986 1988 to 1990 1992 to 1994 1996 to 1998 2000 to 2002 2004 to 2006 2008 to 2010 2012 to 2014 Females Malesyears 65 2016 1986 * Married status includes civil partnership
There is also an increase in marriage rates for those aged 70 and over since 2009, while the divorce rate has remained relatively consistent… Marriage rates for opposite-sex couples aged 70 and over, by sex, England and Wales, 2005 to 2015 Source: Marriages in England and Wales, Office for National Statistics Divorce rates for opposite-sex couples aged 70 and over, by sex, England and Wales, 2005 to 2015 Source: Divorces in England and Wales, Office for National Statistics 0.0 0.5 1.0 1.5 2.0 2.5 3.0 3.5 4.0 20152014201320122011201020092008200720062005 per 1,000 people Males Females 66 0.0 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 0.9 1.0 20152014201320122011201020092008200720062005 per 1,000 people Males Females
…while nearly all marriages for those aged 70 and over are re-marriages. Source: Marriages in England and Wales, Office for National Statistics Single Widowed Divorced Proportion of marriages for people aged 70 and over by previous marital status, 2015, UK 93% of people getting married at ages 70 and over are either divorced (50%) or widowed (43%). 67
There are concerns over older people’s isolation and access to services… UK Bank, Building Society and Post Office branch numbers Source: House of Commons Library, Commons Briefing papers SN00385 Older people have difficulty travelling to services like banks and post offices. Physical branches are increasingly closing, with services moving online. Source: ILC-UK and Age UK, Future of Transport in an Ageing Society, (ELSA data) 68 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 16,000 18,000 20,000 Number of branches Banks (BBA figures) Banks (business Count data) Building societies Post offices
…with older people more likely to be digitally excluded… Proportion of adults who used the internet in the last 3 months, by age group, 2011 to 2017, UK Source: Internet users, 2017, UK. Annual population Survey, Office for National Statistics 0 10 20 30 40 50 60 70 80 90 100 16-24 25-34 35-44 45-54 55-64 65+ % Use of the internet for social networking, by age group, 2017, Great Britain Source: Internet access - households and individuals: 2017, Office for National Statistics 0 10 20 30 40 50 60 70 80 90 100 2011 2012 2013 2014 2015 2016 2017 % 45-54 55-64 65-74 75+ More older people are becoming digitally literate. This change is reflective of new cohorts entering the older age brackets who have used the internet in their working and social lives, and will continue to do so in older age. However, given the pace of technological advances older people may still find it hard to keep pace with changes. 69
…but more engaged in their communities. Proportion of people who feel people in their local area can be trusted, are willing to help their neighbours and feel they belong to their local area by age, UK, 2014 to 2015 Source: Inequalities in Social Capital by Age and Sex, July 2015, Office for National Statistics. (Data from Understanding Society) 70 0 10 20 30 40 50 60 70 80 90 16 to 24 25 to 49 50 to 64 65 to 74 75 & over % Feel people in their local area can be trusted Feel people in their local area are willing to help their neighbours Feel they belong to their local area Regularly stop and talk with people in neighbourhood
Older people are more fearful of walking alone after dark. Also… - 5 10 15 20 25 30 35 40 16 to 24 25 to 34 35 to 44 45 to 54 55 to 64 65 to 74 75+ % Proportion feeling very safe walking alone after dark, by age group, year ending March 2015, England and Wales Source: Crime Survey for England and Wales, Office for National Statistics Reasons include uneven pavements and fear of falls, poor street lighting, mobility limitations, and fear of crime 71
…older people’s perception of the likelihood of being a victim of crime is greater than the real prevalence of victimisation… 0 5 10 15 20 25 16-24 25-34 35-44 45-54 55-64 65-74 75+ % Say that it is likely or fairly likely they will be victim of a crime Experienced crime in the previous 12 month period Source: Crime Survey for England and Wales: Annual Trend and Demographic tables and Annual supplementary tables, Office for National Statistics Proportion who have been victim of crime and their perception of likelihood of being a victim, by age group, year ending March 2016, England and Wales 72
…with older people less likely to be victims of crime than the population as a whole, for every type of crime. Note: Burglary, vehicle related theft and criminal damage and arson refer to the age of the household reference person. Source: Crime Survey for England and Wales, 2017, Office for National Statistics 0.0 1.0 2.0 3.0 4.0 5.0 6.0 7.0 Fraud Vehicle Related Theft Criminal Damage and Arson Domestic Burglary All Violence Theft from the Person Robbery % Type of Crime Prevalence of crime by selected crime type and age group, 2017, England and Wales All Ages 65-74 75+ % For some types of crime, however, older people can be targeted because of their perceived vulnerability. In particular, distraction burglary, where an offender gains entry to a house under false pretenses in order to commit theft. And also some types of fraud, particularly those where the victim is tricked into transferring money under false pretenses. 73
Globally In partnership with international charities, academic experts, UN agencies and National Statistical Organisations we are leading the UN City Group on Ageing and Age- disaggregated statistics. Over 30 countries have joined, committed to improving the evidence on ageing populations. Directly relevant to measurement of the SDG “Leave no one behind” theme. Within the UK A new ‘Centre for Ageing and Demography’, to be led by ONS. In partnership with other government departments, academia and other organisations we will: • Identify the high priority policy questions. • Fill evidence gaps. Improving the Evidence