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 It’s clear that our political, social and cultural approach towards old age today is already hopelessly out of date, so this event will provide Parliamentarians and stakeholders from across civil society with an opportunity to mark the first anniversary of the House of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.

1. 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

2. Lord Filkin CBE
Chair
Centre for Ageing Better
Chairman
Public Service and Demographic Change
Committee
This event is kindly supported by members of the Ready for Ageing Alliance
#future2030

3. Julia Unwin CBE
Chief Executive
Joseph Rowntree Foundation
This event is kindly supported by members of the Ready for Ageing Alliance
#future2030

4. Professor Phillip Rees CBE
Professor Emeritus, School of Geography
University of Leeds
This event is kindly supported by members of the Ready for Ageing Alliance
#future2030

5. A Review of Trends in Life and Health Expectancies for the
UK, with an International Comparison
Philip Rees
School of Geography, University of Leeds, Leeds LS2 9JT, UK
E: p.h.rees@leeds.ac.uk
Presentation at the International Longevity
Centre/Independent Age Meeting at the House of
Lords, Thursday 13th March 2014

6. Table: Trends and Projections of Period and Cohort Life Expectancy, 1982-2062
Life table Gender Years Life Expectancies Annual Change (arithmetic)
1982 2012 2042 2062
1982-
2012
2012-
2042
2042-
2062
Period MEN Age 0 71.1 79.0 84.7 87.3 0.26 0.19 0.13
Age 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 0.12
Age 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 0.15
Age 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 0.14
Age 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 -0.01
Age 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 -0.01
Age 65 3.8 2.7 2.5 2.5 -0.04 -0.01 0.00
Source: ONS (2013) National Population Projections, 2012 Based
Principal 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

7. 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

8. Table: Time Series of Life and Health Expectancies, Great Britain, 1981-2011
Age, sex Indicator 1981 1991 2001 2000-02 2008-10
At birth
Men Life Expectancy 70.9 73.2 75.7 75.7 78.1 Notes:
GH3-HE 64.4 66.1 67.0 66.8 Indicators
GH5-HE 60.4 63.9 GH3-HE = General Health 3 Category Health Expectancy
YNGH (GH3) 6.5 7.1 8.7 8.9 3 Categories = "Good", "Fair", "Poor"
YNGH (GH5) 15.3 14.2
LLI-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 66.1
YNGH (GH3) 10.1 10.1 11.6 10.5 LLI-HE = Long standing Illness Health Expectancy
YNGH (GH5) 18.0 16.0
LLI-HE 60.8 61.6 62.7 62.9 65.4 YNGH= Expected Year Not in Good Health
YWD 16.0 17.1 17.7 17.5 16.7 YWD = Expected Years With Illness, Disability or Infirmity
At age 65
Men Life Expectancy 13.0 14.2 15.9 16.0 17.9 Source: Office for National Statistics
GH3-HE 9.9 10.8 11.6 11.9 Health Expectancy Statistics
GH5-HE 9.4 10.2
YNGH (GH3) 3.1 3.4 4.3 4.1
YNGH (GH5) 6.6 7.7
LLI-HE 7.6 7.9 8.8 8.8 10.5
YWD
Women Life Expectancy 16.9 17.9 19.0 19.0 20.5
GH3-HE 11.9 13.0 13.2 14.0
GH5-HE 10.8 11.7
YNGH (GH3) 5.0 4.9 5.8 5.0
YNGH (GH5) 8.2 8.8
LLI-HE 8.5 9.3 10.1 10.3 11.3
YWD
1981 to 2001: HEs increase more
slowly than LEs
2000-02 to 2008-10: HEs
increase faster than LEs, at birth
Trends in life and health expectancies and years not spent in good health

9. Global Burden of Disease 2010 Study Results for the UK
Source: 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

10. Figure 1: Age-specific
mortality in the UK
Ranks among 15 EU
members + 4 Others
(AU,CA,US,NO)
B: Men, C: Women
Source:
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?

11. Source:
Rees et al 2013
The Implications of
Ageing and
Migration
for the Future
Population, Health,
Labour
Force 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?

12. 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)61570-6
Interpretation 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: 1507–13
http://dx.doi.org/10.1016/S0140-6736(13)60777-1
Interpretation 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

13. Confidence in very old age support ratios
(Pop aged 50-64/Pop aged 85+)
Year
Median
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

14. Source: The Independent, 17 February, 2014

15. Andrew Kaye
Head of Policy and Campaigns
Independent Age
This event is kindly supported by members of the Ready for Ageing Alliance
#future2030

16. Rt Hon Paul Burstow MP
Member for Sutton and Cheam
This event is kindly supported by members of the Ready for Ageing Alliance
#future2030

17. 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