Health and Well-Being in Later Life: Measurement, Predictions, and Interventions

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There is considerable policy interest in the UK and internationally in improving the health and well-being of older people, in part because it is a major driving factor in determining the demand on the health and social care budgets. This Fellowship will investigate the health and well-being of the ageing population within the UK. This will be achieved by performing the three linked pieces of analysis outlined below.The first piece of work will investigate differences between two common subjective measures of health amongst the older population and analyse what we can learn from such differences. Self-assessed health and satisfaction with health are markedly different in older age, and change in different ways as people age. We will examine what happens to these two measures after the onset of certain health conditions using: (i) techniques used to study the dynamics of the economy; and (ii) vignettes (which anchor individual responses to a common scale). This allows examination of differing effects in the short and long run and also informs us about the way in which individuals consider their subjective health. It is particularly important to understand these dynamics, as satisfaction with health is arguably the most important factor in determining an individual's health behaviours and adherence to treatment. The second piece of work aims to inform future policy by identifying vulnerable groups of individuals before they reach older ages; that is identify groups with higher probabilities of having poor health and low well-being in older age. It will use data from the British Household Panel Survey and its successor Understanding Society to track individuals as they enter older age from working age, and will use variables capturing life-events reported during working age to predict health and well-being in older age. The work will build on the existing literature by using data collected at an earlier age (within the working life period) rather than recalled events which may be measured with error. If we find evidence to suggest, for example, that those who become unemployed suffer from long lasting consequences in terms of health and well-being we can aim government policy at targeting these people earlier, thus increasing their quality of life in older age. The third piece of work will evaluate the impact of strengthening community assets on the health and well-being of the older population. It will take advantage of an integrated care initiative in Salford (a deprived area in the northwest of England) under which additional social events at community centres will be made available. Such interventions are believed to reduce demands on formal health and social care services, but there is little quantitative evidence supporting this hypothesis. Using a unique cohort being collected as part of a National Institute for Health Research funded project, this study will estimate the causal effect of community assets on health and well-being. All three pieces of work make use of representative longitudinal datasets, and will apply advanced econometric and statistical methods to these data sets in order to answer fundamentally important research questions. I (the applicant) will undertake the above research programme under the sponsorship of Prof Matt Sutton (Manchester Centre for Health Economics) and Prof Andrew Jones (Department of Economics and Related Studies, University of York). Both are world leaders in their respective fields, and I will benefit from both their expertise and their research networks as well as from multidisciplinary networks within the Institute of Population Health, at the University of Manchester. I will also benefit from research visits to Arie Kapteyn at the Centre for Economic & Social Research at the Uni. of Southern California. Finally, I will benefit from training at British, European and International Institutions in the form of training courses and conference participation.