Health in 2040: A wake up call for everyone in society Q&A with Dr Carole Easton, Centre for Ageing Better

From your perspective, what do the projections for increased illness mean for older people’s lives, and the support they’ll need to live well? 

These figures should be a wake up call for everyone in society, not just those we might see as ‘older people’. People now in their 30s and 40s should ask themselves whether they have confidence in the support both they and their parents need – now and into the future. Is that support available?  

We’re very lucky that many of us can be expected to live longer lives, but as a society, we need to take a much more holistic view of what support a person currently in their 30s will need at every future stage of their life. This includes preventative measures that start at a young age. 

From the Health Foundation projections, what are you most concerned about and why?  

It’s important to point out that the worst health outcomes are among the poorest in society, and this is more pronounced with age. More than 2 million over-65s currently live in poverty and that number is growing. Similarly, our older population is growing in diversity as well as overall numbers.  

Affluence and belonging to particular minority groups both influence the huge inequalities we see in healthy life expectancy. So, my biggest concern is how these projections would play out for minority groups and people living in poverty – and what this will mean for health inequalities in the future. 

What do you think needs to be in place to support people living well for longer? 

We need to invest much more in prevention of illness, and we need to take a wider view of the determinants of health. These determinants – such as stable jobs, good pay, quality housing and good education – are the building blocks of a healthy society. 

It’s at our peril to only look for medical solutions, when there are many things we can be doing to improve people’s health. And many of those solutions will also improve the quality of life for a wide range of people, including, for example, people with disabilities. 

Cold homes caused 4,000 deaths last winter. The annual cost to the NHS attributed to low quality housing is £1.4 billion for the first year of treatment costs. If you improve the quality and accessibility of people's homes, if you stop people falling, if you stop people developing respiratory conditions, if people can be cared for at home, all this reduces the burden on the health service. 

If you improve people’s local environment by fixing pavements and making public transport more accessible, you will improve physical activity levels for everyone – from young parents pushing buggies, to people who use a walking aid, to wheelchair users. 

The report highlights anxiety and depression as a growing area of concern. While this impacts a wide range of people, factors such as discrimination and poverty are likely to further impact on people's mental health. When people are constantly worrying about their home and work, or are isolated from others, this can also lead to chronic stress, anxiety and depression. 

What tangible things can people in power do now to improve the lives of people living longer in the future? 

One of the things we at the Centre for Ageing Better are calling for is a commissioner for older people and ageing. We want a national strategy around ageing that actually brings together policymakers – not just from health and social care in its pure form, but from housing, transport, community, homes and employment. There needs to be a really joined up approach, with government held to account for how it is tackling the changing demographics of our population.  

On housing, we would like to see a commitment from government to a home improvement strategy to be delivered at a local level, and to enabling financial mechanisms so that people can access the resources they need to improve their homes. We’d also like to see the implementation of recommendations for improving accessibility standards on new build homes. 

When it comes to employment, we’re calling for a national programme of employment support targeted at people aged over 50, because we believe that staying in quality work is good for people’s health, wellbeing and finances. This would include enabling employers to support more flexible working options, access to training and development, and guidance around recruitment.  

We also want measures that support carers to stay in work – enabling carers to be carers as well as to have lives. The recent change that entitles carers to five days’ unpaid leave is a start, but doesn’t go far enough. We would argue for a period of paid leave for carers, and a right of six months’ unpaid leave. Looking towards a time where we will need much more care in the community, this is really important. 

I would finish by saying that sometimes age itself can be medicalised. It can be viewed as an inevitability that people will have a health problem by 65. But focusing on prevention at quite a young age can help ensure that people age better.

Ultimately, we need to recognise that there are many solutions to these health issues that are not ‘health care’. But we do need people across different sectors, with support from both local and central government, to work together to have an impact. 

This content originally featured in our email newsletter, which explores perspectives and expert opinion on a different health or health care topic each month.