The decomposition of disease and disability life expectancies in England 1992-2004

ISBN 978-1-905752-23-2 www.cass.city.ac.uk "This paper originated in an independent report for the Department of Health. Any opinions expressed in this paper are my/our own and not necessarily those of my/our employer or anyone else I/we have discussed them with. In particular, the views expressed may not necessarily reflect the views or policies of the Department of Health. You must not copy this paper or quote it without my/our permission"

Investigating the market potential for customised long term care insurance products

Previous economic research into long-term care (LTC) has mainly been focussed on one issue: the reasons why the LTC insurance market has not been successful. In this contribution, we analyse the prospects for a new type of insurance policy, which offers a top-up on the resources already available to the individual. We abstract from most problems inherent in LTC insurance markets and derive premium rates for various types of insurance policies. Generally, we find that the top-up option reduces premium rates considerably, to the point where it might be expected that a substantial number of people would take up policies, were they available

In sickness and in Health? Dynamics of health and cohabitation in the United Kingdom

The purpose of this paper is to analyse the dynamics of cohabitation and functional impairments among older people. Our research has three main aims. Firstly, we want to analyse the effects of cohabitation on disability. Secondly, we want to study time trends in disability and cohabitation jointly to explore relationships between the two. Thirdly, we examine socioeconomic differences -- as captured by educational attainment -- in disability. These issues are of great interest from several points of view. Firstly, they address an emerging theoretical debate concerning the effects of cohabitation on health and contribute to a sparse empirical literature on the topic. Secondly, our findings are highly policy relevant. Concerning long-term care for older people, for example, cohabitation is of double importance: firstly, since people who cohabit tend to be healthier, and secondly, since a partner is the typical provider of informal care. In a time where family structures among the old are likely to change (due to changes in life expectancy and divorce rates), our research will be useful for planning purposes. Finally, the model can be used to simulate populations of certain characteristics. Hence, it can be used to derive insurance premiums in order to reduce the problem of selection effects in the market for long-term care insurance. Using the British Household Panel Survey dataset, we apply panel data and simulation techniques to exploit the longitudinal characteristic of the panel. We estimate the two dependent variables -- cohabitation status and disability -- jointly, and allow for time trends, age effects and unobserved heterogeneity. We find that there are systematic differences between single and cohabiting people so that a cross sectional analysis would overestimate the causal relationship; nevertheless, cohabitation has a strong and positive effect on health. Furthermore, we find that bereavement of a partner has a significant negative impact on health

The Role of Private Finance in Paying for Long Term Care

An ageing population and increased longevity means that long term care will become progressively more expensive. In 2009 the Government published a Green Paper on future funding options and a White Paper in 2010. This article considers the role of private finance products under the ‘Partnership’ option. It finds that few households are able to pay for LTC based on income and savings but the number increases if housing assets are included. We show that products can be devised for a range of circumstances, although state support would need to continue. We propose a simplified means testing system based on a combination of income and assets

A study into the detrimental effects of obesity on life in the UK

This paper is an investigation into the effect of excess body fat on mortality within the UK. Health surveys from the UK are used to apply a Cox proportional hazards model to UK-specific data (Health and Lifestyle Survey, 1985) to provide an analysis, at various ages, of the effects of obesity on life expectancy. We explore the issues by replicating and extending US research with UK data using both Body Mass Index(BMI) and Waist to Height (WTH) as obesity measures. We measure the impact of obesity in adults on life expectancy and find that mortality risk associated with obesity in the UK is similar to that found in US studies. However, importantly, we also show WTH to be a better indicator of mortality risk than BMI. Our results include the number of years of life lost (YLL) for UK lives in various severitycategories of obesity compared with lives of the same age at optimum levels of BMI or WTH. The research emphasizes how important it is for the government to promote healthy lifestyles in order to avoid premature death

Personal Care Savings Bonds: A New Way of Saving Towards Social Care in Later Life

An ageing population ushers in a completely new era requiring society to find new solutions to funding social care and looking after older people. This is not a temporary issue that will go away and there are no quick economic fixes. In the U.K. it is estimated that the population aged 75+ will double from 5 million to 10 million by 2040. Financial building blocks are needed to pay for social care that will be sustained for decades and provide extra security for the individual. This paper proposes a new savings product called Personal Care Savings Bonds (PCSBs), which are designed to encourage saving for social care by providing extra money at the time of greatest financial need. PCSBs are likely to be attractive to older people who have only a basic pension and modest savings, but also to other age groups, as they not only attract interest but also pay prizes. Based on reasonable assumptions, the paper shows how the fund could build into a substantial investment worth £70 billion with regular monthly prize pay-outs. In concept they are somewhat similar to Premium Bonds, another U.K. personal savings product that has been successfully operating since 1956

The evolution of gregariousness in parasitoid wasps

Data are assembled on the clutch-size strategies adopted by extant species of parasitoid wasp. These data are used to reconstruct the history of clutch-size evolution in the group using a series of plausible evolutionary assumptions. Extant families are either entirely solitary, both solitary and gregarious, or else clutch size is unknown. Parsimony analysis suggests that the ancestors of most families were solitary, a result which is robust to different phylogenetic relationships and likely data inadequacies. This implies that solitariness was ubiquitous throughout the initial radiation of the group, and that transitions to gregariousness have subsequently occurred a minimum of 43 times in several, but not all lineages. Current data suggest that species-rich and small-bodied lineages are more likely to have evolved gregariousness, and contain more species with small gregarious brood sizes. I discuss the implications of these data for clutch-size theory

NeuroImage 84 (2014) 657–671 Contents lists available at ScienceDirect

journal homepage: www.elsevier.com/locate/ynimg Spatial–temporal modelling of fMRI data through spatially regularize

Community Adaptation to Flooding in a Changing Climate: Municipal Officials’ Actions Decision-Making and Barriers

CaRDI Research & Policy Brief Issue 5