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. The fellowship will investigate the health and well-being of the ageing population within the UK.
The MRC award
The MRC award will give Luke the opportunity to consider health and well-being in later life through measurement, predictions, and interventions. He will investigate differences between two common subjective measures of health amongst the older population. "Self-assessed health and satisfaction with health are markedly different in older age, and change in different ways as people age" says Luke, "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 individual 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."
Luke also hopes to inform policy by identifying vulnerable groups before they reach older age. The research will use longitudinal 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 wellbeing 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" commented Luke.
The third piece of work falling under the MRC award 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 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.
Over six months last year, Luke was funded by the School to conduct preliminary analysis to ensure that the data the research team had in mind was suitable for the analysis proposed. "I linked the BHPS and Understanding Society together to ensure that there was a sufficiently large number of people entering older age from working age, with detailed information about their working life. Very preliminary estimates show that people who have been unemployed have consistently lower levels of health and well-being in later life. This work was presented at the European Health Economics (EuHEA) PhD and ECR conference in Paris in September 2015, and we received very useful feedback."
Luke also began a preliminary analysis of the CLASSIC data to see if there was any evidence of community assets impacting health in a cross-sectional dataset. The team hope to build on this by considering longitudinal data when this becomes available. This work involves working closely with Professor Pete Bower in the Centre for Primary Care.
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.
Luke is based in the Centre for Health Economics at the University of Manchester.