Institute of Epidemiology & Health Care


Achieving levelling up health targets could boost employment of older people by 3.7%

21 October 2022

New research led by ICLS' Dr Emily Murray, and published in a report by the International Longevity Centre (ILCUK), finds that a quarter of a million older people could have stayed in paid employment longer had the levelling up health targets been achieved a decade ago.

older man reading a newspaper

The Health and place – How levelling up health can keep older workers working report builds on the earlier findings of the Marmot reviews in 2010 and 2020 led by the UCL Institute of Health Equity, showing that geographical health inequalities are deeply entrenched in England and Wales. The Health of Older People in Places (HOPE) project research led by University College London (UCL) in collaboration with the University of Leeds and the ILC is part of the Health Foundation’s Social and Economic Value of Place programme. The research links these geographical disparities to employment outcomes, finding older people living in the ‘unhealthiest’ areas are 60% less likely to be in paid employment than those from the healthiest.

Between 1991 and 2011 disability-free life expectancy improved in England and Wales. However, the gap between the ‘healthiest’ and ‘unhealthiest’ areas widened from 2001 to 2011. In 2011, disability-free life expectancy at age 50 varied from a low of 13.8 years in the ‘unhealthiest’ local authority to a high of 25.0 years in the ‘healthiest’ local authority; a gap of 11.3 years.

But these significant health and employment outcomes gaps can be turned around. Modelling by the Health of Older People in Places (HOPE) project measured what would have happened if the current levelling up health targets had been achieved between 2001 and 2011 and concluded that this would have increased older people’s participation in the labour market by 3.7%, equivalent to 250,000 older people.

Dr Emily Murray, Principal Investigator of the HOPE project and Senior Research Associate, UCL Department of Epidemiology and Public Health commented:

”What this project shows is how closely linked the health of older people in our communities is to the labour market for all in those communities. And how these geographic inequalities in health are long-standing, with the same places that were the ‘Unhealthiest’ in 1991 highly likely to also be the ‘Unhealthiest’ 20 years later. 

“Since the onset of the COVID-19 pandemic, almost 400,000 people aged 50-64 years have left the labour market and not returned. The HOPE project shows that if we focus on improving the health of older people in these ‘Unhealthiest’ local authorities, we have a chance to improve the economies of these places as well.” 

David Sinclair, Chief Executive of ILC argued:

“Health inequalities are not inevitable, and this Government must not squander any further opportunities through the levelling up agenda to address this long-standing problem. By taking action to reduce health inequalities we could increase labour market participation of older workers in historically ‘unhealthier’ areas, bringing economic benefits to everyone – and give people more reason to hope.”