UCL News


Achieving levelling up health targets could boost local economies

20 October 2022

A quarter of a million working-age people aged 50 or older, could have stayed in paid employment for longer, had the levelling up health targets been achieved a decade ago, finds a new UCL-led study.

older lady working

Researchers believe this is important as staying in work can provide both positive health and financial outcomes for individuals. Meanwhile, remaining in good health allows people to be able to make the choice of staying in the labour market – rather than being forced out by ill health.

The report, published by ICL, the UK’s specialist think tank on the impact of longevity on society, builds on the earlier findings of the Marmot reviews in 2010 and 2020, led by the UCL Institute of Health Equity, which found that geographical health inequalities are deeply entrenched in England and Wales.

The Health of Older People in Places (HOPE) project research, which UCL led in collaboration with the University of Leeds and 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 all adults living in the “unhealthiest” areas are 60% less likely to be in paid employment than those from the healthiest.

The researchers defined the ‘unhealthiest’ places as the third of local authorities in England and Wales where the highest proportion of older people said their health was either fair or poor.

However, modelling by the HOPE project measured what would have happened if the current levelling up health targets, of reducing the gap in healthy life expectancy across local authorities by five years, had been achieved between 2001 and 2011.  

Researchers used data on 122,000 respondents from the Office for National Statistics’ Longitudinal Study, a 1% representative sample of the England and Wales censuses, who were aged 40-64 years and in paid work in 2001. The findings concluded that this would have increased older people’s participation in the labour market by 3.7% - equivalent to 250,000 older people.

Principal Investigator of the HOPE project, Dr Emily Murray (UCL Epidemiology & Public Health), said: “What this project shows is how closely linked the health of older people in our communities is to the labour market for all 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.”

Between 1991 and 2011 disability-free life expectancy improved in England and Wales. However, there remained a significant gap between the “healthiest” and “unhealthiest” areas. In 2011, disability-free life expectancy at age 50 varied from a low of 13.8 years in the “unhealthiest” local authority (Blaenau Gwent) to a high of 25.0 years in the “healthiest” local authority (Kingston Upon Thames) – a gap of 11.3 years.

David Sinclair, Chief Executive of ILC, said: “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.”



Media contact 

Poppy Danby 

E: p.danby [at] ucl.ac.uk