International Longevity Centre - UK

The ILC-UK organised an event today on the sensitive topic of so-called ‘under-occupancy’ by older people. This is a topic we’ve been interested in for a while - we felt that our work on housing and planning had lead us to a contradiction between everyday industry talk of the need to ‘free up’ the ‘under-occupied’ homes of older people and Government agenda of keeping people independent at home for as long as possible.

Clearly, this recognition that the housing circumstances of the older population in mainstream housing must be taken seriously by Government policy is welcome. The home is a key defining environment in which - as we age - design and condition of our housing can come to hugely influence our chances of enjoying ‘active ageing’ in good health. Given future demographic trends, there has never been a more timely opportunity to invest in preventative, housing-based solutions to promote wellbeing.  But what is the right balance between encouraging people to stay at home, and encouraging downsizing?  The evidence was clear that ‘under-occupancy’ exists. Or better put, based on our current definitions (usually 2 or more bedrooms per household than ‘necessary’) 46% of households fell into that category. For older households (65+) this was 56%. Not a huge difference. ‘Under-occupancy’ is not really an age issue at all – it is a wealth issue. If we are going to hold a moral standpoint on using up too much space, it’s going to have to include all ages (i.e., the wealthy.) Talk of under-occupancy that focuses solely on older people is simply ageist.  For ‘under-occupancy’ to exist as a concern, over crowding must also exist. And it does: in the UK today, 500,000 households live in over-crowded conditions. The impact of this on families is thought to be increased risk of ill-health, stress, family breakdowns and poor educational performance. 

So what can we do about it? We could build more homes, but we are already losing the battle to meet grow in demand, to the tune of 40,000 households per year. The public is not yet ready to build on green field sites, and there simply aren’t enough brown field ones to meet demand. Furthermore, we could make sure those houses we do build are family sized homes, i.e. 3 or 4 bedrooms. But provision of these has fallen recent years, and the majority of new housing is now 1 or 2 bed flats. Affordable housing is such a dominant issue, (by which we usually mean affordable housing for young people) that this is unlikely to change much in the new future.  What are our chances of encouraging downsizing? Fairly low, seemingly. Mobility is lowest in older age groups (around 2% per year) and most older people want to remain in their own homes, and rightly so.   

But there is a margin – about 45% of people 50+ indicate they are open to the idea of a pre or post retirement move. Few actually do, but homeowners are most likely to consider it. This is good news as they are the majority of older people. Housing markets that offer the kind of suitable, downsized housing that will meet the aspirations of the relatively wealthy baby boomers are more likely to be successful. This means local authorities giving priority to older people’s specialist housing, earmarking suitable sites and defending them from competing concerns.  No one should be coerced into moving. We all aspire to own our home, and live free from insecurity in later life. But positive measures to encourage downsizing would not interfere with that. Impartial advice and information services acting in the interests of older people could ensure those who want to move are helped to do so. Even small movements at the top of a housing chain will impact all the way down to the first time buyer.  If nothing else, today’s debate showed that this is complex topic with competing view-points. The ILC-UK is keen to promote debate on the topic, so if you are keen to make a point, please do post a comment in response to my posting. 

This weeks’ call from Government advisor Lord Layard that schools should teach happiness touches on an interesting aspect of individual health, wellbeing, and ultimately longevity. (see http://news.bbc.co.uk/1/hi/education/6618431.stm )

We have known for many years that mental health is closely linked to physical health. Quite how much so took many people by surprise when studies such as the famous Whitehall longitudinal survey of civil servants began to report back in the 70s. Previously, people had assumed that the more stressed a person was, or the more responsibility they had to cope with, the worse their health. Not so, according to Whitehall. Rather, the higher the status of the individual, the more likely they were to report good health in later life. This held true for an astonishing range of conditions, from cancer through to heart disease, even for back pain and gastrointestinal diseases.
 
In short, you’d rather your chances of living to 90 as the busy executive than the cleaner, and for each step up or down the ladder, you can expect fairly a linear upgrade or downgrade in terms of health. A 1997 to 1999 study showed the life expectancy gap between professionals and unskilled manual workers was about 7.5 years for men, and 6 years for women.
 
What has all this got to do with happiness? In essence, our experience of life (through work and socializing, together with your early life influences and lifestyle factors), comes to dominate your health characteristics whether you like it or not. We know that the self-reported degree of control over work is closely linked to incidence of coronary heart disease. The less you have, the more strain you appear put on you heart. We know that people in insecure employment, prone to worrying and stress, show worse health than either those either fully employment, or unemployed.

Why should this be the case? Quite simply, unhappiness, depression, and stress appear to take a terrible toll in the physiological reactions they cause. And how we rank ourselves on the social gradient is also a factor. A 2001 paper looking at the life-spans of famous actors found that Oscar winners appeared to live about four years longer than comparable peers who hadn’t won anything. (http://news.bbc.co.uk/1/hi/health/1331401.stm ) The suggestion appears to be that self-esteem, happiness, recognition and status within a social group has a major impact on our health.

For those of us unlikely to win an Oscar, where might we look to boost happiness? As social creatures, it seems clear that humans are happy when they have both company and a social function to play. It is thought to be one of the factors why keeping pets appear to create happiness - the owner has a manageable responsibility of care, and therefore ascribes importance to their actions. In the 2005 TV show ‘Making Slough Happy’ successful strategies included nurturing a plant, smiling at strangers and cutting television viewing by a half. This need for a role is particularly powerful when combined with membership of a group, such as employment, volunteering, or membership of a group of hobby or sport enthusiasts. Studies of centenarians show that, alongside a degree of genetic luck, they are more likely to report good and regular social and family relationships. Furthermore, they tend to be happy people with a degree of emotional resilience and a good sense of humour, with and a zest and delight in life. Many studies also suggest that centenarians tend to be interested in intellectual activities, and hobbies, including playing musical instruments.
 
So, our mental states clearly are worth looking after, even if simply in terms of physical health. So can we teach happiness? To some extent, yes. We can certainly advise people of what we know about what seems to make people happy, without going anywhere near the creation of Happiness Squad at the thought-police. Individuals could be better educated to spot depression and stress, and consider to what extent those factors are environmental and changeable. People can be taught to consider how physical exercise, diet, community, belonging, family, friendship, hobbies, team and/or group membership and a sense of self-worth could enrich life and offer escape routes from unhappiness.
 
It is interesting that the Government’s recent (and possibly since mothballed) ‘Respect Agenda’ was borne out of perceived voter frustration and anger about the simpler aspects of life – vandalised neighbourhoods, incivility, and a desire for freedom from unnecessary anti-social behaviour. In the light of how stress, self-worth and the human tribe affect us, it seems true that such ‘aesthetics’ therefore deserves real, meaningful attention from policy makers, and we should ignore the sceptics.

Lord Layard would also be well advised to consider the key role of early life in shaping the mental and physical health of tomorrow’s adults. Shockingly, the UK came last in a recent UNICEF European survey of child happiness. What was the secret of the winners, the Netherlands, at no.1? A caring a protective environment at home and the school, and putting time with your children first over the office. Not a finding that sits well with the UK’s long hours work culture.

Obviously, we can’t all end up as CEOs or Oscar winners. Someone has to do the less exciting day-to-day tasks that keep our society running. But a more ideal society designed to better respect our innate human need to feel useful and meaningful and better support us when forming relationships, families and groups, would seem to offer everyone the best possible shot. How we do this is, of course, is a big enough question to keep us occupied for several generations to come. And although we are quite some ways from working it out, at least we have the hard facts to make us realise we ought to start.

Ed Harding