Population Ageing: Pomp or Circumstance

Dylan Kneale, Mark Mason, Sally-Marie Bamford

April 2012 ww.ilcuk.org.uk

The International Longevity Centre - UK (ILC-UK) is an independent, non-partisan think-tank

dedicated to addressing issues of longevity, ageing and population change. It develops ideas,

undertakes research and creates a forum for debate.

The ILC-UK is a registered charity (no. 1080496) incorporated with limited liability in England

and Wales (company no. 3798902).

ILC–UK

11 Tufton Street

London

SW1P 3QB

Tel: +44 (0) 20 7340 0440

www.ilcuk.org.uk

This report was first published in April 2012

© ILC-UK 2012

Acknowledgements

This report was researched and written by Dylan Kneale, Mark Mason and Sally-Marie Bamford

(ILC-UK). It was funded by an unconditional grant from Alliance Boots. ILC-UK has editorial

responsibility for this publication, and for any errors or omissions.

We are grateful to Trinley Walker and Lyndsey Mitchell for research assistance and assistance

with formatting. We are grateful to Professor David Taylor (UCL) and to Andrew Bonser for

assistance with question design and for stimulating discussions. Fieldwork was carried out by GfK-

NOP, although any mistakes or inaccuracies in the analysis are the responsibility of ILC-UK as are

any errors in the question design. Feedback is welcome and any comments will be gratefully

received (dylankneale@ilcuk.org.uk).

Table of Contents

Executive Summary ................................................................................ 4

Introduction ............................................................................................. 7

Data and Methodology .......................................................................... 12

Healthier Ageing and a Healthy Society ............................................... 14

The Economics of Living Longer ......................................................... 21

Is the UK an ageing population ............................................................ 27

Summary and discussion ..................................................................... 31

References ............................................................................................. 33

Appendix ................................................................................................ 36

4

Executive summary

Introduction

The UK’s population is unquestionably ageing, leading to anticipated social changes that are

already becoming apparent in policy. Health and the workplace are two areas of major projected

change. While there is some degree of understanding of people’s attitudes towards older people,

which are almost invariably negative, there is less understanding on people’s awareness and

attitudes on some of the macro-level changes associated with an ageing society.

Data and Methodology

This report examines some of these issues through specially commissioned polling data as well as

employing data from the British Social Attitudes Survey. We use a combination of bivariate and

regression analyses to offer insight on public attitudes towards: health and personal responsibility

for health; older people and the workplace; as well as general opinions on an ageing society.

Results

Health behaviours and healthy ageing

Most people (almost nine-in-ten) believe that if people stop smoking and eat a balanced diet, they

can not only live to an older age, but live a healthier life in old age.

Control over health

Most people (just over three-quarters) believe that they are in charge of their own health more than

other parties including the government, their hospital or GP. People in lower social classes are

around 40 per cent less likely than those in the highest social class to agree that they are more in

charge of their own health more than other parties including the government, their hospital or GP,

after controlling for other factors.

Healthy ageing and control over health

When we combine information on health behaviours and perceptions of who is in charge of day-to-

day health, we find two-thirds of adults are categorised as being both ‘aware’ (that a healthy

lifestyle can lead to a healthier old age) and ‘in charge’ of their health (of their day-to-day health

compared to other parties such as the government, hospital or GP). Those who are in the

youngest age groups and who are in the lower social classes are those least likely to fall within the

‘aware and in charge’ group and may be those who may be naturally least prepared for an era of

personal responsibility for health.

The future of the NHS in an ageing society

Almost half of adults (45%) believe that the NHS will not be able to provide a service that is free at

the point of use because of population ageing. One of the strongest predictors of whether people

5

thought the NHS would change in delivery because of population ageing was their attitudes

regarding their own influence over their day-to-day health. Respondents who thought that they

were in charge of their day-to-day health more than other parties were 50 per cent more likely than

those who did not to also express scepticism over the future continuation of the NHS, after

controlling for other factors.

Living and working longer

Should people work longer before claiming the state pension?

Just over two-fifths of people agree that because people are living longer and healthier it is right

that people work longer before they can claim a state pension by age group. People aged 45-54

years and people in social class C2 (‘skilled working class’) are those least likely to agree with this

sentiment above.

Older people and economic prosperity

Only one in six people agree that retired people play no part in the economic prosperity of the

country (17%). Social class continued to significantly pattern responses after accounting for other

factors (listed in the data and methods section), and those in the lowest social class were twice as

likely as those in the highest social class to agree that retirees play no part in the economic

prosperity of the country.

Older people and economic competitiveness

Almost two-fifths of adults think that the UK’s ageing population is a threat to our economic

competitiveness with other nations (38%). Responses to this question were significantly influenced

by other attitudes to the economic impact of living longer, although were not statistically

significantly influenced by socioeconomic and demographic factors.

Perceptions of an ageing society

How many older people can we expect in the future?

Over three-fifths of adults indicated that the proportion of oldest old (85+ years) in 2050 would lie

between 3-10% (62%); these were close to the projected estimate of 6 per cent. One-in-ten people

did not think that the proportion of older people aged 85 and above would rise from the current two

per cent, while a further one-in-ten respondents thought that as much as a quarter of the

population would be aged 85 and over in 2050.

Are we overestimating the impact of an ageing society?

Just over two-fifths (42%) of the population think that as a society, we overestimate the impact of

an ageing society. This perception did not vary statistically significantly by socioeconomic and

demographic characteristics.

6

Summary and Conclusions

The title of this report, ‘Population Ageing: Pomp or Circumstance’, refers to the debate as to

whether the public believe that population ageing is pomp (or hype) or is circumstance. Perhaps

the most direct evidence on this issue comes from agreement with the statement ‘as a society, we

overestimate the effect of an ageing society’. We can observe that over two-in-five adults agree

with this statement.

A report launched in conjunction with this paper (Gill and Taylor 2012) critically examines this

issue in a broader sense, and questions whether the ‘apocalyptic’ demographic scenarios that are

sometimes predicted will become reality. The results in this paper suggest that public opinion does

often tend towards a similar view in a number of cases. Further positive glimmers do appear

among attitudes to planning an older Britain of the future through high levels of understanding of

the link between healthy behaviours and living longer and healthier, and flexible attitudes towards

older people and the workplace, particularly among younger people in the latter case. Our results

also give some cause for consideration, as we find that those in lower socioeconomic groups may

also be those least prepared for new policy directions aimed at improving the health of our ageing

population, particularly in terms of taking greater personal responsibility for health.

Overall, our results also highlight the complexity among the attitudes held on an ageing society.

The results in this report suggest that in reality, as with many social issues, the consequences of

an ageing society are framed through political debate leaving a complex, and sometimes fraught,

process for the public in disentangling the facts from the fiction.

7

Introduction

The ageing UK population has been central to discourse among demographers for some time,

impacting on the decisions of policy-makers and seeping into the public consciousness in recent

years. However, the debates have reached something of a crescendo lately, as some of the

implications of an ageing society, such as a lower dependency ratio and higher numbers of

retirees, are manifested through changes to the pensions system and proposed changes to the

funding of long-term care. These changes, pertaining as much to an ageing society as to older

people per se, have received much attention from policy-makers and the media, bringing the issue

of population ageing to the forefront of the public’s attention. Greater numbers of older people are

an outcome of an ageing society; however, the macro-level changes that results from an ageing

society will affect members of all ages, and not just older people. In this respect, understanding

public opinion on an ageing society is related, although somewhat distinct to understanding public

opinion on older people. While public opinion on older people may reflect attitudes to

discrimination or having older neighbours for example, attitudes on population ageing may reflect

concerns about wider economic and social changes that follow an ageing society, and may reflect

the decision and choices we all have to consider as a result of the UK’s changing demography.

However, as is expanded upon below, there is a shortage of evidence that examines this theme,

as well as the interrelatedness of perceptions of an ageing society and older people. This report

provides some new indicative evidence on these themes. The collection of longitudinal (or time-

series) information, beyond the scope of this study, will enable researchers to link changes in

opinion to shifts in the debate on an ageing society; the evidence presented in this report provides

a snapshot of opinion from a week at the end of March 2012 and instead provides a valuable

stepping stone for further research into this area.

Public perceptions on older people

People’s perceptions of age and ageing affect all members of society and they have an impact on

everyone, shaping people’s views about themselves and others. These perceptions in turn have

important implications for individual welfare, social equality and inclusion. Perceptions of older

people have been described as diverse, complex and multivariate (Lyons, 2009). In public

discourse older people are commonly represented according to their age and are often negatively

portrayed. A UK study in 2002 reported that older people felt not only under-represented on the

television, but the few portrayals there were of older people were ‘marginal’ or stereotypical – older

people were seldom at the heart of key storylines or blended to the background through an

adherence to conventional portrayals (Healy and Ross 2002). Another study in 2004 conducted by

TNS for Age Concern revealed a perception among a majority of adults (58% per cent of those

aged 16 and over) in Great Britain that newspapers and television portray older people in a

predominantly negative way (Age Concern 2004). Such negative discourse, or the absence of

older people, particularly pervasive in the media and public parlance, has led to reductive

conceptions of older people’s identity based on the themes of ‘burden’, ’dependency’ and

‘vulnerability’. If we consider the representation of the ageing population more widely, this has also

become synonymous with pejorative phrases such as ‘demographic time bomb’ or ’rising tide’,

thus giving rise to and engraining discriminatory and negative attitudes towards older people.

8

The discernible tendency to treat older people as a monolithic entity is not only a descriptive

misrepresentation, but theoretically flawed in that it effectively ignores the plurality of our affiliations

and attachments as individuals involving class, gender, profession, language, science, sexuality,

morals and politics. Being old has become an all-purpose explanation eschewing the complex

realities of an individual’s myriad attachments and affiliations by the simplifying process of

stereotyping. A study on the ‘voice’ of older people suggests there is little evidence that the

widespread perception of the older population as a homogeneous entity is shared by older people

themselves, or is backed up by the evidences (Help the Aged 2009). Simplistic views of older

people may provide a shorthand label, but critically the individuals concerned invariably fail to

recognise, or adhere to, the prescribed characterisation.

Such perceptions of older people can and do have positive and negative impacts in a wide range

of interactions such as contact with family, friends and members of the community. These

perceptions impact on older people in employment, education, health services and daily life. While

people seem to disapprove of ageism there is evidence to suggest that it is experienced widely

and is manifested in an array of different ways (Abrams, et al, 2009). HSE (2009) highlighted how

people’s negative attitudes and perceptions can have an important impact on older people’s lives:

‘Ageism and ageist attitudes are not the sole factors contributing to elder abuse but can give rise to

a culture which creates a fertile environment in which elder abuse can develop, leading to age

discrimination, and devaluing and disempowering older people’ (HSE, 2009, p.21)

This becomes even more important considering the changing nature of the UK’s demography and

there is now a clear need to understand these attitudes are formed and how they are shaped (e.g.

Narayan, 2008; Raman, et al, 2008). Lyons (2009) found that age, gender, level of knowledge,

culture, modernisation and the media all play a role in shaping people’s perceptions (of ageing and

of older people), although perhaps the most important of these is personal multi- and

intergenerational contact (Abrams, et al, 2009; Lyons 2009). While people in mid-life may have

friends who are younger than 30 and older than 70, less than a third (28%) of people within those

two age ranges have regular contact with people in the other; as a result it is not surprising that

misconceptions prevail.

Further work is required to understand attitudes towards older people in society, particularly as the

expected contribution of older people is undergoing change through initiatives such as the Big

Society and through changes in workplace policies. Until there is clear and reliable evidence on

the perceptions of ageing, and the outcomes of these perceptions, then successful interventions to

promote a more positive view of ageing may not be successful (Allan & Johnson, 2009; Arnold-

Cathalifaud, et al, 2008). Part of this gathering of evidence may involve the exploration of both

attitudes to older people as well as attitudes to an ageing society, and examining any potential

distinctions between these areas. While attitudes towards an ‘ageing society’ and ‘older people’

are clearly interrelated, framing debates through the lens of an ageing society as opposed to older

people may lead to different results. It is possible to imagine that macro-level debates on

population ageing may lead to different responses in attitudes to debates surrounding older people

per se. In addition, different components of the consequences of an ageing society, such as the

health or economic aspects, may elicit substantially different responses in public opinion. Such

opinion is also liable to rapid change as a result of actual or proposed changes in policy, or

9

circumstances or events such as the recession. The need to understand some of these issues

through recent and representative evidence is one of the motivators for this study. Consequently,

we explore some of the extant evidence on public opinion in the areas of health and longer life, as

well as extended working lives, below, while in the remainder of this report we present evidence

from a nationally representative polling exercise that included questions on these as well as

broader perceptions of an ageing society.

Health ageing and public perceptions

With the ageing structure of national and local populations it is becoming increasingly important for

policy makers and professionals to promote healthy ageing (Alongi, Benson, Harris, Moore, &

Aldrich, 2009; Räftegård Fäggren & Wilson, 2009; World Health Organization, 2002). Healthy

ageing is a broad concept which aims to develop and maintain optimal health and well-being in

older adults. It has been more specifically defined by Räftegård and colleagues (2009) as ‘the

process of optimizing opportunities for physical, social and mental health to enable older people to

take an active part in society without discrimination and to enjoy an independent and good quality

of life’.

However the perception of what constitutes healthy ageing is not straightforward. There have been

observed differences among different groups, nationally and locally. For example, Laditka, et al

(2009) asked focus group participants across the USA to consider what ‘ageing well’ meant to

them. They found important differences depending on the ethnicity of the participants. In the case

of Chinese-Americans, participants were more likely than other ethnic groups to consider healthy

ageing to be represented by cognition and physicality (a healthy mental outlook and physical

abilities); Vietnamese-American participants were less likely than other ethnic groups to

emphasize independent living (stressing instead positive social inter-generational integration);

finally, Native Americans did not relate ‘ageing well’ to anything connected to diet or physical

activity (they stressed leisure activities as important in healthy ageing). Such differences across

ethnicity, region or country, or socioeconomic group may also prevail in the UK context.

Some researchers have explored behaviour as well as attitudes, creating a number of typologies

of older people in the general population based on a combination of these. Huy, et al (2010)

identify three different styles of health behaviour among older adults including those identified as

‘fit and performance-hungry’ who engage in more regular exercise and were more likely to follow a

healthy diet; ‘conventional’ older people were those who believe that exercise and healthy eating

were positive towards health, but were engaged less frequently in healthy behaviours, while ‘easy-

going and committed’ people were those who viewed physical exercise and diet as important but

not key to health and fitness in old age. A group that did not view exercise and diet as unimportant

was not explicitly identified, although those in the latter ‘easy going and committed’ group were

those who placed less important on health behaviours. They found that the different identified

groups followed diets which matched their health beliefs, so the more that people believed in

positive health behaviour (such as regular exercising and non-smoking), the more likely they would

be to undertake them. While establishing a link between attitudes and behaviour may ostensibly

appear to adhere to conventional wisdom, understanding typologies of older people in this was is

useful for targeting and intervention.

10

Arguably, however, good health in older age is a product of healthy behaviour across the

lifecourse. For example, studies of centenarians show that healthy behaviours, such as moderate

intake of alcohol, good diet, not smoking, and regular exercise, not only increase the chances of

surviving to a hundred, but are also linked to improved health status on becoming a centenarian

(Hitt et al, 1999, Engberg et al, 2009, Galioto et al, 2010). It is therefore important to understand

the depth of knowledge of the link between healthy behaviours and healthy ageing across different

age groups (and other social groupings). This is of particular relevance in the current policy

landscape of increased personal responsibility for health. Recent statements from the current

coalition government place a renewed emphasis on people to take charge of changing their own

behaviours to improve the prevention of ill-health, as opposed to relying on state intervention and

treatment. Public health campaigns, such as the ‘Change for Life’ campaign, have developed to

inform the public on the results of adopting healthy behaviour on long term health outcomes.

However, while public health campaigns may improve levels of knowledge, the stress on personal

responsibility for health may be met with limited success among groups that do not feel in charge

of their own health destinies. Recent work demonstrates the multifaceted nature of public

perceptions of the value of public health intervention campaigns, with the results indicating that

lifestyle related interventions were given less weight by the public compared to other intervention

types (Singh et al 2012). A further layer of complexity is added when the effectiveness of

interventions is considered, which is likely, in part, to depend on the amount of control that people

feel they have over their own health. These are issues that we present indicative evidence on in

this report through the results of questions on ‘whether people feel in charge of their day-to-day

health’ as well as whether people are aware of the links between ‘stopping smoking and eating a

balanced diet and not only living to an older age, but also living a healthier life in older age’. We

also examine the way that population ageing specifically might impact on the public perception on

health services through a question on the continuation of the NHS as being free at the point of use

in the future.

Public perceptions on the role of older people in the

workplace

There is a growing body of research that signals a positive relationship between older workers and

measures of performance and productivity at work (e.g. Pitt, et al, 2008; Ng and Feldman, 2008;

Meadows, 2004). However the public perception of older people in the workplace is often mixed

and older people are seen as possessing wisdom and reliability while at the same time being seen

as less productive than younger people, resistant to change, and slow to learn (e.g. Thornton,

2002; TNS, 2012). Research by Age UK (2011) across Europe discovered relatively high levels of

negative perceptions of older people in the workplace, with the majority of respondents surveyed

saying they would find it easier to accept a 30 year than a 70 year old as their manager even if

both were equally qualified. Furthermore, around half of all respondents over 50 felt that employers

would always hire a person in their 20s rather than someone older. This level of perceived ageism

was recently supported but the Eurobarometer report on ‘Active Ageing’ which found that the

proportion of respondents reporting age discrimination as ‘quite rare’ had fallen from 52% in 2008

to 37% in 2012, with 58% now regarding it as ‘widespread’. The rise was identified as being driven

by the rising proportion of respondents in their 40s who were increasingly encountering age

11

discrimination. One explanation for high levels of negativity towards older people in the workplace

could be related to instances of economic scarcity, where older workers as are viewed as

competition to younger workers (HSBC, 2006). The effects of the financial crisis and the protracted

recovery may serve to heighten such opinion.

However attitudes and perceptions among employers and younger workers potentially keeping

older workers out of the workplace could be counter-productive. With the ageing population comes

a shifting of the ‘worker –retiree ratio’ where fewer people of current working age will be active in

the economy to support those receiving pensions. One of the potential ways of offsetting the costs

associated with an ageing population is to extend individuals working lives for as long as possible.

This might be done by raising the retirement age, pension reforms, or supporting initiatives which

aim to keep employees in the workforce for longer (e.g. Euwals, De Mooij & Van Vuuren, 2009), or

bring them back into the workplace through initiatives such as ‘career re-entry schemes’ (e.g.

Mutual Learning Programme). The majority of respondents to the 2012 Eurobarometer on ‘Active

Ageing’ felt that there was no need for a compulsory retirement age, with a third (33%) said they

would like to continue working beyond retirement (this varied most significantly by education, with

those having a higher level of education wanting to work for longer). There was also a general

level of support for the possibility of combining part-time work with partial pension (which almost

two thirds of Europeans felt would be preferable to full retirement). However this was not the case

among all European countries, suggesting strong cultural differences in the perceptions of older

adults in the workplace. In addition, recent changes in the age of eligibility for the UK state pension

makes further exploration of the UK context particularly pertinent.

However, limiting opportunities for an early exit from the work place, or incentivising working for

longer might only be part of the solution, particularly when employers are often sceptical about

measures imposed by government (van Dalen, et at, 2010). Perhaps the main challenge for hiring

and retaining older people in the workforce is one of perception. Without changes in the

perceptions of employers and workers on older colleagues, any intervention aimed at coping with

an ageing workforce is unlikely to be effective (van Dalen, et at, 2010). As a result employers need

to consider how negative perceptions of older people in the workforce might impact on their ability

to retain and, or hire, older employees (Vickerstaff, Cox and Ken, 2003). We begin to explore

these and other issues, through a limited number of questions presented to a survey of 1000

individuals, and further outline the methods below.

12

Data and Methodology

Commissioned survey

In March 2012, almost 1000 adults from across the UK were questioned on three interrelated

topics around healthy ageing and personal responsibility for health, older people and working

longer, as well as general perceptions about an ageing society. These questions are found in table

1 and mainly consisted of attitudinal statements developed in conjunction with Alliance Boots and

Professor David Taylor (UCL).

Table 1: Questions for survey on Population Ageing

Statement/Question Response

Healthy Ageing/Personal Responsibility

If people stop smoking and eat a balanced diet, they can not only live to an older age, but also

live a healthier life in older age.

Agree/ Do not agree

I can influence my own day-to-day health more than any other party can, for example the

government, my local hospital or my GP.

Agree/ Do not agree

Because of population ageing this country is unlikely to be able to afford a universally available

NHS free at the point of use in years to come

Agree/ Do not agree

Economics of Ageing

Because people are living longer and healthier than ever before, it is right that people should

work longer before they claim a state pension.

Agree/ Do not agree

Once you are retired, you no longer play a part in the prosperity of the country Agree/ Do not agree

The high number of older people in the UK makes the economy less competitive compared to

countries with a low number of older people.

Agree/ Do not agree

Perceptions of an Ageing Society

Currently, around two per cent of the population in the UK is aged 85+. What percentage of the

UK population do you think will be aged 85+ in 2050?

Three per cent; Six per

cent; Ten per cent; Fifteen

per cent; Twenty five per

cent

As a society we overestimate the impact of an ageing society. Agree/ Do not agree

In addition, data were supplied on respondents’ gender, region/country of residence, age group,

marital status, economic activity and social class. We simplified region/country of residence to

reflect Northern England, Southern England, Wales, Scotland and Northern Ireland. Economic

activity reflected whether respondents were either working full-time, part-time or not at all. Social

class grouped respondents through the National Readership Survey classification system as being

upper or middle class (AB), lower middle class (C1), skilled working class (C2) or working class

(DE). Social class is based on the occupation of the chief income earner in the household. For

those who are unemployed, social class reflects the previous job if the length of unemployment is

less than 6 months, but is categorised to ‘E’ for those who are unemployed for longer than 6

months. For those who are retired, social class is based on previous occupation for those in

receipt of a company pension, although for those living on the state pension alone they are

categorised to ‘E’.

13

Methods

We utilised a combination of bivariate and regression analyses to investigate the results. Bivariate

analyses were conducted through cross-tabulation techniques and interpretation of measures of

association. Regression analyses were conducted through either logistic regression models for

binary outcomes or through multinomial logistic regression models for categorical outcomes. We

pay consideration to some patterns that may be conventionally deemed as borderline statistically

significant (p<0.08), in addition to those that fall within the traditional five per cent cut-off point. One

caveat of the results worthy of highlighting here is the relatively low statistical power from a sample

size of 1000 and the increased potential to fail to reject a false null hypothesis. A fuller set of

caveats is outlined in the appendix. Results were analysed using weights provided by GfK-NOP

and all analyses were conducted by ILC-UK1.

Additional analysis

In addition to results from our own survey, we also employ some data from the British Social

Attitudes Survey (BSA) (2010). This is a survey of a total of 3,200 respondents that are

representative of the population of Great Britain. Not all questions are put to all respondents, who

were randomly selected to receive one of three versions of the survey which included a mixture of

questions common to all three versions as well as some that were specific to that version.

Consequently, closer to 1000 responses were received for some questions. We consider the

following questions in the report, and explore a similar range of factors to those outlined above

including marital status, working status, country/region, age, sex and class. Our derivation of class

attempts to mirror that outlined above, although may differ in the treatment of some groups (see

Stafford 2010 for details for the BSA).

Statement/Question Response N

If I needed the money, I would continue working 1-2 years past age65. Strongly Agree; Agree,

Neither Agree or

Disagree, Strongly

Disagree, Don’t Know

1,686 (asked of only

those in work

Older workers who want to continue working after age 65 should be allowed

to work

See above 3,287

Let older workers who want to continue working with the same employer

after

See above 3,275

1 Any mistakes or inaccuracies in the analysis are the responsibility of ILC-UK as are any errors in the question design

14

Healthier Ageing and a Healthy Society

Can people influence their health and live a healthier older

age?

Most people (almost nine-in-ten) believe that if people stop smoking and eat a balanced diet,

they can not only live to an older age, but live a healthier life in old age.

Data from a representative sample of UK adults show that the majority of people agree that ‘if

people stop smoking and eat a balanced diet, they can not only live to an older age, but live a

healthier life in old age’. Almost nine-in-ten people surveyed (88%) agreed with this statement,

although one-in-ten people did not agree (12%). There were few socioeconomic or demographic

factors that statistically significantly influenced response patterns. Region did exert some influence

over response patterns, with people in Scotland less likely to agree (81%) that people’s lifestyle

could enable them to live a longer and healthier older age than other regions, and those in Wales

more likely to agree (94%); while regional effects as a whole contributed little to explaining

response patterns, the difference between Welsh and Scottish people’s attitudes on this factor did

achieve borderline statistical significance – a larger sample may have detected stronger

differences.

How much relative influence do people feel they have on

their health?

Most people (just over three-quarters) believe that they are in charge of their own health more

than other parties including the government, their hospital or GP.

Social class and age are two significant influencers on the way people perceive their degree of

control over their own health

People in lower social classes are around 40 per cent less likely than those in the highest

social class to agree that they are more in charge of their own health more than other parties

including the government, their hospital or GP, after controlling for other factors.

People aged 45-64 years are around twice as likely as younger people aged 16-24 years to

agree that they are more in charge of their own health more than other parties including the

government, their hospital or GP, after controlling for other factors.

Survey participants were asked whether they exerted greater influence over their own day-to-day

health more than any other party, for example the government, local hospital or GP. This question

was formed in response to a greater emphasis on personal responsibility in public health policy

with the expectation and that the public become more active consumers in taking care of their own

health. Overall, three-quarters of respondents believe that they are in charge of their own health

more than other parties (76%). Bivariate analyses indicated that several factors did statistically

influence response patterns to this question, although these differences were not always

statistically significant. One factor that did statistically significantly influence was social class

15

(p<0.10), with those who were in the top social class most likely to agree that they were in control

of their health more so than external influencers (social class A/B: 82%) compared to those in the

lowest social class (social class D/E: 73%). We also found differences of a similar magnitude in

terms of age, with those in the youngest age group least likely to feel that they could influence their

health more than other influencers (16-24 years: 71%) and those approaching retirement (55-64

years) most likely to feel that they could influence their own health more than other parties (81%).

Response patterns by a number of factors are presented in figure 1 below.

Figure 1: Percentage in agreement they are in charge of their day-to-day health more than any other

party, for example the government, hospital or GP. (Weighted data)

When we model these factors simultaneously (table 2), we find that those who are in older age

groups, particularly those in older working age and approaching retirement (45-64 years) were

around twice as likely than those in the youngest age group (16-24), even after controlling for other

characteristics, to agree that they were in charge of their own health more than other parties, such

as the government, hospital or GP. Similarly, those in social class C2 and DE (commonly referred

65% 67% 69% 71% 73% 75% 77% 79% 81% 83% 85%

16-24

25-34

35-44

45-54

55-64

65+

AB

C1

C2

DE

Scotland

England - North and Midlands

England - London, South and East

Wales

Northern Ireland

Married/Cohabiting

Single

Widowed/Divorced

Full-time working

Part-time working

Not working

Male

Female

Age

Cla

ssR

egio

nM

arita

lS

tatu

sW

orki

ngst

atus

Gen

der

I am in charge of my own day-to-day health more than any other party: percentage in agreement

16

to as working class) are around 40 per cent less likely than those in social class AB (commonly

referred to as upper middle and upper class) to agree that they have more influence over their

health.

Table 2: Output from logistic regression model of respondent being in agreement they are in charge of

their day-to-day health more than any other party

I’m in charge of my own

health more than other parties…

Age (baseline 16-24)

25-34 years 1.204 [0.63,2.29] 35-44 years 1.662

[0.88,3.13] 45-54 years 1.752

$

[0.92,3.35]

55-64 years 1.987*

[1.04,3.81] 65+ years 1.215

[0.60,2.45]

Social class (baseline AB)

C1 0.655 [0.41,1.05] C2 0.606

*

[0.37,0.99] DE 0.588

$

[0.34,1.03]

Country/Region (baseline Scotland)

England – North/Mids

0.969 [0.54,1.75]

England – South, East, London

1.233 [0.68,2.23]

Wales 0.962

[0.40,2.29] Northern Ireland 1.474 [0.48,4.53]

Marital Status (baseline: In a relationship)

Single 0.918 [0.60,1.40]

Widowed/Divorced 0.738 [0.46,1.17]

Gender (Baseline: Male)

Female 0.942 [0.68,1.31]

Work Status (Baseline: In Full-time Work)

In part-time work 1.066 [0.64,1.78]

No in work 1.231 [0.78,1.93]

N 999.000

Exponentiated coefficients; *significant at 5% level;

$significant at 10% level; Weighted data

Taking charge of health: interrelatedness of indicators

Those who are in the youngest age groups, who were previously in a relationship, and who are

in the lower social classes are those least likely to fall within the ‘aware and in charge’ group.

o 62 per cent of people aged 16-24 fall within the ‘aware and in charge’ group compared

to 75 per cent in the 55-64 year group

17

o 75 per cent of those in the top social class (AB) were classed as ‘aware and in charge

compared to 63% in social class C2.

These are groups who may be the least prepared for an era of personal responsibility for

health.

We would expect some degree of association between those who felt that adapting lifestyle factors

would lead to a healthier life later on, and those who believed that they were more influential over

their day to day health than other parties (including the government, local hospital and GP). Those

who agreed with both statements may be those who we could hypothesise are most likely to follow

the advice of public health campaigns and/or health related initiatives and take steps to look after

their own health. When we combine the information, we find that the majority (two-thirds) of the

overall sample agreed with both statements; we label this group as those who believe that their

health can be influenced and is most influenced by their own actions, the ‘aware and in charge’.

Unusually, we found that there wasn’t a strong association between the two indicators with, for

example, those who believed that they were in charge of their own health more than other parties

being no more likely than those who didn’t also agree that a healthy lifestyle can lead to a healthier

old age. However, when we examine the probability of being ‘aware and in charge’, finding through

bivariate analyses, that those in higher social classes were more likely to be both ‘aware and in

charge’ than people in lower social classes, as were those who were single, and, in comparison to

those aged 16-24 years, those who were aged 55-64 years. We present this descriptive

information on these factors in table 3 below.

Table 3: Proportion who fall within ‘aware and in charge’ group by selected characteristic

Factor % Factor %

Age Group

16-24 years 61.9%

Social Class

AB (Upper and Upper Middle Class)

74.5%

25-34 years 66.6% C1 (Lower Middle Class) 65.5%

35-44 years 68.5% C2 (Skilled Working Class) 63.2%

45-54 years 65.4% DE (Working Class) 64.0%

55-64 years 75.3%

65+ years 62.8%

Marital

Status

Married/ Cohabiting 67.1%

Single 68.8%

Widowed/Divorced/Separated 65.4%

Again, this information suggests that it is younger people in lower social classes who are least

likely to perceive their health as being in their charge and to associate healthy living with an

extended healthy life. We also construct a logistic regression model to analyse the effect of these

factors simultaneously with the results presented in the appendix. This model shows that people

aged 54-64 years were twice as likely to be ‘aware and in charge’ as those aged 16-24 after

controlling for other factors. People in lower social classes (C2 and DE) were also between 33-44

per cent less likely than those in the highest social group to be ‘aware and in charge’ of their health

18

in a regression model. Finally, marital status remained a significant predictor2, with those who had

been in a relationship but were no longer (widowed, divorced or separated) around 30 per cent

less likely than those who were in a relationship to be categorised in the aware and in charge

group.

From a public health perspective while it is encouraging that the majority of the sample do fall

within the ‘aware and in charge’ group, the results also signal that the likelihood of being in this

group remains significantly patterned by socioeconomic status, which are known to lead to

substantial health inequalities (for example Marmot 2010). These pronounced differences by social

group represent a substantial cause for concern as those in lower socioeconomic groups are

known to be most vulnerable to adopting negative behaviours (for example Mackenbach et al

2008, McMunn et al 2006). Furthermore early adoption of these behaviours is known to have

negative consequences across the lifecourse, reaching into older age. In addition, younger people

and those from lower socioeconomic groups are more likely to deem other parties to be in charge

of their day to day health, these groups are also likely to be those that engage the least with

healthcare providers (Mercer and Watt 2007). In summary, those who are at greatest risk of

adverse health outcomes are also those who are highlighted here as being unlikely to view

themselves as the prime influences of their day-to-day health status, and are less likely to view

good health in later life to rest on the adoption of healthy lifestyle behaviours. In an era of

increasing personal responsibility for health those who are younger and in lower social classes

may find the new ‘responsibility deal’ to be a significant challenge. However, two-thirds of adults

are categorised as being both aware (that a healthy lifestyle can lead to a healthier old age) and in

charge of their health (of their day-to-day health compared to other parties such as the

government, hospital or GP).

The future of a free health service

Almost half of adults (45%) believe that the NHS will not be able to provide a service that is free

at the point of use because of population ageing.

Those in the lowest social class3 and those in Northern Ireland are some of the groups who are

most likely to believe that the NHS will not continue in the same fashion in the future because

of an ageing population - over half of both groups express this attitude.

One of the strongest predictors of whether people thought the NHS would change in delivery

because of population ageing was their attitudes regarding their own influence over their day-

to-day health. Those who thought that they were in charge of their day-to-day health more than

other parties were 50 per cent more likely than those who did not to express scepticism over

the future continuation of the NHS after controlling for other factors.

Respondents were asked to consider the consequences of population ageing on the health

service. Specifically, they were asked whether they agreed with the statement that ‘because of

population ageing this country is unlikely to be able to afford a universally available NHS free at

the point of use in years to come’. There was an almost even split of responses among the adults

surveyed, slightly fewer agreeing with the statement (45%) than did not agree with the statement

2 At the ten per cent level.

3 Differences by social class achieved borderline significance which may reflect sample size.

19

(55%). While differences by age were relatively moderate, differences by social class were more

pronounced and borderline statistically significant (p<0.07), with those in the highest social class

least likely to agree with this statement (42%) and those in the lowest social class most likely to

(53%). Therefore, while those in the lowest social class are most likely to believe that the NHS was

likely to lose its status as being free at the point of usage, based on earlier evidence, they are also

least likely to perceive their day to day health as being in their charge compared to other parties.

This could relate to current cuts in health services that may be already be felt disproportionately

among those from lower socioeconomic groups. Regional differences were also apparent, with the

small number of respondents from Northern Ireland most likely to perceive the continuation of the

NHS in its present state as under threat from population ageing, while respondents in Wales were

the least likely to. There was also something of a North-South split within England, with those in

the North (North East, North West and Midlands, 48%) more likely to view the continuation of the

NHS in its present state as under threat compared to those in the South (East, South and London,

42%).

Figure 2: Percentage in agreement because of population ageing this country is unlikely to be able to

afford a universally available NHS free at the point of use in years to come. (Weighted data)

35% 40% 45% 50% 55% 60% 65% 70%

16-24

25-34

35-44

45-54

55-64

65+

AB

C1

C2

DE

Scotland

England - North and Midlands

England - London, South and East

Wales

Northern Ireland

Married/Cohabiting

Single

Widowed/Divorced

Full-time working

Part-time working

Not working

Male

Female

Age

Cla

ssR

egio

nM

arita

lS

tatu

sW

orki

ngst

atus

Gen

der

Because of population ageing this country is unlikely to be able to afford a universally available

NHS free at the point of use in years to come

20

When we considered the factors in figure 2 simultaneously, we found that country/region continued

to exhibit some influence in dictating responses. However, we also considered earlier results, and

examined whether perceptions of who was most in charge of respondents’ day-to-day health

(themselves or another party) were also significant predictors of people’s scepticism about the

ability of the NHS to continue to be free at the point of use in light of population ageing, and found

a significant association. Those who viewed themselves as being more in charge of their day-to-

day health were also those who were more likely to agree that population ageing would push the

NHS to charge at the point of usage (47%) compared to those who did not see themselves as

primarily in charge of their day-to-day health (38%). This could suggest that those who lay the

main responsibility for their own health on themselves do so alongside higher levels of pessimism

about the future of the NHS; this may even be related to current perceptions of the NHS, although

we are unable to explore such a notion here. When we model all factors simultaneously through a

logistic regression model, we find that this latter result holds, and that those who feel that they are

in charge of their day-to-day health are 50 per cent more likely (than those who do not) to think

that the continuation of the NHS being free at the point of contact is under threat due to population

ageing.

21

The Economics of Living Longer

Living Longer and Working Longer?

Just over two-fifths of people agree that because people are living longer and healthier it is

right that people work longer before they can claim a state pension by age group.

People aged 45-54 years and people in social class C2 (‘skilled working class’) are those least

likely to agree with this sentiment.

Despite the rapidly increased pension aged for women in the age group 55-64 years, they were

not significantly less likely than women of other age groups, or men of the same age group, to

agree that people should work longer before claiming a state pension.

When a representative population of UK adults were asked about their opinions on whether

‘because people are living longer and healthier than ever before, it is right that people should work

longer before they claim a state pension’, less than half agreed with this statement (42%). The

response pattern exhibited an unusual pattern by age group, with those in the youngest (16-24)

and oldest age groups (65+) most likely to agree with this statement (47% in both cases, figure 3).

Figure 3: Percentage in agreement because of population ageing it is right that people work longer

before they can claim a state pension by age group (Weighted data)

Social class significantly predicted response patterns, with those in the highest social class most

likely to agree that people should work longer before claiming a pension (49%) and those in social

class C2 (skilled working class) the least likely to (34%). People in Southern England (South, East

and London) were also more likely to agree (46%) than those in other countries/areas, for example

0.0%

5.0%

10.0%

15.0%

20.0%

25.0%

30.0%

35.0%

40.0%

45.0%

50.0%

16-24 25-34 35-44 45-54 55-64 65+ Total

Because of population ageing, it is right that people work longer before they can claim a

state pension (% in agreement)

22

Scotland (29%), that people should work longer before claiming the state pension, although

regional effects on the whole were not statistically significant4. While the age of eligibility for the

state pension has risen relatively quickly for women born 1950-1953 from 60 to 65 years (for

women aged 55-64 in this sample), there was no evidence that women in this age group were

significantly more likely to agree (or not to agree) with a rising pension age than women of other

ages or men of the same age. However, people aged 45-54 years, who will be among the first

group to see the pension age rise from 66 to 67 years, were those least likely to agree that people

should work longer. When we examine the effect of these factors simultaneously through a logistic

regression model (see figure 4 for depiction of odds ratios), we find that this latter age group

remained around half as likely to agree that people should work longer than those in the youngest

age group; similarly those in social group C2 were around half as likely to agree that people should

work longer than those in the top social group.

Figure 4: Odds of being in agreement that because people are living longer and healthier it is

right that people work longer before they can claim a state pension by age group (Weighted

data)

4 Sample size was perhaps a factor contributing to a lack of overall statistical significance.

0 1 1 2 2

16-24

25-34

35-44

45-54

55-64

65+

AB

C1

C2

DE

Scotland

England - North and Midlands

England - London, South and East

Wales

Northern Ireland

Married/Cohabiting

Single

Widowed/Divorced

Full-time working

Part-time working

Not working

Male

Female

Age

Cla

ssR

egio

nM

arita

lS

tatu

sW

orki

ngst

atus

Gen

der

People are living longer and healthier than ever before, people should work longer before they

claim a state pension: Odds of Agreement

23

Older people and economic prosperity

• Those who agree that retirees play no part in the economic prosperity of the country are in the

minority (17%).

• Social class continued to significantly pattern responses after accounting for other factors

(listed in the data and methods section), and those in the lowest social class were twice as

likely as those in the highest social class to agree that retirees play no part in the economic

prosperity of the country.

Less than a fifth of people (17%) agreed that once people retire, they play no part in the economic

prosperity of the country. This could suggest that the majority of the population view the unpaid

work that is often associated with older people, such as volunteering, caring and grandparental

childcare, as being necessary to the economic prosperity of the country. Interestingly, older people

themselves were the most likely to agree that retirees played no part in the economic prosperity of

the country (65+ years, 22% agree), while younger age groups were the least likely (<16% among

those aged 44 years and under), although this difference was not statistically significant. People in

the lowest social class were more likely compared to those in the highest to agree (DE group:27%

versus AB group:14%), as were those who were not working (including retired people: 24%)

compared to those who in some form of work (15-16%)5. Our use of logistic regression (see

appendix) showed that social class continued to be a significant factor in influencing people’s

perceptions about the country’s economic prosperity after controlling for a number of factors; those

in the lowest social class (DE: unskilled working class) were approximately twice as likely as those

in the top social class (AB: upper and upper middle class) to agree that retirees did not play a part

in the economic prosperity of the country.

Older people and economic competitiveness

Almost two-fifths of adults think that the UK’s ageing population is a threat to our economic

competitiveness with other nations (38%).

Responses to this question were not statistically significantly influenced by socioeconomic and

demographic factors, although were significantly influenced by other responses.

When we analysed responses to questions on whether people should be eligible for state

pension age at a later age and whether the UK demography interfered with the economic

competitiveness jointly, we found that most adults (57%) agreed with neither sentiment.

While only a minority of people thought that retirees held no part to play in the economic prosperity

of the country, greater numbers of people agreed that the high number of older people in the UK

makes the economy less competitive compared to countries with a low number of older people,

with almost two-fifth (38%) agreeing with this statement. Responses to this statement were not

5 Borderline significant results (p<0.06). Further investigations revealed that this difference was generally not attributable to age effects.

24

statistically significantly patterned by socioeconomic and demographic factors. There was,

however, a significant association whether people thought that older people should claim a state

pension later, and unsurprisingly, those who viewed older people as a restriction on the

competitiveness of the country were also more likely to think that people should claim the state

pension later (table 4). The largest group overall were those who do not think that people should

work longer before claiming a state pension and do not think the high number of older people

affects economic competitiveness (39% of adults) – to utilise language from the climate change

debate, these could be termed ‘demography deniers’ by some. The second largest group were

those that agreed that people should work longer before claiming the state pension, but did not

think that the (current) demography of the UK was detrimental to economic competitiveness (23%)

– these might be termed ‘population pragmatists’. The third largest group were those who agreed

that people should retire later and that the high number of people was damaging to the economic

competitiveness of the country (19%) – these may be deemed ‘ageing alarmists’ by some. The

fourth largest group were those who did not think that people should have to work longer before

claiming a state pension, but did think that the high number of older people interfered with the

economic prosperity of the country (19%) – these might be termed the ‘ageing pacifists’ by some.

Table 4: Association between attitudes of older people and economic prosperity

Because people are living longer and healthier it is right that people work longer before they can claim a state pension

Do not agree Agree Total

The high number of older people in the UK makes the economy less competitive compared to countries with a low number of older people

Do not agree

Weighted number 392.7 227.6 620.3

% within economic competitiveness

63.3% 36.7% 100.0%

% within retirement and prosperity

67.9% 54.2% 62.1%

Agree

Weighted number 185.9 192.2 378.1

% within economic competitiveness

49.2% 50.8% 100.0%

% within retirement and prosperity

32.1% 45.8% 37.9%

Total

Total weighted number 578.6 419.8 998.4

% total within economic competitiveness

58.0% 42.1% 100.0%

% within retirement and prosperity

100.0% 100.0% 100.0%

When we utilise analyse these categories further by socioeconomic and demographic factors, we

found some results that were statistically significant (at the 10 per cent level), with regional

differences (displayed below in figure 5) and differences by employment status becoming

apparent; these differences were not significant in a regression model.

25

Figure 5: Proportion of respondents in different categories based on responses to two attitudinal

questions by country/region (see guidance notes in text)

Older people and the workplace: evidence from other

sources

Data from the British Social Attitudes Survey shows that a high proportion of people were in

agreement that people should be allowed to work beyond the age of 65 (87%) and a similarly

high proportion of people would continue to work themselves beyond the age of 65 (89%) if

they needed to.

Data from the British Social Attitudes Survey (BSA, 2010) provides more indicative evidence on

people’s perceptions on older people and retirement policies. Our analysis shows that almost nine-

in-ten (89%) people agree or strongly agree that they would work for a short period past over 65 to

enhance their economic wellbeing. A similar proportion in the BSA (87%) also agreed or strongly

agreed that people should be allowed to work beyond 65, the default retirement age at the time the

survey was conducted6. However, the data collected for this report suggests that despite the

willingness of respondents in the BSA survey to engage in the labour market for longer for

individual gain, this does not necessarily impact on people’s perceptions of state pension age

eligibility; we find that only 42 per cent of respondents think it is right that people should have to

work longer before they are able to claim the state pension (as a result of gains in longevity). In

combination, both sources tend to suggest that while people agree that there should be flexibili ty

around older people’s participation in the labour market, the majority of people think that this

flexibility should not be at the expense of eligibility for the state pension; however, such a

6 This question was only asked to those in work at the time of the survey.

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Scotland England:North

England:South

Wales NorthernIreland

Total

Ageing Categories* by Country/Region *see text for guidance notes

Ageing Alarmists

Ageing Pacifists

PopulationPragmatists

DemographicDeniers

26

statement does come with caveats, many of which are outlined in the concluding section. In

addition, while data from the BSA suggests that there is support for allowing older people to

continue in the workplace, there was less enthusiasm for allowing older people to continue with the

same employer, with 63 per cent of respondents agreeing or strongly agreeing that older workers

(65+) who want to continue working with the same employer should be able to do so. This could

suggest that while the majority of people do agree with individual flexibility in terms of the ability of

older people to continue in the workplace, they are less sure how this flexibility should be afforded

in terms of employer policies.

Some interesting differences were also apparent in the BSA sample by age and class. Those

classified in the highest social class were more inclined to agree that they would continue to work

beyond the age of 65 if they needed the money than those in the lowest social class (92% (AB)

compared to 85% (DE)). However, those in the lowest social class were more likely to agree or

strongly agree that people over the age of 65 should be allowed to continue to work with the same

employer (64% (DE) compared to 58% (AB)), although there were no significant differences by

class in terms of agreement as to whether older people should be allowed to work over the age of

65 if they wanted to in general. Younger age groups were significantly more likely than older age

groups to agree or strongly that older people should be allowed to work over the age of 65 if they

wanted to (for example 93% of those aged 16-24 compared to 84% aged 65 and over). However,

younger and older attitudes did not significantly differ as to whether they would personally work

longer or whether they thought older workers should continue with the same employer.

Together, both the BSA data and data from our own survey point to some interesting trends by age

and class. We find that younger people are more likely than middle aged people to think that

people should work longer before claiming state pension, and are more likely than older people to

think that workplace policies should allow for older people to continue to work beyond the age of

65 years. However, it is not possible to disaggregate from these data whether this is an artefact of

a change in attitudes across different age cohorts, or whether this is a reflection of the way that

attitudes naturally change with age. In the case of social class, those in lower social classes were

less likely to think people should have to work longer before being eligible for the state pension

and were less likely to say that they would want to work beyond the age of 65 years themselves.

Several factors may explain these differences that are known to vary by social class, which are not

fully explored here, including differences in health and industry of occupation may alter people’s

ability to continue in the labour market.

27

Is the UK an ageing population?

How many oldest old will there be?

Over three-fifths of adults indicated that the proportion of oldest old (85+ years) in 2050 would

lie between 3-10%; these were close to the projected estimate of 6 per cent.

One-in-ten people did not think that the proportion of older people would rise from the current

two per cent, while a further one-in-ten respondents thought that as much as a quarter of the

population would be aged 85 and over in 2050.

Age was one of the few influencers over responses to this question; older people were more

likely to significantly overestimate the future population of oldest old while younger people were

significantly more likely to state that there would be no growth in this population.

Population ageing can be expressed through numerous current and projected statistics, including

the population of the ‘oldest old’ (aged 85 and over). Currently, just over 2% of the UK population

is aged 85 and over, although by 2050 the population is expected to rise to six per cent (Office for

National Statistics 2011), including over 300,000 centenarians. Respondents to the survey were

given the current proportion of the population aged 85 and over and were asked what the

proportion would be in 2050. Responses were clustered around six per cent (29%), and if we take

those who guessed either three or ten per cent, the next closest answers, over three fifths of

respondents gave an answer that was within a close range to the projected number (62%).

Interestingly, over one-in-ten people did not anticipate any growth in the population aged 85 and

over, while a similar proportion expected a quarter of the total population to fall within the ‘oldest

old’ age group.

To assist in our interpretation, we group respondents to reflect respondents that don’t anticipate

any growth in the population aged 85 and above (12% of the total responses), those that predict

growth within a reasonable range (62% of the total), those that predict exaggerated growth (22%),

and those were not able to provide an answer (5%). We examined how socioeconomic and

demographic characteristics influenced responses, finding a statistically significant trend for older

people to exaggerate the anticipated proportion of older people in the UK compared to younger

groups. For example, 26 per cent of those in the oldest group thought that older people aged 85

and over would account for 15-25% of the population in 2050, compared to 16% of those aged 16-

24 years. Conversely, almost a fifth (19%) of those in the youngest group thought that the

proportion of those aged 85 and above would not rise, compared to less than one-in-ten of those

aged 65 and over (9%). If we view responses to this question as an interpretation of perceptions of

different age groups have over the ageing population, it would appear that those in the youngest

group are least concerned and those in the oldest age groups most concerned.

Other socioeconomic and demographic factors did not appear to statistically significantly pattern

responses to this question, although we examined whether any of the effects described above for

age could be related to other characteristics through constructing a multinomial logistic regression

models (output in appendix). The results described above in terms of patterns by age generally

28

remained statistically significant (at the 10 per cent level). The model showed that the relative risk

of those in older age groups (35-44, 45-54, and 65+) to provide an ‘exaggerated’ response on the

future numbers of older people was around twice as high as those in the youngest age group (16-

24), even after accounting for several other factors (borderline significant)7. This may reflect the

higher levels of concern among older people on the issue of population ageing, which we explore

more in depth in the next section. We present proportions in each response group by age in figure

6 below, and the output from the model in the appendix.

Figure 6: Grouped response distribution to ‘what percentage of the UK population do you think will be

aged 85+ in 2050?’ by Age Group (see text for explanation of notes)

Are we overestimating the effect of an ageing society?

Just over two-fifths (42%) of the population think that as a society, we overestimate the impact

of an ageing society.

Despite the tendency of older people to estimate much higher levels of oldest old in the population

by 2050, older people were no more likely than younger people to think that as a society we

overestimate the effects of an ageing society. Over two-fifths of the total respondents did think that

we overestimated the effects of an ageing society (42%). However, unlike other areas explored in

the survey, responses to this question were not statistically significantly influenced by

socioeconomic or demographic variables. This suggests that the perception that we are

overestimating the effects of an ageing society is relatively widely held and distributed fairly evenly

between social groups; this perception may instead be determined by other factors, such as

7 Differences by age were borderline significant (p<0.10) in the multinomial model. However, if we simplify our independent variable to reflect

whether or not respondents gave an exaggerated answer, we find that some differences were also statistically significant at the five per cent level.

0.0%

10.0%

20.0%

30.0%

40.0%

50.0%

60.0%

70.0%

80.0%

16-24 25-34 35-44 45-54 55-64 65+

Grouped responses to anticipated percentage of oldest old in 2050 by age group

No change

Reasonable Change

Exaggerated Change

Don't Know

29

educational or personality characteristics, ethnicity, family structure, media exposure or political

persuasion. Similarly, had we have asked whether society or government is prepared for an

ageing society, we may have garnered a very different response distribution. However, the

response to this question suggests that policies aimed at helping society respond to an ageing

society, such as raising of the pension age or new proposals to fund social care in the future, may

be viewed as unnecessary by a fairly large proportion of adults from all walks of life.

Summarising responses

Additional analyses reveal the complexity around measuring attitudes on ageing. We observe

differences in attitudes across different outcomes that may be affected by an ageing society.

We posit that concerns about an ageing society may be tied with wider concerns on some

societal issues, and further work is needed to untangle people’s attitudes towards an ageing

society specifically.

When we examined the relatedness of our indicators of people’s perceptions of ageing further, we

found some unexpected results. For example, we might have expected those who thought that it is

right that people should work longer because of an ageing society (those who see a problem and a

solution) to be much less inclined to also agree that we overestimate the impact of an ageing

society, although we found no evidence to support this notion here. Similarly, we may expect those

who think that population ageing is likely to interrupt the future continuation of the NHS in its

present form to also be less inclined to agree that we overestimate the impact of an ageing

society; in fact, we found a conflicting result where 48 per cent of those who thought population

ageing would interrupt the future continuation of the NHS in its present form also thinking that we

overestimated the effects of population ageing, compared to 38 per cent among those who did not

see population ageing as a threat to the NHS being free at the point of use (a statistically

significant difference). Furthermore, those who overestimated the proportion aged 85 and above

were also more likely to think that the effects of population ageing had been overestimated;

conventionally, we might expect those who give an inflated population estimate to also feel that the

impacts of an ageing society were actually underestimated.

Several reasons may explain these apparent discrepancies. One explanation may revolve around

the way people interpreted the final question on overestimating population ageing from a societal

level, given that many of the patterns suggest that some may have interpreted the question as

being about their own concerns about an ageing society. Similarly, questions about the NHS may

reflect concern and an emotive response from respondents about its future continuation in general,

as opposed to a direct reflection of ageing directly.

We had originally intended to combine some indicators to produce a single score to reflect

attitudes to an ageing population. However, apparent discrepancies suggest that understanding

the interrelatedness of the attitudes on ageing may require further investigation (with a larger

sample), as well as further refining (and piloting) of our questions and indicators. Moreover, these

results suggest that people’s attitudes to ageing may be sensitive in different ways to the future

numbers of older people, the economic consequences, the health consequences, and the

multitude of other domains affected by increased longevity. This analysis throws into doubt the

30

validity of a blanket statement or opinion on ‘the ageing’ population, and highlights some of the

complexities in attempting to understand people’s opinions on the impact of the longevity

revolution.

31

Summary and discussion

Summary

Health behaviours and healthy ageing

Most people (almost nine-in-ten) believe that if people stop smoking and eat a balanced diet, they

can not only live to an older age, but live a healthier life in old age. Similarly, most people (just over

three-quarters) believe that they are in charge of their own health more than other parties including

the government, their hospital or GP. Combined, these suggest that many people may be not only

aware of the health implications brought home by public health campaigns such as ‘Change 4

Life’, but also may be in a position to influence their own day-to-day health through feeling in

charge of their own health. However, these results also point to groups – the young and the less

socioeconomically advantaged – who are less likely to be receptive to movements towards

personal responsibility for health. At a time where people are expected to take greater personal

responsibility for their health, these results suggest that those from lower socioeconomic

backgrounds who already endure significant health inequalities, may be left behind.

Living and working longer

Just over two-fifths of people agree that because people are living longer and healthier it is right

that people work longer before they can claim a state pension by age group, which could suggest

that the majority of people disagree with changes to the pension system. This group varied by age

and social class so that people aged 45-54 years and people in social class C2 (‘skilled working

class’) were those least likely to think that people should have to work longer before being eligible

for the state pension. For the majority of people, retired people continued to play a part in the

economic prosperity of the country (83%), suggesting that most people do place an (economic)

value on the roles that are frequently adopted to retired people, for example volunteering or caring

duties. However, there was greater discord among respondents in terms of higher levels who

thought that the high numbers of older people in the UK were a threat to the nation’s economic

competitiveness (38%) signalling that while people do put an economic value on the role of older

people may take, this role may still not be perceived as (economically) valuable as the role

younger people and younger workers may take.

Perceptions of an ageing society

Over three-fifths of adults indicated that the proportion of oldest old (85+ years) in 2050 would lie

between 3-10%; these were close to the projected estimate of 6 per cent. However, one-in-ten

people did not think that the proportion of older people aged 85 and above would rise from the

current two per cent, while a further one-in-ten respondents thought that as much as a quarter of

the population would be aged 85 and over in 2050. Older people were more likely to significantly

overestimate the future population of oldest old while younger people were significantly more likely

to state that there would be no growth in this population. Crucially, just over two-fifths (42%) of the

population think that as a society, we overestimate the impact of an ageing society. For

organisations that aim to raise awareness of the impacts of rising longevity, and those

organisations that wish to encourage people to plan for the future, these results suggest some

degree of saturation or complacency among the public. The debate on population ageing has been

32

compared to the debate on climate change by some. Climate change deniers have become an

increasingly vilified group, although data from a Department for Environment and Rural Affairs

study suggests that 23 per cent of the population agree or strongly agree that the effects of the ‘so-

called environmental crisis facing humanity have been greatly exaggerated’8. In this respect,

should we believe that the effects of an ageing society have not be overestimated, ‘demographic

deniers’ appear to far outnumber ‘climate change deniers’.

Conclusion

The title of this report, ‘Population Ageing: Pomp or Circumstance’, refers to the debate as to

whether the public believe that population ageing is pomp (or hype) or is circumstance. Perhaps

the most direct evidence on this issue comes from agreement with the statement ‘as a society, we

overestimate the effect of an ageing society’. We can observe that over two-in-five adults agree

with this statement, although unfortunately we do not have the proportions who think that we

‘correctly estimate’ the effects of an ageing society or who think that we ‘underestimate’ an ageing

society. However, we also found that those who hold this view are also those who are more likely

to overestimate the future population of the oldest old (those aged 85 and above). This may be

counterintuitive in one sense, as we could expect those who think that the effect of an ageing

society has been overestimated to also underestimate the future number of older people.

However, in another sense, this may reflect some conflation in public opinion between what is

quite often a negative press about and ageing society and the actual projected reality of an ageing

society. A report launched in conjunction with this paper (Gill and Taylor 2012) highlights this issue

in a broader sense, and questions whether the ‘apocalyptic’ demographic scenarios that are

sometimes predicted will become reality. The results in this paper suggest that public opinion does

often tend towards a similar view in a number of cases. However, it should also be remembered

that a similar proportion of people who thought that the effects of an ageing society had been

overestimated also thought that the NHS would not remain free at the point of use because of an

ageing society, emphasising that that attitudes towards an ageing society appear both complex

and context specific.

The results in this report suggest that in reality, as with many social issues, the consequences of

an ageing society are framed through political debate and presented in the popular media, which

leaves a complex, and sometimes fraught, process for the public in disentangling the facts from

the fiction. Positive glimmers do appear among attitudes to planning an older Britain of the future

through high levels of understanding of the link between healthy behaviours and living longer and

healthier, and flexible attitudes towards older people and the workplace, particularly among

younger people in the latter case. Nevertheless, as an old Italian proverb states, ‘between saying

and doing many a pair of shoes is worn out’ (Brandom 2008), emphasising that the gulf between

attitudes and behaviour is one that has preoccupied social scientists and philosophers alike for

some time. The context of these analysis at a time, for example, of rising levels of obesity (for

example Kneale 2010) and with the level of smoking in the UK stubbornly above the 20% mark

(NHS 2010), suggest that there is still much work to be carried out in bridging this gulf. The

analyses also suggest that such a gulf may be most apparent among those in lower

socioeconomic groups.

8 Own analysis of 2009 Omnibus Questionnaire Addition.

33

References

Abrams, D., Eilola, T., and Swift, H. (2009) Attitudes to age in Britain 2004-08, Research Report No 599,

London: Department for Work and Pensions.

Age Concern (2004) How Ageist Is Britain? London: Age Concern England

Age UK (2011) A Snapshot of Ageism in the UK and across Europe. Age UK. London. England.

Allen, L.J., and Johnson, J.A., (2009) Undergraduate attitudes towards the elderly: The role of knowledge,

contact and aging anxiety. Educational Gerontology, 35 (1), 1-14.

Alongi, J.B., Benson, W.F., Harris, A..C., Moore, M., & Aldrich, N. (2009) Meeting the challenges of an

ageing society: The experience of state health departments. Atlanta, GA: National Association of Chronic

Disease Directors.

Arnold-Cathalifaud, M., Thumala, D., Urquiza, A., and Ojeda, A. (2008) Young people’s images of old age in

Chile. Exploratory Research. Educational Gerontology, 34 (2), 105-123.

Engberg H., Oksuzyan A., Jeune B., Vaupel J.W., Christensen K. (2009) Centenarians--a useful model for

healthy aging? A 29-year follow-up of hospitalizations among 40,000 Danes born in 1905, Aging Cell, 8(3):

270-276

Euwals, R., de Mooij, R., and van Vuuren, D. (2009) Rethinking Retirement. From participation towards

allocation. CPB Netherlands Bureau for Economic Policy Analysis. Number 80. The Hague. The

Netherlands.

Galioto A., Dominguez L.J., Pineo A., Ferlisi A., Putignano E., Belvedere M., Costanza G., Barbagallo M.

(2008) Cardiovascular Risk Factors in Centenarians, Experimental Gerontology, 43(2):106-13

Gill, J. and Taylor, D. (2012) Active Ageing: Live longer and prosper. London: University College London.

Health Service Executive (HSE) (2009) Open Your Eyes HSE Elder Abuse Service Developments 2008.

Health Service Executive, Dublin.

Healy, T. and Ross, K. (2002) Growing old invisibly: older viewers talk television. Media, Culture & Society

24:105-120

Help the Aged (2009) Voice: A briefing paper on the voice of older people in society.

http://www.ilcuk.org.uk/index.php/news/news_posts/voice_-_a_briefing_paper

Hitt R., Young-Xu Y., Silder M., Perls,T. (1999) Centenarians: the Older You Get, the Healthier You Have

Been, Lancet, 354(9179):652

HSBC (2006). The future of retirement. What businesses want. London: HSBC.

Huy, C., Schneider, S., Thiel, A (2010) Perceptions of aging and health behaviour: determinants of a

healthy diet in an older German population. Journal of Nutrition Health and Aging. Volume, 14, Issue 5, pp.

381-385.

Kneale, D (2010) Parental Health in Hansen, K., Jones, E., Joshi, H. and Budge, D (eds.) Millennium

Cohort Study Fourth Survey: A User’s Guide to Initial Findings. London: Centre for Longitudinal Studies,

Institute of Education, University of London.

Laditka, S.B., Corwin, S.J., Laditka, J.N., Liu, R., Tseng, W., Wu, B., Beard, R.L., Sharkey, J.R., Ivey, S.L.

(2009) Attitudes About Aging Well Among a Diverse Group of Older Americans: Implications for Promoting

Cognitive Health. The Gerontologist, 49, (S1): S30-S39

34

Lee, Y.A., (2009) Measures of student attitudes on aging. Educational Gerontology, 35 (2), 121-134.

Lyons, I. (2009) Public perceptions of older people and ageing: A literature review. National Centre for the

Protection of Older people. Review 1. November 2009. University college, Dublin. Dublin: Ireland.

McMunn, A., Breeze, E., Goodman, A., Nazroo, J. and Oldfield, Z. (2006) Social Determinants of health in

older age in Marmot, M. and Wilkinson, R. (eds.) Social Determinants of Health. Oxford: Oxford University

Press

Mackenbach, J. P., Stirbu, I., Roskam, A-J. R., Schapp, M. M., Menvielle, G., Leinsalu, M. and Kunst, A. E.

(2008) Socioeconomic Inequalities in Health in 22 Countries. The New England Journal of Medicine.

358(23): 2648-2681

Marmot M. (2010) Fair society, healthy lives. University College: London

Meadows, P. (2004). Retirement ages in the UK: A review of the literature. London, 18: DTI.

Mercer, S. W. and Watt, G. C. M. (2007) The Inverse Care Law: Clinical Primary Care Encounters in

Deprived and Affluent Areas of Scotland. The Annals of Family Medicine, 5(6):503-510

Narayan, C., (2008) Is there a double standard of aging?: Older men and women and ageism. Educational

Gerontology, 34 (9), 782-787.

Ng., T. W. H., & Feldman, D.C. (2008). The relationship of age to ten dimensions of job performance.

Journal of Applied Psychology, 93 (2), 32-423.

NHS (2010) Statistics on Smoking: England, 2010. London: NHS

http://www.ic.nhs.uk/webfiles/publications/Health%20and%20Lifestyles/Statistics_on_Smoking_2010.pdf

Office for National Statistics (2011) National Population Projections, 2010-based projections.

http://www.ons.gov.uk/ons/rel/npp/national-population-projections/2010-based-projections/index.html

Pitt-Catsouphes, M., Taylor, P., Flynn, M., Lewis S., Matz-Costa, C., Sheaks, C., and Besen, E., (2008)

Sand Pictures: Perceptions of Older Workers at the 21st Century Workplace. A Working Paper Prepared for

the 2008 AARP International Forum on the Future Workforce New Strategies for New Demographics.

European Commission. Brussels. Belgium.

Räftegård Fäggren, T., and Wilson, G., (2009) Healthy Ageing in Europe: lessons learnt and ways forward:

Stromberg. Stockholm.

Raman, P., Harwood, I., Weiss, D., Anderson, J.L., and Miller, G. (2008) Portrayals of older adults in U.S.

and Indian magazine advertisements: A cross-cultural comparison. Howard Journal of Communications, 19

(3), 221-240.

Singh, J., Lord, J., Longworth, L., Orr, S., McGarry, T., Sheldon, R. and Buxton, M. (2012) Does

Responsibility Affect the Public’s Valuation of Health Care interventions? A Relative Valuation Approach to

Health Care Safety. Value in Health. http://dx.doi.org/10.1016/j.jval.2012.02.005

Stafford, R. (2010) British Social Attitudes 2010 User Guide. London: National Centre for Social Research

Thornton, J.E. (2002). Myths of aging or ageist stereotypes. Educational Gerontology, 28, 301-312.

TNS Opinion and Social (2012) Active Ageing. Special Eurobarometer 378 / Wave EB76.2. European

Commission. Brussels. Belgium.

van Dalen, H.P., Henkens, K., and Schippers, J. (2010) Productivity of Older Workers: Perceptions of

Employers and Employees. Population and Development Review, Volume 36, Issues 2, pp309-330.

35

Vickerstaff, S., Cox, J., and Keen, L. (2003). Employers and the management of retirement. Social Policy &

Administration 37: 271-287.

WHO (2002) Active ageing: A policy framework. WHO/NMH/NPH/02.8. Geneva: World Health Organisation.

36

Appendix

Appendix A: Tables

Table A1: Output from logistic regression model of probability of being ‘aware and in charge’ of health

Odds of being

categorized as ‘Aware and in charge’

Age (baseline 16-24)

25-34 years 1.229 [0.67,2.24] 35-44 years 1.314

[0.74,2.34] 45-54 years 1.222 [0.68,2.18]

55-64 years 1.960*

[1.08,3.57] 65+ years 1.062

[0.57,1.98]

Social class (baseline AB)

C1 0.666 [0.44,1.01] C2 0.605

*

[0.39,0.94] DE 0.662

$

[0.41,1.08]

Country/Region (baseline Scotland)

England – North/Mids

1.031

[0.60,1.77] England – South, East, London

1.243

[0.72,2.14] Wales 1.492 [0.65,3.41]

Northern Ireland 1.761 [0.64,4.86]

Marital Status (baseline: In a relationship)

Single 0.823 [0.56,1.21]

Widowed/Divorced 0.679$

[0.44,1.04]

Gender (Baseline: Male)

Female 0.904 [0.67,1.22]

Work Status (Baseline: In Full-time Work)

In part-time work 1.165 [0.73,1.87]

No in work 1.195 [0.79,1.80]

N 999.000

Exponentiated coefficients*significant at 5% level;

$significant at 10% level; Weighted data

37

Table A2: Output from logistic regression model of probability of agreeing that because of population

ageing this country is unlikely to be able to afford a universally available NHS free at the point of use

in years to come

Odds of Agreement

Age (baseline 16-24)

25-34 years 0.929 [0.51,1.70]

35-44 years 1.154 [0.64,2.07] 45-54 years 0.936

[0.52,1.70] 55-64 years 1.230 [0.68,2.21]

65+ years 0.994 [0.54,1.84]

Social class (baseline AB)

C1 0.909 [0.62,1.33] C2 1.125

[0.75,1.68] DE 1.467

$

[0.95,2.27]

Country/Region (baseline Scotland)

England – North/Mids

1.033

[0.61,1.76] England – South, East, London

0.818

[0.48,1.39] Wales 0.653 [0.30,1.40]

Northern Ireland 2.488$

[0.91,6.81]

Marital Status (baseline: In a relationship)

Single 0.986 [0.67,1.45]

Widowed/Divorced 0.992 [0.67,1.47]

Gender (Baseline: Male)

Female 1.257 [0.95,1.66]

Work Status (Baseline: In Full-time Work)

In part-time work 0.958 [0.61,1.51]

No in work 1.018 [0.68,1.52]

Because of Population Ageing the NHS cannot

continue to be free at the point of use (Baseline: Don’t agree)

Agree 1.496*

[1.09,2.06]

N 999.000

Exponentiated coefficients*significant at 5% level;

$significant at 10% level; Weighted data

38

Table A3: Output from logistic regression model of probability of agreeing that retirees play no part in

the economic prosperity of the country

Odds of Agreement

Age (baseline 16-24)

25-34 years 0.802 [0.35,1.81] 35-44 years 0.652

[0.28,1.53] 45-54 years 0.972 [0.45,2.12]

55-64 years 1.040 [0.48,2.24] 65+ years 0.867

[0.40,1.89]

Social class (baseline AB)

C1 1.039 [0.61,1.76] C2 0.894

[0.50,1.60] DE 1.984

*

[1.16,3.38]

Country/Region (baseline Scotland)

England – North/Mids

0.905

[0.48,1.70] England – South, East, London

0.952

[0.51,1.79] Wales 0.625 [0.21,1.85]

Northern Ireland 2.303 [0.74,7.16]

Marital Status (baseline: In a relationship)

Single 0.856 [0.51,1.43]

Widowed/Divorced 1.268 [0.77,2.08]

Gender (Baseline: Male)

Female 0.891 [0.61,1.31]

Work Status (Baseline: In Full-time Work)

In part-time work 0.776 [0.39,1.56]

No in work 1.053 [0.62,1.78]

N 999.000

Exponentiated coefficients*significant at 5% level;

$significant at 10% level; Weighted data

39

Table A4: Output from multinomial logistic regression model of results from respondents’ guess as to

the percentage of oldest old people in the population by 2050: relative risk of selecting a category

other than a ‘reasonable estimate (3-10%)

Relative risk of estimating no change vs

reasonable estimate

Relative risk of estimating exaggerated change vs reasonable

estimate

Relative risk of ‘don’t know’ vs reasonable

estimate

Age (baseline 16-24)

25-34 years 0.607 1.211 0.270$

[0.25,1.45] [0.52,2.80] [0.06,1.18] 35-44 years 0.769 1.997

$ 0.554

[0.34,1.75] [0.91,4.41] [0.17,1.84] 45-54 years 0.412

$ 1.982

$ 0.763

[0.16,1.03] [0.92,4.29] [0.23,2.48]

55-64 years 0.622 1.716 0.542 [0.26,1.50] [0.79,3.73] [0.17,1.77] 65+ years 0.524 2.067

$ 0.662

[0.21,1.33] [0.93,4.61] [0.21,2.07]

Social class (baseline AB)

C1 1.061 0.876 2.087

[0.57,1.98] [0.55,1.40] [0.78,5.56] C2 1.744

$ 0.850 1.809

[0.94,3.23] [0.51,1.41] [0.63,5.20]

DE 1.484 0.676 2.692 [0.74,2.98] [0.39,1.16] [0.98,7.38]

Country/Region (baseline Scotland)

England – North/Mids

0.733 0.647 0.559

[0.32,1.66] [0.35,1.19] [0.21,1.50] England – South, East, London

0.751 0.512* 0.459

[0.34,1.67] [0.28,0.94] [0.16,1.28] Wales 0.516 0.258

* 0.670

[0.15,1.78] [0.09,0.76] [0.15,3.00]

Northern Ireland 1.738 0.361 0.679 [0.48,6.30] [0.10,1.30] [0.11,4.15]

Marital Status (baseline: In a relationship)

Single 1.295 1.262 1.844 [0.71,2.37] [0.77,2.07] [0.84,4.05] Widowed/Divorced 1.031 0.744 1.224

[0.55,1.94] [0.45,1.22] [0.52,2.88]

Gender (Baseline: Male)

Female 1.028 1.031 1.009

[0.67,1.58] [0.73,1.46] [0.57,1.80]

Work Status (Baseline: In Full-time Work)

In part-time work 1.023 1.228 0.956 [0.52,2.00] [0.71,2.14] [0.31,2.91] No in work 0.916 1.710

* 1.039

[0.46,1.82] [1.04,2.81] [0.46,2.36]

N 999.000 999.000 999.000

Exponentiated coefficients*significant at 5% level;

$significant at 10% level; Weighted data

Appendix B: Limitations

Limitations

This analysis represents indicative evidence on respondents’ attitudes to an ageing society for

some dimensions. As discussed earlier, this report does not constitute a full review of people’s

opinion, but an indicator of people’s response to some relatively divisive statements. These

questions were not piloted before being used for the survey9, and we therefore do not know if

these were interpreted in the expected way, and the extent to which people responded within the

context of ageing specifically or within a broader context. In addition, more subtle features of the

questions, such as the order, structure or range of responses may have influenced responses.

Respondents were also asked whether they agreed with a number of the statements, while

9 Any inaccuracies are those of the author and not of GfK-NOP.

40

ordinarily they may have been asked to respond according to a Likert scale (Strongly Agree to

Strongly Disagree). While the analysis would likely have examined those that agreed or strongly

disagreed as one group, and grouped all other responses as a single category, there remains the

possibility that the response distribution may have been affected by not having a Likert scale.

Other factors also constitute limitations to this study and caveats to the results. These include the

controlling factors available. While age, gender, region/country, economic activity, and social class

were included, others such as education, income, family structure, ethnicity, and household

composition may have affected the results. We use social class essentially as a proxy for some of

these variables above, namely education and income, although social class does not always

correlate closely with these variables. Finally, while close to 1000 people were surveyed (999), this

represents a relatively small sample compared to some other data sources (including the BSA

featured in our analyses earlier). One consequence of a small sample size is to increase the size

of our standard errors, which may mean that we overlook significant trends10. These are caveats to

the results which we discuss further below.

10

The relatively small sample is one reason why we consider some results that only achieve borderline statistical significance.

41

ILC–UK

11 Tufton Street

London

SW1P 3QB

Tel : +44 (0) 20 7340 0440

www.ilcuk.org.uk