Connecting pensions, health and care – £930,000 award for research on old-age support systems

May 23, 2023


A research team led by Dr Olena Nizalova, Senior Lecturer at the Personal Social Services Research Unit, has been awarded almost £1 million by the Nuffield Foundation to set the bases for policy design that takes a holistic approach to support systems for the UK’s ageing population.

Working alongside Dr Nizalova on ‘Connecting pensions, health and care’ will be colleagues from the School of Social Policy, Sociology and Social Research, the School of Economics, and the School of Computing.

Older people rely on the pension, healthcare, and long-term care systems to support themselves and achieve good quality of life and well-being. With the share of 65+ year olds approaching 20%, the UK and other developed countries face the challenge of ensuring that these systems deliver what is promised in an affordable way.

However, current trends regarding fertility decisions and family dynamics, as well as living arrangements and mobility of family members, represent significant challenges to the sustainability of these systems, and raise concerns about intra- and inter-generational equity, especially following the COVID-19 pandemic which experts say has both exacerbated the situation and highlighted the need for a significant change and reform.

To help address these issues, the team aims to develop a new conceptual framework and tools to analyse the complex problems faced by pensions, healthcare, and long-term care systems. More specifically, they will first study people’s attitudes to various features of each of the old-age support systems, as well as to their welfare components.

The ‘Connecting pensions, health and care’ project team will then review the existing evidence on how the systems are linked via the cumulative effects of the individual choices that people make at different stages of their lives e.g. how many children to have and when, how much to save, and whether to invest in a long-term care insurance, and identify what knowledge is missing and how it can be generated.

Finally, the team will develop a pilot theoretical overlapping generations model to enable assessment of the policy options and their effects on intra- and inter-generational inequality, supported by a better understanding of the trade-offs that people and societies make in the face of population ageing.

Dr Nizalova said: ‘Although governments constantly look for better policy solutions for each of the three old-age support systems, their efforts are often disjointed. As a result, the solutions for one system may jeopardise the affordability of the other two. For example, an increase in the pension age may improve the sustainability of the pension system but create challenges to the long-term care system by reducing the pool of informal carers and, thus, putting pressure on the healthcare system because of unmet care needs.

‘Moreover, certain solutions may be beneficial for one population group while penalising or discriminating against another, potentially increasing political divides and exacerbating social inequality. For example, financing generous social care provision via taxation of the working age people may increase inter-generational tensions.

‘Given the complexity of the task, we plan to bring together both academics and non-academics from a variety of relevant disciplines and practices to ensure inclusion of various perspectives.’

Alex Beer, Welfare Programme Head at the Nuffield Foundation, said: ‘The Nuffield Foundation has a long-standing commitment to funding research designed to improve the lives of older people and their families. ‘Connecting pensions, health and care’ is an exciting, strategic grant that will develop a new framework and analytical tools to help analyse the complex problems the pension, health, and social care systems face, informed by insights on public attitudes and preferences. It will shine a light on the interdependencies between the three systems with potential for policy insights that might improve the provision of supports for and the wellbeing of people in later life.’

Research team (% = project input)

Dr Olena Nizalova PI (40%), Senior Research Fellow in Health Economics, Personal Social Services Research Unit (PSSRU) within the School of Social Policy, Sociology, and Social Research (SSPSSR).

Professor Julien Forder (2.5%) Professor of the Economics of Social Policy and Co-Director, PSSRU.

Professor Miguel León-Ledesma (5%) Professor of Economics and Head of the School of Economics.

Dr Katsuyuki Shibayama Co-I (30%) Senior Lecturer in Economics, School of Economics.

Professor Heejung Chung Co-I (25% Y1; 20% Y2-Y3) Professor of Sociology and Social Policy, SSPSSR.

Dr Irina Murtazashvili (5%, pro bono) Associate Professor Economics, Drexel University, USA

Dr Marek Grzes (5%) Lecturer, School of Computing.