Projected costs of long-term care for older people in England: the impacts of housing quality improvements

Good quality housing is vitally important to public health. However, its economic consequences for the long-term care sector and implications for health policy have not been thoroughly examined. This study investigates the impacts of housing improvements on future costs of long-term care in England. Using data from two national surveys, the English Longitudinal Study of Ageing (ELSA) and the Health Survey for England (HSE), we combined a Markov model with a macrosimulation model to make projections of long-term care costs under a series of housing intervention scenarios. We project that, without housing interventions, formal care costs will increase from £22.4 billion to £40.8 billion and unpaid/informal care costs will increase from £55.2 billion to £90.8 billion between 2022 and 2042. In a scenario where all housing problems are remedied, formal and unpaid care costs in 2042 are projected to be £2.8 billion and £7.1 billion lower than the no intervention scenario, respectively. There are substantial synergies between health and housing policies. Well-designed housing improvement programmes delay the progression of long-term care needs, resulting in lower long-term care costs. The cumulative savings of long-term care costs over time can pay back the investment needed for housing improvements.