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 pound billion to 40.8 pound billion and unpaid/informal care costs will increase from 55.2 pound billion to 90.8 pound 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 pound billion and 7.1 pound 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.