Journal Publications

Watts, P. N., Blane, D., & Netuveli, G. (2019). Minimum income for healthy living and frailty in adults over 65 years old in the English Longitudinal Study of Ageing: a population-based cohort study. BMJ open, 9(2), e025334.

The Minimum Income for Healthy Living (MIHL) is a threshold income required for individuals to lead a healthy life. The MIHL concept, which is is based on previous research, survey data and real costs, emphasises the importance of having a certain level of income to meet basic needs and maintain good health in older age. This study investigated the relationship between living below the MIHL threshold and frailty among older adults. Frailty refers to a decline in physical and mental health, leading to increased vulnerability and reduced resilience to stressors. We used data from the English Longitudinal Study of Ageing and focused on the impact of living below the MIHL threshold on frailty in adults aged 65 years and over.

The results indicated that individuals who lived below the MIHL threshold at least once had a higher likelihood of being frail at a later point in their lives. This association was observed using two different measures of frailty. The study also highlighted that MIHL is sensitive to changes in individual circumstances, such as living or working conditions, which can influence whether they meet the MIHL threshold. Additionally, MIHL is influenced by changes in pension credit levels and the cost of items required for a healthy life. The research underlines the importance of understanding the socioeconomic factors that contribute to frailty in older adults and the potential implications for health and well-being.

Watts, P. N., & Netuveli, G. (2022). Costs of healthy living for older adults: the need for dynamic measures of health-related poverty to support evidence-informed policy-making and real-time decision-making. Public Health, 212, 1-3.

This paper examines how older adults over the age of 65 are disproportionately impacted due to the steepest increases in the costs of health living affecting food and energy prices, which constitute a large proportion of the income older adults require for healthy living. The results showed that progress in closing the gap between the ‘Minimum Income for Healthy Living’ (MIHL) and Pension Credit levels has been reversed by the rising costs of living. From April 2021 to August 2022, the MIHL for single older adults rose from £5.57 per week below to £11.83 per week above Pension Credit levels.

The cost of living crisis is likely to push many older adults into health-related poverty, and for some, this will be for the first time in their lives. The paper concludes, “There is a need for dynamic measures of health-related poverty to support evidence-informed policy-making and real-time decision-making to mitigate the health impacts on older adults. Older adults whose income falls below the MIHL are at a greater risk of poorer health outcomes, including frailty.”

The research highlights that the dynamic costs of healthy living do not fit conveniently within the timing of government budget cycles or long-term strategies to reduce health inequalities. In the United Kingdom, increases in the State Pension and Pension Credit for older adults on low incomes are typically calculated annually, many months in advance. For example, the April 2022 increases in Pension Credit were announced in November 2021 before the consequences of some of the sharpest increases in costs were experienced by many older adults.