does living in a retirement village extend life expectancy? the case of whiteley village
TRANSCRIPT
Great Expectations:
Does living in a retirement village
extend life expectancy? An ILC-UK and Cass Business School joint event
22nd February 2017
This event is kindly supported by Whiteley Homes Trust
#LivingLonger
Welcome from ILC-UK
Baroness Sally Greengross
Chief Executive
ILC-UK
This event is kindly supported by Whiteley Homes Trust
#LivingLonger
Presentation from Whiteley Village
Chandra McGowan
Chief Executive Officer
Whiteley Village
This event is kindly supported by Whiteley Homes Trust
#LivingLonger
Presentation of report findings
Prof. Ben RickayzenHead of the Faculty of Actuarial
Science and InsuranceCass Business School
This event is kindly supported by Whiteley Homes Trust
#LivingLonger
Does living in a retirement village extend life expectancy?
The case of Whiteley Village
By Les Mayhew, Ben Rickayzen and David Smith
Cass Business SchoolCity, University of London
Sponsored by the Worshipful Company of Actuaries
Background
• Around 500 residents, most of whom entered with limited financial means
• 262 cottages, 51 extra care apartments, a residential home and nursing home
• Cottage residents pay approx £1,000 per month
• The Whiteley Homes Trust aims to enable villagers to live as independently as possible
• Extensive social facilities offered
Eligibility criteria
• Whiteley was founded by a charitable bequest and had certain requirements of its intended villagers:
• “Poor persons…of good character and of sound mind”
• Relying on a State provided pension
• Preference given to people “engaged in commercial or agricultural pursuits”
• In good health at entry (ie expected to live independently for several years)
Gender breakdown of Whiteley population over time
050
100150200250300350400
Ave
rage
nu
mb
er o
f re
sid
ents
Calendar period
Male
Age at entry in to Village - Women
0
20
40
60
80
100
120
140
160
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
Nu
mb
er
of
en
tran
ts
Age at entry
Age at entry in to Village - Men
0
10
20
30
40
50
60
70
80
90
60 61 62 63 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 79 80
Nu
mb
er
of
en
tran
ts
Age at entry
Lengths of Village stay - Women
0
10
20
30
40
50
60
70
80
0 5 10 15 20 25 30 35 40 45 50
Nu
mb
er
of
pe
op
le
Years in Village
Die in Village
Lengths of Village stay - Men
0
5
10
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35
40
0 5 10 15 20 25 30 35 40 45 50
Nu
mb
er
of
pe
op
le
Years in Village
Die in VillageWithdraw from…
Methodology
• To test whether Whiteley has improved the Villagers’ longevity we analysed the percentages of Villagers surviving to specific ages
• These ages were derived by looking at the survival percentages of the general population of England & Wales
• If a greater percentage of Villagers were surviving to these ages then this indicates a possible survival boost from village life
• We identified the following typical ages at entry• Women: entry age 65 to 69 (assume age 67)
• Men: entry age 68 to 72 (assume age 70)
Age at death of female Villagers who entered between age 65 and age 69
60
65
70
75
80
85
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1920 1930 1940 1950 1960 1970 1980 1990 2000 2010
Age
at
de
ath
Year of death
Village deaths based on ageof entry 65 to 69 excludingwithdrawals
E&W 90% alive; 10%deceased
Observed versus expected number of female deaths for each specified percentile cut-off
Percentage of deaths 10% 50% 90% 95%
Observed deaths 31 196 486 516
Expected deaths 56 280 504 532
N=560
P-value: one-sided 0.0002 <0.0001 0.0056 0.0010
Age at death of male Villagers who entered between age 68 and age 72
50556065707580859095
100105110
1920 1930 1940 1950 1960 1970 1980 1990 2000 2010
Age
at
de
ath
Year of death
Village deaths based onage of entry 68 to 72excluding withdrawalsE&W 90% alive; 10%deceased
E&W 50% alive; 50%deceased
Observed versus expected number of male deaths for each specified percentile cut-off
Percentage of deaths 10% 50% 90% 95%
Observed deaths 30 111 211 232
Expected deaths 24.5 122.5 220.5 232.75
N=245
P-value: one-sided 0.8793 0.0709 0.0215 0.4130
Life expectancy analysis - methodology
• Female cohort analysis by decade of entrants: Whiteley vs England & Wales cohort tables
• Whiteley entrants age 65 to 69 who died in the Village compared to age 67 E&W cohorts for 1930 to 1980
• E.g. Whiteley residents who entered between 1925 and 1934 were compared to E&W 1930 cohort
• We compared mean and median duration for the two populations
Median duration to death at age 67 for female Whiteley cohorts and corresponding England and Wales cohorts
Median duration to death(years)
Whiteley cohort centred
on yearSample
sizeAverage age
at entry
(A)Whiteley Residents
(B)
E&W
(C)Difference
(B)-(A)
1930 80 66.9 16.1 11.4 4.7
1940 78 67.2 15.2 12.5 2.7
1950 112 67.0 15.6 13.5 2.1
1960 101 66.8 19.2 14.4 4.9
1970 55 67.0 18.4 15.5 2.9
1980 45 67.2 17.9 16.7 1.3
16.1 15.2 15.6
19.2 18.4 17.9
11.4 12.5 13.5 14.4 15.516.7
0
5
10
15
20
25
1930 1940 1950 1960 1970 1980
Year
s
Cohort
Whiteley and England & Wales median life expectancies
Whiteley
England & Wales
0
5
10
15
20
25
1930 1940 1950 1960 1970 1980
Year
s
Cohort
Whiteley and England & Wales median life expectancies
Whiteley
0
2
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22
1930 1940 1950 1960 1970 1980
Year
s
Year of entry
Median life expectancy with 90% confidence intervals
Englandand Wales
WhiteleyVillage
Female survival curves for the 1960 cohorts of E&W and Whiteley
0102030405060708090
100
0 5 10 15 20 25 30 35
Pe
rce
nta
ge s
urv
ivin
g
Duration to death (years)
E&W (1960)Whiteley…
P
Q
X Y
14
15
16
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18
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Q5 Q4 Q3 Q2 Whiteley Q1
Year
s
Median life expectancy by quintile
14
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19
Q5 Q4 Q3 Q2 Whiteley Q1
Year
s
Median life expectancy by quintile
14
15
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Q5 Q4 Q3 Q2 Whiteley Q1
Year
s
Median life expectancy by quintile
Caveats to our analysis
• To be allowed entry into the Village, residents must be deemed to be physically fit…. while not at level of life assurance underwriting, it is a form of selection
• We have excluded people who withdrew from the Village; remaining residents may be more social than the general population
• Residents may need to be relatively young to gain the survivorship boost
• The average age and gender mix of the Village changes over time and this may impact on the social cohesion of Whiteley
Conclusions
• Strong statistical evidence that females entering Whiteley between ages 65 and 69 received a substantial boost to their longevity
• Whiteley’s longevity advantage reached a high of 4.9 years for females entering in the 1960 cohort
• This advantage lessened in 1970 and 1980, mainly due to the average pensioner in the wider population becoming wealthier relative to a Whiteley pensioner
• Indeed, the median duration of a female entrant in the 1980 cohort in Whiteley was between 2.7 and 3.3 years higher when compared to the poorest 20% of female 67 year olds in the wider population
Conclusions (continued)
• Whiteley appears to boost the longevity of female residents to the equivalent of them coming from quintile 1 or 2
• For males, there was evidence that the majority of residents lived at least as long as the general population
• Hence, being a Villager seems to nullify the higher mortality rates usually experienced by members of lower socio-economic groups
• Retirement villages appear to help in the Government’s aim to reduce mortality inequalities experienced by the lower socio-economic groups, as well as enhancing quality of life
Panel Discussion
Anna Dixon
Chief Executive Centre for Ageing
Better
This event is kindly supported by Whiteley Homes Trust
#LivingLonger
Tamara Finklestein
Director General Community NHS
Professor Les Mayhew
Professor of Statistics, Faculty of Actuarial Science and Insurance
Cass Business School
Discussion
Future opportunities
Baroness Sally Greengross
Chief Executive
ILC-UK
This event is kindly supported by Whiteley Homes Trust
#LivingLonger
Discussion close
Baroness Sally Greengross
Chief Executive
ILC-UK
This event is kindly supported by Whiteley Homes Trust
#LivingLonger
Final Reflection
Peter Wilkinson
Chair of the Trust
Whiteley Village
This event is kindly supported by Whiteley Homes Trust
#LivingLonger
Great Expectations:
Does living in a retirement village
extend life expectancy? An ILC-UK and Cass Business School joint event
22nd February 2017
This event is kindly supported by Whiteley Homes Trust
#LivingLonger
Save the date
Future of Ageing Conference29th November 2017
Central London