Dr Emily T Murray, PhD
Senior Research Associate in Epidemiology
Department of Epidemiology and Public Health
University College London
Department of Epidemiology and Public Health
University College London
1-19 Torrington Place
London WC1E 6BT
Second State Pension age review: independent report call for
Written by Dr Emily T. Murray, in conjunction with Prof Nicola Shelton, Prof Jenny
Head and Dr Paul Norman.
1. Dr Emily T Murray is an international expert in examining how where people reside across their lives
relates to their health and socio-economic circumstances. Prof Shelton has published extensively on
geographic inequalities in health including in later life. Prof Head is an international expert on healthy
ageing, healthy life expectancy and healthy working lives. Dr Norman is an expert in health geography,
GIS and statistics.
2. Collectively, our peer-reviewed research is exploring which concepts and metrics of health are
appropriate to measure the health of the older population in a given place, and how these health-in-a-
place measures are related to employment outcomes of all adults in those places.
3. See more information of the research project ‘The Health of Older People in Places’ here.
3.4. Metrics for setting State Pension age (SPA)
• Are there other metrics which are relevant or more suitable to help determine State
Pension age in future, and if so, what metrics?
RESPONSE: Our research has shown that older people (aged 50-74 years) residing in
local authorities with the ‘unhealthiest’ older population, had higher odds of not being in
paid work, including all four types of economic inactivity.1
o We compared associations between nine health-in-a-place measures (including
objective and self-reported) and three employment outcomes in 2011: not being in
paid work, working hours (part-time, full-time), and economic inactivity (unemployed,
retired, sick/disabled, other).
o The nine measures included: self-rated health, long-term illness, age-specific
mortality rates, avoidable mortality, life expectancy (LE) at birth, LE at 65 years,
disability-free LE, health LE and infant mortality rate.
LONDON’S GLOBAL UNIVERSITY
o The strongest associations were seen for the health-in-a-place measures that were
self-reported: long-term illness and self-rated health.
o For example, adults 50-74y living in the third of local authorities with the highest
proportion of older people with a long-term illness (i.e., Unhealthiest) had 1.60 times
higher age-adjusted odds (95% CI 1.52–1.68) of not being in paid work than older
people who lived in the ‘Healthiest’ areas,
o Odds remained significant, at 1.33x higher for local authority-level Infant Mortality
Rates (95% CI 1.25–1.43), the weakest of the nine health-in-a-place measures
o However, strengths of association did vary by economic inactivity category. For
example, sick/disabled people had 2.75 times higher odds (95% CI 2.55–2.97) than
economically active people to be living in the ‘unhealthiest’ rather than ‘healthiest’
third of areas. Odds were 2.02 for the unemployed (95% CI 1.87–2.19), 1.49 for
other [not employed] (includes students, homemakers, and miscellaneous
categories) (95% CI 1.36–1.63) and 1.36 for retired (95% CI 1.29–1.44) economic
o These differences were robust to adjustment for age, gender and individual self-
Based on this research, we would recommend that self-rated health measures be included
in determining the State Pension Age in future. Where self-reported place-level measures
are not available, healthy or disability-free life expectancy measures can be substituted with
the understanding that they will display a slightly weaker association with employment
outcomes. These measures will reflect both the proportions of the wider population fit for
work, but also reflect in some areas long term cycles of economic decline associated with
deindustrialisation and a low level of economic investment from both private and public
sources, which are beyond the control of individual jobs seekers.
• Is it reasonable for people to expect to spend a fixed proportion of their adult life in
receipt of State Pension?
RESPONSE: No. Inequalities in life expectancy and healthy life expectancy across
socioeconomic groups and geography means the expectation of a fixed proportion of their
adult life in receipt of State Pension is a fallacy where State Pension Age is universal. Past
research from members of our team have shown that:
o Lower social class groups are negatively affected by uniform state pension ages,
because they are more likely to stop work at younger ages due to health reasons.2
o In 2014, in a representative birth cohort of 68-year-olds English and Welsh residents,
88% of men and 69% of women had retired from their main job before State Pension
Age. 28% of the men and 21% of the women who stopped working before or at SPA
did so because of negative reasons: own health, partner’s health, becoming a carer,
bereavement, redundancy, unhappiness with job or with working or work problems.
This is compared with 18% of men and 16% of women who retired before or at SPA
for positive reasons including being financially able, left early with good bonus, early
retirement or voluntary redundancy package, life style change, or retired with
o Using prospective longitudinal data drawn from seven studies, including four from
the UK, older workers aged 50y with lower education level or low occupational grade
were more likely to leave work for health reasons, compared with workers age 50y
with high level education or occupational grade, after adjustment for self-rated health
and birth cohort.4
o There are regional differences in the likelihood of older workers being able to stay in
work past the age of 50 years. From 2001-2011, men in the ONS Longitudinal Study
(LS) had significantly higher odds of staying in paid work in the East Midlands (1.4×)
East of England (1.5×), South East (1.6×), and South West (1.6×) compared with the
North East. Women in all regions apart from London and Wales had significantly
higher chance of extended working compared with the North East: ranging from 1.15
times in the North West and West Midlands to 1.6 times in the South West.5
o Two likely explanations for geographic differences in extended working are local
employment opportunities and the health of individuals in those areas. Using data
from adults aged 40-69y in the ONS LS, we found that higher local authority-level
unemployment and worse individual self-rated health in 2001 were both
independently related to the likelihood of identifying as sick-disabled or retired,
compared to being in work, 10 years later; even after adjusting for socio-
o There are large inequalities in healthy life expectancy and disability-free life
expectancy by area and socioeconomic group that imply that some groups will be
less able to extend their working lives due to poor health. Using data from the
English Longitudinal Study of Ageing, we found that both men and women in routine
and manual occupations could expect around four fewer years of healthy life beyond
the age of 50 compared to those in professional occupations.7 Similarly, there was
socioeconomic disadvantage in disability-free life expectancy according to peoples’
wealth: people in the poorest third could expect to live seven to nine fewer years
without disability than those in the richest third from the age of 50.8
• Are there options for taking account of differences in circumstances when setting
State Pension age in future? What are the advantages and disadvantages of these
options, and how could they operate within the current pensions framework?
RESPONSE: One option highlighted by some participants in recent focus groups with
English and Welsh 50–74-year-olds was an option for early State Pension receipt for
individuals working in physically demanding or dangerous occupations. Other participants
felt it would be unfair to base the SPA on differences in circumstances.
One solution could be to reduce the State Pension Age by following the current United
States model, and similar models in Scandinavia,9 of allowing any applicant to receive
benefits up to five years ‘early’ (age 62) but the monthly benefit payment will be reduced –
leading to a more equitable and potentially zero cost increase solution. For example, if a
person turns age 62 in 2022, their monthly benefit would be about 30% lower than it would
if they first claimed at the full retirement age of 67 years in 2027.10 Though this might lead to
short term increase in pensions and pension credit claimed it could reduce burden in other
parts of the benefits system, such as statutory sick pay, universal credit, and employment
support allowance. This could be operationalised within the current pensions framework by
using area level self-rated health (identified by the HOPE project as a key correlate of work
exit) to determine a suitable age to which reduce State Pension Age to nationally (or
regionally) and then extending to younger ages the current system for pension access or
deferment (currently deferment only available beyond State Pension Age). This also
removes stigma that may be attached to benefits other than pensions.
Alternatively, or additionally, focused reductions in State Pension Age could be attached to
specific dangerous occupations as they are in several European countries or the age at
which people joined the labour market (left full time education or training) could be used to
determine State Pension eligibility, though this would not reflect wider area level issues that
influence work exit.
1 Murray ET, Head J, Shelton N, Beach B and Norman P. Linking the health of older
people in places with labour market outcomes for all: does it matter how we measure
health? SocArXiv, 23 Apr. 2022. Available here: https://osf.io/preprints/socarxiv/w9vcu/
2 Murray ET, Carr E, Zaninotto P, Head J, Xue B, Stansfeld S, Beach B and Shelton
N. Inequalities in time from stopping paid work to death: findings from the ONS
Longitudinal Study, 2001–2011. J Epidemiol Community Health 2019; 73: 1101–1107.
3 Stafford M, Cooper R, Richards M, Murray ET, Zaninotto P, Head J, Stansfeld S,
Carr E, Kuh D. Physical and cognitive capability in midlife and later work participation.
Scandinavian Journal of Work, Environment and Health 2017 Jan 1;43(1):15-23 [Epub 30
Aug 2016]. doi:10.5271/sjweh.358
4 Carr E, Murray ET, Zaninotto P, Cadar D, Head J, Stansfeld S, Stafford M. The
association between informal caregiving and exit from employment among older workers:
prospective findings from the UK Household Longitudinal Study. Journal of Gerontology A
Biol Sci Med Sci. [Epub 7 Dec 2016]. doi: 10.1093/geronb/gbw156.
5 Shelton N, Head J, Carr E, Zaninotto P, Hagger-Johnson G, Murray ET. Gender
differences and individual, household, and workplace characteristics: Regional
geographies of extended working lives. Population, Space and Place 2018; 25(2): e2213.
6 Murray ET, Head J, Shelton N, Hagger-Johnson G, Stansfeld S, Zaninotto P,
Stafford M. Local area unemployment, individual health and workforce exit: ONS
Longitudinal Study. The European Journal of Public Health 2016; 26(3): 463-9. DOI:
7 Head J, Chungkham HS, Hyde M, Zaninotto P, Alexanderson K, Stenholm S, Saol P,
Kivimaki M, Goldberg M, Zins M, Vahtera J, Westerlund H. Socioeconomic differences in
healthy and disease-free life expectancy between ages 50 and 75: a multi-cohort study.
Eur J Public Health 2018; 29(2): 267-272. DOI:10.1093/eurpub/cky215
8 Zaninotto P, Batty GD, Stenholm S, Kawachi I, Hyde M, Goldberg M, Westerlund H,
Vahtera J, Head J. Socioeconomic Inequalities in Disability-free Life Expectancy in Older
People from England and the United States: A Cross-national Population-Based Study. J
Gerontol A Biol Sci Med 2020; Apr 17;75(5):906-913. doi:10.1093/gerona/glz266.
9 OECD. Ageing and Employment Policies.
https://www.oecd.org/employment/ageingandemploymentpolicies.htm [Accessed 24 April
10 Social Security Administration. Retirement benefits. Publication No. 05-10035
January 2022. Available here: https://www.ssa.gov/pubs/EN-05-10035.pdf (page 3).