The second King’s College London Symposium on Ageing and Long-term Care in China was convened from 4 to 5th July 2019 at King’s College London in London. The aim of the Symposium was to have a better understanding of health and social challenges for aging and long-term care in China. This symposium draws research insights from a wide range of disciplines, including economics, public policy, demography, gerontology, public health and sociology. A total of 20 participants from eight countries, seek to identify the key issues and research priorities in the area of aging and long-term care in China. The results published here are a synthesis of the top four research areas that represent the perspectives from some of the leading researchers in the field.

This paper examines the impact of raising the State Pension age on women's health. Exploiting a UK pension reform that increased women's State Pension age for up to 6 years since 2010, we show that raising the State Pension age leads to an increase of up to 12 percentage points in the probability of depressive symptoms, alongside an increase in self‐reported medically diagnosed depression among women in a lower occupational grade. Our results suggest that these effects are driven by prolonged exposure to high‐strain jobs characterised by high demands and low control. Effects are consistent across multiple subcomponents of the General Health Question and Short‐Form‐12 (SF‐12) scores, and robust to alternative empirical specifications, including “placebo” analyses for women who never worked and for men.

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Lo sviluppo tecnologico appare oggi in accelerazione esponenziale, soprattutto grazie al digitale. Comunicazioni, pratiche sociali e culture si presentano come forme simboliche sempre più elusive, evanescenti e cangianti. L'ambito della salute è una delle dimensioni più investite dalle scoperte e dalle nuove applicazioni. Possiamo utilizzare lo smartphone per curarci, fare prevenzione, migliorarci. In generale, possiamo raccogliere big data su noi stessi. Ovviamente, anche le organizzazioni e le professioni si giovano delle nuove possibilità. Parallelamente, il discorso sulla salute si estende oltre la medicina e la malattia per abbracciare le dimensioni dello stare bene e della qualità della vita. In altri termini, accanto alla cura, prendono corpo interventi istituzionali, aziendali e di altre organizzazioni volti ad accrescere il benessere (well-being) delle persone e la loro felicità. Non va tuttavia dimenticato che il "soluzionismo tecnologico" non ha inciso molto sulle grandi e gravi diseguaglianze sociali e che i bramini della rete hanno spesso alimentato aspettative irrealistiche. La stratificazione sociale condiziona ancora pesantemente i destini individuali. In questo contesto, la Collana BTS -aperta anche a tematiche relative al welfare e al benessere sociale nella sua accezione più ampia -attraverso contributi sociologici rigorosi, ma scritti con uno stile divulgativo, vuole proporre modelli teorici, ricerche empiriche e strumenti operativi per analizzare e intervenire su questa mutevole realtà sociale.

In this paper, we study how elderly individuals adjust their informal long-term care utilization to changes in the provision of formal care. Despite this is crucial to design effective policies of formal elderly care, empirical evidence is scant due to the lack of credible identification strategies to account for the endogeneity of formal care. We propose a novel instrument, an index that captures individuals' eligibility status for the long-term care programs implemented in the region of residence. Our estimates, which are robust to a number of different specifications, suggest that higher formal care provision would lead to an increase in informal care utilization as well. In the context of current theoretical economic model of care use, this result points to the existence of a substantial unmet demand of care among older people in Europe.

Objectives We examine whether socioeconomic inequalities in home-care use among disabled older adults are related to the contextual characteristics of long-term care (LTC) systems. Specifically, we investigate how wealth and income gradients in the use of informal, formal, and mixed home-care vary according to the degree to which LTC systems offer alternatives to families as the main providers of care (“de-familization”). Method We use survey data from SHARE on disabled older adults from 136 administrative regions in 12 European countries and link them to a regional indicator of de-familization in LTC, measured by the number of available LTC beds in care homes. We use multinomial multilevel models, with and without country fixed-effects, to study home-care use as a function of individual-level and regional-level LTC characteristics. We interact financial wealth and income with the number of LTC beds to assess whether socioeconomic gradients in home-care use differ across regions according to the degree of de-familization in LTC. Results We find robust evidence that socioeconomic status inequalities in the use of mixed-care are lower in more de-familized LTC systems. Poorer people are more likely than the wealthier to combine informal and formal home-care use in regions with more LTC beds. SES inequalities in the exclusive use of informal or formal care do not differ by the level of de-familization. Discussion The results suggest that de-familization in LTC favors the combination of formal and informal home-care among the more socioeconomically disadvantaged, potentially mitigating health inequalities in later life.

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A lthough econo m ic literature has recently started to concentrate on the design, the scope and the regulations of m ain public program m es of Long-T erm-C are in E urope, no analysis have, so far, com pared different system s in term s of their degree of inclusiveness w ith respect to vulnerable elderly's health status. Focusing on several E uropean countries, this paper investigate how LT C regulations assess vulnerability, as w ell as how they define a m inim um level of objective-dependency that w ould entitle individuals to receive public benefits (in-kind or in-cash) for hom e-based care. O ur contribution is threefold. W e provide detailed inform ation on assessm ent and eligibility fram ew orks for eleven LT C program m es in E urope. W e show that substantial heterogeneities exist both at th e extensive m argin (the health-outcom es that are included in the vulnerability-assessm ent) and at the intensive m argin (the m inim um vulnerability threshold that defines benefit eligibility) of the assessm ent strategies. B uilding on this inform ation, w e com pare L T C program m es in term s of their degree of inclusiveness, i.e., w e investigate the extent to w hich each program m e is able to cover a standard population of elderly individuals facing functional and cognitive lim itations. T he com parison is perform ed follow ing both a directly-and an indirectly-adjusted strategy using SH A R E data.