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Prevention is better than cure

The IFoA’s immediate past president Jules Constantinou considers the importance of a preventative approach to health and care


07 NOVEMBER 2019 | THE ACTUARY TEAM
Jules Constantinou
Jules Constantinou


Preventative health enables and empowers people to live fulfilling lives and promotes physical and mental well-being. However, it is hard to quantify and place a monetary value on the impact of preventative measures – how do you measure something that did not happen, as opposed to something that did? – and this has led to a focus on cure, rather than prevention.

The government is consulting on prevention in the 2020s – unsurprisingly focusing on the role of technology and data in delivering proactive, predictive and personalised health and care services. The IFoA has responded to this consultation, drawing on research from both the Actuarial Research Centre and a number of working parties, to urge the government to use information on population health to target health interventions and forecast future demand. This will help to inform policymakers and health providers.

The government reaffirms the Continuous Mortality Investigation findings that improvements in life expectancy are slowing and that people are spending more of those later years with health needs. 

The ongoing debate about the social care crisis has highlighted the fact that people are not receiving the care they need to live with dignity in later life. Age UK reports that 1.4 million people aged 65 and over have unmet care needs, and this number is expected to rise as the UK population ages. The proportion of people aged over 80 is set to double from 2010 figures by 2030, and reach eight million by 2050. A comprehensive ‘ageing strategy’, which prioritises keeping people in good health for longer, is required if we are going to meet the needs of an ageing population and ensure that people’s extra years of life are disability-free and fulfilling. That is why the IFoA is supportive of this consultation’s focus on disability-free life expectancy. This consultation identifies the reliance of the health and care sector on other areas of social policy, such as employment and housing, thereby supporting a need for cross-government thinking and action in order to truly implement a preventative approach to health and care. It is also important to raise awareness of the high cost of social care,both for individuals and for taxpayers, as failure to tackle this could have significant economic consequences.

The paper also highlights that, in particular, people who live in deprived areas are spending more time in poor health. The IFoA’s latest research suggests that – in addition to the widely accepted lifestyle-related and cultural norms of different socio-economic groups, such as smoking, excessive drinking, obesity, drug abuse and mental illness – people living in deprived areas are also not accessing health services in the same way as those in more affluent areas. This has serious implications for our understanding of the service needs of different population groups, and how we tackle health inequality.

As you would imagine in response to a consultation focused on technology and data, we have drawn upon the experience of wearables in the insurance industry. While the use of wearables is just at the start of its journey, and their optimal practical application remains inconclusive regarding long-term behavioural change, they have been found to have a positive effect as part of a comprehensive approach to disease management. Chronic disability resulting from type 2 diabetes has been found to be largely preventable with the right incentives around nutrition and lifestyle. An annual estimate of the NHS cost for treating diabetes and associated complications is around £10bn. This is expected to increase year on year unless preventative action is taken on major challenges around poor nutrition, lack of exercise and obesity.

Turning the ideas in this consultation into concrete action will require input from a range of stakeholders, including actuaries, and will go some way to ensuring that the UK does its part in ensuring that the United Nations Sustainable Development Goals (SDGs) are met. Goal 3: Good Health and Well-being has a significant focus on reducing preventable deaths by improving access to health services and encouraging healthier behaviours – covering many of the topics identified in this consultation as requiring government intervention. The ways in which actuaries are contributing to progress on Goal 3, as well as the full suite of the SDGs, is being explored through the IFoA’s SDG campaign.

The IFoA’s Policy and Public Affairs team will continue to work with members to get their analysis in front of policymakers and decision-makers on these issues. The best way to keep up to date with these activities is to read the bi-monthly Public Affairs Brief. or visit our policy web pages at: bit.ly/ifoaPubPolicy


Age UK reports that1.4 million people aged 65+ have unmet care needs. People aged >80 are set to reach 8 million by 2050.