Tom Sefton

ECONOMIC EVALUATION OF COMPLEX HEALTH AND SOCIAL CARE INTERVENTIONS

The use of economic evaluation in relatively complex areas of health and social care has been limited. The level of complexity is influenced by the nature of the problems and interventions under evaluation, being dependent upon the degree of user involvement and the complexity of the inputs and outcomes. Complexity does not preclude the achievement of a good quality economic evaluation, but it can add significant difficulties. Efforts must be made to ensure scientific validity of evaluations, whilst recognising that the complexity inherent in many health and social care interventions may require deviations from and additions to traditional evaluation models. Fundamentally, the net effect will be the need for more time and money than would perhaps be required for the evaluation of a simpler intervention.

The Relationship between Women’s Work Histories and Incomes in Later Life in the UK, US and West Germany

Using data from several large-scale longitudinal surveys, this article investigates the relationship between the work histories and personal incomes (from both public and private sources) of older women in the UK, US and West Germany. By comparing three countries with different welfare regimes and pension systems, we seek to gain a better understanding of the interaction between the life course, pension system and women’s incomes in later life. The association between older women’s incomes and work histories is strongest in West Germany and weakest in the UK, where there is evidence of a ‘pensions poverty trap’ and where only predominantly full-time employment is associated with significantly higher incomes in later life. Work history matters less for widows (in all three countries) and more for recent birth cohorts and more educated women (UK only). The article concludes with a brief discussion of the treatment of women under different pension regimes assessed by the criteria of adequacy, proportionality, vertical equity and horizontal equity.

Family ties: women’s work and family histories and their association with incomes in later life in the UK

This paper examines the relationship between the family and work histories of older women in the UK and their individual incomes in later life, using retrospective data from the first fifteen waves of the British Household Panel Survey. The associations between women’s family histories and their incomes later in life are relatively weak, and in many cases insignificant. Divorce, early widowhood and re-marriage are not associated with significant differences in older women’s incomes, whilst motherhood is only associated with a small reduction in incomes later in life – and not at all for certain sub-groups of the population. Whilst there are significant differences in the work histories of older women with different family histories, this does not translate into large differences in their personal incomes, because work history-related income differentials are also relatively small. Even long periods in employment are not associated with significantly higher incomes in later life if these periods were in predominantly part-time or ‘mixed’ employment. Our analysis demonstrates how effective public transfers have been in dampening work history-related differentials in older women’s incomes, especially for widows and those towards the bottom of the income distribution. On the one hand, this could be seen as a positive finding in that the ‘pension penalty’ associated with events such as motherhood and divorce are not as severe as is often anticipated. On the other hand, the main reason for this is that the pension returns to working longer are relatively low, especially for low-skilled women. Recent pensions reforms should eventually produce more equitable outcomes as between men and women, though possibly at the expense of greater inequality among women with different work and family histories.

100 Questions: identifying research priorities for poverty prevention and reduction

Reducing poverty is important for those affected, for society and the economy. Poverty remains entrenched in the UK, despite considerable research efforts to understand its causes and possible solutions. The Joseph Rowntree Foundation, with the Centre for Science and Policy at the University of Cambridge, ran a democratic, transparent, consensual exercise involving 45 participants from government, non-governmental organisations, academia and research to identify 100 important research questions that, if answered, would help to reduce or prevent poverty. The list includes questions across a number of important themes, including attitudes, education, family, employment, heath, wellbeing, inclusion, markets, housing, taxes, inequality and power.

Dinamica del reddito e ciclo di vita

Income Dynamics and the Life Cycle - This article argues that our understanding of income and poverty dynamics benefits from taking a life-cycle perspective. A person’s age and family circumstances - the factors that shape their life cycle - affect the likelihood of experiencing key life events, such as partnership formation, having children, or retirement; this in turn affects their probability of experiencing rising, falling, or other income trajectories. Using ten waves of the British Household Panel Survey, we analyse the income trajectories of people at different stages in their lives in order to build a picture of income dynamics over the whole life cycle. We find that particular life events are closely associated with either rising or falling trajectories, but that there is considerable heterogeneity in income trajectories following these different events. Typically, individuals experiencing one of these life events are around twice as likely to experience a particular income trajectory, but most individuals will not follow the trajectory most commonly associated with that life event. This work improves our understanding of the financial impact of different life events and provides an indication of how effectively the welfare state cushions people against the potentially adverse impact of these events.