Reductions in local government spending on community-based social care and unmet social care needs of older people in England

This paper investigates whether there is a statistical association between spending per person in community-based adult social care for older people and the probability that an older person has unmet needs. Two definitions of unmet needs are introduced: a) if an individual who had difficulty with one or more ADLs/IADLs did not receive any help at all or if they received help, it did not always meet their need to perform the activity or activities, and b) only considering people who received help. Using two-level and cross-classified panel logistic regressions on data from the English Longitudinal Study of Ageing between 2004/05 and 2012/13, the paper finds that a fall of 29 per cent in expenditure on community-based care for older people per head would lead to an increase of 6.1 per cent or 9.7 percent in the proportion of older people with unmet needs, depending on the definition of unmet needs: contractions in public spending make many older people experience the double plight of having social care needs and not being able to meet them in full. In view of demographic projections-of proportions of older people, of changes in household size and structure, and of geographical residence patterns within family membersunpaid long-term care will lag increasingly behind the needs of the older population; further budgetary reductions are likely to negatively affect particularly older people on low incomes. (c) 2017 Elsevier B.V. All rights reserved.