Temperance scaremongering about old people drinking

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Accompanied by a stock photograph of a grey-haired couple with a glass of wine, the latest piece of anti-booze scaremongering has hit the news:

New figures show that dangerously high levels of alcohol consumption by baby boomers are leading to growing numbers of over-65s being hospitalised, adding to pressures on the NHS. “The number of older people drinking unsafely and unhealthily is rising at an alarming rate, putting their health at risk and further strain on NHS services,” said Dr Tony Rao, Britain’s leading expert on older people’s drinking.

It seems that boozed-up oldies are swamping the hospitals as they succumb to something called by the doctors "mental and behavioural disorders related to alcohol use". It's not clear what exactly these mental and behavioural disorders are (or indeed whether they are directly related to alcohol or merely exacerbated by drinking). Dr Rao though has seen a huge increase in patients at his clinics:

“Ten years ago I would have been treating no more than three people at any one time for alcohol-related brain damage. Now there are at least 10 patients with that in the service I work in.”

Yes folks, this entire story is about ten people in South London who have Korsakoff Syndrome - hardly a problem that is going to 'bankrupt' the NHS. And we don't even know whether Dr Rao's ten patients are over 65 and whether what they have is Korsakoff Syndrome or some other form of alcohol induced brain damage. The truth here - and this is hinted at in the article - is that the patients admitted to hospital for these 'mental and behavioural disorders' are people with a long history of heavy drinking. This isn't about that couple in the picture having a glass of wine with dinner but about people we might call 'serious drinkers'.

And all this ignores the well-established evidence showing a link between moderate alcohol consumption and reduced incidence of dementia:

The inverse relationship between moderate wine drinking and incident dementia was explained neither by known predictors of dementia nor by medical, psychological or socio-familial factors. These results were confirmed from data of the Rotterdam study. Light-to-moderate drinking (one to three drinks per day) was significantly associated with a lower risk of any dementia (hazard ratio 0.58 [95% CI 0.38-0.90]) and vascular dementia (hazard ratio 0.29 [0.09-0.93]). No evidence that the relation between alcohol and dementia varied by type of alcoholic beverage was found.

Not that the temperance lobby are interested in this sort of evidence. They prefer to scaremonger.

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The real story is health spending not spending on the elderly.

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This graph is doing the rounds, usually attached to arguments about how favoured the old are under the present government.

Right now spending on 'older people' (which I assume means the state pension and assorted other welfare payments directed to retired folk) has got back to the position it was relative to other spending back in 1997. We can also note that, despite falling unemployment and endless stories about the evil DWP, the rest of welfare spending has barely budged as a proportion of total spending. And there's a reason perhaps for old people getting more of the budget - there's a whole lot more of them than there used to be:

I'm not defending the 'triple lock' or other decisions made by government over the past several years merely observing that the increased number of older people inevitably means a bigger bill for old age pensions.

To return to that graph from the Resolution Foundation again, the real change that shows isn't the up and down in terms of funding for old or young but the acceleration in health spending as a proportion of total spending. Now this is, in part, another consequence of those older people - something like three-quarters of NHS spending is on the over 65s (for the simple fact that they need the health care while younger folk mostly don't) - but it is also shows that health spending is the real priority of government. And reminds us that the efficient and effective use of that growing resource represents the dominant challenge for any UK government. Shouting about how old folk are getting a better deal isn't the issue here - getting to grips with the health budget is.

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How to patronise older people Mhairi Black style

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Too often we treat older people as if they are incapable of independent thought. And nowhere is this worse than among left-leaning politicians. Here's SNP wunderkind Mhairi Black patronising the hell out of old people under the heading: "We need to help our elderly see through the Tories' scare stories":

Too many of them were on an information diet of fear and scaremongering from Better Together; force-fed Unionist spin by a biased establishment and a host of questionable reporting. And it worked. Analysis of the referendum vote revealed it was older voters who significantly voted No.

The inference here is that old people are incapable of independent thought and analysis, that their desire to remain in the United Kingdom they've spent their lives in is somehow the consequence of ignorance, of an inability to understand things unless they're guided by their youngers and betters.

It really is about time politicians like Ms Black started treating older people as intelligent human beings capable of thinking for themselves and making up their own minds. They're not "our elderly" to be patronised but John, Sid, Mary and Sylvia - men and women with stories to tell and lessons they can teach us.

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Is the mix in new housing development wrong?

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OK I don't know and these figures are from the USA where the world is different. Except I don't think that it is:

Of course, we’re not so resistant to reality that we still believe traditional family life in America implies a single-working spouse and a couple of rug rats. But not many of us grasp how little that resembles the current American household — or the current American homebuyers. 

The presentation goes on to point out that these traditional - and even non-traditional - families are a minority of house purchaser (and by implication a minority of housing demand). Indeed just shy of 60% of all US households consist of just one or two people. And I suspect the same is true for the UK.

Yet we're still building a mix of housing that is overwhelmingly focused towards families - to that traditional mom, dad and two-point-four kids. In the USA nearly two-thirds of the housing market consists of family housing (over there this is the 'single family detached house'). By comparison, 55% of UK owner-occupied housing stock is either detached or semi-detached.

In the UK, the ONS estimates that two-thirds of new households formed will not have dependent children (i.e. they will be either single adults or couples without children) yet, when we look at housing completions by housing type, 60% of new build are houses nearly all of which are three or more bedroom 'family' homes.

There does seem to be something of an imbalance in the system. Partly this is because assessed need and actual demand for homes differ - you may only 'need' a one-bed flat but you'll buy a three-bed semi because it gives you things (a garden, a spare room, space for an office/games room, a garage and so forth) that the pokey little flat won't provide. But there's also a continuing presumption in the minds of planners that housing demand - driven as it is by new household formation - is about families rather than other sorts of people.

At the moment we are, for example, spending a great deal of money (both individually and via the paying of taxes) to adapt homes for people who are ageing. On top of this we are spending comparable amounts of money shuttling between the homes of these ageing people providing support and related social care services. This is because the current provision of housing - whether sale or for rent - for older people does not meet the expectations of those older people merely the 'needs' as identified by planners. As a result older people choose not to move into the current provision - there's no spare room, no garden, no office come games room, no garage.

We need to think much harder about how we match what we know about needs (and especially predictable future needs) with public expectations about what a home should contain. This needs a reconsideration of housing in local centres - indeed in city and town centres - and about whether the needs of older people can be met in a better way than at present. In concluding, I'll give you one observation - a real one that came from a real person who said she wasn't selling her (unsuitable) house and moving to a brand new specialist housing complex for the simple reason that it was not only in town but also in the middle of a council estate.

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Quote of the day

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Exposing the ludicrous story about old folk liking a tipple:

"Whilst sensible drinking is sound advice, nannies don't need the nanny state telling them what to do.

"Our own research amongst almost 1,000 over-50s shows that they tend to drink less than 10 units of alcohol a week, much less than the recommended 14 for women and 21 for men."

So says the chap from Saga demonstrating that the New Puritans are wrong again.

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Things public health say that simply aren't true...

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'The idea of an older woman with a glass of sherry is way out of date. It is more likely to be a bottle of wine a day.’

This from Andrew Langford of the British Liver Trust is a classic of the public health genre. Old ladies may not be drinking a little glass of sherry but, let's be clear, most of them - nearly all of them in truth - are not drinking a bottle of wine a day. They are more like to be drinking no alcohol.

According to the ONS (this is for 2009) just 4% of women aged over 65 had drunk more that six units on any occasion in the week prior to survey. And 74% of such women had consumed less that 3 units. Indeed 57% of women over 65 had not touched a drop.

And just for completeness, the average weekly consumption for women aged 65 or over is just 4.6 units.

There may be a few elderly women with a drink problem but it is not a hidden' public health scandal. Not even a little one.

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