Which cities will be hit hardest by the social care crisis?

Blackpool, which may be uniquely placed to have a really awful time in the next few decades. Image: Detroit Publishing Co.

The latest instalment of our weekly series, in which we use the Centre for Cities’ data tools to crunch some of the numbers on Britain’s cities.

We have a problem. People aren’t getting any younger, their brains aren’t getting any healthier, and the NHS that was founded to care for them isn’t being particularly well funded.

The wonders of medicine seem to have brought us to a place where people can be physically fit, relatively speaking, for years and years longer than ever before, but where debilitating degradations of the mind such as Alzheimer’s and dementia are snatching more and more of our loved ones from us, replacing them with forgetful, changed shells.

And it’s on that cheerful note that we’re faced with an NHS that hasn’t seen serious increases in funding since the end of New Labour in 2010, and a social care system that has only been further frustrated by the disastrous part-implementation of the Lansley reforms during the Coalition government.

So. We know there’s a problem. And as we know that cities aren’t really mythical lands of young people strolling around being fresh and hip: our urban centres will have to tackle the demographic shift of people getting older and living longer, too. Whether it’s ensuring our cities are accessible, guaranteeing at-home care for the elderly in urban flats, or building assisted living retirement villages alongside homes for first-time buyers, there’s planning to be done.

But which cities will face the biggest burden? There are three ways to handle this question, from a data-led perspective.

The easiest answer is demographic.

The cities with the highest proportion of people aged over 65, as per the most recent census in 2011, are Bournemouth, Blackpool, Worthing, Southend, and Birkenhead.

The top ten cities by proportion of population over 65. Click to expand. Image: Centre for Cities

But though there are only three cities with more than 20 per cent of the population over 65, a hefty 32 cities have more than 15 per cent of retirement age.

And those proportions will undoubtedly grow.

The top ten cities by proportion of population aged 45-64. Click to expand. Image: Centre for Cities

At least 28 cities count 45-64-year-olds as more than a quarter of their populations – scattered from Blackpool in the lead to Swindon in 28th place, with Swansea and Glasgow somewhere in the middle.

While some of those may retire out of cities and into the countryside, the bulk will stay, putting added pressure on city services just as many try to keep themselves attractive and affordable for younger people to move, work, and produce.

The wealth of cities is an important factor, too. For many older people, care problems are solved privately, with baby boomers sitting on tidy nest eggs that can be slowly dribbled out to private care homes in the twilight years. Properties can be sold when their residents move into homes or granny annexes, and the proceeds used to pay for visiting nurses, so on and so forth.

As per usual, the richer you are, the sweeter a deal you get. Data-wise, the poorer a city, the more likely it is that more people will have no financial option other than to turn to the good old NHS.

The bottom ten cities by average weekly workplace earnings. Click to expand. Image: Centre for Cities

Southend, Wigan, Huddersfield, and Birkenhead fall at the bottom of the list for average weekly workplace earnings, based on data from 2016. Norwich, Worthing, Doncaster, Stoke, Swansea and Barnsley make up the remainder of the bottom ten, whilst cities like London, Reading, and Crawley predictably fill up the top spots.

Obviously housing costs are something to bear in mind when it comes to actual day-to-day disposable income and wealth, but with regards to your ability to pay for a private care home, a low disposable income living in a £1.5m Chiswick town house is probably going to do you more good than a relatively higher disposable income living in a rented property in say, Swansea.

The bottom ten cities by mean house price. Click to expand. Image: Centre for Cities

Take a look at the mean house prices in 2016, and cities such as Burnley, Hull, Blackburn, Barnsley and Sunderland take a star turn languishing in the bottom ten – which suggests that even homeowners in those cities may have less equity to flash around if a home is sold to pay for private social care. 

In a similar vein, looking at the data for welfare spend per capita may also provide clues as to which cities will face higher demand on state provision for social care.

The top ten cities by welfare spend per capita. Click to expand. Image: Centre for Cities

Data from 2014 shows Cambridge and Oxford clocking the lowest welfare spend per capita, while the top five are Sunderland, Swansea, Birkenhead, Liverpool, and Blackpool.

Bringing up the rear of the top ten highest welfare spends per capita are Burnley, Dundee, Middlesbrough, Blackburn, and Newport.

By this point, it’s noticeable that certain cities keep cropping up.

Cambridge, Oxford, and London have people with higher incomes who cost less in terms of welfare spend per capita – and also don’t have particularly high proportions of people over 65.


By contrast, Blackpool repeatedly tops charts of high welfare spends, low weekly incomes, and high proportions of people over 65. Birkenhead crops up repeatedly, while the cities of South Wales and the south coast clock in a few appearances.

The social care crisis will be felt by all of us as our grandparents, parents, and – eventually – we grow older.

If you’re in Surrey, you’ll probably get on just fine. But in Blackpool, Birkenhead, or south Wales?

Best of luck to you. 

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London Overground is experimenting with telling passengers which bits of the next train is busiest

There must be a better way than this: Tokyo during a 1972 rail strike. Image: Getty.

One of the most fun things to do, for those who enjoy claustrophobia and other people’s body odour, is to attempt to use a mass transit system at rush hour.

Travelling on the Central line at 6pm, for example, gives you all sorts of exciting opportunities to share a single square inch of floor space with a fellow passenger, all the while becoming intimately familiar with any personal hygiene problems they may happen to have. On some, particularly lovely days you might find you don’t even get to do this for ages, but first have to spend some exciting time enjoying it as a spectator sport, before actually being able to pack yourself into one unoccupied cranny of a train.

But fear not! Transport for London has come up with a plan: telling passengers which bits of the train have the most space on them.

Here’s the science part. Many trains include automatic train weighing systems, which do exactly what the name suggests: monitoring the downward force on any individual wheel axis in real time. The data thus gathered is used mostly to optimise the braking.

But it also serves as a good proxy for how crowded a particular carriage is. All TfL are doing here is translating that into real time information visible to passengers. It’s using the standard, traffic light colour system: green means go, yellow means “hmm, maybe not”, red means “oh dear god, no, no, no”. 

All this will, hopefully, encourage some to move down the platform to where the train is less crowded, spreading the load and reducing the number of passengers who find themselves becoming overly familiar with a total stranger’s armpit.

The system is not unique, even in London: trains on the Thameslink route, a heavy-rail line which runs north/south across town (past CityMetric towers!) has a similar system visible to passengers on board. And so far it’s only a trial, at a single station, Shoreditch High Street.

But you can, if you’re so minded, watch the information update every few seconds or so here.

Can’t see why you would, but I can’t see why I would either, and that hasn’t stopped me spending much of the day watching it, so, knock yourselves out.

Jonn Elledge is the editor of CityMetric. He is on Twitter as @jonnelledge and also has a Facebook page now for some reason. 

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