Demography: future trends

• The population is growing
  Over the next 20 years (2012-2032) the population in England is predicted to grow by 8 million to just over 61 million, 4.5 million from natural growth (births – deaths), 3.5 million from net migration.
• The population is becoming more diverse
  By 2031, ethnic populations will make up 15 per cent of the population in England and 37 per cent of the population in London.
• More people are living alone
  By 2032 11.3 million people are expected to be living on their own, more than 40 per cent of all households. The number of people over 85 living on their own is expected to grow from 573, 000 to 1.4 million.
• After recent growth, the number of births each year is expected to level off
  Over time birth rates have fluctuated quite significantly. Current predictions are that the annual number of births will level off to around 680,000–730,000 births per year.
• Life expectancy and healthy life expectancy are growing
  In 1901 baby boys were expected to live for 45 years and girls for 49 years. In 2012, boys could expect to live for just over 79 years and girls to 83 years. By 2032, this is expected to increase to 83 years and 87 years respectively. Healthy life expectancy is growing at a similar rate, suggesting that the extra years of life will not necessarily be years of ill health.
• The population is ageing
  The combination of extending life expectancy and the ageing of those born in the baby boom, just after the Second World War, means that the population aged over 65 is growing at a much faster rate than those under 65. Over the next 20 years the population aged 65-84 will rise by 39 per cent and those over 85 by 106 per cent.
• After a recent decline, the number of deaths each year is expected to grow
  The number of deaths each year is expected to grow by 13 per cent from 462,000 to 520,000 by 2032.
• Health inequalities persist
  Men and women in the highest socio-economic class can, on average, expect to live just over seven years longer than those in the lowest socio-economic class, and more of those years will be disability free.

• Overall population size
  It is difficult to forecast the size of the population and the net impact of migration.
• Births
  Current projections suggest a levelling off of the birth rate, yet the historical pattern is one of significant fluctuation. There are a variety of forces at work and it is hard to predict what future birth rates will look like.
• Life expectancy
  Medical advances, future patterns of disease and population behaviour could all have a significant impact on life expectancy and either drive it up or down.
• Economic impact of ageing population
  Older people could be a driver of economic growth and social wellbeing or place a significant economic burden on the younger working population. The net economic impact is hard to predict.

Source: The King's Fund analysis of Office for National Statistics 2010-based National Population Projections. NB These are based on Office for National Statistics mid-2010 estimates and will be superseded by 2011 census-based projections.

The population size in England is expected to grow by 8 million by 2032 – approximately 4.5 million from natural growth (births-deaths) and 3.5 million from net migration1 .

Actual and projected population, England, 1971-2032

Projected population change, England, 2012-2032

Source: Office for National Statistics (2011). Statistical Bulletin. National population projections, 2010-based projections

• 1Office for National Statistics (2011). Statistical Bulletin. National population projections, 2010-based projections

Changes to the ethnic composition of the population

By 2031 minority ethnic groups are estimated to make up approximately 15 per cent of the UK population, up from 12 per cent in 2011. The increase is driven not only by the impact of migration but by differences between fertility rates of some ethnic groups1 .

Across England, mixed populations are the fastest growing, followed by newer immigrant groups and traditional communities of South Asian origins. London has the greatest diversity in its population and by 2031 ethnic minority populations are predicted to rise to 37 per cent of the total2 .

The ethnic profile of the population is important because of the differing rates of disease in different ethnic groups. For example, Asian and black groups have higher rates of diabetes than the general population, and many minority ethnic groups have lower rates of cancer3 .

• 1Wohland P, Rees P, Norman P, Boden P, Jasinska M (2010). Research paper. ‘Ethnic population projections for the UK and local areas, 2001-2015’. University of Leeds
• 2Wohland P, Rees P, Norman P, Boden P, Jasinska M (2010). Research paper. ‘Ethnic population projections for the UK and local areas, 2001-2015’. University of Leeds
• 3Wohland P, Rees P, Norman P, Boden P, Jasinska M (2010). Research paper. ‘Ethnic population projections for the UK and local areas, 2001-2015’. University of Leeds

Immigration and emigration trends

Immigration to the UK rose from around 500,000 to 600,000 a year between 2001 and 2005, but has remained steady since. Over the past 10 years emigration has fluctuated between 300,000 and 400,000 a year. The net migration (immigration – emigration) has therefore been about 200,000 people a year for the past 10 years1 .

In addition, roughly 5 per cent of the population of England and Wales move local authority every year. The impact is not evenly felt, as some cities and regions have very high population change – as much a 20 per cent every year in some London boroughs2 .

Migration trends can affect the population size indirectly; for example, the fertility rate of mothers born outside the UK is significantly higher than that of those born in the UK3 .

Long-term international migration estimates, UK, 2001-2011

Source: Office for National Statistics (2011). Statistical Bulletin. Provisional Long Term International Migration (LTIM) estimates June 2011

Regional level internal migration moves, year ending June 2010

Source: Office for National Statistics (2011) Internal Migration within England and Wales, year ending June 2010

• 1Office for National Statistics (2011). Statistical Bulletin. Long-Term International Migration, November 2010
• 2Office for National Statistics (2011). Statistical Bulletin. Long-Term International Migration, November 2010
• 3Office for National Statistics (2012). Statistical Bulletin. Births in England and Wales by parent’s country of birth, 2011

Family and household structures have changed significantly over the past 50 years and this looks set to continue.

Households occupied by people living on their own

Over the next 20 years a sharp increase in the number of people living on their own is predicted. By 2033 it is expected that 11.3 million people will be living on their own (41 per cent of all households in England); in 1961 only 12 per cent of households were single person households1 .

This growth in lone households is particularly marked for older people. The number of people over 65 living on their own is expected to grow from 3 million in 2008 to 4.8 million in 2033 and the number of people over 85 living on their own from 573,000 to 1.4 million2 .

One person household projections by age of household reference person, England, 2008-2033

Source: Communities and Local Government (2010). Report. Updating the Department for Communities and Local Government's household projections to a 2008 base: Final Report

Family structures

At the same time, family structures are becoming more complex. There has been a decline in marriage and a growth in cohabiting. Over one in three (35 per cent) of all marriages are now remarriages (3). Stepfamilies are the fastest growing family forms in Britain, accounting for one in ten of all families3 .

The number of single-parent families is also growing, expected to rise by 31 per cent from 2013 to 2033  to just over 412,0004 .

• 1Communities and Local Government (2010). Report. Updating the Department for Communities and Local Government’s household projections to a 2008 base, Final report
• 2Communities and Local Government (2010). Report. Household projections, 2008 to 2033, England
• 3Office for National Statistics (2011). Report. Households and families, Social Trends 41
• 4Ipsos MORI (2009). Report. The impact of changing family structures and what the public think

Birth rates

Birth rates fluctuate significantly. Between 1993 and 2002 the annual number of births fell, but the number has been rising since. Between now and 2032, the number of live births is projected to fluctuate between 680,000 and 730,000 births per year1 .

The rise in birth rates after 2003 reflected a rise in the fertility rate of mothers born in the UK and the higher fertility rates in mothers born outside the UK. The fertility rate for mothers born in the UK rose from 1.69 in 2004 to 1.90 in 2011; for mothers born outside the UK the rate fell from 2.50 in 2004 and 2.29 in 2011, but is still significantly higher than for women born in the UK2 .

There are significant regional variations. In the north east the number of live births is set to decrease by 11 per cent from 2012 to 2032 (31,200 to 27,900); in London over the same period the number of live births is set to increase by 5 per cent (134,900 to 141,800)3 .

The percentage of childless women is expected to remain around 17 per cent4 .

Number of live births, England and Wales, and England only; 1920-2032

Sources: Office for National Statistics (2011). Statistical Bulletin. National population projections, 2010-based projections and Office for National Statistics (2011). Report. Households and families, Social Trends 41

Conception rates for older mothers

Current trends show conception rates for older mothers increasing. Between 1990 and 2010, conception rates have doubled in women over 40, nearly doubled in women aged between 35 and 39, and increased by nearly 50 per cent in women aged 30 to 34.

Relative changes in age-specific conception rates, 1990-2010

Source: Office for National Statistics (2012). Statistical Bulletin. Conceptions in England and Wales 2010

• 1Office for National Statistics (2012). Report. Births in England and Wales by Parents' Country of Birth, 2011
• 2Office for National Statistics (2012). Report. Births in England and Wales by Parents' Country of Birth, 2011
• 3Office for National Statistics (2012). Report. Births in England and Wales by Parents' Country of Birth, 2011
• 4Office for National Statistics (2012). Report. Births in England and Wales by Parents' Country of Birth, 2011

In 1901 life expectancy was 45 years for men and 49 years for women. By 2012 this had increased to 79.2 years for men and 83.3 years for women1 .

This is expected to rise further by 2032 to 83.3 years (an increase of 4.1 years) for men and to 86.8 years (an increase of 3.8 years) for women. The gap between male and female is predicted to be consistent, ie, 3.7 years in 2012 and 3.6 years in 2032. Both biological and non-biological factors play a role in this difference2 .

This projection is based on the current trend. The precise extent of the increase will depend on patterns of disease and the population lifestyle. Predictions by the Office for National Statistics over the next 70 years show a possible variation of 20 years by 20853 .

Actual and projected period expectation of life at birth, England, 1981-2085

Life expectancy at birth is the average number of years that a person can be expected to live from birth, assuming that age-specific mortality levels remain constant.

Healthy life expectancy

Life expectancy is an estimate of average expected life span, healthy life expectancy is an estimate of the years of life that will be spent in good health. The trend for healthy life expectancy at 65 in England for males and females has increased approximately in line with overall life expectancy at 65.  For example, between 2006 and 2009, healthy life expectancy increased by 0.8 years for females and 0.5 years for males while overall life expectancy grew by 0.6 years for females and 0.7 years for males. This suggests that that the extra years of life will not necessarily be years of ill health4 .

There are important socio-demographic differences in healthy life expectancy. Not only can people from more deprived populations expect to live shorter lives, but a greater proportion of their life will be in poor health.

Healthy life expectancy is the average equivalent number of years of full health that a newborn could expect to live, if he or she were to pass through life subject to the age-specific death rates and ill-health rates of a given period. The new measurement of healthy life expectancy was done to harmonise the calculation of healthy life expectancy with that of the European Union. More information on the methodology of the General Health Survey can be found on the Office for National Statistics website.

The dip in healthy life expectancy in the graphs below is a consequence of the new measurement of healthy life expectancy (explained above), and trends are still moving towards a greater period of healthy years after 65.

Health inequalities

The length and quality of people’s lives differ substantially. Some of these differences are unavoidable  (eg, genetic differences) or random (eg, accidents). However, as discussed elsewhere, factors that are amenable to change, such as socio-economic status, education and quality of one’s immediate living environment, also play a significant part, leading to large inequalities in life expectancy.

The gap in life expectancy between rich and poor persists. After some fluctuation, the gap is larger now than in the early 1970s. Men and women from the richest social class can on average expect to live more than seven years longer than those in the poorest social class5 .

• 1House of Commons (1999). Research Paper 99/111
• 2Office for National Statistics (2009). Statistical Bulletin. Period expectation of life, England, 1981-2032 (uses 2008-based population projections)
• 3Office for National Statistics (2009). Statistical Bulletin. Period expectation of life, England, 1981-2032 (uses 2008-based population projections)
• 4Office for National Statistics (2004). Statistical Bulletin. Health expectancies at birth and age 65 in the United Kingdom 1981–2001 and Office for National Statistics (most recent, August 2012). Statistical Bulletin. Health Expectancies in the United Kingdom 2000–2002 to 2008–2010
• 5Department of Health (2011). Statistical Bulletin. Life expectancy, all-age-all-cause mortality, and mortality from selected causes, overall and inequalities

Population trends

People born in the baby boom just after the Second World War will reach their late 80s by 2035 – and are more likely to reach that age than the previous generation.

Age breakdown of England population by national population projections (2012 and 2032)

From 2012 to 2032 the populations of 65-84 year olds and the over 85s are set to increase by 39 and 106 per cent respectively whereas 0-14 and 15-64 year olds are set to increase by 11 per cent and 7 per cent respectively.

Source: 2001 census and 2011 census population estimate

The projected change in the age structure of the population in England over the next 20 years

Source: Office for National Statistics (2010). Statistical Bulletin. 2008-based subnational population projections

Regional population projections

Regional population projections reflect the national trend – with the exception of London. In London there are 1.3 people under the age of 15 for every person over the age of 65, while for rest of the country the number of people over the age of 65 outnumber those under the age of 151 .

The impact of the ageing population

The impact of the ageing population on health and social care services is hard to predict. It may lead to increased costs or the growing number of older people may create new economic and social opportunities.

Factors suggesting that the ageing population will increase costs

• the annual costs of health and social care are significantly greater for older people
• the number of elective and non-elective hospital admissions for older people has increased more rapidly than the growth in absolute numbers
• current projections suggest that a high proportion of older people in the future will be living on their own and are therefore likely to require formal care
• the number of older people with care needs is expected to rise by more than 60 per cent in the next 20 years.

Growth in activity over last 20 years, by age group, England, 1989/90-2009/10

Source: Figures obtained through correspondence with the Department of Health

If current working patterns continue, the ‘old age dependency ratio’ (that is, the number of people over the state pension age for every 1,000 people of working age) is likely to increase:

• in 1971 the ratio was 280 per 1,000
• in 2009 this ratio increased to 314 per 1,000 
• by 2032 the ratio will become 349, even with implementation of higher state pension ages.

Public expenditure on pensions and related benefits is going to rise from 4.7 per cent of GDP in 2007 to 6.2 per cent of GDP in 20322 .

Old age dependency ratio per 1,000 people of working age, UK, 1971-2051

Source: Population estimates and 2010-based principal population projection, Office for National Statistics February 2012

Factors suggesting that the ageing population creates economic and social benefits

After deduction of the costs of pensions, welfare and health care, the Women's Royal Voluntary Service have estimated that the over-65s make a net contribution to the UK economy of £40 billion through tax payments, spending power, donations to charities and volunteering (3).

The Office for National Statistics estimated that over the past decade, an increasing number of older people (those aged 65 and over) are in work. In October to December 2010:

• 2.7 per cent (270,000) worked full-time, up from 1.2 per cent (106,000) in January to March 2001.
• 6.1 per cent (600,000) worked part-time, up from 3.4 per cent (306,000) in January to March 20013 .

Older people also contribute financially through a variety of other routes, including:

• spending power of £76 billion, to rise to £127 billion by 2030, growth of 68 per cent
• provision of social care worth £34 billion, growing to £53 billion by 2030
• volunteering, which has a hidden value of £10 billion per annum
• donations of £10 billion to charities and family4 .

If people can stay healthy for longer, they will remain engaged members of society.

• 1Office for National Statistics (2011). Statistical Bulletin. 2010 based population projections, October 2011
• 2Crawford R, Emmerson C and Tetlow G (2009). Survey. A survey of public spending in the UK Institute of Fiscal Studies
• 3Office for National Statistics (2011). Statistical Bulletin. Older workers in the labour market - 2011
• 4Women's Royal Voluntary Service (2011). Article. Gold age pensioners: valuing the socio-economic contribution of older people in the UK

From 1963 to 1990, deaths in England and Wales were fairly constant with between 250,000 to 300,000 deaths per year for both males and females. From 1990 to 2011 there was a marked decrease in deaths – in 2011 there were 235,000 male deaths and 250,000 female deaths. Over the period from 1963 to 2011 there was a 20 per cent reduction in male deaths and an 11 per cent reduction in female deaths.

Death projections for England on its own show an increasing trend for both males and females from 2012 to 2032. Over this period male deaths are expected to grow by 20 per cent and female deaths by 9 per cent1 .

Death registrations and projections by sex, 1963 to 2032, England & Wales and England

Sources: The King’s Fund analysis of Office for National Statistics (July 2011). Statistical Bulletin. Death registrations by single year of age, England and Wales 2010 and Office for National Statistics (2011) 2010–based national population projections, Mortality Assumption.

• 1The King’s Fund analysis of Office for National Statistics (July 2011). Statistical Bulletin. Death registrations by single year of age, England and Wales 2010 and Office for National Statistics (2011) 2010–based national population projections, Mortality Assumptions