Defining a minimum income for healthy living (MIHL): older age,
England
JN Morris, Paul Wilkinson, Alan D Dangour, Christopher Deeming
and Astrid Fletcher
London School of Hygiene & Tropical Medicine, Keppel Street,
London, WC1E 7HT.
International Journal of Epidemiology, Advance Access published
online on July 12, 2007
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Abstract
Background Worldwide biomedical and social research is providing
evidence on the personal requirements for health and well-being.
Assessment of the minimum personal costs entailed in meeting
these requirements is important for the definition of ‘poverty’.
Barriers to health must arise if income is below this level. We
demonstrate the principle of such assessment for people aged 65
years plus without significant disability living independently
in England.
Methods Current best evidence on the needs for healthy living
was derived for nutrition, physical activity, housing,
psychosocial relations/social inclusion, getting about, medical
care and hygiene. We used conclusions of expert reviews,
published research and where necessary, our judgement. This
knowledge was translated into presumptively acceptable ways of
living for the specified population. Current corresponding
minimal personal costs were assessed from familiar low cost
retailers/suppliers or, where unavoidable, from national data on
the expenditure of low-income older people.
Results Minimum income requirements for healthy living, MIHL,
for this population in England is 50% greater than the state
pension. It is also appreciably greater than the official
minimum income safety floor (after means testing), the Pension
Credit Guarantee; that will also have to meet any extra costs of
disability.
Conclusion Objective evidence-based assessment of MIHL now is
practicable but not presently as a basis of health and social
policy in the UK or elsewhere apparently. Such assessment could
also be an operational criterion of poverty and society's
minimum income standards. The results suggest that inadequate
income currently could be a barrier to healthy living for older
people in England.
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