Social Care Costs of Depressive Symptoms in the English Older Population: Then Role of Housing Quality Improvements.

Background and Objectives: Poor housing conditions pose a substantial threat to older people's mental health and create inequalities in social care needs. However, their economic consequences for the social care sector have not been thoroughly investigated. This study projects the costs of social care for community-dwelling older people with depressive symptoms under different housing intervention scenarios in England. Research Design and Methods: Drawing on data collected from 10,601 individuals (33,461 observations across 4 waves) participating in the English Longitudinal Study of Ageing, we combined a Markov model with a Macrosimulation model to make projections of social care costs. Multinomial logistic regression and linear regression analyses were conducted to derive the parameters for the 2 simulation models. Results: We estimate that the costs of unpaid care for older people with depressive symptoms will rise from £33.6 billion in 2022 to £59.9 billion in 2042, and the costs of formal home care will rise from £4.2 billion in 2022 to £8.1 billion in 2042 in the base case scenario of no interventions to improve housing quality. In a scenario where the number of housing problems is reduced to zero, the costs of unpaid care and formal home care in 2042 are projected to rise to be £3.5 billion lower and £0.3 billion lower, respectively, than the no intervention scenario. Discussion and Implications: Housing improvements reduce social care demand in the older population by delaying and reversing the progression of depressive symptoms, which has the dual benefits of elevating personal well-being and generating long-term cost savings in the social care sector.