With poverty rising and no end in sight to the financial crisis, it is incumbent on all of us to take collective and meaningful action
For the second time in three years, the UK is facing a public health emergency in which the most vulnerable in our society are bearing the brunt. Like the Covid-19 pandemic that came before it, the cost of living crisis, left unchecked, will widen health inequalities and leave a generation with poorer mental and physical health than their predecessors.
Poverty is a long-standing and deeply entrenched problem in the UK. As income stagnates and inflation grows, increasing numbers of people, who at one time would have been able to weather the storm, are finding themselves unable to afford the basics. Almost 4 million children are now living in poverty, 75% of whom live in a household where at least one person is working. The situation is now worsening further with forecasts suggesting the number of people in absolute poverty will rise from 11 million to 14 million by the end of 2023/24.
The impact this will have on health outcomes is stark. There is a 27-year life-expectancy divide in men and a 21-year difference for women between the least and most deprived areas of the country – a gap that was already widening before the pandemic. Rates of obesity, cardiovascular disease and diabetes are increasing and survey after survey shows physical and mental health is being damaged by the financial crisis.
It is clear that the economic and social circumstances we all live in have a greater influence on our health than any other factor. Yet the inextricable link between economic prosperity and health is often not well understood. Rising poverty levels and widening health inequalities have severe consequences for the individual, for the NHS and social services, and for the economy as a whole.
We cannot simply restate the problem and wring our hands. We need targeted, evidence-based, long-term intervention to tackle this public health crisis at a local, regional and national level.
In May, the Faculty of Public Health, the Royal Society for Public Health, the Royal Society of Medicine, and the Association of Directors of Public Health came together at a special conference to identify meaningful solutions that can be implemented in key areas including child poverty, housing and fuel. Those working in public health are doing the best they can with ever-dwindling budgets but cannot solve this alone. Collective action is needed from national governments, alongside businesses and local councils.
It is important we identify where to direct our energies to have greatest impact. We need clear data and evidence on how poverty and the cost of living crisis is affecting different populations including ethnic minorities, those with young children, the elderly and those with disabilities, and to identify the barriers that individuals face in accessing services and help.
We need a national, wide-ranging strategy to tackle poverty and improve health that includes bold policies on energy prices, income, housing reform, food security, and a living wage. Strategies such as a minimum income guarantee, universal basic income and universal basic services must be seriously considered to ensure economic success and better health for everyone.
We need urgent reform to Universal Credit to ensure households can afford the basics. This also means removing the benefits cap and scrapping the two child limit. Figures show 90% of low income households receiving Universal Credit are going without at least one essential like food, a warm home or toiletries. For people who have lost their job, who are caring for sick relatives, or who have no safety net when life circumstances change, it is unconscionable that they are struggling to feed their families, to heat their homes and keep the lights on.
We need a national housing strategy to deliver more affordable and quality, secure social and rental housing. An estimated 8 million people in England are living in overcrowded, unaffordable or unsuitable homes. Those living in poverty are particularly vulnerable to poor conditions and temporary housing. The tragic death of two-year-old Awaab Ishak from a respiratory illness caused by exposure to mould should be a wake up call to all of us.
Child food poverty is one of the greatest and escalating challenges we have as a nation, but is also one where we have the ability to make real change by widening access to free school meals.
Local authorities are already using data and intelligence to design interventions that meet the needs of their populations. Local public health teams are collaborating with social care, housing, education and the voluntary sector to provide household support grants and emergency food vouchers, wellness checks, and hubs offering access to food banks, clothes and toiletries as well as advice on health and wellbeing and warm spaces in the community. Yet this emergency response is being done against the backdrop of repeated real term cuts in public health funding. We need to move beyond fire-fighting and towards a more sustainable approach to public health.
We have people who are suffering, children who are starving and individuals dying early. No organisation can deal with this alone. Tackling the impact of the cost of living crisis will require prioritisation and collaboration to ensure health, justice and prosperity for everyone.
Professor Kevin Fenton
FPH President
Professor Paul Roderick
Chair, FPH Poverty Special Interest Group
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