Claire Ainsley, Executive Director of the Joseph Rowntree Foundation, writes as we prepare for the launch of our final report in our year-long inquiry into health and social care in England, on the link between poverty and health, and how solving poverty can help improve our nation's health.
If there is one lesson we should learn from the last couple of years it is that millions of people across our country do not feel that the current public and political debate properly represents the challenges they are facing in their daily lives.
We are seeing record levels of public concern about poverty and rarely a day goes by without there being a news story about our nation’s health getting worse. However, seemingly little progress has been made so far in developing a systemic approach to tackling the root causes of both these issues.
In December, the Joseph Rowntree Foundation (JRF) reported on the unacceptable rise in child poverty over the last five years and showed how in-work poverty is now rising faster than our strong employment rate.
The upcoming publication by the Centre for Progressive Policy, Beyond NHS: Addressing the root causes of poor health, will highlight an important issue central to JRF’s work: the huge impact struggling to make ends meet has on every aspect of a person’s life – especially their health and well-being.
“For about three years I was in and out of work. My son was the only thing that kept me going. I got into debt with nurseries for childcare. I split up with my boyfriend and I became really ill.” - Single mother from Leeds
Worrying figures released recently found that the prevalence of emotional disorders, such as anxiety and depression, are almost twice as high in children living in households in receipt of low-income benefits.It’s almost three times as high for children living in a household where someone has a disability. Moreover, people living in the most deprived areas of the country are more likely to attend accident and emergency departments and are at greater risk of dying at a younger age.
None of us want to see a situation where the amount of money your family has restricts your ability to live a long and healthy life. As well as people’s income affecting their health, it is shameful how much a person’s health prospects vary depending on where they live.
Low pay, insecure work combined with the lack of decent and affordable housing is bound to take its toll on people’s physical and mental health. This is made worse by the fact that benefits have been frozen for years, meaning the support available to families is falling further and further behind what they need.
The grinding pressure of worrying from day-to-day, meal-to-meal where the money is going to come from, leaves individuals with very little space to think beyond the present moment.
“If I was to compare things to an object, it would be a hamster’s wheel. No matter how hard I work and how hard I push myself, I still feel like I’m getting nowhere.” - Single working mother from Fife
This makes it clear that something major needs to change. Despite there being actions individuals can take to improve their health, we all have a shared responsibility to bring about the systemic change needed to improve our nation’s health. We need to tackle the underlying factors that affect long term health if the public purse is to catch up with the demands placed on it.
Tackling economic and social factors harming people’s health is an essential part of building a more inclusive economy and a healthier society.
This needs to take the shape of more and better-paid jobs which provide security for workers. We also need to seriously increase the supply of decent low-cost rented homes, as well as reforming Universal Credit so that it more effectively loosens the grip of poverty by providing enough support when people need it.
For too long we have failed to do enough to provide people with fluctuating health conditions with the support they need both to live a healthy life and, where possible, access opportunities for them to succeed in the workplace.
In addition to this, there is already so much great work taking place in communities across the country. The NHS and other public health practitioners can be a huge force for positive change in our society. We must learn from current best practice to identify ways to better connect people with the other support services they need.
At JRF we are pleased to be supporting the Collaboration for Wellbeing and Health, which is being convened by the Health Foundation. The Collaboration aims to build on the existing work and evidence to create the conditions for people to live healthier lives by taking a social and economic approach to health.
There is also encouraging work taking place in the West Midlands, where Public Health England are actively working with the Centre for Progressive Policy and other local organisations to drive forward the agenda of the Inclusive Growth Unit set up by the West Midlands Combined Authority.
All of this tells us that there is a real appetite and restlessness to bring about the change which will help people break free from poverty. We have made progress in reducing child and pensioner poverty before and we can do so again. But it will require a comprehensive, joined up strategy where all of us play our part and we welcome the contributions made by the Centre for Progressive Policy and like minded organisations to this debate.
This is a defining moment in our country’s history. We must make solving poverty a top priority if we are serious about improving the nation’s health and building a brighter future where everyone can thrive.
Claire Ainsley is Executive Director of the independent Joseph Rowntree Foundation. She is a member of the advisory board of the Centre for the Study of British Politics and Public Life. Her book, ‘The New Working Class: how to win hearts, minds and votes’, was published in May 2018 by Policy Press. She is a trustee of Involve, a public participation charity.