The escalating crisis of poverty and deepening financial insecurity in the UK represents a significant obstacle to public health and perpetuates health inequalities.
Poverty detrimentally affects health across the lifespan, particularly impacting children, and diminishes life expectancy and healthy life years. These health ramifications reverberate across the NHS, public services, the labour market, the economy, and society as a whole.
To safeguard the well-being of our communities and combat widening health disparities, prioritising the prevention and alleviation of poverty and its health impacts is imperative.
At the Faculty of Public Health (FPH), we are steadfast in our commitment to addressing the health impacts of pervasive levels of poverty that afflict millions annually, a challenge further exacerbated by the current 'cost of living' crisis.
The state of UK poverty
The statistics underscore the severity of the situation: In 2021/22, government data revealed that 14.4 million people, including 4.2 million (1 in 3) children, lived in poverty. It disproportionally affects certain types of household including lone parent families, families with 3 or more children, households with a carer and/or disabled member, and households from many ethnic minority groups. Poverty has deepened, becoming more severe in low income households so that the Joseph Rowntree Foundation (JRF), reported that 3.8 million people experienced destitution in 2022, a figure almost two and a half times higher than in 2017.
UNICEF reported a 20% increase in child poverty in the UK between 2012 and 2021, surpassing all other EU/OECD countries. The Resolution Foundation forecasts an additional 300,000 people falling into absolute poverty in 2024/5.
A public health crisis
Living in poverty has acute and chronic health effects across the lifespan, driving health inequalities, increasing susceptibility to poor health outcomes, and hindering access to essential resources for well-being. Childhood poverty profoundly impacts cognitive, behavioural, social, and educational development, with enduring repercussions on life prospects and health. The rise in infant and child mortality, particularly among marginalised communities, underscores the urgency of addressing this crisis. The Royal College of Paediatrics and Child Health have said rising child poverty is a major concern and “reducing child poverty must finally become a national priority...this has to be a wake-up call for us all and [we] urge our political leaders to action." A recent Academy of Medical Sciences report has highlighted the UK’s worsening child health and the impact of child poverty.
The horrific health impacts of living in poverty were starkly brought to light by the tragic case of Awaab Ishak, a 2-year old who died from a severe respiratory condition caused by prolonged exposure to mould. Living in cold and damp homes can result in respiratory problems and other health issues, especially in children, the elderly, and those vulnerable due to pre-existing health conditions.
Inadequate nutrition and hunger lead to a range of health issues, including deficiency-related conditions such as rickets and stunting, both of which have increased in children in recent years. Poor diet due to lack of affordability and access to healthy food leads to obesity and risk of many chronic diseases.
Constantly worrying about having enough money can also lead to chronic stress, anxiety, and depression, and exacerbate existing mental health problems. Poverty also restricts social participation, leading to isolation and loneliness. And both the frequency and impact of health harming behaviours (tobacco, alcohol misuse, gambling) are greatest in low-income households. These are just some of the many negative impacts of poverty on health.
All of this ultimately leads to the increased risk of long-term conditions, reduced healthy life expectancy, and premature mortality, contributing to the life expectancy gap (between the least and most deprived communities) of 10 years for men and 8 years for women, and healthy life expectancy gap of around 19 years. In recent years, both men and women in the most deprived areas have seen their life expectancy decrease.
Taking action
National governments bear responsibility to ensure sufficient income for good health, especially during crises. A comprehensive, national system wide strategy addressing poverty and improving health is imperative. It should encompass bold policies on ensuring secure employment with the real living wage, an adequate safety net for all through the benefit system, and housing reform to ensure affordable quality homes for rent. It will also need to address food and energy security, access to affordable childcare and public transport, and ensure high quality education and skills training for all ages. Furthermore, a fairer distribution of wealth through taxation reforms and innovative solutions like universal basic services must be seriously considered to ensure economic prosperity and improved health outcomes for all.
Public health teams have played a pivotal role in mitigating the cost-of-living crisis locally, collaborating across sectors to provide essential support and resources to households in need. However, these efforts are challenged by repeated cuts in public health funding, necessitating a shift from reactive responses to sustained action in preventing and mitigating poverty.
At FPH, we are committed to leading the charge against poverty in public health, and have prioritised this as one of our eleven Board Led Focus Areas for action between 2022-2025. Recognizing poverty as a public health issue, we focus on raising awareness, developing resources, supporting professionals, and advocating for policies promoting health equity.
Our Poverty Special Interest Group (SIG), established in October 2022, underscores our commitment to addressing poverty's root causes and mitigating its impact on health. The SIG has developed a range of evidence-based resources for members to support them to take action in this area, and is developing more. It is collaborating on cross-cutting issues with other SIGs (e.g. on transport, sustainability) to develop webinars for Faculty members.
In 2023 we collaborated with the Royal Society of Medicine, Royal Society of Public Health and the Association of Directors of Public Health to run a one-day event on poverty which led to a consensus statement, a blog, and a summary was reported in an article on the BMJ. We are running a similar event in May 2024.
FPH members in Scotland produced the Scottish Call for Action: The Cost-of-Living Crisis is a Health Crisis: A Call to Action from the Faculty of Public Health in Scotland Oct 23. We have supported the Joseph Rowntree Essentials Guarantee campaign and are exploring opportunities to strengthen collaborative work with ‘Health Equals’ particularly on work and housing.
Recently, the Faculty also led a cross-sector call to support better access to nutritious food for children and families most in need, launching a new report “The Health of the Next Generation: Good Food For Children�? at a major event at the House of Lords.
Finally, the FPH is committed to ensuring that the training and examination process for public health registrars addresses the causes of poverty, its consequences for public health and national and local solutions. To achieve this the Poverty SIG is working to identify opportunities to ensure poverty is addressed in the curriculum, in the training resources available and in the assessment process.
Conclusions
Poverty in the UK constitutes a public health crisis, stemming from systemic socio-economic factors. To create a society where everyone can thrive and be healthy, we must address the underlying determinants of poverty, ensuring adequate income, stable jobs, quality housing, education, and access to essential goods and services.
FPH's work on poverty is centred around advocating for a more just future that fosters a healthier and greener society for all. Together, through collective action and unwavering commitment, we can confront this crisis and build a brighter, healthier future.
