In a lot of the Westminster reporting, poverty and health are treated as different, maybe even rival concerns – a story might say the Chancellor has decided to “put the NHS first” and so action to tackle family hardship is going to have to wait.
But for scholars of public health, the two things are umbilically joined: poverty is probably the single most important cause of preventable ill-health and disease. Sometimes the links are obvious, poor food being one clear channel. The damage – occasionally fatal – that damp housing can do to lungs is another.
Sometimes, particularly with mental health, the connections are more complex, but still easy enough to grasp. In my research for the Joseph Rowntree Foundation, I found that the financially insecure were more than twice as likely to report waking up worried at night or having a stilted social life. Here
a “spiral” is at work: poverty creates anxiety about paying the bills, anxiety knocks social confidence, which diminishes work prospects, and so ends up deepening poverty again.
Occasionally, however, the association between poor health and hardship, though crystal clear in the data, work in more oblique ways. When a broken oven can’t be repaid without a debt from the loan shark, or the nearing of a child’s birthday is experienced as a financial threat, poverty gets under the skin. Such recurrent, money-related stressors gradually translate into hypertension, diabetes and ischemic heart disease, then eventually strokes and heart attacks. It is, then, no coincidence that a century of uninterrupted progress on life expectancy started to peter out after George Osborne took an axe at so many benefits and services for the poor. Beneath the headline of average stagnant longevity over the last decade or so, the official statistics record that women specifically in poorer neighbourhoods started dying earlier than previously in the late 2010s; the pandemic then imposed the heaviest death toll on men in the same deprived postcodes. One lesson for today’s Labour government is that, even if tackling deeply poverty isn’t one of its five “missions”, it will have to get a grip on rising penury to stand any chance of delivering on its “health mission” of a country “where everyone lives well for longer.”
Another is that it needs to proceed very carefully as it overhauls social security for sick and disabled people. The aim is to arrest a rising caseload to make savings for the taxpayer and, ministers hope, encourage some extra disabled people into work. Both goals have a logic, but for the sake of “living well for longer” it’s essential to remember the large – and probably overwhelming – proportion of the caseload that won’t realistically be moving into work any time soon. And even those claimants who might do so will be alarmed that benefit cuts are due to bite before the enhanced employment support that’s promised is fully up and running.
Yes, it could be good news for some sick and disabled benefit claimants and the taxpayer alike if more people are supported into work. The risk, however, is that many poor families who rely on such benefits could become poorer again; and, moreover, that the effects will ripple across the depressed local economies where these claimants are concentrated. Absent an unprecedented transformation in both employment opportunities and wider support services, we could end up with more poverty rather than less. And that wouldn’t be a recipe for everyone living well for longer, but rather for a sicker society than before.
This article first appeared in our Spotlight on Child Poverty supplement, of 23 May 2025, guest edited by Gordon Brown.
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