This Challenge Poverty Week, Public Health Scotland’s CEO, Paul Johnston explains how PHS are advocating for a Scotland where everyone has access to an adequate income to enable a healthy standard of living:
Living in poverty is detrimental to health and one of the main causes of poor health and health inequalities, with negative consequences for children and adults. Policy changes which impact on the drivers of poverty (income from employment, income from social security and the cost of living) have the potential to impact on population health and health inequalities.
Since 2010 a series of changes have been implemented to the UK (reserved) social security system. An intention of The Welfare Reform Act 2012 which triggered these changes was to help people into work and reduce poverty for adults and children, which in turn would lead to improvements in health.
Policies included reduced financial support to low-income families with three or more children and increased conditionality for lone parents. These are families who already have an increased risk of living in poverty.
Since 2013, Public Health in Scotland (PHS) has been monitoring the economic and health trends associated with Welfare Reform. Our latest report Improving Lives? highlights that the anticipated improvements to income and health from Welfare Reform have not been realised for people in Scotland.
Aspects of health have worsened or remained unchanged since 2010 and importantly, many of these trends pre-date the COVID-19 pandemic. These trends were also observed for the rest of the UK. A forthcoming PHS systematic review found that for people exposed to the changes, UK Welfare Reform made mental health worse, and had no positive effect on physical health.
While some working-age families and children benefitted from Welfare Reform (through increased employment), these gains were offset by those who were harmed by the changes.
This is concerning, especially as our report shows that population groups most likely to be affected by these changes are the groups who are already more likely to be at risk of or experiencing poverty. We know from 2013 that the relative child poverty rates in Scotland increased after a period of decline.
Evidence also tells us that mental health problems became more prevalent, especially after 2015, while health inequalities have risen. The period also saw stalled improvement or worsening trends in financial insecurity and long-term sickness.
This Challenge Poverty Week, we are advocating for a Scotland where everyone has access to an adequate income to enable a healthy standard of living. This will help to create a Scotland where everybody thrives.
A number of changes are needed to make this happen. These include promoting quality employment which supports good health. Almost 19% of employees in Scotland aged 18-55 are in poor quality work, and most working-age adults and children in poverty live in a household where someone works.
We also need to ensure our social security system protects people’s mental health and wellbeing. This could include an Essentials Guarantee to protect people from hardship, supported by 72% of the population.
It could also include improved support for working-age adults with health problems, especially mental health problems.
We know that change is possible.
During 1997–2010 policy choices by the UK government directed financial support at children and pensioners and as a result poverty fell for both of these groups. This period also saw increased employment rates translate into improved mental health for lone parents. This proves that we can make a difference to people’s lives through social security and employment policies.
In Scotland, child poverty rates are lower than many other UK nations. In Scotland, we are doing things differently to tackle child poverty.
The Scottish Government estimates that around 100,000 children will be kept out of poverty as a result of the Scottish Child Payment this year and low-income families are being further supported with the costs of pregnancy and looking after children through Best Start Grants and Best Start Foods payments.
Scotland is delivering a strengthened employment offer to parents, to provide holistic support and address specific barriers to enable more parents to gain and progress in work. This along with focussed action to create a Fair Work Nation, which includes supporting more employers to pay the living wage, provides a platform to build on, to support more parents to escape poverty.
Learning and evidence from past UK policy approaches and Scotland’s actions to tackle child poverty should be used to inform further policy changes to address poverty and improve health.
It is imperative that providing an effective social security safety net for when families need it and creating high quality, flexible employment opportunities for parents, will be central to the UK’s child poverty strategy going forward.
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