We know that people in poverty have worse health outcomes. But where’s the sense in treating ill health without tackling the poverty that enables it?

Clean Slate and Quids in! are thinking about health and wellbeing. We’re still in the business of helping people on low incomes to become better off but we keep coming back to the same question. If helping someone lift themselves out of poverty isn’t about improving their life chances, then what are we doing it for?

Our day-to-day contact with people on low incomes, and all our research among 240,000 Quids in! readers, reminds us that financial insecurity makes people frightened, anxious and depressed. Sixty per cent of them, to be precise, according to our latest research, increasing to 73 per cent among working-age social tenants not in full-time employment. That same research found 48 per cent skipped meals; and a staggering 68 per cent among those who cannot work.

If they don’t have money, many healthier choices are just closed to them

Hannah Poll, Diabetes UK

I recently met with Hannah Poll, Prevention Policy Lead at Diabetes UK. We compared notes on health inequality and how health commissioners and wellbeing charities tend to go after low-income households to promote healthy lifestyles. I asked what happens if we tackle the root cause, poverty. “It gives them the choice. If they don’t have the money, many healthier choices are just closed to them.”

Over the next couple of months, we’ll come back to health inequality and mental health as priority concerns for financial wellbeing activities. Right now though, we’re reflecting on our relationship with food insecurity. The domestic type, not so much the threat faced by all of us from climate change and war in Ukraine… although we know from fuel prices that these are very real things to worry about.

For over a year now, Clean Slate has offered money guidance to everyone using foodbanks in and around Bath, where our West of England ‘Quids In Centre’ is based. The principle, supported first by Feeding Britain and more recently by Trussell Trust, is that if someone cannot afford food then they should have priority access to money guidance to help them stretch and grow their budget. We help identify additional income, benefits or grants, or employment if they’re able, and budget savings they might make. Participants are on average hundreds of pounds (a year) better off. It has a better prospect of stopping or slowing the revolving door of crisis support than food parcels
alone.

Regulated money advice is not the only hero service in town

The same goes for Healthy Start Vouchers and, for that matter, Household Support Fund payments and DWP loans. Why just hand out money? Schools have universally failed to set us all up with the bare necessities for good money management, so we have to find other mechanisms for reaching out to adults in need. It’s not like there isn’t low-hanging fruit. How many times will I hear the same question: “Why does no one ever tell us this stuff?”

So, why is it so hard to get money guidance taken seriously? Even debt advice is better-funded and written into government plans for supporting people in financial difficulty. But debt advice is still a crisis intervention and is not really about recalibrating and nurturing how people think about their money. Nor is it delivered when people are primed to learn, as consumers usually only access this service when they cannot tolerate the constant demands for payment any longer. Our money guidance service truncates the twelve to eighteen-month wait people endure to around six weeks. And that’s if we can’t give participants the words – and the bottle – to speak to council tax collectors, landlords and utility companies for themselves. Regulated money advice is not the only hero service in town.

Earlier this month, I was at an event for the Money and Mental Health Policy Institute, fronted by Martin Lewis. They made a clear and robustly evidenced call for investment in money guidance within Talking Therapies. They want new service users to be asked a mandatory triage question on money worries and a specialist on hand for those who are struggling. It would save enough in mental health care to fund the service. And make a saving. And improve health outcomes. The same principle would be true if food handouts had guidance built in. No need to ask about money worries because they are self-evident when someone is forced to seek a food handout.

The government and shadow ministers attending the event to launch the report, Breaking the Cycle, honed in on employment as the way to help people out of money worries. Both missed an important point: Financial problems are a barrier to both mental wellbeing and employment, so this guidance is needed to unlock both. It’s like turning a blind eye to the number of kids who turn up at school hungry. They are no more able to participate and learn in the classroom than over-indebted people are able to find and hold down a job.

Breaking the cycle is about grasping the money nettle. Tackle the root cause, or key exacerbator, of these types of ill-health. Engage people when they reach out for help. Invest in more than crisis interventions.

Image: Polina Tankilevitch / Pexels