Tackling poverty and supporting people’s health

08 October 2019

This blog marks both Self Management Week and Challenge Poverty Week and discusses self-management of health conditions in the context of people living in poverty.

A 2017 United Nations report into disabled people’s rights in the UK found that erosion of basic rights, such as transport, work, housing, health and social security, were preventing many from living independent lives. At the same time, further erosion of two significant disability benefits has led to UK legal challenges

So, it’s timely that campaigns to challenge poverty and raise awareness of the importance of self-managing health conditions are in the spotlight this week. In Glasgow, well-proven links already exist between poverty and ill health. Around 1-in-4 Glaswegians live with some type of disability or long-term health condition which limits activity or ability to work. The scale of this challenge is a reminder of the recognised need to increase community engagement to support bolder ways of delivering health and social care services across Scotland.    

There are many good examples of different sectors coming together to address some of these challenges. Over the last two decades, welfare and money advice services have been effectively working in GP surgeries, clinics treating people with cancer and alongside midwives and health visitors supporting families with young children. There is good evidence that this way of working puts much needed money in pockets and encourages people to access services which they might not usually engage with. 

The value of this type of partnership work was reinforced in our recent report. Over 12 months, nine GP practices based in some of the most disadvantaged areas in Glasgow referred 654 people for money advice. The project reached many reporting no past contact with advice services. This ensured people received the benefits they were entitled to claim and led to around £1.5 million in financial gains, with disability benefits making up half of the gains. Support was also given to manage personal debts, which amounted to £470,000. For every £1 invested in this project the return was £25. 

Before receiving this support, many people were surviving on income way below the standard poverty measure. Therefore, it doesn’t take a leap of imagination to see how grinding money worries, feeling isolated and not knowing where to turn, can lead to people with health conditions (and those taking up to nine medications) not viewing self management as a number one priority. 

In a podcast to accompany this blog, a conversation between a local GP and advice worker paints a vivid picture of how working alongside vulnerable people can build enough trust for them to accept support and gain more control over their lives. Their conversation on supporting someone whose life had been shaped by trauma and a general lack of trust in people is worth listening to.

There are valuable lessons for anyone supporting people with long-term health conditions, particularly Community Link Workers based in GP practices and the new Social Security Scotland workforce which will eventually be responsible for disability benefits currently being administered by the Department of Work and Pensions. 

Placing welfare advice and other support services in NHS clinics and surgeries is not a silver bullet that will abolish poverty or address some of these bigger health care challenges. However, the learning gained over the last two decades can at least spark conversations for more co-ordinated efforts across health, transport, education, work and housing. This is vital if we want to ensure that all people with disabilities and limiting health conditions can live dignified and independent lives.

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About the author

James Egan Public Health Programme Manager

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James Egan is a Public Health Programme Manager and jointly leads the work programme ‘Tackling inequality across the life course’ with Fiona Crawford. Some of the key areas being developed under this new programme of work include:

  • Improving understanding of continuing welfare changes with a focus on the roll out of Universal Credit and associated developments around in-work conditionality
  • Understanding and promoting equity of access to services by vulnerable population groups
  • An early years focus that includes improving understanding of the causal pathways between Adverse Childhood Experiences and health outcomes and evaluation of childcare, early learning and interventions.
  • Work to explore the potential of new forms of social protection in a 21st century context

In his current role, James is leading and supporting the development of work on welfare changes and equity of access to services by vulnerable population groups. He is also working with partner agencies to explore the potential of new forms of social protection in a 21st century context.

Read all articles by James Egan

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