Linking poverty, inequality and health

We held the second seminar in our Delivering Public Health series on May 15th, with a focus on the impact of poverty and inequality on increasing health outcomes at local level.

Laura Austin Croft, who leads on the GLA’s health inequalities work, started us off. She was involved in the development of the Health Inequalities Strategy in 2010, and ran through achievements so far in meeting its objectives. These took the form of cross-departmental programmes and campaigns involving GLA’s housing, transport, economic development and health teams. The London Health Commission, established in September 2013 by the Mayor of London, is currently seeking evidence, and Laura took the opportunity to ask the audience for views on future direction.

Rachael Takens-Milne, Grants Manager for Trust for London, ran through some of the data from the latest edition of London’s Poverty Profile, a data resource funded by the Trust. Most striking was the fact that whilst the percentage of people in poverty in London has not changed significantly over the last decade, there have been three key demographic and spatial shifts: the average household in poverty is now found in outer London, is housed in privately rented accommodation, and contains at least one person in employment. Whilst there are clearly links between the poverty of an area and its level of health inequalities, others – such as child mortality – do not follow a particular spatial pattern, demonstrating that certain issues can be tackled successfully at local level.

Finally, Ellie Kuper Thomas, Senior Strategy and Performance Officer at London Borough of Tower Hamlets, reported on the key findings of their Fairness Commission. She explained the importance of engaging with different sections of the community to maximise outcomes; for example, the commitment from the private sector to give work experience to 25% of young people in Tower Hamlets is a step towards a more equal society in the borough.

Poverty inequality and health panel

Event chair Angela McConville, Chief Executive at Westway Trust, drew in the audience for an engaging Q&A and discussion. Points that came up across the event are:

The New Homes Bonus has been top sliced to be spent on jobs and growth priorities by the London Local Enterprise Partnership (LEP). (This is a scheme to boost funding for LEPs nationwide). This has reduced borough funding for affordable housing, and dialogue with the GLA Housing Committee is required to discuss mitigation.

With the changes in public health responsibilities, it was posed that fuel poverty may have fallen through the net, often not being a clear priority of Clinical Commissioning Groups or boroughs, though some boroughs are ensuring that fuel poverty is considered when revising Joint Strategic Needs Assessments.

The Social Value Act can keep poverty on the agenda and serve as a tool for reducing inequalities through public service contracts; a high profile example being the number of local people employed at the London 2012 Olympics. On the other hand, there are EU procurement rules that could potentially restrict this.

There was a sense of frustration that poverty and inequality are still so high in London, despite decades of hard work both strategically and on the ground. Short-termism was recognised as a factor, which could be countered by influencing Local Plans that tend to have 20-year timelines. And with both Health and Wellbeing boards and Local Plans in relative infancy, boroughs have the tools to develop solutions.

Thanks to all the speakers and attendees, and to Arup for hosting. We hope to see some of you at the third and final event in the series looking at collaborative approaches to food and health on 5th June.

Slides from the event are available below:

Podcast: Laura Austin Croft
Podcast: Rachael Takens-Milne
Podcast: Ellie Kuper Thomas