The impact of the economic downturn and policy changes on
health inequalities in London UCL Institute of Health Equity
www.instituteofhealthequity.org
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Commissioned by the London Health Inequalities Network. To
assist local authorities in London to identify and mitigate
negative impacts of the economic downturn and welfare reforms on
health inequalities and the social determinants of health to 2016,
particularly employment, income and housing impacts, by providing
the following: Literature review on the likely impacts. Some
recommendations regarding what local authorities could do to
minimise any negative effects. A set of indicators that local
authorities should use to monitor the impact of the changes in
development.
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London has large inequalities in mortality and health Action to
reduce health inequalities needs to focus on the social
determinants of health
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Evidence from previous economic downturns suggests that
population health will be affected: More suicides and attempted
suicides; possibly more homicides and domestic violence Fewer road
traffic fatalities An increase in mental health problems, including
depression and possibly lower levels of wellbeing Worse infectious
disease outcomes such as TB + HIV Negative longer-term mortality
effects Health inequalities are likely to widen
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The report specifically looks at the impact of the recession on
income, employment and housing: The economic downturn is causing a
rise in unemployment, a fall in income for many households, which
in turn may cause housing problems for those who experience lower
incomes. Unemployment, low incomes and poor housing contribute to
worse health. These problems are more likely to occur among
particular groups within the population and among those already on
low incomes.
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Employment Unemployment is bad for health and can have
long-term impacts, particularly for those who experience long-term
or early unemployment London unemployment up from 6.7% (Q2 2008) to
10.1% (Q1 2012) More deprived areas in London have higher
proportions of young people who are NEET Self-rated health can be
worse in an economic downturn for those who stay in work higher
levels of job security anxiety, bigger work demands, financial
problems resulting from pay constraints, lack of control over work
situation Increased competition for jobs may drive down wages and
working conditions Employers may be less likely to prioritise
work-life balance, flexible working and diversity initiatives Fall
in equal pay and sex discrimination claims recently fear of job
loss?
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Many of those in poverty live in working families. Receiving a
living wage will support their chances of remaining above the
poverty threshold and receiving the minimum income for healthy
living
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Impact of the welfare reforms 18 billions welfare savings
Intended to strengthen incentives to work, but there is a shortage
of jobs. Many households face reduced benefits lower incomes,
harder to cover housing costs. Affects low-income households, in
particular: workless households; households in more than 16 hours
per week of low-paid work; lone parents; households with children;
larger families; some ethnic minority households; disabled people
reassessed as ineligible for new benefit; private rented tenants.
Households unable to afford current accommodation will need to find
an alternative solution, eg. Become employed, re-negotiate rent, go
into rent arrears (leading to repossession or non-renewal of
tenancy), become homeless, become overcrowded, compromise on
housing conditions, move to a less expensive area of the capital or
out of London. London should expect significant migration within
and between boroughs as more areas become unaffordable. Likely
widening of socioeconomic health inequalities.
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Recommendations 1.Assess and respond to area needs Local
measurement and monitoring Cross-sector working 2.Ensure sufficient
incomes Strengthen financial incentives to work Sufficient income:
Employers should pay a living wage that ensures a minimum income
for healthy living Good quality and affordable childcare 3.Ensure
sufficient and affordable housing
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4.Ensure an adequate supply of good jobs Stimulate employment
Encourage good work: Jobs must be sustainable and offer a minimum
level of quality, to include not only a decent living wage, but
also opportunities for in-work development, the flexibility to
enable people to balance work and family life, and protection from
adverse working conditions that can damage health 5.Sufficient
provision of services to cope with likely issues NATIONAL MEASURES
inc. Health equity impact assessments of all policies and Active
Labour Market Programmes
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Institute website: www.instituteofhealthequity.org Full report:
http://www.instituteofhealthequity.org/Co
ntent/FileManager/pdf/london-full-rep- medium-res.pdf
www.instituteofhealthequity.org
http://www.instituteofhealthequity.org/Co
ntent/FileManager/pdf/london-full-rep- medium-res.pdf