During Challenge Poverty Week, Ashley McLean from the Poverty Alliance spoke with healthandcare.scot about the intersection of health, wellbeing and poverty – and what is still needed to support Scots in poverty.

Ahead of the Poverty Alliance’s annual conference in Glasgow, here are some key insights from the charity.

Poverty is a public health crisis. This sentiment and call to action is shared across third sector organisations and the Scottish parliament's own Health, Social Care and Sport Committee inquiry, which states: ‘tackling poverty must be considered a major public health priority’.

Marking 30 years of tackling poverty, the national charity to advocate for and support people experiencing poverty urges government to make change. Poverty Alliance today holds its ‘Learning from the Past – For a Better Future’ conference. Ashley McLean, Policy and Parliamentary Officer for the Poverty Alliance, outlines the organisation’s work around causes and solutions to poverty:

“Poverty Alliance is Scotland's anti-poverty network. Together we have approximately 400 members who stem from individual members of the public who've got a vested interest in tackling poverty, all the way up to big NGOs, like Barnardo’s.

“Basically, what we do is influence policy and practice, and lots of work with people currently living through poverty, and try and make sure that it's those voices are being elevated in our policy.”

Funded by the Joseph Rowntree Foundation (JRF) to deliver workshops throughout Challenge Poverty Week, the Poverty Alliance has highlighted increasing health inequalities across Scotland.

In the JRF’s Poverty in Scotland 2022 report, the organisation found that 2 in 3 households that reported feeling very financially insecure were experiencing negative impacts on their physical health, worsening with the cost-of-living crisis:

“Just like mental health, the cost-of-living crisis has both short- and long-term impacts that will affect people’s lives for years to come and will cost the government money in healthcare provision to counteract.”

The Poverty Alliance has called for the government to provide more support for people living in poverty in Scotland, particularly through uprating of social security and benefits in line with rising inflation.

Money matters

Almost 1 in 5 households on low incomes in Scotland were found to have gone both hungry and cold this year, even before entering the winter months. With over 4,196 respondents from Scotland – which the foundation believes to be the biggest poll so far of people’s experiences of poverty in Scotland – found that 70% of single parent families also reported negative mental health impacts associated with money worries.

Responding to the JRF report’s findings Ms McLean said:

“From some of the key headlines, unfortunately it is not surprising – especially in the current cost-of-living crisis. It's obviously always important for us to emphasise that the cost-of-living crisis isn't new to people living on the lowest incomes, they've always had a cost-of-living crisis.

“When we talk about experiences of poverty because there are no specific profile. There's obviously some households that are more vulnerable to poverty and more likely to experience it;  families who have disabled members of the household, single parent households and those with three or more children.”

Ms McLean said that much of this vulnerability to poverty stems from the way our social security system is set up, and particular difficulties finding and maintain work.

However, she adds that “the thing that is quite stark” is the increasing number of people in-work who are also living in poverty, with two thirds of kids in poverty living in a household where somebody has a job. She says that the primary action needed at a local and national level is that people need more money.

The JRF report calls for a “cash-first approach” to the cost-of-living crisis from the Scottish and UK government, recommending the Scottish government boost its Scottish Welfare Fund by 50%, or £17.75m. Alongside this, the foundation says its important to enhance promotion of the fund so that households facing “extreme financial duress” are able to more easily access income support.

Within the Scottish parliament’s recent report on health inequalities, the division of powers between the Scottish and UK governments was raised as a barrier of the ability of devolved powers to lift people out of poverty. The Committee also called for the Scottish government to continue work within devolved powers to prioritise actions with the aim of mitigating the effects of poverty.

A majority of the committee also called upon the UK government to increase the statutory living wage to the real living wage, and to take further action to increase 'in-work' benefits to eliminate in-work poverty. Only Conservative MSPs Tess White and Dr Sandesh Gulhane opposed this recommendation in the committee's report.

Mental health

Ms McLean adds that mental health services in Scotland are not where they need to be to support people experiencing multiple deprivations, particularly with existing pressures on the NHS:

“I think the issue of the mental health crisis is so complex because it's not just linked into the health service itself, but it also links into the funding and the support available for community organisations. Organisations that do free counselling sessions for people on low incomes are already maxed out.

“Often we talk about treating people who are already dealing with poor mental health. So people have kind of gotten to that point where they're in crisis mode and are needing that support, or don't do a very good job of talking about the mental health of people on lowest incomes in terms of preventative measures – supporting ways of managing stress.”

She says improving the linkages between welfare and debt advice with mental health support is essential, adding:

“People who are born into and live in poverty – it’s just pretty stark, you’re shot down from the instant you’re born basically. Our concern is that a lot of policy focusing on poverty and health is on behaviour management – telling people “don't spend your money on X, Y, Z” and then we have these stick measures with benefit sanctions. We know that sanctions don't actually help people.”

“We’re not doing enough to look at the way our structures facilitate and support folk on low incomes in behavioural choices. That links into the way that we support folk on low incomes to deal with and manage stress – poverty is just stressful, too.”

She adds that accessing healthcare is itself difficult, with people on the lowest incomes facing the barrier of transport costs and fewer services readily available in areas of deprivation.

She says there that are a range of organisations working to make health fairer in Scotland, supporting those on low incomes in both physical and mental health, adding that financial support from the government must be increased:

“In terms of what people need, benefits must be uprated in line with inflation. To not do so is just to sign people’s death certificates. It’s abhorrent, it’s cruel and it’s just pointless. It might sound a bit dramatic but it’s true and people are going to die in winter without this.”

Today’s conference will hear from the First Minister Nicola Sturgeon on how the Scottish government will work to meet Scotland’s current and future poverty challenges.

Read more: Social deprivation linked to frailty; Unpaid carers “spiralling” in cost-of-living crisis; Can Scotland make health fairer?

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