During the cost-of-living crisis, a recent review by the UCL Institute of Health Equity found around half of Londoners are already struggling, and this is having a significant impact on their health.

The report states that the cost-of-living crisis is negatively impacting the same groups that were impacted by a decade of austerity from 2010-2020. These groups include children, women, people living with disabilities and long-term conditions, minority ethnic groups, lone parents, and socially excluded individuals such as rough sleepers, undocumented migrants, and sex workers.

Despite being the wealthiest city in the U.K., London has the highest poverty rate of any region in England, with over a quarter of residents living in poverty after considering housing costs. The pandemic has also widened inequalities in life expectancy between the richest and poorest communities in London and across England, with the poorest communities experiencing larger falls in life expectancy for both men and women.

In 2020, London saw the highest increase in preventable deaths of any region in the U.K., which disproportionately affected the most deprived communities. These same communities are also most at risk from the cost-of-living crisis.

Income inequalities

“Income inequalities are wider across the capital than the rest of the U.K. with people in the top 10% of society earning over ten times more than people in the poorest 10%—and those people earn 30% less than the rest of the U.K. Income inequality has been further impacted by the pandemic: real wages have declined, and this has impacted lower paid sectors more than higher wage professionals in London,” the researchers explain. “We must act now and implement the review’s interventions to help alleviate the horrific financial pressures too many people are facing.”

The authors argue that there is an urgent need for coordinated action, with no single intervention likely to be effective on its own. As a result, they urge a combination of national and local solutions to address the various factors that contribute to the financial circumstances of households.

The review points to an urgent need for “coordinated activity, with organizations playing their role as employers, service providers and commissioners,” and explains “there is no single mitigating intervention.” Consequently, “bespoke combinations at national and local levels are needed to address the different factors (including health) that contribute to a person or household’s financial circumstances, and the impacts on health and health inequalities that will result.”

Making things better

The recommendations focus on three key factors that determine a household or individual’s ability to cope with high inflation: income, the cost of essential expenses, and financial resilience. The review acknowledges that government intervention is needed to address the widening health inequalities. Some of the recommendations across these three themes include:

• Local employers should provide subsidized on-site childcare where feasible, offer childcare deposit loan schemes, and ensure flexible working options for parents to help address both the high cost of childcare and child poverty in London.
• All employees should be paid the London Living Wage, including those employed through contractors.
• Benefit, debt, and welfare legal advice services should be funded and made more accessible so that individuals can claim all benefits to which they’re entitled and manage problem debts.

“Logic, social justice and evidence clearly indicate that where a problem is driven by people having insufficient income, then increasing their income will reduce the problem—ensuring everyone is paid the London Living Wage is one starting point,” the authors conclude. “Integrated Care Service (ICS) partners’ data and intelligence functions can identify households and communities who are most at risk from the rising cost of living. Investing in voluntary and community services, in particular advice and support services, is another obvious intervention as it offers a high return on investment.”