Poverty and health Being poor makes people more likely to have an illness or to die earlier than The prerequisites are for peace, shelter, education, social security, social relations, people who are affluent. Deprivation is food, income, the empowerment of women, therefore a major risk to health. The a stable ecosystem, sustainable resource mechanisms by which poverty use, social justice, respect for human rights threatens health – as well as the and equity. Above all, poverty is the greatest threat to health. relationship between poverty and other risks to health – are the subjects of World Health Organisation much study and debate in this country 1997 and elsewhere. The World Health Organisation considers that poverty is the greatest threat to health. There has been much effort in recent years by government to establish the now statutory minimum wage. Recent research estimates that a single person in the UK needs to earn at least £14,400 a year before tax (in 2010), to afford a basic but acceptable standard of living. A couple with two children needs £29,200. Concepts of ‘low income’ The most commonly used threshold of low income is a household income that is 60% or less of the average (median) British household income. In 2007/8, the 60% threshold was worth: • £115 per week for single adult with no dependent children; • £199 per week for a couple with no dependent children; • £195 per week for a single adult with two dependent children under 14; and • £279 per week for a couple with two dependent children under 14. These sums of money are measured after income tax, council tax and housing costs have been deducted, where housing costs include rents, mortgage interest (but not the repayment of principal), buildings insurance and water charges. They therefore represent what the household has available to spend on everything else it needs, from food and heating to travel and entertainment. In 2007/08, 13½ million people in the UK were living in households below this low-income threshold. This is around a fifth (22%) of the population. Over the last decade, the poorest tenth of the population have, on average, seen a fall in their real incomes after deducting housing costs. This is in sharp contrast with the rest of the income distribution which, on average, has seen substantial rises in their real incomes. The UK has a higher proportion of its population in relative low income than most other European Union (EU) countries: of the 27 EU countries, only 4 have a higher proportion than the UK. The proportion of people living in relative low income in the UK is twice that of the Netherlands and one-and-a-half times that of France. The remainder of this section includes an overview of: • overall deprivation levels (using the Index of Multiple Deprivation), • poverty and its effects on children, • poverty and its effects on working age adults, and • poverty and its effects on older people. 53 Poverty and health Index of Multiple Deprivation The Index of Multiple Deprivation (IMD) 2007 measures deprivation based on income, employment, health, education, barriers to services, living environment and crime. IMD 2007 – Borough Rank IMD 2007 Overall Score Borough Quintile (1 is most deprived) IMD 2007Quintile Overall Score 5 (5) Borough Quintile (1 is most deprived) QuintileQuintile 5 (5) 4 (4) Quintile 4 (4) Middlehaven QuintileQuintile 3 (5) 3 (5) Quintile 2 (4) QuintileQuintile 1 (5) 2 (4) Gresham North Ormesby and Brambles Farm University Quintile 1 (5) Ayres om e Park Clairville Pallister Thorntree Linthorpe Beckfield Park Local extremes End Beechwood Within Middlesbrough Acklam Ladgate Marton Brookfield Kader Hemlington Marton Stainton Coulby West and Newham Thornton Nunthorpe The most deprived wards are: The least deprived wards are: • Middlehaven, • Nunthorpe, • University and • Marton West and • Gresham. • Brookfield. IMD 2007 Overall Score IMD 2007 – National Rank Borough Rank (Q1 Most Deprived) Quintile 5 (1) Wards by IMD National Quintile (Number of Wards)Quintile 4 (1) Quintile 5 (Least deprived) (1) National Position Quintile 4 (1) Quintile 3Quintile (4) 3 (4) Middlehaven Quintile 2 (2) Comparing deprivation Quintlie 1 (MosQuintile t deprived) (15 )2 (2) North Ormesby and Gresham Quintlie 1 (15) in Middlesbrough with Brambles Farm England University Clairville Pallister Thorntree Ayres om e Park Linthorpe Beckfield Park Beechwood End Acklam Ladgate Marton Brookfield Kader Hemlington Marton Stainton Coulby West and Newham Thornton Nunthorpe In the national context, Middlesbrough is the 9th most deprived local authority of 354 in England. Fifteen of Middlesbrough’s wards are in the most deprived quintile of wards in England. One ward is in the least deprived quintile. 54 Poverty and health Domains of Deprivation in MiddlesbroughWards IMD 2007 Ward Borough National Code Ward Name rank Tees rank Rank IMD 2007 Income Domain Employment Domain Health Domain & Education Skills Domain Barriers to & Housing Services Crime Domain Living Environment Red in Total Zone 00ECNT Middlehaven 1 1 6 6171 1707001 32 588 7 00ECPB University 7 11 100 100 127 403 66 249 7388 74 241 7 00ECNK Gresham 9 13 120 120 236 294 164 237 7709 16 84 7 00ECPA Thorntree 2 3 22 22 24 33 29 8 6656 291 4089 6 00ECNQ N Ormesby & Brambles Fm 3 6 54 54 104 91 67 71 7809 178 1186 6 00ECNW Pallister 4 7 60 60 133 114 72 36 7764 33 3079 6 00ECNF Beechwood 5 9 65 65 151 71 56 212 6270 30 4174 6 00ECNY Park End 6 10 75 75 91 144 118 29 6096 114 3680 6 00ECNH Clairville 8 12 116 116 212 116 82 464 7592 6 3478 6 00ECNE Beckfield 10 17 181 181 373 90 113 348 7089 104 4177 6 00ECNL Hemlington 11 21 290 290 289 171 222 586 5425 351 6980 6 00ECND Ayresome 12 23 312 312 426 404 276 335 6611 128 1883 6 00ECNX Park 13 34 770 770 1306 688 431 2274 7844 17 1611 4 00ECNN Ladgate 14 41 1128 1128 1166 840 598 1165 7035 733 5456 2 00ECNJ Coulby Newham 16 51 1676 1676 1778 1263 616 2477 4191 1804 7105 1 00ECNP Linthorpe 17 57 2534 2534 3060 2523 1447 4271 7854 318 3311 1 00ECNZ Stainton and Thornton 15 50 1562 1562 1671 1043 1011 2478 4447 1129 6559 0 00ECNR Marton 18 65 4020 4020 6225 3607 2716 4955 3305 1116 6372 0 00ECNC Acklam 19 68 4172 4172 5716 3036 2408 4717 7772 1002 5280 0 00ECNM Kader 20 69 4216 4216 4714 3031 2090 4986 6450 2458 5922 0 00ECNG Brookfield 21 70 4445 4445 6036 2987 2131 3614 6162 3552 6508 0 00ECNS Marton West 22 82 6056 6056 7074 4388 2902 6372 4422 3568 7543 0 00ECNU Nunthorpe 23 86 7095 7095 7651 5158 3617 7424 5862 3588 7645 0 Actual number of wards in red zone 13 12 13 15 12 0 15 3 83 Expected number of wards in red zone 2 2 2 2 2 2 2 2 16 "Excess" number of wards in red zone 11 10 11 13 10 0 13 1 67 Key Among the 10% most deprived wards in England Among the 10% - 50% most deprived wards in England All others Middlesbrough has more wards in the most deprived 10% than would be expected. Barriers to services and living environment are of less concern than other domains. 55 Poverty and health The impact of financial exclusion A sense of ‘financial exclusion’ is obtained by identifying those people, households and communities which display behavioural, attitudinal and demographic characteristics that collectively indicate a requirement for, and exclusion from, mainstream financial services. Such indicators include income, financial products holdings, affluence, outstanding borrowings and proportion of disposable income spent on household fuel. The demographic profile of each of these characteristics have been combined to create an overall score for each census ward. The score indicates relative levels of financial exclusion between wards. Each ward is ranked across the 10,000 wards in Great Britain and placed into quintiles based upon likely levels of financial exclusion. The map shows electoral wards in Teesside according to their national rank of financial exclusion score. The lower ranked wards, shown in red, indicate relatively higher levels of financial exclusion. Financial exclusion in Teesside Financial Exclusion Rank of 10,000 UK Wards Financial Exclusion Rank of8,000 10,000 UK to Wards 10,000 (1) 8,0006,000 to 10,000 to (1)7,999 (10) 6,000 to 7,999 (10) 4,0004,000 to 5,999 to (14) 5,999 (14) 2,0002,000 to 3,999 to (16) 3,999 (16) 1 to 1,999 (51) 1 to 1,999 (51) Sarah’s Story – the human cost of credit Sarah, a single mother of three, has multiple debt The loan company insisted that the agreement must problems. She's been struggling with her finances for be rewritten or the car surrendered, which would over ten years and debt and its related stresses have mean being unable to work. This rewriting of the almost become a way of life for her. Almost all her agreement has happened between two and four debts are to non-mainstream lenders and total times a year for the last five years. Each time the around £10,000. last payment is set at such a high level that Sarah is Sarah is a care assistant and relies on her car to get faced with the choice of giving up the car or re- her to work. Sarah contacted a lending company signing another agreement. through her local newspaper who claimed “instant The loan company use the Bill of Sale Act 1882 as credit – no credit checks” and who were prepared the basis of these agreements.