Tag Archives: inequality

Food for thought: how the UK food strategy is trying to revolutionise the way we think about and access food

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Research has shown that healthy food choices are three times more expensive than unhealthy ones, food bank use is at it highest ever level and the NHS is anticipating significant struggles in long term treatment of people with conditions linked to obesity and unhealthy lifestyles, like cancer, diabetes and heart disease.

A forecast published in a report by the Food Foundation showed that if we continue at our current rate and type of food consumption 22% of children born in 2020 will be overweight or obese by age 5, rising to 46% by the time they reach age 21.

But the impact doesn’t stop there. The food system – agriculture, food production, distribution and retail combined – releases more greenhouse gases than any other sector apart from energy. In the UK, the food system accounts for a fifth of domestic emissions – but that figure rises to around 30% if we factor in the emissions produced by all the food we import.

The food we eat – and the way we produce it – is doing damage to both the environment and our health and the government is now trying to take steps to mitigate the damage, and improve our health and wellbeing in the process through the roll out of a national food strategy.

Fixing a broken system

Figures from the Trussell Trust show that between April 2020 and March 2021, a record 2.5 million emergency food parcels were given to people in crisis. The increasing use of foodbanks shows just how deeply entwined inequality, food and health are, and how important it is for a robust and equitable food strategy to be rolled out.

The Broken Plate 2021 report from the Food foundation provides an overview of the food system in the UK, looking across four main themes:

  • making healthier options more appealing;
  • making healthier options more affordable;
  • making healthier and more sustainable options more available; and
  • addressing inequalities in food so that everyone can have the chance to live longer, healthier lives.

In July 2021 the UK government published a review into how the food system in the UK works and the interventions that could be brought in to prevent the harms from what we eat and the way we eat. The plan sets out recommendations and a strategy for the future which focuses on food being equitable, accessible, healthier, and sustainable.

The recommendations cover a number of key themes:

  • escape the “junk food cycle”, including introducing a Salt and Sugar Reformulation Tax;
  • reduce diet-related inequality, including extending eligibility for free school meals;
  • make the best use of our land – including guaranteeing agricultural payments to help farmers transition to more sustainable land use; and
  • create a long term shift in food culture, including the development of a robust system of data collection and reporting to help monitor long term progress.

Inequality exacerbated by unequal access to food

One of the most pressing issues around food is its availability and its ability to exacerbate existing inequalities, particularly among disadvantaged groups. We have already seen that food bank use is high (disproportionately so among lower income groups) and that eating healthier food is more expensive than unhealthy food.

The shelf life of more unhealthy and highly processed food is also often longer, so it is easier to store, and food can be spread out and eaten across multiple days more easily. Processed foods, which are often higher in sugar, salt and trans fats (unhealthy fats) also often require less cooking (both in terms of heat energy required to cook them and knowledge of how to prepare them) which for people with reduced access to kitchens, experience of fuel poverty or limited knowledge of preparing food can be more convenient. Research consistently shows that people who fall into these groups are significantly more likely to come from lower socioeconomic backgrounds and have experience of poverty.

Steps are being taken to try and improve access to healthier food for people living on lower incomes, including free school meals and (with a bit of persuasion from Marcus Rashford) a wider roll out to also offer meals during school holidays. The government also runs a voucher system for new parents to help them get access to fresh food like fruit and vegetables.

More recently there has also been discussion about the roll out of “food on prescription” services, both for those people on lower incomes and for those people who are at risk of medical complications or disease as a result of being overweight or obese.

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Sustainable as well as healthy

As has been made clear in the reports, food systems don’t just impact on us as individuals, they also have a significant impact on the environment. The changing climate is at the forefront of everyone’s mind, including multiple extreme weather events, the publication of an IPCC report on climate change, and the run up to COP26, due to be held in Glasgow. So the way we grow and process our food, and how this negatively impacts our environment is coming under greater scrutiny.

Currently, many practices are having a negative and detrimental impact on our environment across a number of areas including carbon emissions, water pollution, reduction in soil health, loss of biodiversity, land use/deforestation.

And commentators are now emphasising that our food system as well as being healthy and accessible should also be sustainable, with programmes developed to reduce food waste, support community-based agriculture schemes, help farmers to transition to more sustainable ways to farm and use land and stimulate demand for in season, sustainably grown, locally sourced food.

Final Thoughts

Food, and our relationship with it is becoming increasingly important, not only for our own personal health and wellbeing, but also for the health of communities more generally, and the health of our planet.

Sustainable, healthy and equitable food systems help to promote healthier choices and reduce our impact on the planet. And food can also play its part in helping to relieve other pressures on society, like food poverty, inequality and the rising use of food banks. Food on prescription services can help support people to make better choices and reduce the risk of diseases like cancer, heart disease, stroke and obesity.

In short, food is not just vital for life, but also for living well.

Follow us on Twitter to see which topic areas are interesting our research team.

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Keeping our finger on the pulse: recent additions to our collection across health

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The health and care landscape has been changed in unprecedented ways over the past year. The coronavirus pandemic has not only highlighted strains within the system and required a response to a public health emergency unlike anything else that has been seen for decades, it has also provided an opportunity to push innovation in areas like digital infrastructure and partnership working, and encouraged decision makers to look at public health as an essential part of policy making in all areas.

The Knowledge Exchange database is full of reports, articles and documents which offer insight into these themes, published by organisations from across the heath and social care landscape. In this blog post, we’re highlighting some recent additions to our collection and some of the big themes being discussed within the sector.

Covid-19, “building back better” and a “health in all policies” approach

In March 2021 think tank IPPR published their report State of health and care: the NHS Long Term Plan after Covid-19. The recommendations form a £12 billion blueprint to ‘build back better’ in health and care and the report calls for an adaptation of the NHS Long Term Plan published in 2019 focusing on cancer, mental health, cardiovascular disease and multimorbidity. The authors believe the Long Term Plan needs to change to ‘build back better’ health and care post-pandemic, in relation to: ensuring a sustainable workforce; resourcing the NHS to deliver transformation; empowering integration; upgrading the digital NHS; funding and reforming social care; and levelling up the nation’s health.

Another report, from the Local Government Association (LGA), published in September 2020, provides specific guidance to local authority councillors on ways to improve the approach to population health and use of public health resources in dealing with the pandemic, highlighting the Health in All Policies (HiAP) approach to addressing health inequalities and improving wellbeing. There are a number of other resources which look at public health approaches to tackling other areas of policy such as youth violence and urban regeneration.

Build back fairer: the Covid-19 Marmot Review: the pandemic, socioeconomic and health inequalities in England, published by the Health Foundation and the Institute of Health Equity examines inequalities in coronavirus mortality, looks at the effects that the pandemic, and the societal response, have had on social and economic inequalities, the effects on mental and physical health, and the likely effects on health inequalities in the future. The report assesses the inequalities in the risk of COVID-19 and mortality and explores the impact of containment on inequalities in the social determinants of health, in terms of: early life; education; children and young people; employment and working conditions; a healthy standard of living; healthy and sustainable places and communities; and healthy behaviours.

Mental health

Mental health services have been under significant pressure in the UK for a number of years now, with children’s services (CAMHS) particularly stretched as the number of specialist practitioners is limited. The coronavirus pandemic has, according to many specialists, exacerbated existing pressures and placed even more demand on services. In April 2021 the All-Party Parliamentary Group on a Fit and Healthy Childhood published a report: The COVID generation: a mental health pandemic in the making – the impact on the mental health of children and young people during and after the COVID-19 pandemic  which explores a range of themes in relation to the impact of the pandemic on the mental health of children and young people. The report presents evidence from a range of sources on the potential implications of the pandemic on young people’s mental health and discusses the impact of school closures on children’s future health and well-being.

The Children’s Commissioner for England recently published a report  which looks at the progress made in improving children’s mental health services in England, and  the impact of the pandemic on the mental health of children. The report also examines the provision and accessibility of children’s mental health services in 2019/20, finding that access is still not adequate and not improving as quickly as expected.          

The other pandemic: the impact of Covid-19 on Britain’s mental health  explores how the mental health of people in the UK has been affected by the pandemic, drawing on a survey of over 4000 people. It describes the different experiences of groups across society and the highlights the disproportionate mental health impact on people who are exposed to higher levels of social deprivation, as well as on women, younger people and those who live alone.

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Structural reform

In August 2020 the Health Devolution Commission launched its final report, Building back health and prosperity. Among other themes, such as taking a “health in all policies approach”, the report found that devolving accountability and power to a more local level creates the potential to understand communities and places better, and to meet their needs.

One of the main focuses of the health and social care white paper published in February 2021 is around developing an integrated health and social care system and taking a ‘population health’ preventative approach to healthcare, while a report from the NHS confederation recommends a reformation of the framework for elective care and increased healthcare funding.

Digital transformation

Even before the pandemic, The King’s Fund was publishing widely on digital transformation. But their recent report Understanding factors that enabled digital service change in general practice during the Covid-19 pandemic  looks specifically at the impact of the pandemic on accelerating the transformation of the delivery of some services by GPs to focus more on digital delivery and whether this change can (or should) be sustained once the pandemic is over. It explores the challenges around trust, staff and patient digital literacy and the evaluation of digital tools in practice. Parliamentary Office of Science and Technology (POST) published their own review of AI and healthcare , providing an overview of AI in the healthcare system and its potential impacts on the cost and quality of healthcare, and on the workforce.

Final thoughts

The landscape of health and care is changing. The Covid-19 pandemic has placed unprecedented demands on a system which was already facing significant challenges. While in some instances this has led to innovation and accelerated the pace of change, it has also exposed some of the significant weaknesses of the system.

This blog highlights some of the big topics the sector is currently grappling with, but there is more available for TKE members on our database. Members can also sign up to receive our health Topic Update, which will provide fortnightly email updates of items recently added to the collection in health, easily allowing you to stay up to date.

If your organisation is not a member of the Knowledge Exchange and you would like more information, please contact us.

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A nudge in the right direction? Using behavioural insights in health

Virtual reality: a game changer for mental health treatment?

Devolving health and social care in England: an opportunity to transform how we approach health and care?

Cross-border handshakes: what’s next for digital contact tracing?

Healthy ageing: how health inequality can be tackled at the local level

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Image: Peter Kindersley via Centre for Ageing Better

Older people make up a significant portion of our population, and projections show the proportion of people over the age of 60 within the global population is set to rise even further over the coming years. ONS data shows by 2066 there will be a further 8.6 million projected UK residents aged 65 years and over, taking the total number in this group to 20.4 million and making up 26% of the total population.

Supporting people to age well, and age healthily is something which both local and national policymakers will have to take account of in order to not only ensure good quality of life for their ageing populations but also ensure that services are not overwhelmed.

Studies show the higher levels of deprivation people face in their earlier years, the more likely they are to enter older age in poor health and die younger compared with people who experience lower levels of deprivation. This highlights the need to tackle inequality across the life course, with the preventative action having a positive knock on impact on health inequalities in later life.

Some of the main drivers of inequalities include: social exclusion and isolation; access to and awareness of health and other community services; financial difficulties including fuel poverty and housing issues; insecure or low paid employment, with reduced opportunity to save or enrol in a formal pension to prepare for retirement; a lack of transport and distance from services; low levels of physical activity; and mobility or existing poor health, often characterised by long term chronic health issues.

These inequalities often combine and overlap to create even more challenging situations as people move into older life. More recent research has shown that the Covid-19 pandemic has only exacerbated these inequalities further.

Tackling inequalities at the local level

Alongside the national discussions around ageing, local demographic change has received comparatively less attention, despite place-based policies and concepts like “ageing well in place” being used in public health conversations for a number of years.

Research from the Resolution Foundation explores the intersection between demography and place, and its implications for politics and policy while further research is looking increasingly at local level case studies to highlight pockets of best practice which could help to inform the national approach.

A review from Public Health England looked at the specific experiences of older people in coastal and rural areas and the specific challenges they face in comparison to people living urban areas, exploring local level interventions and interventions which adopt a place- based approach, responding to the specific needs of people living in the area.

Other research in this area stresses that councils have a clear leadership role in supporting an ageing society and that they are uniquely placed to create strategies which reflect the needs of their populations. Through local engagement of older people systematically and regularly, and through co-production and co-design in the production of local policies and services, councils are in a position to underpin a more positive outlook on ageing, ensuring that older people are regarded as full citizens, rather than objects of charity or pity.

Approaches to poverty reduction in Greater Manchester

In Greater Manchester, healthy ageing and age inequalities have been made mayoral priorities and the Greater Manchester Combined Authority set up the Greater Manchester Ageing Hub to respond to what policymakers there see as the opportunities and challenges of an ageing population.

In 2018 the city published an “Age Friendly Strategy” to promote increased social inclusion within the city by trying to tackle the barriers to inclusion created by poverty and inequality, including creating age friendly places which allow older people to participate within their local communities, and promoting healthy ageing through strategies like GM Active Ageing, a partnership with Sport England.

Image: Peter Kindersley via Centre for Ageing Better

Creating a consensus on healthy ageing

The Centre for Ageing Better and Public Health England established 5 principles for healthy ageing which they are urging government and other policy actors to adopt to support future healthy ageing the five principles are:

  1. Prevention
  2. Opportunities
  3. Good homes and neighbourhoods
  4. Narrowing inequalities
  5. Tackling ageism

These principles can be used as building blocks to help organisations create strategies and policies which accurately reflect the core needs of people as they age. One thing which continues to be a challenge, however, is integrating intersectionality into both research and strategies or frameworks on ageing.

Not treating “older people” as one homogenous group, but taking account of the individual experiences of specific groups and how this may impact on their experience of inequalities: this is something researchers are making efforts to resolve in their work, and while there are limited studies which look specifically at BAME or LGBT groups, in the future taking account of intersectionality in ageing and inequalities will become more commonplace.

The future of ageing

We are living longer than ever before. Taking steps to reduce inequalities and support healthy ageing will ensure that those extra years are fulfilling, both for the individual and for society.

Helping people to continue to contribute to society, to really live into old age, embrace and enjoy it – and not just exist – in old age should be a priority for everyone, Reducing inequalities to support people to age well will be a major contributor to ensuring this happens.

If you enjoyed this article you might like to read:

A home for life? Developing lifetime neighbourhoods to support ageing well in place

“Same storm, different boats”: addressing covid-19 inequalities and the ‘long term challenge’

Inclusive streets: from low expectations to big dreams

Follow us on Twitter to see which topic areas are interesting our research team.

Shared Prosperity Fund – greater productivity and inclusivity for Scottish cities?

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There are many questions surrounding the UK’s departure from the European Union, not least on the future of funding.

In Scotland’s regions and cities, EU Structural Funds have provided significant additional funding to support economic development for many years. The current structural funds programme is worth about €10.7 billion to the United Kingdom and up to €872 million to Scotland across the seven-year budget period which ends in 2020. The Funds were originally created to help rebalance regional social and economic disparities. With regional inequality a dominant feature of the current economic landscape, and the potential of Brexit to further exacerbate this inequality, continued investment to address this is vital.

The UK Government has made no commitment to continue with the EU Structural Fund approach following exit from the EU and has instead proposed to introduce a domestic successor arrangement – the Shared Prosperity Fund (SPF). The objective of the SPF is to “tackle inequalities between communities by raising productivity, especially in those parts of our country whose economies are furthest behind.” This objective is widely welcomed. However, as yet there has been no formal consultation on the new Fund and no detail on how it will operate.

Nevertheless, it had been suggested in recent research from the Core Cities Group on Scottish cities that despite the significant contribution from Structural Funds over the years, the proposed SPF could be an opportunity for greater productivity and inclusivity.

Success of EU Structural Funding

The two major EU Structural Funds utilised in Scotland are the European Social Fund (ESF), focusing on skills and jobs, and the European Regional Development Fund (ERDF), which focuses on correcting regional imbalances.

Over £134m per annum is being invested in economic development in Scotland through these funds over the current programming period, which is supported by a significant amount of match funding, largely from the public sector. According to the Scottish Government, the total funding will be around €1.9 billion.

The Scottish Cities – the collaboration of Scotland’s seven cities (Aberdeen, Dundee, Edinburgh, Glasgow, Inverness Perth, and Stirling) – and city regions have already successfully invested in each of the four Scottish Economic Strategy priorities (innovation, investment, inclusive growth and internationalisation) and the UK Industrial Strategy’s five foundations of productivity (ideas, people, infrastructure, business environment and place).

Some examples of projects include:

Research suggests that the ending of such funding poses a risk to organisations and the positive economic impact gained, as illustrated by reductions in funding in other areas of the UK.

Limitations

Despite the successes that have been achieved through the use of Structural Funds, the approach is not without its limitations. As argued by the Core Cities report, the approach to managing, overseeing and using the funding has become more bureaucratic and cumbersome. Particular issues highlighted include:

  • increasing centralisation of funding and decision-making;
  • the requirement to provide match-funding at an individual project level becoming increasingly problematic due to public sector budget cuts;
  • monitoring, compliance and audit requirements have become increasingly onerous;
  • in the current programme period, the role of the Managing Authority has become more transactional, with little engagement at the project development stage;
  • eligibility rules restrict what can be funded, with some important elements of economic development no longer able to be supported e.g. new commercial premises, transport infrastructure, which can limit the benefits from other Structural Fund investment (such as business growth and employment creation on strategic sites);
  • the system does not encourage innovation, with high levels of risk aversion amongst programme managers, and a high degree of risk for project sponsors if project delivery does not proceed as planned – a particular issue for projects working with the most disadvantaged groups and those with complex needs.

The report argues that these factors have had the effect of limiting the achievements of the Funds, such as preventing some organisations from applying for funding, which in turn has made others wary about applying. This has led to projects being designed to meet the funding criteria rather than maximising benefits, resulting in too much time and effort on administrative activities rather than those which will have an impact on the economy.

As such, it is suggested that the introduction of the SPF affords an opportunity to change this.

Opportunity for change

According to the report, there is an opportunity to move away from the limitations of the Structural Fund programme approach to more effective arrangements that will increase productivity and contribute to a more inclusive economy. There is scope to increase the funding available through the SPF, reduce bureaucracy and become more responsive to local need.

It is suggested that there is potential for SPF investment in the Scottish Cities to deliver an economic dividend of up to £9bn as productivity increases, producing higher wages at all levels in the workforce, and contributing to a more inclusive economy overall.

Given that Scotland’s performance on some of the key economic indicators is likely to be taken into account when allocating SPF – GVA per job and per hour worked, employment rate, deprivation levels – the report also contends that there is a case for a greater share of the SPF for Scottish Cities. It argues that significant SPF investment in these areas “…will increase competitiveness and tackle inequality, as set out in Scotland’s Economic Strategy, as well as contributing towards the objectives of the UK’s Industrial Strategy, raising productivity and reducing inequalities between communities”.

The report warns that “Scotland will not make significant progress towards a more inclusive economy and society without addressing the deprivation challenges in the Scottish Cities.”

It is recommended that:

  • the SPF should use a transparent, needs-based allocation system;
  • the SPF budget should not be determined by previous levels of Structural Funds, and should be significantly increased; and
  • the Scottish Cities must be closely involved in the design of the SPF.

Final thoughts

There appears to be wide consensus for providing a replacement for EU Structural funding. Most organisations that have commented on the proposed SPF also agree that the level of funding should at least be maintained at its current level.

The concerns in Scotland, and indeed the other devolved legislatures, is the impact the SPF might have in devolved decision making powers currently exercised under EU Structural Funding.

The Scottish Cities have made clear their views on the proposed SPF and the Scottish Government has also launched its own consultation on how the Fund might work for Scotland.

Only time will tell whether the UK Government will take these comments on board, and indeed whether the opportunity for change will be realised at all.

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Tackling health inequalities: what does the data tell us and how can it help?

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Health inequalities in Scotland are significant. Every year we hear about how Scotland has some of the biggest gaps in the health and wellbeing of the poorest and richest in society. In some cases, Scotland has the largest gaps in equality in the whole of Europe. And in many instances, they are rising. Scotland also has the lowest life expectancy of all UK countries.

A number of studies and research projects have been commissioned to try to identify the key indicators and factors that are creating and reinforcing these inequalities, and what sorts of interventions would work best to try and reduce or eradicate them altogether. It is hoped that by conducting research, and compiling data, policymakers can use this to identify groups and geographic areas where health inequalities are significant, and to intervene to reduce them, with data to help back up and evaluate the effectiveness of these interventions. In Scotland, work is being done by a number of organisations including the Scottish Government, Glasgow Centre for Population Health (GCPH) and Public Health Innovation Network Scotland (PHINS).

What indicators and factors are being measured?

Income inequality has a related impact on health inequalities, and the scale of low pay is significant. The relationship between health inequalities, poverty and household income is one which has been explored at length and is often highlighted as one of the main factors which influences health inequalities. Studies which look at income, and also at relative levels of deprivation can provide useful comparison points, with comparable datasets on employment status and income readily available at a national and local level. Data also considers trends over time, comparing pre- and post-economic crash data, as well as relative earnings and expenditure relative to inflation and the rising cost of living. Other factors include age (those under 25 and earning a lower minimum wage for example) and by gender, with more women in lower paid, lower skilled and part time or insecure work.

How usable is the research being created?

The research which examines health inequalities explores a whole range of interrelated factors, and highlights just how complex the landscape of inequalities is. Creating a clear and holistic picture of all of the factors which contribute to health inequalities is not easy. Many studies, while detailed and effective, are niche, and focus on a very limited number of factors across a limited demographic source. As a result, questions have been raised about the utility of this research and its applicability and scalability at a national level. In an attempt to tackle this, combined data sets are being produced which provide opportunities for comparison across data from a range of studies.

The “Triple I” tool from NHS Health Scotland is designed to help policy designers to create effective interventions to reduce health inequalities. A second edition of the tool is due to be released in 2018/19. Triple I aims to provide national and local decision makers with practical tools and interpreted research findings about investing in interventions to reduce health inequalities in Scotland. It does this by modelling the potential impact of different interventions and policies on overall population health and health inequalities.

 

What can be done to act on the data?

While the research being produced is high quality, and thorough in relation to findings, the real question is what can actually be done with the research, and what steps can policymakers and practitioners take to use the findings to inform their own practice.

There are, researchers suggest, significant opportunities presented by the recent research which has been done on income inequality. In particular, they cite the public sector and public sector pay as a key way to reduce the income, and therefore the inequality gap, particularly among higher earners and those who would be considered “working poor” or “just about managing”. In Scotland, significantly more people are employed in the public sector than in any other part of the UK, and there is, researchers suggest, an opportunity to better align and increase low wages to help to reduce the gap.

The adoption of new initiatives, such as the “housing first model”, which is due to be rolled out in Glasgow to help homeless people break the cycle of homelessness, are also opportunities not only to address inequalities, but to ensure that long term help and support is in place to prevent any relapse into chaotic or risky behaviour. In relation to housing first, the savings on front line services such as emergency admissions to hospital, or contact with the police after committing a crime are significant, and while more in depth research is needed to create a full cost benefit analysis model of the scheme and its effectiveness, early studies show that the impact on health and wellbeing on those who had previously been homeless is huge in terms of reducing inequalities and improving wellbeing. However further data on homelessness in Scotland shows how far we have to go, and that housing first is only one mechanism which can be used to begin this process of reducing inequalities among the most and least deprived communities in Scotland.

Alternatively, some have suggested a more radical overhaul of how we distribute welfare and wealth within the country. Research has been coming thick and fast on the subject of a “citizens basic income”, particularly following the trial which was rolled out in Finland (the findings of which have not yet been published). Research on how this could impact on inequalities is not widespread yet, as pilots have been small scale, However, it is suggested that a total overhaul of welfare, replacing it instead with a citizen’s basic income would be a more effective way to reduce inequalities across the board, including in health.

Summing up

Health inequalities are significant in Scotland. Much of the research focuses on the impact of deprivation, poverty and low income on health inequalities and how, in order to tackle health inequalities in Scotland we must also tackle some of the other significant social problems within our communities, including low income and insecure work, and the impact of homelessness or chaotic lifestyles on health.

Data can be used in a number of ways to help inform policy decisions, some more radical than others. But creating a complete understanding of inequality in Scotland is challenging. It is up to researchers and policymakers to work together to create a better understanding of the conditions and factors which contribute to inequality, and what can be done to help tackle systemic and entrenched inequalities in our communities through policy levers and evidence based policy making.

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Universal basic income: too good to be true?

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Eating or heating: tackling fuel poverty in the UK

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nastural gas flame

“It is a complete scandal that people die because they can’t afford to heat their homes. ‘I, Daniel Blake’ shows the tragic circumstances and daily dilemma of ‘heating or eating’ faced by many thousands of people in Britain today.”

Those were the words of I, Daniel Blake lead actor Dave Johns as he backed a report published in November 2016 by the charity National Energy Action. The report, which looked at the health problems related to fuel poverty, claimed that a child born today may never see fuel poverty eradicated from the UK unless more assistance is given struggling families.

Identifying the “fuel poor”

In England, according to the most recent official government statistics, more than 2.3 million (10%) households are living in fuel poverty. Leeds, Birmingham, Manchester, Liverpool and Cornwall are among the places worst affected. At risk groups include single parent households with dependent children, rural households, and those living in the private rented sector. Research also highlights that those customers who use prepay meters, which include a large proportion of the most vulnerable customers, are more likely to be “fuel poor” as they do not have the flexible tariff options and reduced rate deals which are offered to customers who pay via direct debit.

The picture is not much better elsewhere in the UK. A report produced by the Scottish Fuel Poverty Strategic Working Group estimated that there are currently over 800,000 households (35%) living in fuel poverty, with levels as high as 50% in rural areas. Meanwhile, in Wales the latest estimates suggest that 23% of households are currently living in fuel poverty.

heater gauge

Tackling the causes of fuel poverty

Not being able to afford to heat your home, or having to choose between eating or heating is the stark choice many families in the UK are being forced to make, however it is clear that fuel poverty stems from a number of different factors, including the cost of fuel, the price of energy, and rising energy consumption habits.

The latest Scottish Government strategy on tackling fuel poverty suggests that four drivers of fuel poverty need to be tackled before fuel poverty can be eradicated. These are:

  • Raising incomes – 8 out of 10 households (in Scotland) in income poverty are also fuel poor.
  • Making energy costs affordable – in many cases the cost of fuel is rising faster than household incomes.
  • Improving energy performance in housing – people living in a home with low energy performance are 3.5 times as likely to be suffering from fuel poverty as those in a home with high energy performance.
  • Changing habits of energy use – adopting energy-saving behaviours can make a significant difference to fuel bills by reducing overall demand. There is also a need to better understand and increase use of “green energy”.

But what about energy suppliers?

In December 2016, a report from Turn2Us suggested  that two million households suffer from fuel poverty. Subsequently, the “big six” energy suppliers met at Westminster to discuss what they could do to help tackle fuel poverty. At the moment, there is no legal requirement for energy companies to take action to reduce fuel poverty. However, they are coming under increasing pressure to help tackle fuel poverty, by reflecting some of their profit margins in the rates they give to customers. The idea of automatically putting vulnerable or “at risk” customers onto the lowest fuel tariff was discussed. However the bulk of the discussion, according to reports, concentrated on how to increase awareness of existing options, including the government-led Warm Home Discount, individual support grants, the Cold Weather Payment, and practical support from suppliers themselves.warm fire

Practical strategies to tackle fuel poverty

A number of schemes have been developed to try to help tackle fuel poverty, with national roll outs being supplemented by more localised programmes often funded by local authorities or charities.

In November 2016 the Scottish Government pledged an extra £10m to be spent on tackling fuel poverty. £9m was allocated for councils and housing associations to make it easier for tenants to heat their homes. A further £1m is to be made available to provide interest free loans to help people make their homes more energy efficient.

Other schemes have also been introduced by local authorities to try and tackle fuel poverty, including Ready to Switch? Launched in November 2012, Peterborough City Council’s collective switching scheme uses the combined buying power of residents and businesses within the community to negotiate cheaper prices with energy companies. According to figures from Peterborough Council, to date, hundreds of households have switched to save on gas and electricity, with some reducing annual bills by nearly £150.

Boilers on prescription (BoP) is a new funding stream which is being tested in a number of local authority areas, including Sunderland. The fund is managed through NHS Clinical Commissioning Groups, and householders at risk of cold related illnesses are referred for heating upgrades via health professionals. One of the main ideas behind BoP is to reduce a resident’s need for NHS interventions by improving their thermal comfort at home. It is hoped that a warmer, healthier home could reduce the number of GP appointments or emergency admissions.

Energie

 

Altering the design of new homes and subsidising the retrofitting of older ones is also a key policy strategy for tackling fuel poverty. Providing homes which are designed or adapted to be energy efficient through improved insulation, the installation of solar panels or using appropriate lighting or heating systems will allow the government not only to reduce fuel poverty in the present, but should also reduce the likelihood of more people falling into fuel poverty in the future. Reducing the demand for energy by creating homes which use less of it may also help to drive down the cost of energy, resulting in even bigger savings. However, it is not just the responsibility of individual homeowners to carry out these improvements. Local authorities, housing associations and private landlords also need to (and have in many instances) recognise the vital role they play, particularly in relation to more vulnerable customers who are at increased risk of falling into fuel poverty. Retrofitting has been increasingly popular in other parts of Europe, as these case study examples show.

The issue of fuel poverty in the UK does not appear to be going anywhere fast. Despite the attempts of governments across the UK to reduce the figure, in many areas the number of people falling into fuel poverty continues to rise. While there are individual areas of good practice aiming to help some of the UK’s most vulnerable families to heat their homes, it is clear that a wider commitment to combat the underlying causes of fuel poverty is needed, along with a recognition that there is a responsibility across the board to provide help and information to families suffering as a result of fuel poverty.

If you found this article interesting, you may also like to read our blog on the Dutch Energiesprong model and our research briefing on retrofitting (member access only).

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What’s going on in our universities … and what does the crisis around campus sexual harassment say about our society?

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by Stacey Dingwall

One of the most worrying elements of Donald Trump’s election campaign was his apparent attitude towards women. Critics have highlighed a wide range of sexist comments made by the now President-elect over the years – comments he now claims to regret and has apologised for.

The continuing problems of ‘isms’

Sexism is just one of the ‘isms’ that we seem unable to get rid of, despite efforts to create a more tolerant and diverse society. We’ve highlighted this several times on the blog this year; from the persistent gender pay gap to an increase in hate crime. Yet it seems we are still frustratingly far from living in an equal society.

Trump’s critics have suggested that it is in fact insecurity that has driven him to make some of his remarks. Although it is true that large numbers of (white) women voted for him, it has also been argued that part of his success is down to “angry white men” who feel threatened by the progress made by women, ethnic and other minorities towards the creation of a more equal society.

Sexual violence on campus

The all too frequent accounts of sexual harassment on university campuses around the world represent a particularly ugly aspect of enduring inequality within our society. While the media may focus on incidents occurring within the fraternity system in American campuses, the problem is just as bad in Britain. In September, a poll conducted by the charity DrinkAware indicated that 54% of the female students they surveyed had experienced some form of physical or verbal sexual abuse.  15% of male students reported similar experiences.

It’s not only male students who are subjecting their peers to this abuse, or female students who are on the receiving end. Last month, more than 100 women – students and academics – shared their experiences of sexual harassment and abuse at the hands of male university staff.  The stories depict a culture dominated by the male voice, in which women are frightened into silence rather than taking action against their abusers. Many of the victims indicated feelings of futility in terms of reporting their experience, due to the perpetrators’ power and status. Those who did have the courage to make a complaint reported their frustration at the limited action taken.

How is this being addressed?

Recent reviews by the National Union of Students (NUS) and Universities UK have made recommendations to universities on how to tackle sexual harassment on their campuses. A particular focus has been on implementing policies to prevent and deal with the issue: both reviews found that institutions sometimes didn’t have a sexual harassment policy at all, or it was ineffectively tied in with an overarching policy on bullying and harassment.

Universities UK’s review highlights several examples of good practice from universities in terms of improving the reporting process (the University of Cambridge), implementation of policy (SOAS, University of London), and establishment of taskforces to both raise awareness of and deal with sexual violence on campus (Durham University Sexual Violence Task Force).

More prevention work needed

While it’s encouraging that universities are taking action to respond to this problem, and work is also being done in terms of communicating that campuses should be a safe space for all, the majority of initiatives are focused on dealing with the aftermath of abuse rather than prevention. This is similar to the message often communicated by the media and others that people (predominantly women and girls) should take steps to ‘avoid’ being attacked or raped, rather than communicating to men and boys that they shouldn’t perpetrate these crimes in the first place.

While girls are fed these messages from an early age both at home and at school, there is no similar onus placed on their male peers to learn about consent at the same time. The fact that the debate over the provision of a sex education that is appropriate for the society in which we currently live remains unresolved unfortunately means that these depressing statistics on sexual violence in our universities are unlikely to improve in the near future.

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Gender pay gap – will it ever close?

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égalité des sexes

By Heather Cameron

Last Thursday was labelled ‘Equal Pay Day’ – the last day of the year women effectively stop earning relative to men – just one day later than the previous year.

According to the Fawcett Society, this means women are in effect ‘working for free’ until the end of the year as a result of the gender pay gap.

Given that it is 46 years since the Equal Pay Act was introduced ‘to prevent discrimination, as regards terms and conditions of employment, between men and women’, it is dispiriting that considerable inequalities remain between men and women’s pay.

How much of a gap?

The Fawcett Society has calculated the current gender pay gap for full-time workers at 13.9%.

Recent research by Deloitte suggests that the gender pay gap will not close until 2069 unless action is taken to tackle it now. It shows that the hourly pay gap between men and women is closing at a rate of just 2.5 pence per annum, and in some cases is even widening.

The study also notes that men receive considerably higher average pay even in female-dominated occupations, such as teaching and caring.

And new research from New Policy Institute (NPI) found that, although things have been improving with higher employment rates and increases in earnings, the formal employment rate for women is still lower and female weekly earnings are still less than 70% of male weekly earnings.

The research also highlighted that significant barriers continue to prevent women entering the labour market, particularly when it comes to high-paid, secure, quality jobs.

The overall global situation would appear even worse as the most recent Global gender gap report from the World Economic Forum indicates that the gap could take 170 years to close.

In terms of the economic impact, the gender pay gap has been highlighted as a particular issue in relation to the UK’s low productivity problem.

It has been suggested that equalising women’s productivity could add almost £600 billion to the economy, and that 10% could be added to the size of the economy by 2030 if the millions of women who wanted to work could find suitable jobs.

Causes

The gender pay gap has been attributed to four main causes by the Fawcett Society:

  • Discrimination – often women are still paid less than men for the same job and unfair treatment remains common, especially around maternity
  • Unequal caring responsibilities – women continue to play a greater role in caring for family
  • A divided labour market – women are more likely to be in low-paid and low-skilled jobs
  • Men in the most senior roles – men continue to make up the majority of those in the highest paid and most senior roles

Deloitte’s research similarly highlights that women are disproportionately more likely to enter low paid industries or sectors.

However, it emphasises that one contributory factor to the gender pay gap occurs before labour market entry, when boys and girls decide what to study at school and in further education. Three times more boys than girls take computing and 50% more boys than girls study design and technology.

This is significant because the gap in starting salaries between men and women who have studied Science, Technology, Engineering and Mathematics (STEM) subjects, and who go on to take jobs in these sectors, was found to be far smaller.

Way forward

Deloitte’s research therefore suggests that increasing the participation of females in STEM subjects and careers could help reduce the gender pay gap.

Nevertheless, it also notes that as there are several causes, no single measure will be enough to eradicate it.

The government’s policy to introduce mandatory gender pay gap reporting for all large companies employing more than 250 employees has been welcomed as a step forward. But there are concerns this is not enough. The NPI research suggests that it could go further, with extension of the duty to companies employing 50 people.

In addition, encouraging take-up of the voluntary living wage and boosting pay in sectors that have been traditionally low paid and have predominantly employed women are suggested as ways to help speed up the reduction of the gender pay gap.

The NPI report calls for ‘a multi-dimensional policy response, sitting underneath a clear gender focused employment strategy’ to reduce gender inequalities and the subsequent pay gap.

If you enjoyed reading this, why not take a look at some of our other posts on equalities issues

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Equal to the task? Addressing racial inequality in public services

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huddleCLR

Throughout October, a series of events to promote diversity and equality will take place as part of Black History Month. Although there are many achievements to celebrate, it is an unfortunate fact that many people in the UK today still experience disadvantage due to the colour of their skin.

Over the summer, reports by the Equality and Human Rights Commission (EHRC) and the UN Committee on the Elimination of Racial Discrimination (CERD), found that racial inequality in the UK was ‘worryingly high’.

In its biggest ever review of race inequality in the UK, the EHRC concluded that:

“while for certain people life has become fairer over the past five years, for others progress has stalled and for some– in particular young Black people – life on many fronts has got worse.”

Audit of racial disparities announced

The government responded quickly by announcing an audit of racial disparities in public services. It promises to ‘shine a light on injustices as never before’.

From summer 2017, Whitehall departments will be required to identify and publish information annually on outcomes for people of different backgrounds in areas such as health, education, childcare, welfare, employment, skills and criminal justice.

As well as enabling the public to check how their race affects the way they are treated by public services, the data is also intended to help force services to improve.

The audit is being called ‘unprecedented’ – and it certainly is – up until now, public services in the UK have not systematically gathered data for the purposes of racial comparison. Indeed, according to the FT, very few countries, if any at all, currently produce racial impact audits.

‘Worryingly high’ levels of racial inequality

The audit will have its work cut out.  The review by the EHRC found that, compared to their White counterparts, people from ethnic minorities were more likely to be:

  • unemployed
  • on low wages and/or in insecure employment
  • excluded from school
  • less qualified
  • living in poverty
  • living in substandard and/or overcrowded accommodation
  • experiencing mental and physical health problems
  • in the criminal justice system
  • stopped and searched by police
  • a victim of hate crime
  • a victim of homicide

Institutional racism

Similarly, the CERD findings into how well the UK is meeting its obligations under the International Convention on the Elimination of All Forms of Racial Discrimination (ICERD) raised serious concerns about the level of institutional racism in UK public services. Omar Khan, of the Runnymede Trust, suggested that the findings would ‘embarrass the UK on the world stage’.

Longstanding inequalities in access to services, the quality of care received and patients’ health outcomes were criticised, as was the over-representation of persons belonging to ethnic minorities in psychiatric institutions.

The committee echoed the EHRC’s concerns regarding higher unemployment rates and the concentration of persons belonging to ethnic minorities in insecure and low-paid work.  They also criticised the use of discriminatory recruitment practices by employers.

In education, there were concerns regarding reports of racist bullying and harassment in schools, and the lack of balanced teaching about the history of the British Empire and colonialism, particularly with regard to slavery.

The committee also concluded that there had been an outbreak of xenophobia and discrimination against ethnic minorities, particularly since the EU referendum campaign.  Indeed, the rise in post-Brexit racial tensions has been widely acknowledged.

Equal to the task?

Although the audit has been welcomed by many, including the EHRC, others have raised concern about the extent to which it will tackle the root of the problem.  Danny Dorling, of Oxford University, remains sceptical, stating that “within two or three years every single one of these audits is forgotten”.

Some have noted that in order to be effective, the audit will also have to capture outcomes for migrant families, and for poorer White people, who also suffer from discrimination and disadvantage.  Others, including Labour’s Angela Rayner, shadow equalities minister, have noted that there is a ‘huge gap’ in the review as it would not include the private sector.

The EHRC have called upon the government to create “a comprehensive, coordinated and long-term strategy to achieve race equality, with stretching new targets to improve opportunities and deliver clear and measurable outcomes.”

Certainly, the data produced by the racial equality audit may well provide some basis for the establishment of such targets.

So while this October there is cause for celebrating the progress made so far, the findings of the EHRC and the CERD underline just how entrenched and far-reaching race inequality remains.  As the EHRC states:

“We must tackle this with the utmost urgency if we are to heal the divisions in our society and prevent an escalation of tensions between our communities.”

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Local poverty, national wealth: reflections from the annual SURF conference

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The annual SURF conference took place in Edinburgh on the 1st September 2016. The theme for this year’s conference was Local poverty, national wealth: resourcing regeneration. Delegates came from a range of organisations across Scotland, including local authorities, the Scottish Federation of Housing Associations, COSLA, Creative Scotland, Skills Development Scotland and Transport Scotland. Speakers on the day included director of the Common Weal, Robin McAlpine, Minister for Local Government and Housing, Kevin Stewart MSP, Fiona Duncan from Lloyds TSB Foundation Scotland and Sandra Marshall coordinator and community activist from Leith Hub.

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Image by Rebecca Jackson

Building resilient and equal communities through regeneration

The conference focused on connecting policy, practice and people within communities to promote effective regeneration of spaces to reduce inequality. One of the recurring themes of discussion throughout the day was the localisation of power and services, allowing local communities the ability to plan and decide the best way to regenerate their local area. Other general themes discussed during the day included finance, infrastructure to facilitate regeneration at a local level, and how to create a network of support and integrate professional knowledge to support community regeneration plans. Revisiting a theme from last year’s conference, cooperation with communities rather than imposition of regeneration, formed the backbone of discussion for the day.

Image by Rebecca Jackson

Image by Rebecca Jackson

Economic planning is key to reducing inequality and promoting regeneration

The first session of the day focussed on the policy and economic context around regeneration and reducing inequality. It was suggested in the opening remarks that there needs to be effective development and investment where people live- that poverty and inequality lead to degeneration, and that both must be tackled in order to facilitate effective regeneration of an area. In a way the two are not mutually exclusive: regeneration can help to alleviate poverty and inequality, but in order for regeneration to be as effective as possible, poverty and inequality should be eradicated as far as possible.

As well as this abstract macroeconomic debate delegates and panellists discussed locality based funding, including cooperatives. Panellists suggested that in Scotland the problem is not a lack of money, but a lack of effective distribution of resources. They also discussed how to reduce the gap between the lived experience of communities and what politicians think lived experience is. These insights were put into poignant context by panellist Sandra Marshall, who discussed her own personal struggles, and those of others she has helped in her community of Muirhouse in Edinburgh.

Tackling inequality is high on the agenda of the current Scottish Government, something which was emphasised during the panel session by Kevin Stewart MSP. Working at a community level and having the power to do so was also something which was highlighted as being vital to helping communities affect change through regeneration. Kevin Stewart highlighted the proposed decentralisation bill currently being discussed within the Scottish Parliament, which aims to give greater power to local communities to effect their own change.

pink pig and coins

Resourcing regeneration: the view from funders

There was a general consensus that funding is one of the key enablers, but also one of the biggest barriers to those who want to carry out community regeneration. The ease of access to funders and the ability to identify and engage with them was seen as a big barrier. Longevity of funding was also raised, with most funders donating grants for 3-5 years, despite acknowledging that many projects take longer to come to fruition. The second session of the day invited funders from major Scottish regeneration funding bodies: the Big Lottery Fund, Heritage Lottery Fund, Highlands and Islands Enterprise, Resilient Scotland, and the Scottish Government to present themselves and their funding options to delegates. Panellists were able to highlight their major funding schemes, how to apply and allow people the opportunity to chat directly with funders. The panellists also took part in a “funding cafe” exhibition which saw representatives from 20 of the major funding bodies in Scotland host stalls and interact with delegates.

Making connections and sharing learning

During the afternoon session delegates were able to hear about the lessons from SURF’s Alliance for Action collaboration projects. The projects in Govan, Kirkcaldy, Rothesay and Dunoon highlight the work done by SURF and their partners in using regeneration to promote community cohesion and reduce inequality. Discussions focussed on the projects themselves, how they were implemented, the challenges, barriers and differences in each of the projects, particularly in relation to scale, and the impacts and outcomes they produced. They also discussed how the models used in each of the projects are sustainable and transferable, and considered the role of SURF as the intermediary body through which policy and practice can be merged to the benefit of communities.

Community concept word cloud background

Community concept word cloud background

A bold new vision for regeneration in Scotland

The final session of the day put forward some suggestions for the future of regeneration, in particular using regeneration as a tool to reduce inequality within Scotland’s communities. Panellists discussed alternative and innovative funding methods, including co-operative and community ownership models, the decentralisation of power to help improve community decision making and the importance of addressing systematic and structural themes which underpin inequality within our communities and hinders the process of regeneration.

The conference was a day filled with interesting and unique insights into the regeneration agenda and the impact it can have on reducing inequality within communities. It also provided a platform for discussion about the future potential for regeneration projects within communities. Speakers and delegates came from a variety of policy, practice and community backgrounds, which resulted in a wide ranging and thorough discussion about many different aspects of the regeneration agenda within Scotland.

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