“Poverty” isn’t strong enough to describe the misery so many face. We’re back to destitution

Liverpool, 2009. Image: Getty.

The Labour mayor of Liverpool on the return of Victorian poverty.

Destitution. Just think about that word. Over the past decade, we have moved on from talking about social exclusion, or inequality, or even just poverty. Now, such is the impoverishment of whole communities, buckling after a decade of deep public spending cuts, that we are using the language of the Victorian era.

More than 1.5m people experienced ‘destitution’ in the UK at some point during 2017. Not my words, but the description given by a team of academics in a major new report from the Joseph Rowntree Foundation, Destitution in the UK 2018,which provides a benchmark for what the term means in the modern era.

They conclude that destitution refers to experiencing at least two of six indicators in a ghastly basket of measures of extreme poverty. Has someone slept rough for more than a day? Or had fewer than two meals a day for two or more days? Have they been unable to heat their home for five or more days? Or light it? Do they have appropriate clothing and footwear? Basic toiletries? And is their income so low they might lack these basic essentials in the immediate future? 

The problem of destitution is clustered in many post-industrial urban centres. Unsurprisingly, Liverpool comes second after Manchester, with some of the poorer parts of London, the North East and West Midlands also included.

The legacy issues that remain from the 1980s – including ingrained, inter-generational poverty and high unemployment – are hard to resolve, when eight years of swingeing central government spending cuts have reduced the council’s budget by two-thirds, some £444m.

Nevertheless, Liverpool has made it a priority to support people and families who face dire personal circumstances. Our Citizens Support Scheme and other hardship funds provided crisis payments for more than 10,000 last year – and helped more than 3,000 people and families pay for home essentials. 


We have also invested an extra £1mto prevent hardship and homelessness through discretionary housing payments. Last year we made 11,000 such payments, supporting residents who are suffering due to a shortfall in state benefits caused by government welfare reforms.

Our approach has been to deal with crisis situations, in order to stave off calamities. In many cases, we are one of the few councils in the country to provide this range of support, investing £23.2m last year in preventing our poorest citizens sliding into destitution.

This isn’t just because we are committed to social justice – or because I myself grew up in grinding poverty and know exactly how life-limiting it is. No: we have an additional motive for supporting the very poorest citizens in our city.

 If we allow people to sink to the very depths of despair it costs more in the long run to pull them back up again into mainstream society, transferring the pressure onto other frontline services, particularly the NHS. Destitution is cruel and brutal – but it is also an inefficient way to run a society. Our approach sees social justice and economic efficiency working hand in hand.

 But the most galling aspect of the Rowntree report is how bad government policy is conspiring to make the situation worse:

 ‘People were pulled into destitution by a combination of factors: benefit delays, gaps and sanctions; harsh debt recovery practices (mainly by public authorities and utilities companies); financial and other pressures associated with poor health and disability; high costs of housing, fuel and other essentials; and, for some groups – including young people – even lower levels of benefits than for others, and for some migrants, no eligibility at all.’

A large part of the rough sleeping problem we face in Liverpool involves failed asylum seekers who are designated as having no recourse to public funds. They are left to fall through the cracks – which is why I have instructed my officers to ignore this heartless government diktat.  

Remember David Cameron’s boasts about the “big society,” and claims that “We’re all in this together?” The destitute are those failed by his empty rhetoric and the grinding effects of austerity.

Although we don’t have the resources we need to fix all the problems of destitution – mostly driven by factors outside of my control – when we can prevent someone shivering in a doorway, we will, regardless of the rules.

Similarly, we were the first city in the country to bring forward compulsory landlord registration in order to tackle tenant exploitation and drive up standards in the private rented sector. 

All too often, serious-minded reports like this come along and cause consternation for those of us on the political left, but barely skim the surface when it comes to shifting government policy. 

Let this damning report – exposing the reality of destitution in our country, caused by a decade of austerity – be the moment when even the stony-hearted in Whitehall say, “Enough is enough.” 

Joe Anderson is Labour mayor of Liverpool.

 
 
 
 

What’s killing northerners?

The Angel of the North. Image: Getty.

There is a stark disparity in wealth and health between people in the north and south of England, commonly referred to as England’s “north-south divide”. The causes of this inequality are complex; it’s influenced by the environment, jobs, migration and lifestyle factors – as well as the long-term political power imbalances, which have concentrated resources and investment in the south, especially in and around London.

Life expectancy is also lower in the north, mainly because the region is more deprived. But new analysis of national mortality data highlights a shockingly large mortality gap between young adults, aged 25 to 44, living in the north and south of England. This gap first emerged in the late 1990s, and seems to have been growing ever since.

In 1995, there were 2% more deaths among northerners aged 25 to 34 than southerners (in other words, 2% “excess mortality”). But by 2015, northerners in this age group were 29% more likely to die than their southern counterparts. Likewise, in the 35 to 44 age group, there was 3% difference in mortality between northerners and southerners in 1995. But by 2015, there were 49% more deaths among northerners than southerners in this age group.

Excess mortality in the north compared with south of England by age groups, from 1965 to 2015. Follow the lines to see that people born around 1980 are the ones most affected around 2015.

While mortality increased among northerners aged 25 to 34, and plateaued among 35 to 44-year-olds, southern mortality mainly declined across both age groups. Overall, between 2014 and 2016, northerners aged 25 to 44 were 41% more likely to die than southerners in the same age group. In real terms, this means that between 2014 and 2016, 1,881 more women and 3,530 more men aged between 25 and 44 years died in the north, than in the south.

What’s killing northerners?

To understand what’s driving this mortality gap among young adults, our team of researchers looked at the causes of death from 2014 to 2016, and sorted them into eight groups: accidents, alcohol related, cardiovascular related (heart conditions, diabetes, obesity and so on), suicide, drug related, breast cancer, other cancers and other causes.

Controlling for the age and sex of the population in the north and the south, we found that it was mostly the deaths of northern men contributing to the difference in mortality – and these deaths were caused mainly by cardiovascular conditions, alcohol and drug misuse. Accidents (for men) and cancer (for women) also played important roles.

From 2014 to 2016, northerners were 47% more likely to die for cardiovascular reasons, 109% for alcohol misuse and 60% for drug misuse, across both men and women aged 25 to 44 years old. Although the national rate of death from cardiovascular reasons has dropped since 1981, the longstanding gap between north and south remains.

Death and deprivation

The gap in life expectancy between north and south is usually put down to socioeconomic deprivation. We considered further data for 2016, to find out if this held true for deaths among young people. We found that, while two thirds of the gap were explained by the fact that people lived in deprived areas, the remaining one third could be caused by some unmeasured form of deprivation, or by differences in culture, infrastructure, migration or extreme weather.

Mortality for people aged 25 to 44 years in 2016, at small area geographical level for the whole of England.

Northern men faced a higher risk of dying young than northern women – partly because overall mortality rates are higher for men than for women, pretty much at every age, but also because men tend to be more susceptible to socioeconomic pressures. Although anachronistic, the expectation to have a job and be able to sustain a family weighs more on men. Accidents, alcohol misuse, drug misuse and suicide are all strongly associated with low socioeconomic status.

Suicide risk is twice as high among the most deprived men, compared to the most affluent. Suicide risk has also been associated with unemployment, and substantial increases in suicide have been observed during periods of recession – especially among men. Further evidence tells us that unskilled men between ages 25 and 39 are between ten and 20 times more likely to die from alcohol-related causes, compared to professionals.

Alcohol underpins the steep increase in liver cirrhosis deaths in Britain from the 1990s – which is when the north-south divide in mortality between people aged 25 to 44 also started to emerge. Previous research has shown that men in this age group, who live in the most deprived areas, are five times more likely to die from alcohol-related diseases than those in the most affluent areas. For women in deprived areas, the risk is four times greater.


It’s also widely known that mortality rates for cancer are higher in more deprived areas, and people have worse survival rates in places where smoking and alcohol abuse is more prevalent. Heroin and crack cocaine addiction and deaths from drug overdoses are also strongly associated with deprivation.

The greater number of deaths from accidents in the north should be considered in the context of transport infrastructure investment, which is heavily skewed towards the south – especially London, which enjoys the lowest mortality in the country. What’s more, if reliable and affordable public transport is not available, people will drive more and expose themselves to higher risk of an accident.

Deaths for young adults in the north of England have been increasing compared to those in the south since the late 1990s, creating new health divides between England’s regions. It seems that persistent social, economic and health inequalities are responsible for a growing trend of psychological distress, despair and risk taking among young northerners. Without major changes, the extreme concentration of power, wealth and opportunity in the south will continue to damage people’s health, and worsen the north-south divide.

The Conversation

Evangelos Kontopantelis, Professor in Data Science and Health Services Research, University of Manchester

This article is republished from The Conversation under a Creative Commons license. Read the original article.