Ensure a decent standard of living for all

The PHA is committed to partnership working to address health inequalities and improve the health and social wellbeing of the population in Northern Ireland. This includes working in collaboration with the community, voluntary, public, private and academic sectors to address factors that contribute to poverty and ill health, and to ensure a decent standard of living for all.

Both poverty and economic inequality are bad for health, with poverty an important risk factor for illness and premature death. It affects health directly and indirectly in many ways, including:

  • financial strain;
  • poor housing;
  • poorer living environments;
  • poorer diet;
  • limited access to employment, other resources, services and opportunities.

Poor health can also cause poverty. It is well established that the poorest people live the shortest lives with the worst health. The more one moves up the ladder, the longer one’s life and the better one’s health experience. Poverty is a relative and changing concept in many ways and is subject to fluctuations given macroeconomic conditions.

This section provides information on key programmes of work undertaken by the PHA and partners to address the causal factors of poverty in Northern Ireland.

Poverty

  • Both poverty and economic inequality are bad for health.
  • Persistent poverty in Northern Ireland (21% before housing costs) is double that in Great Britain (GB) (9%).
  • In January 2010, 43,000 children in Northern Ireland were living in severe poverty.
  • There are four main reasons for higher persistent poverty in Northern Ireland: high levels of unemployment, high rates of disability and limiting long-term illness, low wages, poor quality part-time jobs and obstacles to working mothers.

Poverty is an important risk factor for illness and premature death. It affects health directly and indirectly in many ways, for example:

  • financial strain;
  • poorer housing, living environments and diet;
  • limited access to employment, services and opportunities.

Poor health can also cause poverty. In Northern Ireland, research on poverty carried out in 2006 found that 20% of the population was living in relative income poverty (where the household income is less than 60% of the median UK household income for the year in question) over the period 2002/03–2004/05. 

Actions

Across Northern Ireland, the PHA is working in partnership with voluntary and statutory sector partners on a range of initiatives to support vulnerable groups who may not traditionally access services.

Through the Advice 4 Health project, a collaboration between the PHA’s Northern Investing for Health (IfH) Partnership and the Citizens Advice Bureau (CAB), four specialist workers support vulnerable groups across a range of Health and Social Care settings, such as community rehabilitation centres, GP surgeries and local inpatient mental health units.

A programme funded by the Department of Agriculture and Rural Development (DARD) and coordinated by the PHA aims to improve the health and wellbeing of people living in the top 30% of rurally deprived super output areas (SOAs) by making them aware of, or helping them access, local services, grants or benefits.

Outcomes

Since 2006, advice has been provided to over 35,000 people across the Northern Health and Social Care Trust (HSCT) area through the ‘Advice 4 Health’ project – resulting in a minimum of £3.4m income maximisation being recovered for patients and clients.

Next steps

The ‘Advice 4 Health’ project is sharing good practice with other stakeholders with a view to considering how this effective, integrated services model could be developed and expanded across Northern Ireland.

Fuel poverty

22% of households in Northern Ireland are living in fuel poverty.  (Northern Ireland Housing Executive, House Condition Survey 2016).

A household is in fuel poverty if, in order to maintain an acceptable level of temperature throughout the home, the occupants would have to spend more than 10% of their income on all household fuel use.

There are three factors which impact fuel poverty:

  • income
  • the cost of energy
  • the domestic energy efficiency of the home

Research carried out by the Marmot Review Team (2011) and others confirms that living in cold conditions is a risk to health. The inability to adequately heat a home both causes and contributes to worsening health and wellbeing. Impacts on both physical and mental health and wellbeing have been well documented and are worse for particular groups. Those most at risk include: those with an illness exacerbated by the cold e.g. cardiovascular conditions; respiratory conditions; people with disabilities; those with chronic or terminal health conditions e.g. a stroke or cancer; households with young or dependent children; pregnant women; those on a low income and older people 65+yrs.

Across Northern Ireland, the PHA is working in partnership with statutory, community, voluntary and academic sectors to deliver a range of local and regional initiatives to help alleviate the impact fuel poverty for those at most risk.

Improving the homes of those vulnerable to fuel poverty plays an important role, as cold, damp housing can cause respiratory diseases, hypothermia and may contribute to additional winter deaths among older people. The Department for Communities Affordable Warmth Scheme is accessed via local council offices throughout Northern Ireland to help address fuel poverty for home owners eligible for assistance.

The work which the PHA progresses in relation to fuel poverty fits with the organisations wider poverty and health and wellbeing remit. The Public Health Agency Poverty Priorities 2016-2020:

  • Develop and share models of good practice which address poverty, supporting or implementing interventions to:
    • Tackle fuel poverty for vulnerable groups
    • Address food poverty by improving access to healthier affordable choices for those most at risk.
    • Improve incomes and benefit maximisation for those with underlying health needs.
  • Build and extend working relationships with partner organisations and other government departments to achieve shared outcomes around poverty under Programme for Government, Making Life Better, Joint Working with Local Government and within Community Planning.
  • Maintain and develop close linkages with other organisations undertaking work and research in Northern Ireland around poverty.
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