People living in poverty find it harder to live a healthy life, live with greater illness, face barriers to accessing timely treatment, and die earlier than the rest of the population, says analysis from The King’s Fund health and care think tank.
The analysis, commissioned by the Joseph Rowntree Foundation, highlights that while the NHS can treat the health harms of poverty, wider government and societal action is needed to address its root causes.
The authors of ‘Illustrating the relationship between poverty and NHS services’ compiled data showing that people living in deprived communities find it harder to access timely NHS care and are more likely to need expensive emergency treatment. The report cites evidence that:
- 30% of people living in the most deprived areas have turned to 999, 111, A&E or a walk-in centre because they were unable to access a GP appointment, compared to just 10% of people in the least deprived areas.
- Hospital data shows a direct correlation between higher levels of deprivation and higher emergency admissions.
- The increase in length of stay in critical care beds has been greater among more deprived groups. Between 2017/18 and 2022/23 the average length of stay in critical care increased 27% for people in the most deprived communities but just 13% for the least deprived.
- The link between poverty and poor health is a well-known and ongoing issue. Data from January 2024 reveals that 49% of people in the most deprived areas report that the cost-of-living squeeze is impacting their physical health compared with 27% of people in the least deprived areas.
The analysis by The King’s Fund also uncovers a potentially worrying pattern where, for some health conditions, prevalence is actually lower in the most deprived areas yet deaths from those conditions are higher.
The authors point to dementia, which is 1.4 times less prevalent in the most deprived areas of England compared to the least deprived, yet the mortality rate from dementia is 1.6 times higher. A similar trend is seen with the heart condition atrial fibrillation, where people in deprived communities are 1.3 times less likely to suffer the condition yet deaths from it are 1.6 times higher.
The authors describe how patients may struggle to access NHS diagnosis and treatment due to issues such as the cost of travelling, difficulties accessing online services, and paying for NHS charges. They also note that the stigma of poverty can lead to a reluctance to come forward for treatment, or to seek help more broadly, for example by accessing financial advice. Additionally, administrative processes, such as claiming back travel expenses, can be complex.
Experts from The King’s Fund also interviewed senior NHS leaders and found encouraging examples of where the NHS had ‘poverty-proofed’ services in response to tackling the impact of poverty on health. For example, the Children’s Hospital Alliance has introduced a programme across a network of ten hospitals in England that uses AI to identify children at risk of not attending appointments and provides support such as free transport or health appointments in schools.
The researchers stress that while the NHS can, and needs to, do more to make timely care accessible to deprived communities, wider investment and prioritisation to tackle poverty is needed from government and society to address poverty, improve health, and reduce pressures and financial implications on the NHS.
Sarah Woolnough, Chief Executive of The King’s Fund, said: "One of the founding principles of the NHS is that it is free at the point of need, yet our analysis shows the cruel irony that many people living in poverty find it harder than others to access the timely care that could help them better manage their health conditions and prevent future illness.
"The number of people living in deep poverty in the UK has risen, and recent life expectancy figures – a fundamental measure of a nation’s health –show a depressingly stark gap between the most and least deprived areas of the UK. While the NHS can be a force in addressing poverty, as we head towards a general election, widening health inequalities and deepening deprivation must be tackled head on by government and policy-makers."
Saoirse Mallorie, senior analyst and lead author, The King’s Fund, added: "Our analysis highlights that not only do people living in poverty have shorter lives, they also spend a higher proportion of their lives with health problems. To improve the nation’s health and use NHS resources in the best way, tackling poverty must be as much of a priority as bringing down waiting lists.
"While the NHS can do more to treat the symptoms of people experiencing poverty, it cannot alone address the root causes. Bolder action from government, economic and civic society is needed to lift millions of people out of poverty and break this vicious cycle of poverty and its impact on poor health."
Finf out more at: https://www.kingsfund.org.uk/insight-and-analysis/long-reads/relationship-poverty-nhs-services
