The UK is currently experiencing a cost-of-living crisis, reflected by a rising inflation rate currently at 7% - the highest since 1992, with rates predicted to continue rising.
Inflation rates are a measure of how much prices for goods and services are rising over a given period, alternatively you can think of it as a decline of a currencies purchasing power (how much is your money worth). The Office for National Statistics checks the prices of over 700 items on a monthly basis (this is known as the ‘basket of goods’) and includes items such as bus tickets, holiday fees, health care costs, cars, canned goods etc. The average price of this basket is called the consumer price index (CPI), it is compared to the previous year and is used to measure the cost of living.
CPI is one of the most frequently used measures of inflation and deflation, it can be compared to the producer price index, an index used to measure what businesses are paying to produce inputs.
So.. inflation rates are rising, and it is increasing the cost of living to the point where people are struggling to cover basic needs such as food, shelter, heat, water fuel etc, and is the worst real income squeeze since 1945. The reason for the increase is multidimensional; wages aren’t keeping pace with inflation, fuel costs are soaring partly due to the war Ukraine as the west is drastically reducing the amount of oil and gas purchased from Russia, causing a shortage that needs to be covered from other sources, increasing demand, pushing prices up. VAT rates were reduced during the pandemic to support businesses and keep them trading – these rates have however gone back to pre-pandemic levels of 20%. Air passenger duty, cost of postage, water bills, household fuel, rail fares and rising interest rates on mortgages are all going up as well, and food prices could rise by 15%.. all this is creating a perfect storm of price hikes that could push inflation to a record high.
It is easy to see how this can make life miserable and incredibly difficult for the average household, but the cost of living crisis could also have far more serious consequences, as explained by Prof. Mark Shenton at the University of Suffolk. Having worked as a GP for over 30 years, he lays the foundation for the argument that soaring cost of living could reduce the life expectancy of the population by causing relatively small or simple health conditions to spiral out of control into more dangerous and complex presentations. For example, an elderly person with asthma is more likely to have a serious adverse event in a cold, damp and mouldy house than a well-insulated and heated one.
Interestingly, polling by YouGov suggests the price hike, particularly in energy bills, is being felt equally across the socioeconomic spectrum. 56% of households with a combined annual income of £15k say they noticed a major change in gas and electricity prices, compared to 54% of those with a combined salary of £70k. However lower income households are more likely to suffer negative consequences of the price hike. Poorer households have less disposable income and less flex in their budget when costs increase. While a richer household might be able to absorb higher energy costs, for example by reducing how much it saves, that option is likely not available for many low-income households.
The effect on mental health is also likely to be dramatic, especially considering the impact of the last two years of lockdowns and social distancing. The two major areas likely to be affected are autonomy and safety, two significant basic needs that are likely to increase the rise of depression, anxiety, rumination and potentially suicidal ideation.
Another YouGov survey published by The Times revealed that 33% of people say they expect their fuel to be unaffordable this year. Average household electricity bills could jump from £1,277 per year to as much as £2,000 from April 2022, as a result researchers are estimating that that 1.3 million people – including half a million children, will fall into absolute poverty by 2022/2023 unless steps are taken to reduce the squeeze, half the population is also expected to use up their savings this year too.
"It will therefore be more important than every to carry out a comprehensive initial psychosocial assessment to uncover the extent to which the cost-of-living crisis is affecting someone’s health."
Health care service are therefore potentially going to see an increase in referrals for a wide range of conditions – when viewed holistically the cost-of-living crisis can trigger any number of issues leading to a spiral of worsening health. Someone struggling with mental health issues before or during the pandemic may have these exacerbated by the crisis. Similarly, someone struggling with back pain, arthritis, cardiovascular conditions etc. are likely to have these exacerbated too. Providing accurate diagnoses and care to this post pandemic client group will be complicated – as exercise and lifestyle guidance can be difficult for someone to comply with when they can’t eat properly, heat their house or care for their families.
It will therefore be more important than every to carry out a comprehensive initial psychosocial assessment to uncover the extent to which the cost-of-living crisis is affecting someone’s health. It can be a difficult topic to approach as the patient may be unwilling to broach the subject – as the great activist and country singer Dolly Parton pointed out in her 1994 autobiography: the worst thing about poverty is not the living of it, but the shame of it.
If you can build a good rapport with the patient, explore the details of their social situation and mental health, it can help you guide treatment. You can phrase the question differently, but something like: ‘energy bills are through the roof lately, how are you coping at home?’ or ‘how did the pandemic affect you, are you working at the moment?’, anything to open up the topic, you may be surprised at what responses you get from the patient. This can help you connect them to resources that can help, such as social services, local food banks or other online resources such as this one from money saving expert.
Even writing this article today, it seems mad that we need to have a resource called ‘the family cost of living survival kit’ in 21st century Great Britain, but as depressing as it is, that is the situation we find ourselves in. Here are some excerpts from the survival guide:
- Heat the human, not the home. Heated blankets are very cheap to run, close all doors in the house and wrap yourself up. This is just as a short term guide to reducing costs, it can unfortunately be harmful to the integrity and structure of the house to not keep it tempered.
- Household support funds are available through local councils if you are forced to choose between heating and food
- Advice on getting free or very cheap food
There are over 100 other pieces of advice, and the guide is constantly being updated with advice coming in from social media users all over the world.
Long story short we are in a very, very difficult time in our history. Services and people are strained in ways we have never experienced in modern times. Healthcare professionals are essential workers to help mitigate problems and risks and improve quality of life – but they can’t do it on their own. Multidisciplinary in the current climate of health care professionals must include non-traditional organisations like NGO’s, charities, social workers, local councils, even local faith groups, churches, food banks, mental health resources, nursery care, absolutely anything you can think of that can provide relief or respite to the patient and their families suffering.