DYING QUIETLY: The Cost of Staying Alive
In their series exploring the deaths that go unnoticed, Natalie Bloomer and Samir Jeraj examine the impact of austerity and the shrinking of state social safety nets.
“In a single two hour session we met three women who told us they had thought about suicide,” says Natalie Williams, from the Kings Church in Hastings, as she describes the desperation that is seen on a regular basis at the local food bank the church runs.
“We see a high number of mums in particular who are living with a much greater level of stress and depression,” she says. “We’ve been told before that we are all that has stood between them and suicide.”
Hastings is in the top 20% of the most deprived districts or unitary authorities in England. Both health and life expectancy are generally worse here than the England average, but health inequality also exists within the town itself. Women living in the most deprived areas are expected to live 6.2 years less than those in the more affluent parts. For men, the gap is even greater at 9.5 years.
Since the Universal Credit benefit was introduced in Hastings at the end of 2016, Natalie says referrals to the food bank have increased by 118%. “We also saw a massive increase this summer, mainly due to families struggling during the school holidays,” she says. “We currently give out a tonne of food every week.”
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There is no one type of person who turns to the Hastings food bank for help, but national research shows that women have been hit hardest by austerity and cuts and that this has an impact on health.
“We know there is a link between poverty and poor health outcomes,” Mary-Ann Stephenson, director of the Women’s Budget Group, says. “Cuts to welfare and services can push people into poverty and the stress of managing on such a low budget can affect both physical and mental health.”
A report by the group found that poverty takes a toll on an individual’s health because “it reduces their ability to access food, healthcare, good quality housing and social activities.” It also found that women were more likely to act as a “shock absorber” to protect their partner and children from the impact of struggling financially, which in turn can affect their own mental health.
Last year, academics at Imperial College London published research showing that the poorest in society were dying almost 10 years earlier than the rich. It also revealed that life expectancy for women in the most deprived areas has dropped since 2011. At the time, Professor Majid Ezzati, senior author of the research, said: “Falling life expectancy in the poorest communities is a deeply worrying indicator of the state of our nation’s health, and shows that we are leaving the most vulnerable out of the collective gain.
“We currently have a perfect storm of factors that can impact on health, and that are leading to poor people dying younger. Working income has stagnated and benefits have been cut, forcing many working families to use food banks. The price of healthy foods like fresh fruit and vegetables has increased relative to unhealthy, processed food, putting them out of the reach of the poorest.”
Andrew Cairns, Professor at Heriot-Watt University and Director of the Institute and Faculty of Actuarie at the Actuarial Research Centre, has been looking into mortality rates for middle-aged women in the UK, particularly those in their 50s and 60s. He says that mortality improvement rates in this group have flat-lined since 2011 for those living in more deprived areas. Although improvement rates have also slowed for wealthier women, they have not stalled. “Unemployment and income deprivation are the measures most strongly associated with high or low mortality,” he says. “With almost all causes of deaths there is some level of inequality, sometimes small, sometimes very large.”
He explains that, for some causes of death, the onset of a disease might not actually be any different between those in the most or least deprived areas. Rather, late diagnosis, not engaging well with treatment, or the system not working as well for poorer people as it might for those who are more affluent are all possible reasons for why there is a higher death rate among more deprived women.
In Hastings, Natalie says that many of the women they meet feel ashamed that they have reached such a low point that they need to ask for help. “For many women there is a deep sense of shame, they’ll tell us that they’ve been circling the car park trying to build up enough courage to come in,” she says. “But we remind them that there are so many different types of people that use food banks and, like an actual bank, when times are good you can put something in, when they’re hard you take it out.”
The food bank recently had to make an urgent call-out for more food after one of its busiest summer sessions left the shelves almost empty. “We’re having to do that more and more often now,” Natalie says. “You worry that people will get fed up of us saying that we are low on food but somehow they never do, they always come through for us. Hastings has lots of issues but, in terms of community spirit, there is nowhere else I’d rather be.”