Inflation in the UK recently reached levels not seen since the 1970s, and the resultant reductions in 'real income' are likely to have "significant effects on health and health inequalities", according to a new modelling study published in BMJ Public Health.
Results suggested that the proportion of people dying prematurely (before age 75) in Scotland was set to rise by nearly 6.5%, representing 30 extra deaths per 100,000 of the population annually. The estimated toll in the most deprived households was four times that of the least deprived.
The authors said that although their findings were derived from Scottish data, they were likely to also apply elsewhere in the UK.
Inflation Effects Differ With Deprivation Status
The researchers, from Public Health Scotland and the University of Glasgow, u sed data from 2704 Scottish households in the 2015-16 Family Resources Survey to model various scenarios for 2022-2023. They modelled the effects of increased inflation on household incomes according to income quintile, based on the proportion of household spending on different goods and services.
Figures were used to estimate the change in spending power (real income), and the extent to which UK Government mitigation measures could modify differential inflation rates, and scaled to the Scottish population. Evidence consistently showed that low income was associated with poorer health, and falls in income adversely affect health, they said.
The researchers modelled the effects of inflation without any mitigating measures; with the inclusion of the universal energy price grant, and with the inclusion of the grant plus means-tested benefits. They used a cross-sectional relationship between household income and mortality to assess potential mortality outcomes by deprivation quintile.
Higher Impact of Inflation for Most Deprived Areas
Unmitigated price inflation in the model was 14.9% for the highest income quintile versus 22.9% for the lowest, with an average increase in premature mortality of 16% compared with baseline. However this ranged from 5% in the least deprived to 23% in the most deprived areas.
While Government policies partially mitigated financial impacts, households in the most deprived areas of Scotland would still be £1400 per year worse off, the researchers calculated. Even with mitigating measures, premature mortality could increase by up to 6.4%, and life expectancy decrease by up to 0.9%.
The energy grant reduced inflation to 11.7% and 15.7% in least and most deprived areas, respectively, along with reduced estimated mortality increases of 3% versus 16%. Mitigation by both grant and means-tested benefits reduced average increases in premature mortality to 2% and 8%, respectively.
Large and Inequitable Impacts on Mortality Predicted
The authors of the study concluded: "Large and inequitable impacts on mortality in Scotland are predicted if real-terms income reductions are sustained."
The authors noted that even though mortality inequalities had risen since the 1980s, aggregate mortality rates in Scotland had been falling until 2012. However, since then, improvements had stalled – which they attributed largely to "austerity policies implemented over that time".
Mortality actually increased during the period of the pandemic response, when pressures on healthcare and other services resulted in "a substantial backlog of unmet needs". Poorer households have borne the brunt of more recent inflation, as they spend a larger proportion of their income on energy, the cost of which has soared. These trends suggest that "the population may be less resilient to further shocks", they warned.
Despite the various mitigation measures, progressive cost of living support payments were "not sufficient to offset the mortality impacts of the greater real income reductions in deprived areas", the authors stated.
"Entirely Preventable Deaths"
Asked to comment by Medscape News UK, William Roberts, chief executive of the Royal Society for Public Health said the "important" study provided evidence that the cost-of-living crisis hit the poorest and most vulnerable the hardest. "The additional lives that are modelled to be cut short because of rising poverty and growing inequalities are entirely preventable deaths, with a heavy human, social and economic cost," he said.
Mr Roberts called for "bold and decisive leadership by Westminster and devolved nation governments" to avoid "continuing to lurch from crisis to crisis".
He said: "We need urgent action from national governments across the UK to tackle the drivers of poor health, through greater financial support for those that need it most, warmer homes, locally accessible services, and better paid work."
Also commenting to Medscape News UK, the Department of Health and Social Care pointed out that help with essential food and energy costs was available for the most vulnerable households in England through the £2 billion Household Support Fund, as well as the Healthy Start Scheme.
A Government spokesperson said: "We recognise the impact that rising prices are having and we are providing one of the largest support packages in Europe, worth £3300 on average per household – including holding down energy bills, uprating benefits in line with inflation, and delivering direct cash payments."
Publication of the study coincided with findings from the annual tracking survey by the Royal College of General Practitioners which revealed that GPs were increasingly dealing with patients impacted by problems associated with poverty and poor diet.