by George Eckton, CAS Director of advice services

This article was first published in the Herald on 9 May 2022.

The cost of living crisis we are living through is one that will exacerbate inequalities in our society. The gap between rich and poor won’t just grow in terms of people’s bank balances, but also through their health or lack of it. 

Health inequalities has been a historic challenge for Scotland with life expectancy and general quality of life changing radically between one neighbourhood to the next in parts of the country.  

Soaring inflation and record increases to energy prices will exacerbate those inequalities. We are all facing a perfect storm of rising bills, but frankly some of us are in different boats to weather that storm.

The impact this will have on people’s health are clear – the physical impact of fuel and food poverty is well known and understood, and so to should the impact financial stress can have on people’s mental wellbeing.

We need a sustained, collaborative approach that spreads across health, social and economic actors, across communities, with health and social justice at its core. This is where going forward we think the work of the Citizens Advice network can have a real impact on health inequalities across Scotland.

The preventative work of CABs already saves public health services millions of pounds a year, so building on that we should be looking at a renewed social contract with the wider voluntary sector to deliver local outcomes.

Someone who visits a CAB and has their income maximised to the point where they no longer have to choose between heating and eating avoids negative health consequences. Independent research reveals that those savings were the equivalent of over £15 million in mental health spending and £7.3 million in physical health spending.

Poverty leads to additional pressure on health and social care services. A preventative approach based around early intervention could increase these savings to the public purse, which could be redirected elsewhere.

You can’t put a price on good health, but you can put a cost on poverty. That’s not a solution we should allow in Scotland and something CABs are keen to change

Utilising the full potential of the preventative and early intervention infrastructure offered by CABs as voluntary sector partners to augment current personal services will mitigate demand in the long term by stopping problems becoming worse and on an individual and community level tangibly improve health.

Not dealing with poverty and deprivation now and what causes health inequalities, just means we are storing up more problematic outcomes for the most vulnerable communities across Scotland but also not tackling the right thing, not treating more of the symptoms but more of the causes.

CABs have a clear and under-utilised place in the preventative and early intervention public health and social care space, now more than ever given the cost of living crisis and pressure on health board and local authority budgets.

So we want to work with health and social care partnerships, the NHS and local authorities, to help people weather the storm of this cost of living crisis. It makes sense given the value for money CABs provide, the savings generated by the preventative work they do, and will allow us to start the process of reducing the health inequalities that scar too many of our communities.