There is extensive evidence of a strong correlation between low income and almost all forms of poor health. People living in low-income areas are likely to develop multiple long-term conditions 13 years earlier than people living in the most affluent ones. Nearly half of those in problem debt have a mental health condition, according to the National Study of Health and Wellbeing.
This report, which we commissioned from the think-tank Demos, helped us explore ways to reduce financial difficulty among people at risk of developing multiple long-term conditions in our area.
The report's results highlighted that:
The scale of these problems can make them seem hard to overcome. However, the research suggests there is real potential for interventions to end the cycle of poor health and financial difficulty. By improving the financial health of people at risk of developing multiple long-term conditions, we believe we can reduce the number of those affected. This report particularly looked at the needs of those diagnosed with diabetes, coronary heart disease and depression, as statistics show people with these conditions are most likely to progress to multiple long-term conditions. The findings will inform the strategy for our multiple long-term conditions programme, and specifically, our priorities for exploring whether improving the financial health of people and communities can improve health outcomes and reduce the likelihood of moving from a single to multiple long-term conditions.
Demos led a detailed review of evidence associated with financial capability, including an assessment of the Financial Capability Strategy Evidence Hub and the results of the What Works Programme. They also analysed grants awarded over the last five years by ten major funders supporting interventions in this space, including JP Morgan Chase Foundation, Barrow Cadbury and The National Lottery Community Fund. This was to identify the specific programmes that had been funded and which results had generated the most impact.
Finally, Demos conducted a range of interviews with experts from national and local organisations such as Diabetes UK, Macmillan, Lambeth Council and Citizens Advice Southwark, to further understand the range of financial health interventions currently available to people at risk of developing multiple long-term conditions.
Lambeth and Southwark are densely populated boroughs with young, growing populations and high inequality. One in five residents have at least one long-term condition. Both boroughs have a wide range of financial capability, money, debt, welfare, housing and legal advice services.
This research sought to identify the interventions most likely to improve the financial health of a target population in the boroughs. From previous research, we knew that the groups most likely to progress from one to multiple long-term conditions are those diagnosed with diabetes, coronary heart disease and depression, and so chose to consider their particular needs for this report.
Demos’ research also explored pathways between mental health problems and financial difficulty. They found that:
We commissioned the report from Demos, a think-tank based in the UK that specialises in social policy and developing evidence-based solutions in a range of areas - from education and skills to health and housing.
This report helped us clarify the available ways to reduce the chances of financial difficulty among people at risk of developing multiple long-term conditions in Lambeth and Southwark.
These recommendations include:
Target the relevant population, just in time, where they are. A project will be most effective if delivered at a moment of change or crisis in a person’s life – such as a new diagnosis – and co-located with services that they are already accessing.
The best evidence is for staggered money, welfare and debt advice. The most reliable intervention would be money advice, with a referral pathway to welfare and debt guidance for those most in need, delivered over time.
To be more innovative and help people manage fluctuating incomes. A partnership could be established with local landlords and utility companies. People would be offered the option of flexible bill payment, conditional on receiving money advice.
Double down on enabling professionals. One pathway could be in helping professionals triage people to support at the appropriate moment and help track progress against outcomes.
12 November, 2019
This programme provides social enterprises delivering health and wellbeing initiatives with training and funding to improve their impact and sustainability. Eight organisations in Lambeth and Southwark receive grants and a year-long programme of support.
18 September, 2019
We’re supporting academics at King’s College London and Outcomes Based Healthcare to build on our initial research into people’s journeys to multiple long-term health conditions and explore further who is most at risk of progression to multiple conditions.