Let’s be ambitious about ending poverty and improving mental health. If we did end poverty, then all of us, not just those who are poor now, would see benefits for our mental health.
More unequal societies have a wider gap between the richest and poorest. That leads to worse mental health for everyone in that society. But, as with most things, it is the poorest that suffer the most and the 20% least well-off people in the UK are two to three times more likely to develop mental health problems than the richest 20%.
Children and young people are particularly vulnerable to the mental health harm caused by poverty and inequality. It’s one of the reasons we launched its Make it Count campaign for children on World Mental Health Day last week.
Latest figures show that about 4.5 million UK children, a third of under-18-year-olds, live in poverty. That is 400,000 more than last year and rising as austerity and welfare changes continue to bite.
Lacking money to pay for decent housing, healthy food and drink, warm clothes, gym membership and so on is the most obvious way poverty damages health but there are many more subtle ways mental health is undermined.
Two years ago, we produced a powerful report on the effect of both absolute and relative poverty. It confirmed that the harm of economic inequality goes far beyond just not having enough money for the basics of a healthy life.
The report underlined that poverty reduces ‘mental bandwidth’ - the capacity of the brain to perform daily functions - the consequence of which is that poorer people tend to make poorer health choices.
For example, if you’re worried about finding the money to pay the gas bill and replace your child's worn-out school shoes, you are less likely to have the ‘mental bandwidth’ to plan a healthy dinner and you are more likely to grab a cheap takeaway. You are also more likely to smoke and drink harmfully, and take other risks that harm the health of you and your children.
It’s one of the reasons that children living in poverty are much more likely to experience abuse, neglect, violence and other adverse childhood events which, in turn, make mental illness more likely.
How everyone's mental health is affected
Not only does an unequal society push poor people into making poor choices but it also increases the amount of adrenal stress hormone cortisol, our ‘flight or fight’ response, created by everyone living in it.
The greater the gap between the rich and poor, the more all of us worry about our status, the more cortisol we produce and the worse our mental and physical health becomes.
Some people claim that unequal societies are just the product of ‘human nature’ and that we are ‘hard wired’ to look after number one and that there will always be and always have been ‘winners and losers’.
But as Richard Wilkinson and Kate Pickett point out in their new book 'The Inner Level', the human species has spent 90% of its existence living in hunter-gatherer bands where people were basically equal in status.
It is only in the last 12,000 years of agricultural and then industrial societies that have created such disparities and even then some highly affluent and successful societies like Japan and Scandinavia are far more equal and healthy than others.
So how do we make progress and begin to try to 'eradicate poverty'?
On the positive side, huge strides have been made in reducing absolute poverty across the world in recent decades and the average standard of living has continued to rise despite the fallout from the economic downturn since 2008.
The challenge now, recognised by the World Bank (among others not usually noted for their altruism), is to address inequalities, the gap between the richest and poorest, and reduce relative poverty.
Initiatives like the Living Wage, Fair Trade and cutting pay ratios all have a role to play but ultimately ‘social transfers’ are necessary to fairly tax wealth and redistribute resources to the poorest.
Without such measures, wealth will become more and more concentrated, a situation that is highly unstable as we have seen from recent political events, and our communities will continue to be unequally exposed to fundamental risks to their mental health.
Publication: Poverty and mental health
There is a close link between poverty and mental health: poverty can be a cause or consequence of mental ill health.
A growing body of evidence, mainly from high-income countries, has shown that there is a strong socioeconomic gradient in mental health, with people of lower socioeconomic status having a higher likelihood of developing and experiencing mental health problems.