The Impact of the Rising Cost of Living on Health and Healthcare in Wales

The cost-of-living crisis has become a formidable feature of daily life for people living across Wales. With high inflation rising energy, fuel, and food costs, in real terms the crisis refers to the fall in ‘real’ disposable incomes (Institute for Government, 2022). As such, people across the country are struggling to pay their bills, feed their families and secure and maintain suitable housing, having an impact on each corner of public life, not least health care. According to Public Health Wales (Public Health Wales, 2021) health inequalities currently cost the Welsh NHS£322 million every year, a figure which is expected to rise in response to the current economic climate. Moreover, as we head into the difficult winter months which see stark resourcing and capacity pressures across the system, the crisis is expected to have an unprecedented impact on services across the country.

We spoke to Joshua Beynon, a County Councillor on Pembrokeshire County Council since 2017, who said:

“With the increased cost of living and the energy crisis, I have seen a number of constituents come to me struggling to buy either their usual groceries or heat their homes in a way that they would have been able to in past years. I am concerned about the impact on people’s health with a lack of nutrition and the exacerbation of conditions caused made worse by cold homes. I fear that society will in the long term be dealing with a poorer, sicker population that could be prevented by being proactive rather than reactive.”

One of the indicators used to measure population health and needs is health expectancy. Health expectancy refers to the number of years a person can expect to live a healthy life, with contributing factors including deprivation linked to education and employment, access to resources, and level of disposable income (Office for National Statistics, 2017). Health expectancy can be an indicator of differing health outcomes and service needs for those living in the most and least deprived areas in Wales. This is illustrated in the graph below (Public Health Wales, 2020), showing the difference in healthy life expectancy and life expectancy between most and least deprived areas. Women living in the least deprived areas can expect to enjoy almost 17 years more healthy life than their peers living in the most deprived areas.

We know that the cost-of-living crisis will have a greater impact on those with lower household incomes and can reasonably be expected to widen inequalities in health expectancy, putting greater pressure on services in areas worst affected. Research commissioned by the Royal College of Physicians (RCP) has found that 60 per cent of people in Wales felt their health has been negatively affected by the cost of living (Royal College of Physicians, 2022).

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Cold or damp housing contributes to worsening chronic conditions such as asthma and COPD, whilst the RCP reported members experiencing issues such as ulcerations. Alongside this, many people cannot afford high fuel and travel prices and will struggle to attend medical appointments, increasing the risk of delayed health repercussions (Royal College of Physicians, 2022). This is particularly concerning in Wales where 35 per cent of people live in rural areas (Public Health Wales, 2022). Moreover, the impacts on mental health caused by increased financial stress and insecurity are expected to rise. According to Professor Rob Poole of Bangor University (The National, 2022), ‘people living in poverty are more likely to have a mental illness such as depression, anxiety, phobias and especially schizophrenia’. With mental health and primary care services across Wales already under-resourced to meet current demand, this creates a frightening prospect for the coming months and years. One Carmarthenshire GP, Dr Will Mackintosh, said:

“I think everyone in primary care is concerned about the cost-of-living crisis, not least in that we understand that socio-economic status is the key underlying determinant of health then this is not good for our patients in the short and long term.  It is already concerning that in the UK life expectancy for the poorest has stalled and this looks like it will be compounded going forward.  I think it is likely we will see a short term rise in mental health problems; this has anecdotally already begun.  In the long term I think there will be particular concern about a worsening of long-term conditions such as diabetes and obesity as people have less choice in how to manage their own health.  I also anticipate alcohol usage will rise which will have an impact on mental and physical health. 

We are operating in an environment with very limited clinical and non-clinical staff.  As demand rises it creates additional pressure on the whole team and while we will be here for our patients when they are ill these pressures mean we have less ability to provide the continuity of care that help our patients have the best outcomes.”

Through our work hosting the All Wales Cluster Leads Group, talking to NHS staff during our project work, or talking to practices about the products we offer, we are hearing from every corner the fears for the coming winter. There are expectations of increases in patients with new problems and existing problems being exacerbated. With many services already stretched beyond capacity, organisations facing rapidly rising energy and running costs, and staff who are exhausted, this winter poses a serious threat to wellbeing in the healthcare and wellbeing services in Wales. Yma hears every day the dedication and drive that the people working in the NHS have, we are working to support you any way that we can.

If you would like to get in touch with your experiences, contribute to our work or learn more about what we do, please use the CONTACT US page to send us a message.

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Resources used: 

[1] https://www.instituteforgovernment.org.uk/explainers/cost-living-crisis (Last accessed September 2022).

[2] https://phw.nhs.wales/news/tackling-inequality-could-save-hospitals-in-wales-322-million-every-year/ (Last accessed September 2022)

[3] https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/healthandlifeexpectancies/articles/whataffectsanareashealthylifeexpectancy/2017-06-28 (Last accessed September 2022)

[4] https://publichealthwales.shinyapps.io/PHWO_HeathExpectanciesWalesProfile_v2a/ (Last accessed September 2022)

[5] https://www.rcplondon.ac.uk/news/over-half-brits-say-their-health-has-worsened-due-rising-cost-living (Last accessed September 2022)

[6] https://www.rcplondon.ac.uk/news/over-half-brits-say-their-health-has-worsened-due-rising-cost-living (Last accessed September 2022)

[7] chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://phw.nhs.wales/news/rural-communities-face-pivotal-time-of-change-as-triple-challenge-impacts-take-effect/rising-to-the-triple-challenge-of-brexit-covid-19-and-climate-change-for-health-well-being-and-equity-in-wales/ ( Last accessed September 2022)

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