Workshop1: Money Child poverty, health and wellbeing Kerry McKenzie NHS Health Scotland Roddy Samson Improvement Service

Session outline What does child poverty look like in Scotland ? What are the causes of child poverty ? What does this mean for children’s health and wellbeing? Effective intervention: the example of financial inclusion referral pathways between universal NHS services and advice services

Who is at risk of poverty? Source: Family Resources Survey

Relationship between child poverty, health & inequalities Children’s early life experiences and the social circumstances in which they live strongly influence their outcomes in later life. Inequalities begin before birth, can adversely impact health throughout adult life, and can persist across generations. There is a link between socio-economic disadvantage during the early years and health inequalities. The opportunity to reduce the impact of these inequalities is likely to decline as children age. Income matters for child health

  “Having insufficient money to lead a healthy life is a highly significant cause of health inequalities.” Professor Sir Michael Marmot Marmot Review, England 2010. http://www.instituteofhealthequity.org/projects/fair-society-healthy-lives- the-marmot-review

Money makes a difference to children’s health, social, behavioural and cognitive outcomes …causal link Why ? stress and anxiety caused by low income and impact on maternal mental health and parenting behaviour parents’ ability to invest in goods and services that further child development Cooper, Kerris and Stewart, Kitty. “Does Money Affect Children’s Outcomes? An update.” Centre for Analysis of Social LSE, July 2017http://sticerd.lse.ac.uk/case/_new/research/money_matters/report.asp

Child mental wellbeing & income Source: Scottish Health Survey

‘Those children from the most deprived backgrounds are experiencing much worse health compared with the most affluent….. ……more likely to have negative health outcomes, to be born with low birth weight or fail to thrive and be exposed to risks that perpetuate ill health such as poor diet, lack of physical activity, parental drug or alcohol misuse and being in care………More must be done to reduce the number of children living in poverty in Scotland and to minimise the impact of deprivation on health outcomes.’ The State of Child Health 2017 Recommendations for Scotland Royal College of Paediatric and Child Health http://www.rcpch.ac.uk/system/files/protected/page/SOCH-recommendations-Scotland.pdf

‘Poverty makes children sick’ Themes Food insecurity Financial stress and worry Homelessness / poor housing Poverty exacerbating poor health ‘Poverty makes children sick’

Impact welfare reform on children and families? Many families are experiencing financial difficulties because they: - are entitled to less - encounter administrative problems which lead to income crisis or insecurity. Families with dependent children hit the hardest by tax and benefit changes

Unclaimed entitlements £260m of Jobseekers Allowance (JSA), Employment Support Allowance and Income Support unclaimed only 56% of families with children entitled to JSA received it in 2014/15 Sources: DWP (2015) Fraud and Error in the Benefit System 2014/15 Preliminary Estimates (Great Britain); DWP (2016) Income-related benefits: estimates of take-up data for financial year 2014/15 Available from here: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/535362/ir-benefits-take-up-main-report-2014-15.pdf

Role of universal NHS services Midwives, health visitors and GPs are asking pregnant woman and families with young children about money issues routinely as part of their care Active referral pathway to local advice service that is sensitive to needs of pregnant women and families with children

Universal Health Visiting Pathway in Scotland Underpinned by: Trust Building a therapeutic relationship with pregnant women and families with young children Person-centred approach http://www.gov.scot/Resource/0048/00487884.pdf

Every Child, Every Chance: The Tackling Child Poverty Delivery Plan 2018-22 Actions are focused on: Work and earnings Costs of living Social security And, preventative actions that help children and young people avoid becoming parents in poverty http://www.gov.scot/Resource/0053/00533606.pdf

Health and Income Maximisation We will invest an additional £500,000 over two years to support income maximisation services in health settings http://www.gov.scot/Resource/0053/00533606.pdf