inequality

Levelling up the UK: is the government serious about reducing regional inequalities in health?

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This is my “long read” tip. There is some really interesting stuff to reflect on here, particularly in relation to the issues around levelling up being wider and with more dimensions than just simply north vs south. Try rural vs urban!

The Levelling Up white paper, released in February 2022 after major delay, outlines the UK government’s much anticipated strategy for tackling regional inequality. The centrepiece of the government’s reform agenda, “levelling up” is presented as a solution to the UK’s longstanding and serious geographical inequalities (box 1). Although levelling up is already permeating political and media discourse,10 the white paper is the first attempt to translate this broad idea into specific policy commitments to tackle place based inequalities: white papers set out proposals for future legislation.

UK health inequalities made worse by Covid crisis, study suggests

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I am not surprised by this story. The concentration on the elderly as a key component of those most disadvantaged should maintain our focus on rural England as a series of places disproportionately challenged by the impact of the pandemic. It tells us:

The coronavirus crisis has disrupted routine healthcare disproportionately across society with women, older people and minority ethnic groups most likely to report cancelled or delayed appointments, prescriptions and procedures, researchers say.

Public health experts trawled through data from nearly 70,000 people enrolled in 12 major UK studies that surveyed the population before and during the epidemic. They found evidence for widespread inequalities, with disadvantaged groups often facing the greatest disruption to their medical care.

“Many of the people who report experiencing the greatest healthcare disruption often had poorer health prior to the pandemic,” said Vittal Katikireddi, a senior author on the study and a professor of public health at the University of Glasgow. “While experiencing healthcare disruption is common across all social groups, our study raises the possibility that the health of the most disadvantaged in society might actually be more impacted by the disruption to the health system.”

British families took bigger hit to income during Covid pandemic than Europeans

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I found this article particularly interesting to consider through the lens of the fact that it costs more to live in rural England due to distance from services. It tells us:

The greater exposure of British households, revealed in an analysis by the Resolution Foundation thinktank to be published in full this week, comes despite similar levels of average income with our European neighbours.

The typical working-age income level in the UK is £29,437 and £29,350 in France. However, the poorest fifth of working-age households in the UK are 20% poorer than their French counterparts, while the richest fifth are 17% richer in Britain.

The structure of Britain’s economy and income inequality is seen by some as a reason for the heavy toll the pandemic had wrought on the UK. Some public health officials continue to warn that incidences of the virus remain higher in areas with many people in low-paid work and where they cannot work from home. There have been warnings that it could become a “disease of the poor” in some areas.

High employment levels in the UK helped household finances in the run-up to the pandemic last year, with a 75% employment rate – broadly similar to that in Germany and far higher than the 66% record in France. However, the typical hourly rate paid in the UK (£11.20) was much lower than in Germany (£12.33) and France (£13.89). It was partly driven by low self-employed earnings, raising further concerns about the extent of the gig economy in Britain.

Levels of UK welfare support were found to be poor in comparison with other large European nations, underlining the importance of protecting jobs through the government’s emergency furlough scheme rolled out last year. For example, a single adult who had been out of work for two months, having previously earned two-thirds of the average wage, would see their benefit income total just 17% of their previous earnings. The same person would see a benefit replacement rate of 59% in Germany and 64% in France. The gap is closed when housing-related benefits are included, with the UK’s benefit replacement rate rising to 46%, compared with 59% in Germany and 68% in France.

UK public health expert criticises No 10 race report ‘shortcomings’

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Whenever Michael Marmot speaks we should listen. Some fascinating thinking here – this story tells us:

An inquiry into racial disparities used outdated references and notably underplayed the impact of structural racism in health outcomes, the UK’s leading authority on public health has said, in a new blow to the credibility of the much-criticised report.

Sir Michael Marmot, who led a pioneering work into health inequalities in 2010, which was updated a decade later, said that while there was “much that is good” in the report’s chapter on public health, he was concerned about “shortcomings” in its approach.

Writing for the Guardian, Marmot said the report by the Downing Street-appointed Commission on Race and Ethnic Disparities (Cred) had cited his 2010 study but did not consider the 2020 update or a subsequent study he led on structural factors behind varying Covid outcomes.

Marmot also criticised the report’s contention that health inequalities should be considered an outcome of factors such as deprivation and poor housing rather than ethnicity. Such social conditions “are themselves the result of longstanding inequalities and structural racism”, he noted.

The report’s focus on disparities due to social class was only part of the story, Marmot argued. “There are health differences between races that are not fully explained by class, and so therefore racism must play some role. To put it simply, these two issues may overlap but they are not the same thing.”

City dwellers idealise Britain’s countryside, but there’s no escaping rural poverty

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Any one who thinks urban places have a monopoly on disadvantage should read this article. It tells us:

A paper by the Cardiff University geographer Andrew Williams and colleagues offers a reality check, pointing out that austerity did not bypass rural England and Wales. It too has seen big cuts to public infrastructure and services. Rural housing has its own affordability crisis. Poverty, so often imagined solely as an urban affliction, thrives, though often hidden, amid the pretty market towns and rolling green fields.

The disconnectedness of rural living may be part of its charm but it is also a driver of inequality, the paper points out. Almost no one in urban areas lives more than 4km (2.5 miles) from a GP – one in five households in rural areas do. It is the same for supermarkets: 44% of country dwellers have to travel more than 4km to get to one, while 59% are not within 4km of a bank. Public transport has been decimated – if you don’t have a car, good luck.

The closure of Sure Start children centres, jobcentres and youth clubs has exacerbated the access problem. Of 605 libraries closed in England since 2010, 150 were in rural areas. They were more likely to be rescued by volunteers in urban areas, Williams points out, “suggesting that the ‘rural’ is not quite the ‘ideal laboratory’ for community-run public services that it is made out to be by proponents of the big society.”

One way rural local authorities have sought to mitigate the cuts enforced on them by central government is by “switching” services such as public toilets and parks to the care of parish and town councils, who raise local taxes to pay for them. Not a problem for wealthy villagers but hardly fair to those who are less well off, who are in effect taxed twice at a time when their incomes have been shrinking as a result of welfare cuts.

Many rural economies are weak, even in the prettiest, chocolate boxy parts. Low wages and casual labour are rife, and the rural premium on fuel and food is eye-watering. Households in rural hamlets with a car spend an average £139 a week on transport, compared with £79 in urban areas. More than 40% of households in rural Wales live in fuel poverty, says Williams, compared with 22% in urban areas. Similarly, people in isolated rural areas spend an average £71 a week on food, compared with £61 in cities.

Black Lives Matter group offers rural people ‘insight into prejudice’

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A fascinating development – brings some freshness to the whole issue of the nature of rural communities and BAME groups.

Black Lives Matter activists have launched a toolkit designed to help rural communities across the UK to fight racism in their local area.

Their campaign, BLM in the Stix, is aimed at building on the momentum of June and July, when more than 260 towns and cities held anti-racism protests, from Monmouth in south Wales to Shetland in Scotland. It offers rural communities support to take a stand against racism at a local level.

The online toolkit was launched on Saturday with a protest along the banks of the River Colne in Essex.

“This toolkit is about getting people who are not racist to become anti-racist, especially for people who live in rural areas who might be thinking we don’t have that much racism around here,” said Gurpreet Sidhu, founder of the Wivenhoe Black Lives Matter group and co-organiser of the protest.

The toolkit, developed by Wivenhoe BLM supporters with help from Stand up to Racism Colchester and the Local Equality Commission, provides resources on how to start a campaign in a rural setting, describing some of the key challenges as well as ways to overcome this. It is targeted at white people in rural areas who want to stand up against racism but might not know where to start.

Just 6% of UK public ‘want a return to pre-pandemic economy

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This week a thoughtful sign off note that some things may have changed for the better. This article explains:

Only 6% of the public want to return to the same type of economy as before the coronavirus pandemic, according to new polling, as trade unions, business groups and religious and civic leaders unite in calling for a fairer financial recovery.

The former head of the civil service Bob Kerslake, the former archbishop of Canterbury Rowan Williams, the heads of the Trades Union Congress, Confederation of British Industry and the British Chambers of Commerce are among 350 influential figures wanting a “fairer and greener” economic rebuilding, and believe there is no going back to the past.

Their call comes as a YouGov poll shows that 31% of people want to see big changes in the way the economy is run coming out of the crisis, with a further 28% wanting to see moderate changes and only 6% of people wanting to see no changes.

It also showed 44% of people were pessimistic when they thought about the future of the economy, while only 27% were optimistic. Forty-nine percent thought the crisis had made inequality worse.

Labour peer Lord Kerslake said: “As the country begins to emerge from the crisis, it is becoming clear that people want a better future, not simply to return to where we were before. As with big crises in the past – from wars to the Great Depression – it was universally agreed that there was no going back.

Key findings from Public Health England’s report on Covid-19 deaths

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As we get deeper into this pandemic worrying patterns are starting to emerge. This article is interesting in its own right, but it also makes me reflect on whether there are some differential impacts affecting rural dwellers. This story tells us:

The inquiry into disparities in the risk and outcomes of Covid-19 commissioned by the Department of Health identifies major inequalities, confirming that – contrary to the popular refrain – we are not all in this together.

Mortality risk from Covid-19 is higher among black, Asian and minority ethnic (BAME) people.

The Public Health England (PHE) review confirms that the risk of dying among those diagnosed with Covid-19 is higher in those in BAME groups than in white ethnic groups.

After accounting for the effect of sex, age, deprivation and region, it found that people of Bangladeshi ethnicity were at most risk, with around twice the risk of death than people of white British ethnicity. People of Chinese, Indian, Pakistani, other Asian, Caribbean and other black ethnicity had between 10% and 50% higher risk of death when compared to white British. The risk of mortality for people of Bangladeshi ethnicity was in line with other research, by the Office for National Statistics (ONS) and Institute for Fiscal Studies (IFS), but for other ethnicities it was generally lower.

In previous years, all-cause mortality rates were lower in Asian and black ethnic groups than in white ethnic groups, PHE said, meaning that mortality risk for Covid-19 was a reversal of what had been seen in the past.

Diagnosis of Covid-19 among BAME people is also greater.

When adjusted for age the highest diagnosis rates (which does not necessarily correlate with incidence) of Covid-19 were in people of Black ethnic groups (486 in females and 649 in males) and the lowest were in people of white ethnic groups (220 in females and 224 in males).

UK’s organised crime threat at record level, warns National Crime Agency

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Rural places used to be far less crime based than the Cities.  On-line trends like surveillance capitalism and the growth of the dark web mean that “space” has relatively limited impact any more in insulating rural communities from illegality and many rural dwellers are now very vulnerable to modern crime of the type set out in this article. Indeed rural places are often popular settings for modern criminals because of their isolation. This article tells us

The writer Misha Glenny, who will chair a panel of senior officers at the NCA’s report launch in London on Tuesday, said the austerity drive had allowed powerful crime syndicates to flourish in the UK.

Glenny, whose book McMafia documented the globalisation of crime after the break-up of the Soviet bloc, said that when it was published in 2008 organised crime was viewed as a global concern and its impact on most British citizens was minimal.

“In the past 10 years what is really striking is how this industry has grown inside the UK. Austerity has been absolutely critical in this, partly because of the reduction in police capacity but also because of the continuing increase in inequality. A lot of victims of organised crime tend to be people on the margins who don’t have a voice. When you get an impoverishment of the population, which is what we have had over the last 10 years, you get an increase in desperation, and that opens up opportunities,” added Glenny.

Transnational criminal networks, the exploitation of technological improvements and “old-style violence” is allowing serious crime gangs to “dominate communities”, the NCA assessment will say this week.

“It will reveal the changing nature of organised crime and its wholesale undermining of the UK’s economy, integrity, infrastructure and institutions,” said the NCA in a statement.

The assessment, described as the most comprehensive yet by the NCA, will also chart the rise of poly-criminality where organised groups operate in several illegal trades such as drugs, firearms and human trafficking. Last year the agency mapped 4,629 OCGs (organised crime groups) inside the UK with tens of thousands of members and says the threat has since continued to grow. One area of enduring concern remains the use of encrypted and anonymisation technology, the latter primarily on the dark web, that have eroded the ability of investigators to detect offenders.

MPs call on landlords to scrap ‘no DSS’ clauses in rental ads

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This article and the one which follows it tell us much of what we need to know about why it is very hard for anyone of modest means to have much of a prospect of a roof over their heads in large swathes of affluent rural England. And why does it matter? Well mainly because serious social division starts when we remove the mix of different types of people from communities, whether deliberately or as an unintended consequence of ill thought out public policy. This article helps explain this point in powerful detail, particularly in terms of minority groups, women and people with disabilities. It tells us:

MPs have demanded landlords and letting agents end the practice of screening out people on benefits after hearing claims that “no DSS” clauses have become the 2019 equivalent of “no blacks, no Irish, no dogs” notices.

During a hearing into the widespread refusal of landlords to rent properties to those on benefits, the Commons work and pensions select committee on Wednesday confronted the director of Your Move, a national online lettings agency, with an advert it published in March for a home in Telford, Shropshire, that read: “No DSS. Small dogs considered.”

They also drew admissions from leading lettings agencies Hunters and Your Rent that they still run “no DSS” adverts, despite rising opposition to the practice, which Derek Thomas MP said amounted to a “hostile environment” for tenants on benefits.

Heather Wheeler, the housing minister, said last month she wanted to tackle the practice of “no DSS”, but it remains widespread. One current advert for a three-bedroom house in Cheshire reads: “Small Dogs Considered (higher deposit), NO DSS, NO SMOKERS.”

Another for a property in Cornwall seems to be trying to avoid using the letters DSS and instead says: “No —. Small dogs considered.”

In 2017-18, 889,000 households in the private sector needed housing benefit to pay their rent and the housing charity Shelter said the “no DSS” practice breached equality law because it disproportionately affects women and people with disabilities. Renters say it means they have less choice, standards are lower and costs higher.

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