We must tackle poverty in order to address ill health

When you weren’t working you would spend time praying that your child didn’t die. In 1900, under fives accounted for 33 per cent of deaths. If you were posh enough to have a holiday, it would be to a place like Margate. Nowadays, people only go to Margate if they have missed the turning for Whitstable.

In short, life at the turn of the century, while no doubt rich in many ways, lacked the range of opportunities, choices and luxuries we take for granted. No package deals to Malaysia, no X Factor or Dancing on Ice in high definition. And nothing like the public health programme.

So it comes as a bit of a disappointment to discover that despite the medical breakthroughs we have enjoyed over the past 100 years, the many benefits of an ever civilising society and the “healthcare for all” principle of the NHS, the link between poverty, deprivation and mortality is as firmly entrenched now as it was in 1900.

‘You may have enough money to watch Pets Win Prizes on digital TV, but you remain vulnerable to a range of ailments in ways that the wealthier do not’

A recent study into mortality rates showed us that we are living longer and have benefited from a dramatic improvement in preventing early deaths. It showed us that deaths by respiratory, parasitic and infectious disease - which used to be major causes of death - have been replaced by cancer and heart disease. But it showed us also that while the health manifestations of poverty may have changed the outcomes, relatively, haven’t.

What has changed is how poverty manifests itself. A hundred years ago the poor lacked the basic requirements to survive. Fundamental deprivation was widespread in a way it isn’t now. We have deprivation and inequality today, but they manifest themselves in different ways. You may have heating and water, enough money to buy food and watch Pets Win Prizes on digital TV, and your own car - but somehow you remain vulnerable to heart disease, stroke, cancer and depression in ways the wealthier do not.

Poverty is like a virus. Try and eradicate it and it mutates into something more complex. It remains an acute material deprivation - a lack of access for some people to adequate diet and shelter but more widely it is also a lack of access to possibility, education and hope. A kind of material and cultural poverty. Impossible to condemn (you sound illiberal and judgemental) but impossible to ignore.

But there is a clear and underpinning truth that this research reminds us of. If you want to tackle ill health and long term conditions, tackle poverty in all its forms. Yet as politicians jostle for attention and popularity that truth won’t get a mention. It is too tired and too big a responsibility. Funny old world.

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