Most in Need

1. Most in Need Prepared for the Big Lottery FundPresentation 2

2. Definitions of need

3. Definition of needs • Needs can be absolute or relative, objective or subjective, universal or historically and culturally specific, and there are substantial grey areas between each of these poles • Whilst we are aware that the concept of need is not an easy one to explore, for the simplicity of this report we define those most in need as the bottom 5% of income earners • This report is structured by the four areas of need identified in the Sinking & Swimming Report, written in 2009 for the Young Foundation. These are • Material and Physical Needs • Care Needs • Needs for Capabilities • Psychological Needs

4. How needs are met Source: Young Foundation, sinking and swimming 2009

5. Material and physical needs

6. Material and physical needs • The bottom 5% of the population live on an income less than £160 per week • This income poverty is linked to rises in the numbers of people earning below the ‘minimum income standard’ and the number considered ‘materially deprived’ • More widely, although the improving economy has led to recent falls in the total unemployment figure, the number of underemployed and NEETs remain high

7. Income distribution The bottom 5% earn £160 per week or less Median income £419 pw 60% of median £251 pw Mean income £511 pw 5th percentile 3.8 million individuals with income above £1,000 per week Source: DWP 2012

8. Employment Total employment set to increase But national picture varies widely

9. Underemployment Underemployment has risen across the UK And it disproportionately affects the young (2013)

10. Minimum Income Standard Minimum Income Standard is defined as the income people need in order to reach a minimum socially acceptable standard of living in the UK Source: Joseph Rowntree Foundation, 2014

11. Material deprivation The definition of material deprivation is based on the ability to afford a selection of items that are considered to be necessary or desirable The overall severe material deprivation rate has remained broadly unchanged between 2005 and 2011, with 5.1% of the population being deprived in 2011 Source: ONS

12. Deprivation and ethnicity • Ethnic minority groups were more likely to live in deprived neighbourhoods in 2001 and 2011 • In 2011, more than one in three in the Bangladeshi and Pakistani groups lived in a deprived neighbourhood, which is considerably more than any other ethnic group • Despite there being a considerable deprivation gap, the data shows considerable improvement over the last decade Source: Census data, Centre on Dynamics of Ethnicity

13. Unemployment and Migration • No clear link between migration and unemployment • Net migration increased in line with falling unemployment 1991-2005 • But unemployment has risen since 2008 • In periods of high unemployment it might be more difficult for migrants to find jobs • This may be exacerbated by poor language skills, low skills and/or racial discrimination Source: ONS

14. Transport Poverty Across the country, nearly 1 in 10 people have no access to a car or a van – increasing the potential for isolation and deprivation Source: Understanding Society

15. Transport Poverty Transport poverty restricts individual opportunity; denies access to frontline care; and disconnects communities Source: Understanding Society 2011-12

16. Transport Poverty For some, negative perceptions of transport networks are a matter of conveniences – for a large minority, however, it is a fundamental issue of access and service

17. Care needs

18. Care needs • Physical ill health is worsening – according to the most recent Understanding Society data, the proportion agreeing their health is ‘good’ has fallen from 33% to 27% • This is likely related to rises in malnutrition and obesity – a mixture of short and long term trends • Recent forecasts on childhood obesity suggest that a quarter of boys and girls could be obese by 2050 • In addition, there has also been a long term rise in the number of drug-related deaths

19. Health Since 2009-10 there has been a significant decrease in the proportion of people reporting their overall health as good. Part of this could be due to methodological changes* but is also likely to be a result of declining standards of health as a result of economic difficulties Source: Understanding Society, BHPS

20. Adequate nutrition • Malnutrition is a major cause and consequence of poor health and older people are particularly vulnerable • One million people over 65 years old are malnourished or at risk, of which, 93% are living in the community • Malnourished people typically have: • Increased ill health (more hospital admissions and re-admissions) • Longer stays in hospitals and greater healthcare needs (more GP visits, care at home and greater use of antibiotics) • Increased risk of mortality Source: NDNS, Malnutrition Task Force

21. Heat or eat • The poorest of older households are unable to afford to spend more on heat during colder periods • Statistically significant reductions in food spending are observed in response to temperatures two or more standard deviations colder than expected • Reductions in food expenditure are considerably larger in poorer households Source: ONS, Institute for Fiscal Studies

22. Damaging Consumption • Damaging consumption is a term that covers any form of consumption that would be considered dangerous or unhealthy • Such consumption is considered unhealthy either because of the intrinsic nature of the substance involved (drugs) or the amount consumed (obesity) • It is typically used to refer to unhealthy diets and excess consumption of alcohol and/or smoking

23. Obesity – not strongly linked to income Source: HSCIC, 2012

24. Child obesity By 2050, 25% of girls and boys aged under 20 could be obese Source: Government Office for Science, 2012

25. Drug related deaths Source: ONS, 2013

26. Need for capabilities

27. Needs for capabilities • Despite a long term drop in the proportion of the workforce with no qualifications, some 9% of adults have no qualifications – with the figure as high as 17% in Northern Ireland • Pressures in the jobs market and a lack of options for school-leaves has seen a rise in the number of NEETs • For migrants, significant language barriers exist, which can inhibit access to the jobs market

28. Education and Skills -6.4% Source: Labour Force Survey / Annual Population Survey ONS

29. Lost Generation? The recent economic downturn has seen a sharp spike in the number of young people classed as NEET (not in education, employment or training) This has led to fears in some areas of a ‘lost generation’ of young people ill prepared and qualified for adulthood and the workplace Source: ONS

30. Language barriers Age and gender breakdown of the portion of the population of England and Wales reporting a non-English main language in 2011 Male Female Source: Centre on Dynamics of Ethnicity

31. Psychological needs

32. Psychological need • Incidence of clinical depression is most common in middle age – which also correlates to wider emotional stress and the lifestage associated with lowest levels of subjective well-being • Health, fear and anxiety can also enhance isolation and physical disconnectness – preventing people from socialising or accessing services • Although a majority of people have positive views of their neighbourhood, around 10% do not – citing lack of trust and dependency

33. Mental Health • Incidences of mental ill health peak in middle age • This corresponds to a lifestage where individuals are likely to experience a number of major events – from job/financial issues to family changes (children leaving home, parents dying) • In total, 4% of the population were diagnosed with clinical depression in 2011-12 Source: Understanding Society 2011/12

34. Emotional wellbeing and causes of stress Source: Understanding Society 2011/12

35. Subjective wellbeing is lowest in middle age Source: Understanding Society 2011/12

36. Health, lack of services and transport inhibit access to services Source: Understanding Society, 2011-12

37. Participation and Health • Health issues can affect individuals in a variety of ways • Overall, 14% of people say that health has inhibited a social activity to some extent • The problem worsens with age – nearly one in four (23%) over 70s say a health problem has limited their social lives in some way • Lack of socialising and contact can increase loneliness and isolation and has a negative impact on wellbeing Source: Understanding Society 2011-12

38. Neighbourhood cohesion1 in 10 people don’t trust their neighbours Source: Understanding Society 2011-12

39. Future perspective

40. Future perspective • This report has focused on 4 areas of need: • Material and Physical Needs • Care Needs • Needs for Capabilities • Psychological Needs • Each of these areas will continue to change in the future, meaning that the future of need is likely to look very different to today • Many of these changes will be driven by overarching demographic or societal changes (such as immigration or the ageing society), whereas others are emerging as a result of the current economic and political climate

41. How needs will be met Over the next 5 years, the State is likely to continue to reduce public spending, meaning more areas of need will need to be met by other groups

42. Future needs:Physical and Material Needs • Income polarisation will see the gap between the poorest and the rest of society widen – increasing the economic isolation for this group. • In the short term, the national economic situation is likely to improve, but many households will not feel the impact of this: • Reductions in unemployment will not be matched in the short term by a reduction in underemployment • Despite the continued fall in price inflation since 2011, wages remain well below 2008 levels • The main groups affected over the short-medium term will be the bottom 5% of earners, and those either materially deprived or vulnerable.

43. Future needs:Care Needs • Overall standards of health are unlikely to reach pre-recession levels in the short to medium term, as many of the worst affected households will not be able to afford to improve their nutrition. Longer term forecasts anticipate a rise in the childhood obesity. • Rises in the cost of living (despite recent falls in inflation) will also mean that many households will be unable to afford to heat their homes adequately over the next few years – although there is a political willingness to make energy more affordable, this is unlikely to benefit the most vulnerable. • The most vulnerable in this area of need are the very oldest cohort, especially those who are socially or digitally isolated.

44. Future needs:Needs for Capabilities • The worst affected within the ‘lost generation’ of young people are unlikely to recover fully from setbacks experienced during the downturn – but will instead continue to be affected throughout their working lives. • A significant minority of people have no qualifications, which will be increasingly disadvantageous in future as better qualified generations enter the workforce. • Despite political intentions to reduce it, net migration to the UK is likely to increase over the medium term – meaning that language barriers are likely to be a significant obstacle for those entering the workforce.

45. Future needs:Psychological Needs • Mental ill health and lower levels of subjective wellbeing are most likely to affect people in their fifties and sixties • As the large baby boomer cohort enters this age group, incidences of mental ill health are likely to increase • Later in life, although most components of wellbeing remain stable, satisfaction with health declines sharply – as the population ages in the future, this area of need will also grow in prominence

46. Future needs – who?Older people and migrants • The population of the UK is set to grow considerably over the next decade. This is fuelled by two trends – an ageing society (meaning more older people) and high levels of net migration – meaning more people who were born abroad • Needs associated with these groups are likely to increase in demand, simply as a result of population growth – meaning that providers (whether state or third sector) will face challenges keeping up with demand • In addition, workforce and participation statistics show that the younger people have been particularly affected by the downturn – with the rising number of NEETs fuelling concern over a ‘lost generation’

47. Migration and ageing fuel population growth Source: UN WPP / ONS Population Projections

48. Future needs – who?The lost generation and pockets of deprivation • Workforce and participation statistics show that younger people have been particularly affected by the downturn – with the rising number of NEETs fuelling concern over a ‘lost generation’ • In addition, falling incomes and living standards are causing deprivation across the UK, with the bottom 5% of people living on less than £160 per week, and many households unable to afford necessities such as heating or bills

49. Future needs – what? Several new areas of need are emerging • Heat vs. eat – as living costs rise, the proportion of people struggling to afford adequate heating is rising (standing at 7% in 2011). This is also evident in the high number of ‘excess’ winter deaths over between 2010-2013 • Transport poverty – this area of need can be found in both individual’s lack of access to transport (9% have no access to a car or van) and in their lack of public transport options. Transport poverty limits mobility, causes social disconnectedness and enhances isolation • Sharp drop in ‘good’ health – the most recent Understanding Society data shows a sharp drop in the number of people report a ‘good’ standard of health – although this could be a result of a change in methodology, it is most likely linked to worsening nutrition and factors related to the economic downturn

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