What does the Universal Credit cut mean for health outcomes?

Improving access to healthy food for all is central to Nesta’s goal of halving the prevalence of obesity by 2030. The imminent £20-a-week cut to Universal Credit will make it even more difficult for thousands of UK households to access healthy food and risks increasing obesity prevalence.

The £20 reduction will be the biggest overall cut to social security since the establishment of the modern welfare state. It is predicted to push 500,000 people into poverty – more than 14 million people already live below the poverty line. People on low incomes will face a very challenging Winter due to the toxic combination of welfare cuts, a rise in National Insurance and hikes in supermarket and energy costs. The Trussell Trust estimates that more than a million additional people may need the support of food banks. This will have a knock-on impact on already deeply entrenched health inequalities such as obesity and food insecurity.

In response to the Covid-19 pandemic, the UK government increased Universal Credit and the Working Tax Credit by £20 a week. By July 2021, just under six million people were dependent on this payment – double the figure from March 2020. The imminent cut will see 5.5 million families lose up to £1,040 from their annual income. It is predicted that this will hit hardest in areas of the UK already suffering with poor health outcomes. In the 10% of local authorities with the worst health outcomes (average life expectancy of 59.8 years) the average loss to income for working-age families will be £207 per year, almost twice the average loss of £105 for working-age families in areas with the best health outcomes (average life expectancy of 67.6 years).

A significant jump in Universal Credit applications coincides with growing food insecurity, defined as a lack of reliable access to safe and nutritious food. Analysis by The Food Foundation indicated 4.7 million adults and 2.3 million children in the UK experienced food insecurity between August 2020 and January 2021. During this time, the Trussell Trust UK wide network distributed 2.5 million emergency food parcels, an increase of 33% compared to the previous year.

Food insecurity has far-reaching health consequences. Although often treated as separate issues, food insecurity is intertwined with the risk of becoming overweight or obese. Low income households are most at risk of food insecurity and it becomes difficult or impossible to access and afford nutritious food. The price of healthier food can be nearly three times as much as unhealthy food, calorie for calorie. For example, the average price of fruit and vegetables (per 1,000 kilocalories) was £8.21 in 2020 compared to the average price of food and drinks high in sugar and/or fat being just £3.42 (for the same kilocalories). With the cost of healthy food rising, it is seemingly impossible for low-income households to meet government recommendations for a healthy diet in the Eatwell Guide. Analysis by the Food Foundation indicates the poorest fifth of UK households would have to spend 40% of their disposable income to meet the Eatwell Guide. Beyond this, over 50% of households in the UK have an average food budget insufficient to meet the Eatwell Guide – equating to 14.4 million households unable to afford to eat healthily.

Food Insecurity is also deeply stressful. The Food Foundation reports that 1.6 million adults have recently had to go without eating for a 24 hour period. In a recent study, 600 adults were asked about their levels of household food security, stress, ways of coping with stress, diet quality and BMI. The study found those experiencing food insecurity tended to have a higher BMI than those who were food secure. This finding is correlated to experiencing greater emotional distress as a result of socioeconomic disadvantage. Emotional distress is associated with people seeking to alleviate stress through coping behaviours, including consuming energy-dense foods of low nutritional quality. Eating to cope with distressing life circumstances is then associated with high BMI, placing low-income households at greater risk of obesity.

While the impact of cuts to Universal Credit on BMI and obesity are yet to be quantified, studies have explored the impacts of similar cuts to social spending in the UK on health outcomes. Events such as the 2008 financial crisis and austerity measures have been associated with increasing BMI distributions towards obesity, as well as increasing the likelihood of suffering from diabetes and mental health conditions. Such associations are thought to be explained by the impact of the welfare reform aspect of UK austerity policies leading to increased food insecurity and foodbank use.

Ending the uplift to Universal Credit is not only removing a lifeline for the millions of families reliant on social security to live, but will no doubt deepen the nation's health inequalities including our alarming rates of obesity.