Poverty and health: Primary care patients living at the interface

Abstract

Background There is strong evidence associating poverty with poor health, and welfare benefits are an important means of maximising the income of deprived people in the United Kingdom (UK). The welfare benefits system is complex, and many need help in understanding their entitlements and in completing the applications. Research has shown that primary care is a suitable setting for the provision of welfare benefits advice. Objective of study To explore associations between changes in health status and increased income resulting from advice in primary care. Setting Welfare benefits advice services provided in primary care settings. Methods Structured interviews with those receiving welfare benefits advice in primary care, shortly after the advice session, and 6 and 12 months later. Results This paper reports six cases in detail to illustrate the interplay between financial, social and health aspects of the lives of deprived patients. Two patients recognised the role of an income increase in improving their health-related quality of life; in two cases, social and health issues outweighed the benefits of income increase; and two patients had, despite advice, experienced a reduction in income that they believe affected their health for the worse. Conclusion The simple relationship between poverty and health at a population level is not necessarily reflected in the lives of individuals. Nevertheless, there is a clear if modest role for benefits advice as part of a holistic approach to health in primary care.