Why paying people the Living Wage should be a Public Health priority

In this article, I argue that paying the Living Wage should be a public health priority for all publicly funded bodies.

The living wage is a carefully calculated wage designed to provide employees with a minimum standard of living.  Currently it is set at £7.65 per hour (£8.80 in London), compared to the minimum wage of £6.31 per hour.  Currently some 4.8 million people, 20% of the working population, work for less than the living wage.

We know that the living wage is good for employers, reducing absenteeism by 25%, and turnover of contractors falling from 4% to 1%. It is also eminently realistic and achievable, indeed over 100 Local Authorities have a living wage policy already. What is less discussed, however, are the large public health benefits of the living wage.

The public health argument in support of the Living Wage is clear. Professor Kate Pickett calls it “the single best action that I believe local authorities can take to reduce health inequalities”. This is because it will reduce poverty and income inequality and these are very important factors that determine the health and wellbeing of our communities.

Firstly the living wage will reduce poverty. Poverty exposes people to health threats such as poor housing and low quality food. Poverty also causes psychological and social stress, which results in poorer mental and physical wellbeing. Indeed, workers on the living wage report higher levels of mental wellbeing than those below the living wage. Finally, poverty makes it practically and psychologically more difficult to adopt healthy behaviours, resulting in people smoking more, eating less healthily and doing less exercise. Through these mechanisms poverty causes the UK’s shocking levels of health inequalities. For instance women in Tower Hamlets where I work can expect to be healthy for 54.1 years, whereas women in Richmond can expect to be healthy for 72.1 years.

Secondly, the living wage will reduce income inequality. Income inequality is one of the most toxic social determinants of health. Income inequality harms people on low incomes because it intensifies their feeling of low social status. Biologists and epidemiologists have shown how this results in high levels of stress, which increases cardiovascular disease and mental illness.

Most interesting of all, income inequality harms not only the health of those on low incomes, but also the health of the whole population, including the rich. Studies again and again confirm that countries that are more equal are healthier. This is partly because there is less social stress in equal societies but also because equal societies make a whole series of better collective decisions. Being healthy requires collective decisions on provision of healthcare, on acceptable levels of air pollution, on provision of green parks and good cycle lanes. People can only be healthy if we all decided to be healthy together, and that only happens in equal societies. By moving towards a more equal society research has shown that we can expect health gains from lower cardiovascular disease, obesity, drug dependency, mental illness, suicides and homicides, childhood wellbeing and infant mortality.

In summary, public bodies paying the living wage will not solve health inequalities. However it is a simple and achievable step towards equality. There will be large health benefits through reducing poverty and income inequality, enabling people to live healthier, less stressful lives, and enabling us all to make healthier collective decisions.