Multiple long-term conditions

Financial interventions to slow progression to multiple conditions

4 October 2019
3 min read

Our work shows a strong link between a lack of financial security and ill-health. Portfolio Manager Rohan Martryes, and Polly Mackenzie from Demos, share the ways we can design financial interventions to promote better health. 

Polly Mackenzie
Chief Executive, Demos
Rohan Martyres
Rohan Martyres
Programme Director (maternity cover)

We want to determine if we can help slow people’s progression from one long-term condition (LTC) to many by supporting their financial health.

Poor health and poverty are deeply intertwined. Our research shows that people living in areas with high levels of deprivation are more likely to develop multiple long-term conditions 13 years earlier than people living in the most affluent areas. But the relationship between poor health and poverty is not a simple one.

Being unwell can make it harder to earn an income. It can also mean you need to spend a lot more money and make it more difficult to manage what money you have. When people are in financial difficulty, it can make it harder for them to stay well, or recover from illness. People may not be able to afford healthy food or living spaces or to take the time to exercise.

This means that the relationship between ‘financial health’ and poor health is a complex, two-way relationship. We commissioned Demos to help inform what role we can play in influencing this. Demos reviewed the current range of financial health interventions. And, identified opportunities to improve people’s health by changing their financial situation.


Research into financial interventions

Our research suggests that people who develop multiple long-term conditions often start with diabetes, coronary heart disease or depression. Demos’ research focused on financial health support for people with these three health conditions.

We looked at a wide range of financial interventions designed to improve people’s financial health. These ranged from advice to technology – and evaluated how effective they are at helping people with these conditions. We conducted 14 interviews with experts at the national and local level. We also analysed grants issued from 10 major funders to find out what current best practice is and what evidence supports it.

Being unwell can make it harder to earn an income. It can also mean you need to spend a lot more money and make it more difficult to manage what money you have.

Rohan Martyres Portfolio Manager

Recommendations for interventions to improve health

We found that there are four key ways to better design financial interventions to help people with multiple long-term conditions:

  1. Target the relevant population, at the right time, where they are. If you want people to accept financial help or advice, and act on it. It’s important to make sure services can be accessed when people need it. The most effective projects are the ones that are available during a life event such as a diagnosis of a health condition. They should be co-located with services that people are already accessing.
  2. Money, welfare and debt advice are the most effective interventions. Our research shows that money advice has the most evidence of impact, with relevant clients referred to welfare and/or debt advice. There’s no evidence yet that this will have provable outcomes on health. But, there’s a huge opportunity to trial projects in this area.
  3. To be more innovative in helping people manage fluctuating incomes. It seems that people with long-term health conditions end up in financial difficulty because of the struggles of managing a fluctuating income. This is a growing problem given the changes in our labour market. New approaches can be trialled to help people manage their finances and expenses without having to rely on expensive credit. These would bring together housing associations, energy providers and employers. 
  4. Double down on enabling professionals. When professionals are better trained, they feel more confident in directing those who need help to the right place. This has a positive impact on their clients. New interventions should allow professionals to triage people and help track progress. 

We know that financial interventions are complex. They also need support from many different partners, which might take time to set up and deliver. But, to overcome the lack of evidence on what works, we need to come up with more innovative approaches to financial intervention.

As Impact on Urban Health builds on its work on how social risk factors impact on multiple long-term conditions, we look forward to seeing this learning applied to new projects in South London. We hope to contribute to the evidence on what helps to support better financial health for people with long-term conditions.


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