The Impact of Welfare Reform for Women and their Health

There were two speakers at this Feeding Liverpool event: Ruth Patrick spoke on ‘Living with Welfare Reform’ and Annette James spoke on ‘Food Insecurity and Health’. This sheet brings together some of the key messages, from the talks and from the contributions of conference participants who came from a range of organisations including foodbanks, CAB, The Food People, Mencap, Asylum Link, debt advice centres and community groups.  The event brought together research findings and lived experience, statistics and stories.

The PowerPoint of Ruth Patrick’s talk can be downloaded by clicking here.

The PowerPoint of Annette James’ talk can be downloaded by clicking here.

Observations of the day can be read by clicking here.



Policy assumptions

  • Work is the best route out of poverty.
  • Welfare reform was necessary to improve incentives to enter work and avoid welfare dependency.
  • Poverty is largely about individuals and their ‘pathways to poverty’.

By contrast, research and the experience of front-line practitioners show that the successive rounds of welfare reform and the roll-out of Universal Credit have brought a clear mismatch between the policy narrative and real life:

  • Most people want to work – for fulfilment as well as higher income.
  • People’s income can still be too low to manage even when they are working, especially when so many are in unstable employment, are on zero hours contracts, have to combine several very low paid, part-time jobs.
  • Welfare reform has had negative – and even perverse – consequences. People can move further from the labour market as a result of benefit changes, perhaps because of increased stress but also because of the practical inability to undertake training and volunteering as part of their job search requirements.
  • Factors such as addiction, worklessness or family breakdown are often cited as causes of poverty rather than the consequences of it.
  • People on benefits are widely stigmatised.
  • Being on benefits is hard work, entails tight budgeting and facing decisions such as ‘heat or eat’.
  • Problems with the benefits process


The process can be demoralising as Isabella’s story illustrates.

  • Concerns include: (a) payment delays and the impact this can have on short term household budgets; (b) assessment in the case of especially vulnerable people.
  • Apart from the financial effect of changes to multiple benefits, repeat assessments themselves have a cumulative stressful impact.
  • The experiences of claimants echo those of people in the asylum system.
  • The system stifles people’s free choice. They are put in a position where they feel under pressure to take any job rather than an appropriate one.
  • The question was raised as to whether work is always a desirable outcome given childcare or other caring responsibilities and illness.
  • Legal aid is being withdrawn at the same time as welfare reform, but in appeals an ‘expert’ letter is more likely to be believed than the person his/herself.
  • Those administering the benefits process are themselves under pressure to meet targets or demands ‘from on high’.

Impact on Women

  • Women are amongst the hardest hit by welfare reform, especially the Benefit Cap and two child limit.
  • Single parents (most of whom are women) are amongst the most affected.
  • Cumulative impact assessments of tax and benefit changes show women in the lowest income groups (and especially BME women) are disproportionately affected. (Women’s Budget Group, 2017)
  • Single parent households represent 71% of those subject to the benefit cap (45,000 families together caring for > 100,000 children (Gingerbread, 2017)
  • David Webster from Glasgow University has noted particularly high rates of sanctions among pregnant women. Given the importance of ante-natal care, this has serious health implications.
  • There can be inherent tensions between meeting the demands of DWP and caring roles; for example, a conflict with parenting responsibilities when appointments clash with school events.
  • Domestic violence and its impact seems to be a recurring story. People move from place to place and have to make a fresh start each time, away from support of family and friends.



Mythology suggests that food poverty arises because people are unable to budget properly or do not know how to shop and cook well. Research, however, shows that the key causes are insufficient money, lack of access to affordable food and/or lack of equipment or fuel for storage and cooking.

School holidays are particularly difficult for families because of the need to compensate for the lack of school dinners.


Food insecurity and health

Diseases impacted by diet include:

  • Obesity
  • High blood pressure
  • Coronary heart disease
  • Many forms of cancer
  • Metabolic disorders
  • Pre-diabetes and type II diabetes
  • Effects on bone density
  • Anaemia – iron deficiency
  • Chronic health problems caused by deficient vitamin intake

There were reports in 2015 of the return of rickets in the UK as a result of dangerously poor diets and GPs are now having to refer people to foodbanks. Hospital diagnoses of malnutrition nearly doubled between 2009 and 2013 and more than 7,000 people were admitted to hospital with a primary or secondary diagnosis of malnutrition between August 2014 and July 2015.

The impact of poverty – especially on physical and mental health – builds up over time. Food insecurity also has serious consequences for the mental health of adults and children. There is a high prevalence of depression and anxiety amongst foodbank users.


What can be done – Community eating initiatives?

For the foreseeable future, food aid will continue to be required. In addition to foodbanks in Liverpool, a range of other activities set out to make a difference such as: Whitechapel Centre working with homeless people; Asylum Link supporting destitute asylum seekers; Can Cook – share you lunch campaign; neighbours cooking for neighbours; initiatives to reduce waste and ones to encourage growing fresh produce.


What can be done strategically?

The city is attempting to tackle poverty and inequality – and the associated food insecurity – in various ways:

  • The City-Wide Strategy Group on Fairness and Tackling Poverty, bringing together public, private and voluntary sector bodies.
  • The city’s Obesity Strategy
  • Liverpool Food People working for a sustainable food city.
  • Liverpool Play Partnership providing play and food during school holidays.
  • ‘Taste for health’ – a strategy for the city to change the food culture.
  • Feeding Liverpool – bringing together front-line deliverers of food aid and other partners to exchange good practice, raise awareness and draw out policy messages.



The evident failure of welfare policy achieving its declared objectives underlines the need to learn from what is happening:

  • It is important to hear the voices of those who are experts by experience and involve them in the policy debate. It is particularly valuable to track people’s experience over time.
  • It is important to recognise the needs of the most vulnerable groups of women – during pregnancy, suffering domestic violence, those with a disability or with mental health problems – and take steps to protect them.
  • Everyone involved in working with people in poverty and requiring food aid has a role to play in documenting the impact of welfare reform and giving support to those directly affected.
  • The policy messages heard today need to be articulated: not just the negative ones of systemic deficiencies but also the positive ones of the valuable contributions claimants often make – beyond paid work – through volunteering and caring responsibilities.
  • The most effective approach is an asset-focused one, recognising people’s right to food, right to health, right to be respected: ‘If you have come to help then you can go away but if you have come because your liberation is tied up with ours then you are welcome. (Lilla Watson, black social worker, US)


Useful Reading

  • Ruth Patrick, For whose benefit: The everyday realities of Welfare Reform, Policy Press, 2017
  • Kayleigh Garthwaite: Hunger Pains: Life inside foodbank Britain, Policy Press, 2016
  • Stephen Crossley, In Their Place: The Imagined Geographies of Poverty, Pluto Press, 2017