Livelihood security

How health is related to financial situation, work and housing 

Summary

This chapter focuses on three key elements of livelihood security: financial situation, work and housing. These three elements of livelihood security have a major impact on health. Poverty, unemployment, the fear of unemployment and housing problems are major causes of chronic stress. This stress affects physical and mental health (Goijaerts et al., 2022). Conversely, health problems can reinforce problems with financial situation, work and housing (Stronks & Droomers, 2014). The following are the key findings for livelihood security.

Financial situation:

• Utrechters who struggle to make ends meet are more likely to have poorer health and lifestyle and fewer chances of a healthy life than residents who do not struggle to make ends meet. Moreover, health disparities are increasing between Utrechters who struggle to make ends meet and Utrechters who do not.
• Growing up in poverty has negative effects on children's health. These effects can continue into adulthood. In addition, children who grow up in poverty are more likely to live in poverty as adults. This also increases the risk of ill-health.

Work:

• Utrechters aged 18-65 without paid employment are more likely to have mental health problems than Utrechters with paid employment. This difference is also visible among Utrechters on temporary contracts. Utrechters on temporary contracts are one and a half times more likely to report mental complaints and experience stress than those on permanent contracts.

Living:

• The current situation in the housing market, where residents have difficulty finding affordable and suitable housing, causes stress and consequently affects mental health. 
• Utrechters with lower incomes are more likely to live in housing of poorer quality, such as housing with inadequate ventilation. This contributes to health problems such as respiratory diseases. 

Groups of Utrechters with a higher chance of livelihood insecurity are Utrechters:

• who have completed primary education or pre-vocational studies, 
• who have vocational, general secondary or pre-university education, 
• who have a non-Western migration background and 
• who live alone or have single-parent families. 

These Utrechters are more likely to live in the Noordwest, Overvecht, Zuid and Zuidwest districts.

Homeless people have many problems with livelihood insecurity. A large share of them lived on benefits in the years leading up to homelessness. The lack of housing also makes them less likely to receive support and care.

Conclusions and recommendations

Livelihood insecurity has a major impact on the health of Utrechters. Residents who are struggling to make ends meet, have low incomes, are not gainfully employed or are dissatisfied with their homes are more likely to be behind in health, lifestyle and opportunities for healthy living than other groups of Utrechters. This involves a complex relationship between these different elements of livelihood security. This makes it difficult to address health disparities. Cooperation between different domains and sectors is essential for this (RVS, 2021). In addition, it is necessary to invest unequally for livelihood security for all. After all, opportunities in our society are not equal for everyone (Divosa, 2022).

The impact of livelihood insecurity on health can be seen at an early age. Long-term poverty or debt and stress around work and housing pose a risk to a promising start. Children living in families with low income have poorer health than children growing up in families with higher family wealth. Children who grow up in poverty also have fewer chances for a healthy life in older age. In addition, these children are twice as likely to live in poverty as adults. With, again, fewer chances for a healthy life. Thus, it is important to pay attention to family livelihood security from the child's first 1,000 days. 

Groups of Utrechters with a higher chance of livelihood insecurity are Utrechters:

• who have completed primary education or pre-vocational studies, 
• who have vocational, general secondary or pre-university education, 
• who have a non-Western migration background and 
• who live alone or have single-parent families.

Current social developments pose a risk to the livelihood security of all Utrechters. With the COVID pandemic period, increased inflation, energy poverty, the situation in the housing market and an increase in the number of people in temporary jobs, livelihood security is under additional pressure. Many Utrechters are affected. As a result, other groups of Utrechters also face a higher risk of livelihood insecurity, such as Utrechters with an average income or Utrechters with a college or university education. There is a major social task to ensure that all Utrechters have adequate social security.