– By Gary Neil, Rock Trust Operations Manager, Housing Support Edinburgh


During a recent routine visit to my GP seeking a cure for a nagging cough, I was somewhat taken aback to watch the colour drain from the GP’s face as she asked me in capital letters “ARE YOU SURE YOU ARE FEELING OKAY?” I thought I was. Then in her lower case, composed voice (with a look of sheer panic) she told me that my heartrate was 168bpm. This meant nothing to me at the time, although I was soon to become an expert. They fixed me up and packed me off home of course because that is what they do in our NHS, 24 hours a day, every day under the most challenging circumstances but always with kind words and levels of patience that would leave even the saintliest of saints questioning their place in the grand scheme of things.

It was lifestyle choices that broke my heart in the end. Not the stolen kisses and unrequited love I wrote songs about in my youth. Too much of all the bad stuff and not enough of the good. Butter always tastes better with some melted butter poured over. Lager always more satisfying when it’s served in a fancy glass or on special offer in the supermarket. How can a meal not be healthy if it’s been cooked from scratch using good quality ingredients like cheese, cream, butter, bacon, goose fat…?

For me it has been relatively easy to move forward. Choose life. Cut down on booze. Eat sensibly. Take more exercise. Take steps to reduce stress. Take the tablets twice a day.

For those living in poverty the choices facing them are less straightforward. For people who are homeless, poverty can be an ever present in their lives and for young people who are homeless the odds must at times feel like they are stacked against them.

There is a wealth of research and reports on the link between poverty and ill health. People living in poverty are far more likely than their wealthier peers to become unwell with conditions such as asthma, diabetes, heart disease and mental health difficulties.

A study published in 2014 which compared the price per 1000kcal of “more healthy” and “less healthy” foods reveals some astonishing figures. The average price for more healthy items was £7.49 compared to less healthy items at £2.50.  It’s not difficult to see that a healthier diet is less affordable than an unhealthy one.

I was genuinely shocked when I really looked at the aisles in the supermarket, perhaps for the first time. Special offers and BOGOF deals are almost exclusively reserved for items that would certainly fall within the “less healthy” category. And while I’m always going to be seduced by half price multi packs of loo roll, these deals don’t work for someone with a low income who only needs a couple of rolls to get them through until pay day.

Sickness and out of work benefits have been frozen since 2016/17 and most people, especially those on low incomes have seen the biggest squeeze on wages since the end of the Napoleonic Wars. Most people living in poverty are in work. Research by the Joseph Rowntree Foundation predicts that 470,000 more people will be living in poverty in 2020/21.

Let’s not forget how young people can be impoverished by the levels of the minimum wage:

25 and over 21 – 24 years 18 – 20 Under 18 Apprentice
£7.83 £7.38 £5.90 £4.20 £3.70


When money is tight it’s not hard to understand why people choose foods that are cheap, filling and high in instant energy.

For young people faced with homelessness the challenges can be even greater. Many young people sofa surfing or in B&B type accommodation have no access to cooking facilities whatsoever.

Throughout the 15 years I’ve worked in youth homelessness I’ve seen trends come and go. Smoking was still regarded as (almost) socially acceptable back in 2002 when I first started working at the Rock Trust and I spent a lot of time declining requests from young people for a cigarette. Drinking and binge drinking was a significant issue for many of the young people using our services.

Most of the young people I encounter at work now don’t smoke. Of the young people who do drink, the vast majority do so sensibly. Fuel poverty has now emerged as one of the biggest issues for the young people we work with. They regularly experience difficulties heating and powering their home due to the cost of gas and electricity. This directly impacts their diet. With food spoiled and cooking facilities rendered useless snack foods and takeaway food become a staple.

This is not good enough for a nation as wealthy as ours.

There are no easy answers. I’m personally interested in how a basic income could help people move away from poverty for good, but that’s another blog for another day. In the mean-time, understanding the risks to my own health has given me a new perspective on the importance of tackling poverty in order to improve health outcomes. If we are going to make a difference we need to continue to address access to education, employment, fair pay levels, as well as providing adequate welfare support. Only in this way can we begin to address the link between poverty and ill health for our young people and everyone in society.