While the focus of health experts and economists has been on the alarming rise in sickness-related worklessness, at a record 2.8m, less attention has been paid to the low-to-middle income families who suffer from ill health but are still in work. Statistically poor health is associated with deprivation.

The Resolution Foundation has launched a 12-month study of Britain's 13m low-to-middle income families which it says are ‘poorly understood' that ‘will answer a range of questions about the living standards of these families, including their health and how this has changed in the past 30 years'. 

Although low-to-middle income families across Britain have got older and sicker over the past three decades they are still more likely to be in work. They are also more likely to suffer from poor health or a disability compared to three decades ago. But despite these problems, which have particularly come to the fore since the pandemic, lower-income families are far more likely to be in work today than they were in the mid-1990s.

Unsung Britain examines how the economic circumstances of the 13m working-age families in the bottom half of the income distribution have changed since the mid-1990s. It shows that low-to-middle income working-age families are, on average, older compared to 30 years ago. Lower-income families are now almost as likely to be in their 50s as in their 20s, a big shift from the mid-1990s, when people in this group were around 60% more likely to be in their 20s.

As well as being older, they are more likely to suffer from poor health or a disability. Three-in-ten, 30%, of working-age adults in low-to-middle income families said they had a disability in 2022-23, up from less than two-in-ten (19%) in the mid-1990s. More lower-income families are caring for adults as a result. One-in-eight (12%) people in a low-to-middle income family care for an ill, disabled or elderly adult, a trend that has risen over time (although changes in data sources prevent direct comparisons over time). The foundation adds lower-income families are significantly more likely to have adult caring responsibilities than higher-income families (12% vs 8%).

But while lower-income Britain has got older and sicker, a trend that has come to the fore in current policy debates about economic inactivity, this research finds that overall levels of worklessness have fallen over the past 30 years. In fact, the share of low-to-middle income households that are workless has almost halved since the mid-1990s (from 24% in 1996-97 to 13% in 2022-23). This fall in worklessness has been driven by rising employment, particularly among women. Employment rates among mothers in low-to-middle income families have increased most sharply – from 46% in 1996-97 to 58% by 2022-23.

The Resolution Foundation notes the combination of demographic, health and cultural trends means that people in low-to-middle income families are now over three times more likely to be economically inactive due to ill-health (13%) than because they are looking after children (4%). This is a significant change from 1994-95, when the rates were the same (11%). The report says between 1994-95 and 2004-05, the typical non-pensioner low-to-middle income real household disposable income grew by almost 50%. But in the two decades since the mid-2000s, growth has slowed with incomes up by 10% for the typical low-to-middle income family.

Cllr Pete Marland, chair of the Local Government Association's economy and resources board, said: ‘As this report shows, we need a renewed focus on improving health, wellbeing, security and opportunity, including for those on lower incomes. Councils are central to leading and creating communities where people don't just survive, but thrive.'