Guest speaker Helen Rowe, author of Eliminating Poverty in Britain explored the biological impact of poverty and long-term stress.

She explained how when financial insecurity becomes constant, the body’s stress system remains activated. In the short term, stress can be protective. But when stress is prolonged and tied to uncertainty about food, housing or income, the body does not easily return to balance.

Over time, this can affect:

• Brain development, particularly in early years

• Emotional regulation and decision-making

• Inflammatory responses in the body

• Risk of heart disease, stroke and diabetes

• Mental health

She spoke about stress during pregnancy and how this can shape a child’s stress response from the start of life. In a borough working on early years outcomes and reducing inequalities, this is not theoretical. It connects directly to prevention.

Helen also addressed behaviour. Actions that are often judged, such as comfort eating, addiction or avoidance, can be understood as coping strategies in conditions of sustained stress. This does not remove responsibility, but it changes how we design support.

If someone is living in survival mode, adding complexity or shame does not improve outcomes.

Her session echoed what the foodbank report described. People feeling stuck. People describing shame. People navigating multiple services while managing illness or anxiety. People passed between systems that do not align.

In the West Midlands, where health inequalities remain pronounced, this evidence matters. If poverty is carried in the body as well as the budget, then reducing administrative friction, improving access and lowering stigma are part of health improvement.

Helen also touched on how poverty is described in the media. Public understanding is shaped not only by policy but by the stories and language used in headlines and commentary. When poverty is framed as personal failure, stigma deepens and trust in services can erode. Bringing evidence into the conversation, alongside lived experience, helps create a more accurate picture. Clear, balanced reporting supports better understanding of the structural factors that shape financial hardship.

Her evidence also gives us something practical to hold onto. If long-term stress harms health, then reducing stress is preventative action. That can mean simplifying systems, removing small financial barriers, and creating spaces where people feel safe to ask questions. It can also mean noticing early signs of strain in ourselves and others, and responding with patience rather than judgement. Reducing shame and friction is part of improving health.

Poverty and the prevention of homelessness

During the morning I was able to reflect a bit more on how poverty and homelessness are not separate issues. Poverty is often the early stage of homelessness risk.

When someone is living with sustained financial stress, capacity narrows. Sleep is disrupted. Concentration dips. Paperwork feels overwhelming. Deadlines are missed. Letters go unopened. None of this is dramatic on its own, but over time it matters.

Rent arrears rarely appear overnight. They build quietly alongside rising costs, benefit delays, illness, caring responsibilities or reduced hours at work. A missed housing element payment. A sanction. A period of poor health. These tipping points often sit on top of months of pressure.

The barriers described in the report make this clearer. The cost of transport preventing someone from attending an appointment. Lack of mobile data meaning they cannot call to explain non-attendance. Confusing online systems. Each increases the risk that housing instability will follow.

Disability and long-term health conditions add further strain. When income does not cover essentials and work capacity is limited, housing becomes fragile. If support systems are hard to navigate, that fragility deepens.

Shame also plays a role. If people feel judged, they delay asking for help. The earlier someone feels able to speak openly about arrears or housing concerns, the more options remain available. Community spaces, foodbanks and advice sessions often provide that earlier point of contact.

Prevention, then, is not only about housing policy. It is about reducing friction. Clear information. Accessible advice. Digital inclusion. Transport support. Calm conversations that break complex tasks into manageable steps.

Responding at the stage of food insecurity, stress and financial strain is homelessness prevention. Waiting until eviction is crisis response.

How Dudley is responding

Lydia Hester Collins from Dudley Council set out Dudley’s ten-year mitigating poverty strategy. It is built around three strands:

• Preventing poverty through early years and education

• Helping people out of poverty through skills, employment and partnership with business

• Mitigating the impact of poverty through welfare advice, affordable food, fuel and furniture support

The strategy recognises that postcode, digital access and system complexity shape opportunity. It acknowledges that no single organisation can solve this alone. Mapping activity, building subgroups and reporting through the Health and Wellbeing Board are practical steps towards a more joined-up approach.

Dudley is also at a review point. The question now is whether the current approach matches the scale of need and where adjustments are required.

A West Midlands lens

This event sits within a wider regional context. Across the West Midlands, there has been a growing emphasis on prevention and partnership. What came through strongly in Dudley is that prevention cannot be separated from daily realities.

If transport costs block access to health care, prevention weakens.
If digital systems exclude people without devices or data, prevention weakens.
If income does not meet essential costs, prevention weakens.

At the same time, small practical interventions showed immediate impact. Bus passes enabled thousands of journeys. Support with booking appointments kept people connected to care. Clear written steps reduced overwhelm. Community spaces reduced isolation.

These are not small things. They are early interventions.

What members of the public can do

It is easy to read all this and feel powerless. You are not.

There are practical, local ways to make a difference without needing specialist knowledge or large budgets.

1. Support what already exists

If you live locally, consider supporting organisations already doing the day-to-day work, such as:

• Foodbanks and pantries

• Baby banks

• Community groceries and pay-as-you-feel projects

• Community hubs and warm spaces

Support can mean donations, volunteering time, or offering skills such as admin, communications, transport, cooking, gardening or IT support.