Bridging the health and wellbeing gap for Big Issue vendors

The Big Issue’s work spans five key impact pillars to dismantle poverty and one of the most important is health and wellbeing. The Kings Fund reported that 49% of individuals in the most deprived areas are reporting the detrimental effects of the cost-of-living squeeze on their physical health, compared to 27% in less deprived areas. Poverty significantly impacts health outcomes, resulting in increased illness, reduced access to healthcare, and reduced life expectancy. In 2023 the Big Issue’s national support service worked with 542 individuals to provide health and wellbeing services. 

Helen, a vendor support worker in Bournemouth, provides insight into their holistic approach to tackling health disparities, energy poverty, and other critical issues faced by Big Issue vendors and other people affected by poverty.  

Comprehensive health and wellbeing assessments 

A key aspect of Helen’s role involves conducting thorough health and wellbeing assessments with each vendor. “We start by asking about housing, GP registration, dental and optical care, and any mental or physical health issues,” she says. These assessments are not one-off events but part of an ongoing dialogue. “We review these questions at different points to track progress and address new issues as they arise.” 

This approach allows Helen and her colleagues to tailor their support to the individual needs of each vendor. “Sometimes, it’s about relationship building,” Helen notes. “You might not hear the big issues immediately, but over time, through small interactions and trust-building, they begin to open up.” 

Fuel, energy and welfare support: A lifeline for the vulnerable 

Helen highlighted the crucial role of fuel and energy support through Big Issue’s partnerships with the Fuel Bank Foundation and the British Gas Energy Trust. These organisations work with the Big Issue to fund vouchers to help individuals manage their bills, a service that can be a lifeline, particularly for those on prepayment meters. 

“We can generally give out vouchers about ten days apart, but no more than three within six months,” Helen explains. “These vouchers are limited to those on prepayment meters, and over the winter, there’s been a lot of requests, where people have just been finding it really difficult to keep up with payments.” 

Helen also talked about her work on the Big Issue Hand Up Fund “It’s a grant scheme for individuals accessing our services, that can be setting up a first home or obtaining an ID. We also offer more general support such as benefits access, gambling support and sometimes it just can be that they want to come in and have a coffee and a chat.” 

Supporting mental health and addiction

Mental health and addiction are significant challenges for many Big Issue vendors and these are exacerbated by housing, money, and other issues they’re facing. Helen and her team provide empathetic, patient support tailored to each individual. “We ask about any mental health issues or addictions, including gambling, during our assessments,” she explains. The goal is to provide a supportive environment where vendors feel safe to share their struggles. 

The personal touch in these interactions is important so vendors feel able to share their issues fully. Helen recalls, “We met one vendor for budget checks because he has a gambling addiction. He’s got mental health issues and is at risk of eviction. All these things can understandably make you feel like your world is falling down.”  

Addressing health and wellbeing disparities 

Access to healthcare, particularly dental care, as raised by Healthwatch Dorset remains a significant issue. Helen advocates for policy changes to address these gaps, emphasising the need for long-term solutions. “At the Big Issue, all we can do is try to get individuals an Emergency dental appointment but these are only a temporary fix. We need sustained efforts to ensure everyone has access to regular dental care.”  

Even where services do exist, they can be difficult to access for our vendors because of language barriers, lack of money to travel to appointments, or difficulty understanding how these systems work. The Big Issue provides a voice and advocacy to help people gain access to these services,– even registering with a GP is a major step for some people. 

The team also focuses on broader health issues within specific communities, such as the Roma population. “Type 2 diabetes is prevalent amongst the older vendors due to poor access to healthy food and a history of poverty,” Helen explains. Addressing these issues requires a multifaceted approach, including education through healthy eating campaigns, improved access to nutritious food, and ongoing health monitoring. 

Building trust through consistency and care

The Big Issue’s approach is distinct from statutory services because it allows for more time and personalised care. “We’re not like the council or street outreach teams. We have the time to spend with each vendor, building relationships and trust” Helen says. This flexibility enables them to respond to each individual’s unique needs rather than following a rigid pathway. 

“We are bespoke,” Helen emphasises. “We help vendors as needed, rather than following a one-size-fits-all approach. This bespoke method allows us to make a real difference in their lives.” 

Find out more about Big Issue national support service here.