Labour has promised to stop poor people dying so early. A Scottish rapper could help them find the way

Growing up in Glasgow, Darren McGarvey lived in a house with an alcoholic mum. There were many traumatic events. Utopias promised never panned out. She didn’t work, and left home when McGarvey was very young. As he grew up, McGarvey developed his own struggles with addiction and mental health.

It was when, in his early 20s, McGarvey moved to a more affluent area of the city, that he twigged this wasn’t just how it was. “Right in there, already you see all the different forms of inequality that come through as a health problem,” he says.

Now 41, McGarvey is known by the stage name Loki, which he uses as a rapper, but also recognised as a social commentator and author. He has delivered a Reith lecture for the BBC, and his book Poverty Safari won 2018’s Orwell Prize.

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“My story is about addiction, bereavement, family breakdown, which then in my life shows up as low education attainment – that maybe I could have got – that becomes an employment issue, and then I have this catalogue of health issues all through my 20s related to my drinking and mental health. This is how it spins out,” McGarvey says. 

“If you take a preventative look at this, stable housing, access to healthcare when you need it, the right kind of treatment, then my life might have been very different. I’ve done OK, so I get held up as a success story. But I’m the exception. A lot of my friends are dead, family are dead. You don’t hear from them.”

McGarvey is speaking to Big Issue in a hallway in parliament. He wouldn’t normally come here, and resists getting too close to politicians as it can “dull the senses” – but is backing a campaign from Health Equals to try and force action on the visceral ways inequality and poverty blight health and shorten lives.

If there’s one statistic to understand on the topic then it’s this: men born in the poorest areas of the country can expect to die 10.4 years sooner than those born in the richest areas. For women the gap is 8.4 years. That’s what, academically, is known as health inequality. The gap in “healthy life expectancy” – how long you’ll live before bad health starts to limit things – is even more stark, at 18.96 years for men and 19.62 years for men. It is no exaggeration to say poverty kills, and the gap is growing.

In July, the government promised to tackle this, setting out a goal to halve the gap in healthy life expectancy between the richest and poorest regions of the country. In other words, it is pledging to stop poor people dying so soon.

Labour’s way there involves some wider social solutions, such as expanding Healthy Start, ensuring all children with a parent on universal credit have access to free school meals, increasing mental health support for young people, and improving schemes to keep people in work. But the plan also includes eye-catching specifics: a crackdown on children vaping, mandatory targets on the “average healthiness” of companies’ sales of food, expanding access to weight loss drugs like ozempic on the NHS, and launching a “moonshot to end the obesity epidemic”.

At a reception hosted by Health Equals – a coalition set up by the Health Foundation which includes the Red Cross, Mind and Crisis – Ashley Dalton, the government’s minister for public health and prevention, told a crowd “we are prioritising prevention”, and that “housing is a fundamental determination of health”. With Best Start family hubs, people would be able to access different sorts of advice all in the same place.

For its part, Health Equals wants the government to commit to a standalone health inequalities strategy, built on things like quality homes, stable jobs and clean air.

The public are not blind to the situation. Some 53% believe physical health in the UK is getting worse, according to polling commissioned by Health Equals, and 72% believe the government shares responsibility for keeping people healthy.

The answers, however, are well-known, says McGarvey. But perhaps public narratives are yet to catch up. “The way that people discuss issues like homelessness, drug addiction, this is the way that the ancient Greeks discussed it. Casting people out onto the margins of society for their poverty, shaming them, criminalising them,” he says.

“What we’re talking about here is we have a class of people who don’t even get the opportunity to demonstrate their merit, such is the force working against them across every area of their lives – health, education, housing. So before you can argue the country’s a meritocracy, you have to say everyone’s gonna have a chance to demonstrate that. You can’t do that, often, if you grow up in a poorer community.”

That environment is key, says Paul McDonald, chief campaigns officer of Health Equals. “Our health is shaped by the world around us, shaped by the homes we live in, the money in our pockets, the air we breathe. That shapes our health. And those building blocks of health – some of us might take for granted, but they’re not there for everyone,” he says.

There may be something even more important in this for politicians than saving other people’s lives: power. Big Issue founder Lord John Bird warned in May that Labour’s failure to tackle poverty is driving voters to Reform UK, after polling commissioned by Big Issue found 72% of Brits disapprove of Starmer’s approach to poverty, an 18% increase on eight months previously. 

So, says McGarvey, there could be no better place to look than the end result of that poverty. “If I was the prime minister, I’d be copying and pasting this whole campaign into my agenda,” he says. “It’s a great story to tell the country. It doesn’t cost an arm and a leg to do this. These aren’t controversial lightning-rod culture war issues. It’s about the health of children, something we can all get behind.”

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