The Covid-19 pandemic is being accompanied by a substantial rise in demand for mental health services. Whilst investment in mental health services is vital, it is also necessary to tackle the factors that cause and worsen mental ill health in the first place.

The evidence is clear that poverty, deprivation, and economic inequality are toxic to mental and physical health, and therefore policy makers should prioritise reducing them as an urgent public health necessity.

Rates of depression, serious mental illness, and suicide (not to mention nearly every physical illness and injury) worsen with increased poverty and deprivation in a very clear dose-response relationship – the more the exposure, the worse the outcomes.

Although mental and physical health harm increases with deprivation, economic inequality is bad for everyone: rich, poor and those in between. The most unequal developed economies, including the UK and the US, experience higher levels of stress, social problems, and instability than more equal ones such as those in Scandinavia, New Zealand and Japan (Wilkinson and Pickett, 2010). Michael Marmot calls this phenomenon ‘status syndrome’, with a gradient of worsening mental and physical health correlating with one’s economic and social position in society (Marmot, 2004).

Economic inequality intersects with other disadvantages such as those caused by structural racism – many racialised communities in the UK suffer from worse poverty and mental health outcomes, creating multiple disadvantages.

In the UK, poverty, deprivation and inequality are getting worse, with high inflation overlapping with the Covid-19 pandemic and compounding the economic harm of Brexit (Office for Budget Responsibility, 2022) and the austerity which followed the global financial crash of 2007.

If the current trajectory of deepening poverty and deprivation, widening economic inequality and worsening health continues, millions of people will suffer preventable harm and health and social care services will be overwhelmed by demand.

This is a public health emergency that requires action to increase the incomes and reduce the costs of the most deprived 40% of the population.