Adults in poorest areas 'almost four times more likely to die from Covid-19'

Underlying health problems put least wealthy at most risk, English study finds

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An inquiry has revealed that working age adults in England’s poorest areas were almost four times more likely to die from Covid-19 than those in the wealthiest areas.

The findings are disclosed in a report by the Health Foundation, one of the most comprehensive studies into the factors that fuelled the UK’s high Covid-19 death toll.

The nine-month investigation found that the Covid-19 mortality rate was 3.7 times higher for under-65s living in the poorest 10 per cent of neighbourhoods than in the wealthiest in England.

Poorer underlying health left them at greater risk, a pattern which reflects pre-pandemic mortality trends. People in their 50s and 60s living in the poorest areas are twice as likely to have at least two pre-existing long-term health conditions such as lung disease or diabetes.

The inquiry concludes that the recovery needs to prioritise creating opportunities for good health. Around eight in 10 adults surveyed agreed it is important the UK government addresses differences in health outcomes between those living in richer and poorer areas during the recovery. The same number agreed they were worried about the impact of the pandemic on the UK economy.

The report describes how public services were eroded by the 2008 financial crisis and the underlying economy and social fabric were frayed. This damaged health and stalled increases in life expectancy, especially for people living in the poorest areas of the country. In turn, this reduced resilience to the pandemic and significantly reduced the UK’s ability to manage the pandemic effectively.

The charity behind the report is calling for immediate action to prevent further erosion of health from the pandemic and ensure a recovery that improves health, avoiding mistakes of the past. It says the government needs to close the education gap, address the healthcare backlog, support those in greatest poverty and provide targeted mental health support.

We may have to learn to live with Covid-19, but we don’t have to live with its unequal impact

Jo Bibby,
director of health at the Health Foundation

However, the authors say that longer-term repair means investment: creating good jobs and improving working conditions of the lowest paid, and boosting public services to build resilience in the health of the nation for the future.

Jo Bibby, director of health at the Health Foundation, said: “We may have to learn to live with Covid-19, but we don’t have to live with its unequal impact. The shortcomings of the response to the 2008 financial crisis left a legacy of deep-rooted issues – poor health, increased financial insecurity and strained public services – which left the UK more vulnerable to the pandemic’s health and economic impacts.

“We cannot afford to make the same mistake twice. Government must address the root causes of poor health and invest in jobs, housing, education and communities. This is the only way to create a healthier society that can meet the challenge ahead and better withstand future crises.

“Ministers across government should work together to put health at the heart of the forthcoming levelling up strategy, with clear targets and a regular, independent assessment of the nation’s health laid before Parliament.”

The inquiry amassed extensive evidence that existing poor health, reflecting wider inequalities in people’s circumstances, put people at higher risk of death once exposed to the virus. Factors including type and quality of work, housing conditions, and access to financial support to self-isolate all contributed to increased exposure to the virus among working age adults.

The study found that among workers, men in roles such as security guards, care workers and taxi drivers were more likely to die from Covid-19 – with those working in sectors which remained open not only at highest risk of exposure, but also at higher risk of death due to existing poor health.

Low rates and coverage of statutory sick pay and difficulty in accessing isolation payments reduced people’s ability to self-isolate, increasing exposure and spread, the study discovered.

The inquiry also explored the disproportionate impact of the pandemic across certain groups in society. People from ethnic minority communities, young people, those suffering from mental health conditions and disabled people in particular experienced worsening and compounding inequalities, increasing their exposure to Covid-19 and threatening their future health.

The report says that the full impact of the pandemic on household finances is still to come. A build-up of debt and the discontinuation of both the Coronavirus Job Retention Scheme and the Universal Credit uplift later this year risk a crippling blow to people’s finances, particularly in the poorest areas.

Dame Clare Moriarty, chairwoman of the Covid-19 impact inquiry and chief executive of Citizens Advice, said: “The legacy of the pandemic is all around us in terms of unmet health needs, mental health problems, gaps in educational attainment, loss of employment and financial insecurity. If we are to avoid these issues leaving long term scarring on our communities, it’s time to make a choice about how we move forward and where we invest.

“This is our chance to close the chapter on the remnants of the financial crisis response and build back better and fairer. We need to aim for a recovery that builds economic and social resilience, with ‘levelling up’ not limited to geographical areas of disadvantage but that addresses the needs of groups who have experienced the most damaging impacts of the pandemic.”