Inequalities and deaths involving COVID-19 - What the links between inequalities tell us.
The burden of illness and death due to coronavirus (COVID-19) is not being shouldered equally. Across the world, men, older people, and people with long-term health conditions are at higher risk of serious illness and death from the virus. But inequalities in outcomes go beyond these factors alone.
We have seen higher numbers of deaths from COVID-19, than in the general population, among: black and minority ethnic communities, people living in socioeconomically deprived areas, those working in professions like social care, and those who require care in their own homes or a care home.
The reasons for higher COVID-19 death rates among these groups need to be understood and tackled. But, when we know that women are more likely to work in social care than men, or that black and minority ethnic people may be more likely to be exposed to COVID-19 in their living circumstances or professions, it should shape our analysis and public health response.
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COVID-19 studies around the world point to the virus taking a greater toll on men. At all ages, COVID-19 related hospitalisations in England and across Britain, intensive care admissions and deaths in and outside of hospitals are higher among men.
As for many other diseases, evidence of a striking socioeconomic gradient is also emerging for COVID-19. 25% of critical care patients with COVID-19 are from the most socioeconomically deprived fifth of areas and 15% are from the least deprived. The age-adjusted death rate in the most deprived tenth of areas is double that of the least deprived areas.
But the effects of socioeconomic deprivation may be exacerbated by other social factors. Intersectionality theory is a framework to consider whether disadvantage on multiple social dimensions combines to affect outcomes. It was first laid out as a way of understanding how racism and sexism combine to affect the experiences of black women but has been extended to consider discrimination and disadvantage where other identities intersect.
One recently highlighted intersection is that of gender and socioeconomic deprivation. Despite overall increases in life expectancy, socioeconomic inequalities in life expectancy have increased for men and women since 2010. And for women in the most deprived tenth of areas, according to The Marmot review 10 years on, life expectancy actually declined between 2013–2015 and 2016–2018.
Source - The Health Foundation