We can use Covid-19 recovery to redraw the map of health inequality
Eight months into the global pandemic, and it is hard to overstate the impact that Covid-19 has had on all our lives.
Our experience of work, education, health care, shopping, and maintaining our relationships has been completely transformed, with coronavirus disrupting all areas of life, even for those not made severely ill.
It has created a unique moment of national reflection, demonstrating starkly the crucial links between the nation’s health and our social, economic, and environmental wellbeing.
The impact of this disruption has been profound. Alongside the immediate health crisis, we’ve also seen that Covid-19 has exacerbated pre-existing inequalities.
Detailed work by countless organisations has highlighted the fact that those who have been most affected by the pandemic were already suffering in some way before it struck. For example, UK charity the Health Foundation found that those living in Britain’s poorest postcode areas have been hit hardest, facing far higher excess Covid-19 deaths than those in richer neighbourhoods.
Certain groups of the population are suffering from higher rates of infection and worse health outcomes. These include black and ethnic minority communities, who are four times more likely to die from Covid-19 and have accounted for over a third of all coronavirus-related intensive care admissions. Disabled people have also been badly affected, with death rates two to three times higher than those of non-disabled people.
The pandemic has also had a significant but indirect impact on other population groups. Take young people,arguably one of the cohorts most affected by the pandemic, who have missed out on months of face-toface education and interaction with their peers. Furthermore, young people have been disproportionally affected financially, with one in three people aged 18-24 being furloughed or let go from their jobs, which is twice the rate of working-age adults overall.
A recent study by the Scottish Youth Parliament, Youthlink Scotland and Young Scot examined young people’s attitudes towards Covid-19, with the findings showing that 40 per cent are moderately to extremely concerned about their own mental wellbeing. The wider effects of the pandemic on mental health are vast, and it is no surprise that almost half of young Scots are feeling anxious about the future.
Recent analysis also found that health and social care workers themselves have an increased risk of adverse mental health outcomes. Half of health care workers reported that their mental health deteriorated during the peak of the pandemic, while four in five social care workers in Scotland reported that their work during Covid-19 had a negative impact on their mental health.
That might all sound quite bleak – and it is. But I think we can take some heart from the
fact that the pandemic has thrust the issue of national wellbeing into the spotlight. Questions are being asked up and down the country about what truly matters to us as individuals and as a society, and there are choices to be made about what governments prioritise in designing the recovery.
The direct and indirect relationships between health outcomes and social, economic and environmental outcomes are complex. But there is no doubt that the pandemic experience has made us more aware that we do not live our lives with separations between our physical health and mental health, or between our health and our employment, access to food and housing situations.
We live our lives in the round. While the issues thrown up by the pandemic are not exclusive to Scotland, the Scottish Government is already signed up to a wellbeing approach, which includes tackling inequality gaps. The people whose job it is to review the data and measure progress on this ambition will no doubt be looking closely at the different impacts the pandemic has had on groups within our population and considering their policy responses.
Luckily, they will find a wealth of evidence to draw on in the form of the current Covid-19 Impact Inquiry led by the Health Foundation. This inquiry is seeking to understand the impact that the pandemic is having on the nation’s health and health inequalities, and the findings should inform government action as we move through recovery and help ensure better resilience to future societal shocks. I am delighted to be a member of the advisory panel, lending the Carnegie UK Trust’s experience and expertise to this important work.
As the leading independent wellbeing foundation in the UK, Carnegie is well-placed to understand and explain the importance of seeing health within this wider context of our lives. Good physical and mental health are key determinants of our wellbeing as individuals, as are employment, having purpose and meaning, and our personal and community relationships.
You can’t achieve collective wellbeing unless you reduce inequalities between population groups – our attention as a nation has to be on those who were already experiencing inequality before the pandemic, as the groups most likely to be affected by the long-term fallout.
The inquiry is also looking to learn lessons from the positive action taken by communities across the country to adapt to the challenges they have faced this year. This is backed up by our experience at Carnegie UK of the importance of people being supported to solve problems at a local level.
It is really important that all these issues remain central to planning for the recovery, along with other critical wellbeing factors such as good quality jobs, education, and the bolstering of the human ties that make all our lives worth living.
A crisis can create the conditions for seeing and understanding our world in new ways. This crisis has revealed how closely related our health, economy and environment are. We must make the most of this moment of clarity to redraw the map of what matters to us and to prioritise the things that we know will contribute to a flourishing Scotland for us and for future generations.
Sarah Davidson is chief executive of the Carnegie UK Trust
The pandemic has thrust
the issue of national wellbeing into the
spotlight, writes Sarah
Davidson