Blog: Repairing the damage – tackling the inequalities exposed by COVID-19

The COVID-19 pandemic has laid bare both the health and life inequalities faced by sections of our society.

How we, as a system, choose to respond to the widened gaps in people’s life opportunities will define not just our generation, but generations to come.

The virus has targeted those most vulnerable in our society, like our frail and elderly whose needs we already had a good understanding of. But it also highlighted vulnerable sectors of society that have been inequitably targeted by this pandemic. Whether due to poverty, employment, ethnicity or access to care and pre-existing long-term health conditions, it is clear that we must do more towards closing the gaps that exist so that future generations can experience better outcomes.

Among the disparities that have been exposed by this virus, the expansion of employment inequalities is emerging as a major issue. Many low earners and zero hours contract workers have been left without work or are furloughed with uncertainty around future employment status. Many are also now finding themselves being made redundant as the financial fallout of the pandemic takes hold. The ongoing future reliance on technology and remote working, may well favour the more highly educated and those who can afford the space and expense of home kit.

The economic impact has not just affected the current working population. Young people, including those graduating university this month, are sadly facing the toughest employment market in more than a generation. We know that unemployment and loss of income can have detrimental effects on long-term health and therefore widen health inequalities further.

Coronavirus has also increased the health inequalities between the white majority and minority ethnic groups. Those particularly impacted are people of Pakistani or Bangladeshi origin, who are much more likely than others to work in sectors that have been shut down and Black people, who are disproportionately represented in key worker occupations and have been contracting COVID-19 at far higher rates. The crisis also appears to have further increased the gap in death rates between better-off and less-affluent areas.

Whilst we have seen COVID-19 hit men harder than women – with more suffering severe cases and dying from the virus - there is also an economic and gender inequality growing due to the changes experienced from home working. The additional childcare and housework as people stay at home with schools and nurseries closed has, in many cases, fallen more on mothers than fathers. There must be a risk that this unduly inhibits work and career progression for mothers, when progress in closing the gender wage gap had already stalled.

While undoubtedly this paints a worrying picture, not all impacts of the pandemic are negative. Some may even turn out to be positive.

Remote working and its increased productivity in many sectors, could be especially helpful for mothers’ careers. As fathers are spending more time at home and with their children this may improve changes to gender bias and gender norms.

Widespread home working may also allow more high-paid and high-productivity jobs to be located away from London. This may be especially beneficial for Surrey as a county negatively impacted by being close to London, as workers had previously been encouraged to travel for slightly higher wages rather than work locally.

For any positives to be gained and inequalities to be minimised we will need to work together to address challenges like access to training and education. Children, especially poorer children, who are missing out on school will need additional teaching post crisis.

Supporting the unemployed to access and learn new skills and take up new job opportunities will be crucial. But most of all we need to recognise and change our attitudes – to the welfare system, to key workers, to inequalities between ethnic groups.

This is where our partnership working both at local and system level will be more important than ever if we are to reverse some of the longer term consequences of the virus.

Avoiding the worst outcomes for all and giving everyone a chance at the best.

I’m taking a mini break from my blog next month but I’ll be back in September. As always I’m keen to get your thoughts and ideas for what you’d like to hear more about – please do get in touch This email address is being protected from spambots. You need JavaScript enabled to view it.

Thanks for reading and stay safe

Charlotte

Dr Charlotte Canniff

Clinical Chair

NHS Surrey Heartlands CCG


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