Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 7 de 7
Filter
1.
Soc Sci Med ; 311: 115319, 2022 Sep 05.
Article in English | MEDLINE | ID: covidwho-2008124

ABSTRACT

One of the most consistent and worrying features of the COVID-19 pandemic globally has been the disproportionate burden of the epidemic in the most deprived areas. Most of the literature so far though has focused on estimating the extent of these inequalities. There has been much less attention paid to exploring the main pathways underpinning them. In this study, we employ the syndemic pandemic theoretical framework and apply novel decomposition methods to investigate the proportion of the COVID-19 mortality gap by area-level deprivation in England during the first wave of the pandemic (January to July 2020) was accounted for by pre-existing inequalities in the compositional and contextual characteristics of place. We use a decomposition approach to explicitly quantify the independent contribution of four inequalities pathways (vulnerability, susceptibility, exposure and transmission) in explaining the more severe COVID-19 outcomes in the most deprived local authorities compared to the rest. We find that inequalities in transmission (73%) and in vulnerability (49%) factors explained the highest proportion of mortality by deprivation. Our results suggest that public health agencies need to develop short- and long-term strategies to alleviate these underlying inequalities in order to alleviate the more severe impacts on the most vulnerable communities.

2.
BMJ Open ; 12(8): e058658, 2022 08 10.
Article in English | MEDLINE | ID: covidwho-1986364

ABSTRACT

OBJECTIVES: To examine how ecological inequalities in COVID-19 mortality rates evolved in England, and whether the first national lockdown impacted them. This analysis aimed to provide evidence for important lessons to inform public health planning to reduce inequalities in any future pandemics. DESIGN: Longitudinal ecological study. SETTING: 307 lower-tier local authorities in England. PRIMARY OUTCOME MEASURE: Age-standardised COVID-19 mortality rates by local authority, regressed on Index of Multiple Deprivation (IMD) and relevant epidemic dynamics. RESULTS: Local authorities that started recording COVID-19 deaths earlier were more deprived, and more deprived authorities saw faster increases in their death rates. By 6 April 2020 (week 15, the earliest time that the 23 March lockdown could have begun affecting death rates) the cumulative death rate in local authorities in the two most deprived deciles of IMD was 54% higher than the rate in the two least deprived deciles. By 4 July 2020 (week 27), this gap had narrowed to 29%. Thus, inequalities in mortality rates by decile of deprivation persisted throughout the first wave, but reduced during the lockdown. CONCLUSIONS: This study found significant differences in the dynamics of COVID-19 mortality at the local authority level, resulting in inequalities in cumulative mortality rates during the first wave of the pandemic. The first lockdown in England was fairly strict-and the study found that it particularly benefited those living in more deprived local authorities. Care should be taken to implement lockdowns early enough, in the right places-and at a sufficiently strict level-to maximally benefit all communities, and reduce inequalities.


Subject(s)
COVID-19 , Communicable Disease Control , England/epidemiology , Health Status Disparities , Humans , Pandemics
3.
BMC Public Health ; 22(1): 590, 2022 03 26.
Article in English | MEDLINE | ID: covidwho-1765444

ABSTRACT

BACKGROUND: We estimated socioeconomic factors associated with food insecurity during the first year of the Covid pandemic in the UK and explored potential mechanisms explaining these associations. METHODS: Data were from the April, July, and September 2020 waves of the UK Understanding Society Covid Survey. Food insecurity was measured as 'not having access to healthy and nutritious food' and 'reporting being hungry but not eating'. Logistic regression estimated the relationship between socioeconomic factors and food insecurity. A decomposition approach explored if financial vulnerability and having Covid-19 explained associations between socioeconomics factors and food insecurity. RESULTS: Single parents and young people aged 16-30 years had a higher odds of reporting both measures of food insecurity. Financial insecurity explained 5% to 25% of the likelihood of reporting being food insecure for young people and single parents depending on the food insecurity measure used. Experiencing Covid-19 symptoms explained less than 5% of the likelihood of being food insecure for single parents but approximately 30% of not having access to healthy and nutritious food for young people. CONCLUSION: Policies providing additional financial support may help to reduce the impact of Covid-19 on food insecurity in the UK.


Subject(s)
COVID-19 , Pandemics , Adolescent , Adult , COVID-19/epidemiology , Food Insecurity , Food Supply , Humans , Socioeconomic Factors , United Kingdom/epidemiology , Young Adult
4.
The Lancet ; 398, 2021.
Article in English | ProQuest Central | ID: covidwho-1537163

ABSTRACT

Background The COVID-19 pandemic and associated UK containment measures implemented to reduce viral spread are likely to influence the prevalence of food insecurity. Food insecurity is associated with wide-ranging negative effects on health and wellbeing. Specific containment measures such as closure of schools and hospitality venues might be expected to disproportionately affect some vulnerable groups, including single parents and young people. We aimed to identify sociodemographic and economic factors that increase the likelihood of reporting food insecurity during the COVID-19 pandemic, and to explore the extent to which financial vulnerability and experiencing COVID-19 symptoms explain the likelihood of becoming food insecure. Methods This analysis used cross-sectional cohort data from April, July, and September, 2020, of the UK Understanding Society COVID-19 Survey, which involved approximately 17 000 households. Food insecurity was defined as reporting positively to either or both of: “being hungry and not able to eat” or “inability to access sufficient and nutritious food because of lack of money or other resources”. Logistic regression was used to identify sociodemographic and economic factors associated with increased risk of food insecurity during the COVID-19 pandemic. A decomposition approach was used to explore the extent to which these associations were explained by financial vulnerability, or experiencing COVID-19 symptoms. Ethics approval for the study was not required. Findings Single parents and young people aged 16–30 years were at highest risk of reporting either or both measures of food insecurity. For single parents, financial vulnerability explained 5–20% of the likelihood of being food insecure, and experiencing COVID-19 symptoms explained less than 5%. For young people, financial vulnerability explained 5–25% of the likelihood of being food insecure, and experiencing COVID-19 symptoms explained 5–30%. Interpretation Single parents and young people may be especially at risk of food insecurity in the context of COVID-19. The wide explanatory ranges identified could be attributable to heterogeneity within groups and differing eligibility for financial support. Targeted funding, including for those self-isolating, could be an effective strategy to avoid or mitigate food insecurity among such vulnerable groups in the UK during the COVID-19 pandemic and other future pandemics. Funding None.

5.
Journal of Epidemiology and Community Health ; 75(Suppl 1):A63, 2021.
Article in English | ProQuest Central | ID: covidwho-1394163

ABSTRACT

BackgroundEarly in the COVID-19 pandemic it was clear that inequalities were emerging in the distribution of deaths, with more deprived areas harder hit than less deprived ones. How these inequalities began, evolved, and changed with the implementation of the first national lockdown did not receive as much attention. We used COVID-19 death counts per local authority (LA) over the first wave (up to 4th July, 2020) to understand how COVID-19 impacted different areas, and to shed light on the equity effects of a strict national lockdown.MethodsWeekly COVID-19 death counts per LA were provided by the Office for National Statistics, along with population estimates for mid-2019 and data on the index of multiple deprivation (IMD) and median age per LA. Mortality rates for each area were calculated as deaths per 100,000 persons. Characteristics of the evolution of mortality rate per LA and decile of IMD were calculated, for example the speed of increase to each LAs peak rate. Simple linear models and descriptive statistics were used to compare areas.ResultsMore deprived LAs tended to begin recording COVID-19 deaths earlier than less deprived areas. Mortality rates in more deprived LAs rose at a faster rate to their peak, which was also higher than in less deprived LAs. All LA death rates peaked between 3 and 9 weeks following the implementation of the first lockdown. The time between the lockdown announcement and the peak death rate was significantly negatively associated with the speed of increase, adjusted for the median age of the population (95% CI -0.33 to -0.31 deaths per 100,000 per week). Total cumulative mortality varied from 10.79 to 170.61 deaths per 100,000 persons per LA. Cumulative death rates were significantly higher in the most deprived 10% of LAs compared to others (p<0.001). Until lockdown, the most deprived 20% of LA’s recorded 64% more deaths than the most deprived 20%. By 4th July, this gap had narrowed to 16%.ConclusionVariation in the timing and speed of increase of local mortality rate curves occurred in the first wave and led to large inequalities across deprivation quintiles. This inequality was reduced but not completely abolished by the strict national lockdown imposed in March 2020. Timings of future national lockdowns should consider differences in local epidemic evolution, with extra support offered to those areas hardest hit.

6.
Journal of Epidemiology and Community Health ; 75(Suppl 1):A51-A52, 2021.
Article in English | ProQuest Central | ID: covidwho-1394160

ABSTRACT

BackgroundIn light of the Covid-19 pandemic, the government has prioritised reducing obesity rates. Many local authorities have employed planning guidance to manage the local food environment and promote a healthy environment. There is a lack of evidence on the effectiveness of this type of guidance on the food environment and subsequently health outcomes in particular inequalities. The primary aim of this paper is to examine the impact of planning guidance on the number and type of food outlets, health outcomes in particular obesity rates for children, and inequalities in these outcomes in a local authority in the North East of England. Gateshead implemented a blanket ban on all new takeaways in 2015.MethodsThe datasets consist of yearly number and type of food outlets in Gateshead from the Food Standards Agency Food Hygiene Rating System, Index of Multiple Deprivation 2015/2019, population density from the Office for National Statistics, childhood obesity data from the National Child Measurement Programme, and type 2 diabetes and hypertension data from Public Health England. The data is merged and analysed at lower layer super output area level across 8 years from 2012–2019. We use fixed effects and difference in difference models to investigate the impact of planning guidance on the food environment in Gateshead. The control groups are the neighbouring local authorities where did not implement the guidance. A fixed effects model will be employed to test the relationship between the density of food establishments and incidence of the relevant health conditions such as childhood obesity.ResultsOur preliminary results show the planning guidance significantly reduced the proportion of takeaways compared to all other types of food outlets (p-value: 0.000). However, there was no statistically significant reduction in takeaways.ConclusionThis study provides preliminary evidence on the effectiveness of policy to manage the food environment. Our next step will be to explore how changes to the food environment impact on health outcomes and inequalities.

7.
Scand J Public Health ; 49(1): 17-26, 2021 Feb.
Article in English | MEDLINE | ID: covidwho-1207566

ABSTRACT

This article examines gender-based health inequalities arising from the COVID-19 pandemic by drawing on insights from research into the 'gender health paradox'. Decades of international research shows that, across Europe, men have shorter life expectancies and higher mortality rates than women, and yet, women report higher morbidity. These gender-based health inequalities also appear to be evident within the pandemic and its aftermath. The article starts by providing an overview of the 'gender health paradox' and the biological, social, economic and political explanations for it. It then outlines the international estimates of gender-based inequalities in COVID-19 morbidity and mortality rates - where emerging data suggests that women are more likely to be diagnosed with COVID-19 but that men have a higher mortality rate. It then explores the longer term consequences for gender-based health inequalities of the aftermath of the COVID-19 pandemic, focusing on the impacts of government policy responses and the emerging economic crisis, suggesting that this might lead to increased mortality amongst men and increased morbidity amongst women. The essay concludes by reflecting on the pathways shaping gender-based health inequalities in the COVID-19 pandemic and the responses needed to ensure that it does not exacerbate gender-based health inequalities into the future.


Subject(s)
COVID-19/epidemiology , Health Status Disparities , Europe/epidemiology , Female , Humans , Male , Sex Distribution
SELECTION OF CITATIONS
SEARCH DETAIL