[Effects of the COVID-19 pandemic on health inequalities and mental health: effective public policies]. / Gli effetti della pandemia COVID-19 sulle disuguaglianze di salute e salute mentale: politiche pubbliche efficaci.

ABSTRACT

The aim of this article is to examine the effects of the COVID-19 pandemic on health inequalities and mental disorders and to analyse the most effective public policies in containing them. COVID-19, in addition to causing the worst health crisis since World War II, has generated a severe economic recession and a rise in unemployment. The poorer socioeconomic classes have been most affected by infections and deaths caused by the SARS-CoV-2 virus due to inequalities in working, housing and area of ​​residence conditions, psychosocial factors, and unequal access to health care. The pandemic crisis, in addition to causing psychiatric and neurological problems in people who have been hospitalized, appears to have increased the risk of psychological problems through various mechanisms such as social distancing, loss of a loved one, unemployment, and economic difficulties. In many countries, however, there was no significant increase in suicides in 2020 and there have even been decreasing temporal trends. It is possible that the crisis, in addition to creating stress and social isolation, may have promoted reciprocity, interpersonal help, and greater motivation to take care of one's health.The most effective policies in reducing COVID-19 mortality have the potential to limit the most adverse effects of the pandemic on health inequalities and mental health. Thanks to vigorous preventive interventions on the territory, based on testing, tracing, isolating, timely, countries who managed best the pandemic avoided prolonged and repeated lockdowns, protected public health and the economy. However, more vigorous social protection measures are needed in favour of those populations most affected by the health crisis and its socioeconomic effects. This pandemic offers the opportunity to learn lessons on the protection of public health and stress the need to adopt a syndemic model oriented towards prevention.