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Pre-existing regional inequalities contributed to disparities in Covid-19 deaths, report finds


By Awil Mohamoud
Reporter
15 December 2020

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Significant health and social inequalities seen between regions over the last decade have contributed to disparities in Covid-19 mortality, a report by Sir Michael Marmot has found.

Sir Marmot’s latest review found that the more deprived the local authority, the higher the Covid-19 death rate, with the North of England the worst hit. 

The report said that the close association between factors such as deprivation and Covid-19 had made living in more deprived areas in some regions ‘particularly hazardous’. 

‘There is clear evidence relating Covid-19 mortality to occupation, being from a Black, Asian and minority ethnic (BAME) group, living conditions, deprivation, population density and prior health conditions – all factors that differ by region,’ it added. 

The review builds on another of Sir Marmot’s reports, published in February, which uncovered growing inequalities in the social determinants of health between regions – namely around wealth, income, employment, and government funding.

Today’s report (15 December), Build Back Fairer, said these regional inequalities will have ‘significant long-term impacts’ on health, which will be accelerated by the regional employment impacts – and by how measures taken to contain Covid-19 have been enacted in different areas.   

Impact on young people 

The report also found that the economic consequences of Covid-19 have already been greater in areas that entered the pandemic with the weakest economies. 

It said that the issue of rising unemployment and low wages following the pandemic will also lead to ‘worse health and increasing health inequalities’ in the future. 

The pandemic has also had an adverse impact on young people’s social and emotional development, the review found, with the closure of early years settings likely to worsen early child development and the closure of schools contributing to ‘an already wide educational gap’. 

Sir Marmot urged the Government to reverse cuts to children’s centres, local governments and health services, and restore pre-student funding in schools in his recommendations. 

‘Britain has tried the austerity experiment, in the decade from 2010, and it did not work – if health and wellbeing are the markers of success,’ the report said. 

‘At a time of zero interest rates, with a tax rate that is at the low end among European countries and with control of its own currency, a nation can borrow for the purpose of building a better society.’

‘Urgent need to do things differently’

The review also highlighted the ‘shockingly high’ Covid-19 mortality rates among BAME groups and said that much – but not all of this – can be attributed to people living in deprived areas, crowded housing and being more exposed to the virus at work and at home. 

‘These conditions are themselves the result of longstanding inequalities and structural racism,’ the report said, adding that there was also evidence that many people from BAME groups have not been well protected at work, ‘and less well protected than their White colleagues’. 

Sir Marmot said: ‘The Covid-19 pandemic has shown us how highly valued our health is, and how closely it is linked to the functioning of society and it would be a tragic mistake to attempt to re-establish the status quo that existed before the pandemic – a status quo that saw the UK as the worst in Europe, marked by stagnation of health improvement and widening health inequalities.

‘There is an urgent need to do things differently, to build a society that functions to meet the needs of its members; to build a well-being economy that puts achievement of health and well-being at the heart of government strategy, rather than narrow economic goals; to build a society that responds to the climate crisis at the same time as achieving greater health equity.’

The report concluded that England’s excess death rate is the highest in Europe because of ‘specific failures to control the pandemic’ and pre-pandemic socioeconomic conditions. 

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