The Covid-19 Pandemic Exaggerated Health Inequalities in England

The Pandemic has increased health inequalities in England, according to a recent report by the Institute of Health Inequalities – Build Back Fairer – The Covid-19 Marmot Review: The Pandemic, Social and Health Inequalities in England.

Prior to the Pandemic, from 2010 to 2020, health inequalities between the least and most deprived were increasing in England.

Pre-pandemic, increases in life expectancy had stalled, but life expectancy for the most deprived 10% of the population actually decreasing in some regions (such as parts of the North East and London) during some years in that 10 year period.

Covid-19 increased health inequalities

The charts below show the mortality rates per one thousand between March and July 2020.

As you can see, there are drastic differences already between the least and most deprived deciles – 600/ 100 000 for the poorest decile, compared to 400/ 100 000 for the wealthiest decile.

But the difference is greater when we look at the covid related mortality rate – this is 200/100 000 for the poorest, compared to nearly 100/ 100 000 for the wealthiest.

So health inequalities increased from a difference of 1.5.1 to nearly 2:1 as a result of the Pandemic.

Some of this difference is explained by the different levels of exposure due to occupation – as a general rule, professional workers are more able to work from home and stay isolated, while manual workers and care workers need to actually go to work in person, and this is reflected in the different mortality rates by occupation (‘social class’) for the same period as above:

Explaining health inequalities… it’s not ALL about the Pandemic

Professor Marmot is at pains to point out that these health inequalities were in existence BEFORE the pandemic, and that government health policies between 2010 to 2020 explain WHY poor people have died in such huge numbers from covid-19 and why England has the highest covid related mortality figures in Western Europe.

In particular Marmot points to the following government policies:

  1. A political culture that undermined social inclusivity and cohesiveness and failed to promote the common good
  2. Widespread inequality, which is bad for socio-economic outcomes in general, with the most deprived ‘steered’ towards poor living conditions and unhealthy lifestyles.
  3. Government austerity policies – an underfunded health and social care sector.

In terms of what to do, the report makes a number of suggestions, mainly to do with introducing policies to improve health outcomes of the most deprived, and this will take a broader/ deeper approach to social change rather than just being about health!

Relevance to A-level Sociology

This is a VERY sociological report – putting the covid mortality rate in longer term context.

The point is that we can’t just blame the Pandemic for killing people – certain types of people (the poor) died in larger numbers proportionality to the rich – which means there was a social cause to the high covid death toll in England.

And that cause was, according to this report, already high levels of existing inequality.

This is a rare example of some long-term quantitative analysis, it sounds almost like Functionalism/ Positivism in its approach.

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