Debbie Weekes-Bernard: City Hall’s Covid study shows where to start on reducing London’s health inequalities

Debbie Weekes-Bernard: City Hall’s Covid study shows where to start on reducing London’s health inequalities

As the scale of the pandemic grew, I and colleagues at City Hall started to hear alarming stories of how it was affecting London’s communities unequally, particularly, Black, Asian and minority ethnic people. We wanted to quickly find comprehensive evidence to discover the extent of this. Study after study appeared to confirm disproportionate impacts, including on mortality rates, while qualitative research and feedback from civil society organisations collated by the Greater London Authority (GLA) drew links to structural inequalities.

While the government commissioned Public Health England to conduct a rapid national review of Covid-19 disparities, we commissioned the University of Manchester to conduct a complementary study with a different focus. It would look at disability, ethnicity, religion, gender, sexual orientation, gender identity, socioeconomic position, age and other factors, including homelessness and being in prison, to understand how such characteristics intersect with others known to affect outcomes, such as deprivation, occupation and health. The aim was to provide a London focus and help with understanding the rapid spread of the virus in a major global city with high population density.

The results of the study, newly-published, are stark. In some respects, they are not surprising: we already knew, for example, that older and disabled Londoners are at greater risk from the virus. However, the results also exposed other inequalities. These include particular ways in which the pandemic is affecting women. Although men are disproportionately more likely to die from Covid-19, women have been experiencing disproportionate economic, social and psychological impacts.

The study also reveals implications for Londoners on low incomes. Some are more likely to be in jobs that cannot be done from home, increasing their risk of exposure to the virus. Others are in precarious employment in sectors more likely to be shut-down, reducing their incomes further. The impact on disabled people is shown to be hugely concerning. Poverty is experienced more acutely by disabled people due to the range of additional living costs they incur and the impact of the disability pay gap.

We always knew there were going to be issues in obtaining data for many of these areas. Civil society has played a crucial role in adding to this important evidence base. As well as a formal literature review, the Manchester researchers enlisted the help of the Ubele Initiative to consult with voluntary, community and social enterprise organisations in London. This perspective was vital to ensuring that the review covered all of the protected equalities domains enshrined in the Equality Act 2010. For example, evidence from the voluntary sector has shed light on the mental health impacts on LGBTQ+ people, as and their risks of abuse, violence and discrimination – issues academic, think tank and policy (including government) sources do not have detailed information on.

The review is a cornucopia of information and I would urge anyone who wants to understand more about the wider impacts of the pandemic to read it. It ends with a series of recommendations, written from the authors’ perspective. We will look at these carefully and consider which are in our power to affect and take action on. One of the main aims for London’s recovery must be to narrow social, economic and health inequalities. This review provides an up-to-date picture of where we all need to start.

Read the full Rapid Evidence Review report at the London Datastore. Debbie Weekes-Bernard is Sadiq Khan’s Deputy Mayor for Social Integration, Social Mobility and Community Engagement. Follow her on Twitter.

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