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COVID-19 Multiple long-term conditions

How we are acting on health inequalities during COVID-19

6 May 2020
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3 min read

When our health suffers, so do our social and economic lives. With the pandemic making this even sharper, Programme Director Barbara Reichwein shares how we’re working to address health inequalities during COVID-19, and beyond.

The relationship between people’s livelihoods and ill-health sits at the heart of our multiple long-term conditions programme.

At present, the crisis is making the importance of this even clearer. When our health suffers, so do our social and economic lives, and vice versa. This is true not only in Lambeth and Southwark, but nationwide and globally, too.

 

The pandemic hits those in cities hardest 

Recent data shows the pandemic disproportionately affects those living in inner-cities. People living in densely populated areas, with high levels of socioeconomic deprivation, are the hardest hit. For example, in our place, an estimated 16 – 17% of people are at clinical risk of severe illness from COVID-19. And, the lives and normal clinical management of those with a diagnosed long-term health condition is being disrupted.

During the pandemic, those with the lowest household income are six times less likely to be able to work from home. These people are also three times less likely to be able to self-isolate.

I recently spoke to Sandra, a nursery teacher in Southwark, who is currently looking after the children of key workers. Despite low pay, Sandra supports her brother who is self-isolating with an underlying health condition. Yet, her job is only secured until next month. Between the pandemic and government regulations, her employer is stuck between a rock and a hard place.

If Sandra loses her job, her diet, and that of her self-isolating brother may suffer. Pre-existing physical health conditions could also be affected, as could their mental health.

Vulnerability to COVID-19 in Lambeth and Southwark

An increasing vulnerability to ill-health

To make things worse, any change in lifestyle or financial circumstance due to COVID-19 could result in people developing long-term health conditions quicker. In a household where one person lives with diabetes, asthma, kidney, liver, or lung disease, everybody will need to exercise caution. Will we have an epidemic of chronic disease on our hands, once the first COVID peak has passed? There is reason to believe we might.

We need to urgently explore strategies to first mitigate against this risk. And second, reduce the economic and social disadvantage of people living with ill-health. To do this, we need to:

– Look at how these people might engage with society;

– How they can continue or return to work in a world where COVID-19 exists;

– And, what their ‘new normal’ could look like when the country re-opens.

Our focus is on stabilising the circumstances of people who are not classed as clinically vulnerable (the shield group), but are struggling to cope due to income, housing or health.

 

How we will address these inequalities

We are developing a twelve-month plan to pre-empt where people might ‘fall through the cracks’ of the evolving support system that the Government, civil society, businesses and volunteers are putting in place.

Firstly, we are ‘actively listening’ to our partner organisations rooted in our communities. By doing this, we are seeking out mid-term plans to work with them beyond food provision. 

Alongside our commitment to Pembroke House in Walworth, we are providing response funds to High Trees Community Trust. These funds are to help employment and housing support clients in Tulse Hill to remain connected to the outside world.

We are also providing urgent assistance to organisations via the London Community Response Fund. And, to individual organisations like Studio X, who are providing remote entertainment infused with mental health support.

We know that people from Black, Asian and minority ethnic (BAME) communities have the cards stacked against them in multiple ways. This leads to worse health outcomes, and this has been brought into sharp focus by the COVID-19 pandemic.

The intersection between isolation, financial hardship, caring responsibilities, unemployment and precarious work is coupled with a greater burden of long-term health conditions.

This is why we are working with BlackThrive to understand the needs of BAME communities within our place. And, to identify any gaps in the response from Government and community organisations. We will place more emphasis on racial equality in our programme strategy going forwards.

Finally, we are exploring what our place will feel like for people living with long-term conditions during a recession. Namely, how the economic landscape will impact the rapid onset of further long-term conditions, and what can be done to cushion the blow.

Future models of support will be hybrid or digital-first, rather than face-to-face delivery. We will focus on ways to scale remote approaches that do not widen the health inequality gap.

Before the crisis, we knew that our financial health, housing and work can, at their worst, cause people to lose up to 15 years of healthy life years. We are working to not let this gap between advantaged and disadvantaged areas grow further. 

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