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Multiple long-term conditions COVID-19

One year on from lockdown: building back fairer

24 March 2021
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4 min read

Programme Director Rohan Martyres shares his reflections on the impact of COVID-19 on local health inequity, and what it means for our multiple long-term conditions programme.

February 2020 saw the ten-year anniversary of Professor Sir Michael Marmot’s review into health inequality in England. Whilst we knew that many inequalities had worsened in the last ten years, there was no way we could predict how this would accelerate in 2020.

A year after the first national lockdown, we are reflecting on our initial response to the pandemic, and lessons for our ongoing work on the social determinants of health in urban places.

Local action on health inequity

Through the work of our multiple long-term conditions programme, we’re addressing the social and economic factors that accelerate how quickly some people develop multiple long-term health conditions. Where you live, where you work and your financial health all have a role to play – and importantly, can be changed.

COVID-19 has had a huge impact on people living in cities, and as the Office of National Statistics demonstrates, people living in densely populated areas with high levels of socioeconomic deprivation most of all.

Whilst the statistics help to paint a picture, we wanted to better understand the impact COVID-19 was having on residents in Lambeth and Southwark. Working with The Social Innovation Partnership and community researchers, we found that people living in our boroughs often had unequal access to public services, increasingly relied on social support networks and had a significant mistrust of the healthcare system. A large proportion of residents also experienced high levels of anxiety, fear and isolation. We responded in several ways.

We found that people living in our boroughs often had unequal access to public services, increasingly relied on social support networks and often had a significant mistrust of the healthcare system. A large proportion of residents also experienced high levels of anxiety, fear and isolation.

Rohan Martyres Programme Director

We continued our work in neighbourhoods; working with organisations rooted in communities, we built on local knowledge to make sure residents were supported in a way that was tailored to local circumstances.

For example, we supported High Trees Community Development Trust to provide remote advice, wellbeing check-ins and loans of IT equipment to residents in Tulse Hill. The project supported 200 working-age adults in three housing estates who sought employment, education or housing assistance before the COVID-19 pandemic.

We also developed new initiatives to engage communities, landlords, employers and others.  This includes a partnership between Kineara and Southwark Law Centre to provide specialist legal advice for households most at risk of eviction, an initiative by Centre for Responsible Credit that coordinates creditors and GP surgeries to provide a COVID financial shield for people at risk and work by the Liminal Space to develop a programme to protect the health of night shift workers.

Liminal Space workers
Working with The Liminal Space to engage night shift workers and employers to create a healthier working experience.
Women at High Trees
Women receiving advice and wellbeing check-ins at High Trees Community Trust (before the pandemic).

Reflections on the pandemic

Looking back over the past 12 months, I have three key reflections.

First, our multiple long-term conditions programme is more relevant than ever. We know that that people most likely to live with, or develop, a long-term health condition are at higher risk of serious illness from COVID-19, and that the causes of this are largely socio-economic.

Second, making sure systems are in place to support people before ‘cliff-edge’ moments is a collective responsibility. For example, people living with the dual burden of long-term conditions and financial ill-health continue to have limited options to manage both, even before the pandemic began.

Finally, some of the ways of working developed during the ‘emergency response’ phase of the pandemic can act as a blueprint for long-term systemic change. The projects I’ve been most inspired by bring together small groups of organisations that have a range of perspectives and skills with strong local and regional networks. They are creative, focused on fixing complex problems, and work in the context of where and how people live.

We know that that those people most likely to be live with, or develop, a long-term health condition are at at higher risk of serious illness from COVID-19, and that the causes of this are largely socio-economic.

Rohan Martyres Programme Director

What does this mean for the future of our programme?

We know that focusing on environments and the circumstances of people’s lives will be central to a fairer post COVID-19 recovery.

In Lambeth, Black people are more likely to experience deprivation than people of other ethnicities and 29% of Black people in the borough live with two or more long-term conditions compared to 17% of their White neighbours. This is why we need to have a sharper focus on communities that have been disproportionately impacted by COVID-19, especially those that experience structural discrimination.

We have seen an extraordinary capacity for people to come together, and a previously unimaginable willingness to redefine the role of the state alongside other sectors – all of which are critical for many other global health challenges.

As an organisation and programme, we need to be flexible, open to new opportunities and support partners to be resilient to help break the link between poor health and work, housing and finances.

If you have an idea of how we may work together to make sure the post-COVID recovery is fair for all, please get in touch with us. You can also see what else we’ve been working on to support communities during the pandemic.