One of the striking things about the Covid-19 pandemic was the wealth of data it produced. Who can forget the graphics and the charts in briefing rooms, statistics from SAGE and Chris Witty splashed across the news? As the UK gradually begins to view Covid-19 as a thing of the past, it then seems no surprise that there has been a scramble to quantify the data of the impact of Covid-19, both for public health and the concomitant effect of lockdowns considered with pre-existing socioeconomic factors.
A growing body of research has pointed towards the stark impact that Covid-19 has had on the lives of those in deprived areas of the UK, with metrics both for the direct health effects of the virus and also of the impact of government policies to combat it. The effect on poorer regions compared with affluent areas has been signficant the British Medical Journal reported that deprived areas 128.3 deaths per 100,000 population, which was more than double the death rate in the least deprived areas, where it was 58.8 deaths per 100,000. Within London, the difference between deprived and affluent boroughs was stark: according to the Office for National Statistics, deprived boroughs such as Brent had the highest overall rate with 210.9 deaths per 100 000 population, followed by Newham (196.8 deaths per 100 000 population), and Hackney (182.9 deaths per 100 000 population).
Those in precarious circumstances were also at a significantly higher risk from Covid-19, as the least able to self-isolate: people in deprived areas needed jobs even if they were unsafe, or on the periphery of legal work. The dramatic Covid-19 outbreak in Leicester was particularly linked to garment and textile factories, many of which were operating on the periphery of legal employment. Research from Sheffield council in March 2021 showed that, of ten income bracket groups, those in the bottom three were significantly more likely to contract Covid-19 than those in the top seven, the impact of being forced to go to work due to irregular and informal employment.
The impact of lockdown and Covid-19 on access to healthcare has also had a starkly divided impact between deprived and affluent areas. The NHS backlog now reaches over 5 million people – almost one in every 10 people in England – and research from the healthcare policy think tank the Kings Fund released this month showed that 7% of patients on waiting lists in the UK’s most deprived areas wait a year or more for treatment. In more affluent areas, this figure is reduced to 4%. Between 2020 and 2021 waiting lists have grown by 55% in poor areas, outstripping 36% in richer areas. For a pandemic that has profoundly affected, by both direct and indirect means, the poorest in the UK, the continuing impact on ability to access healthcare in deprived areas is only likely to continue to increase mortality.
Research from the Trust for London demonstrated that available jobs had fallen by 5% in London since February 2020 – seemingly a small number, but resulting in 209,000 fewer jobs available. Those in deprived areas, from poorer backgrounds, without extensive education, or who have no right to work in the UK are all groups that inhabited the grey and black market economies, essentially hidden or very casual employment which is difficult to reflect in metrics and which were not eligible for furlough schemes. Trust for London found a 128% increase in those accessing food banks, compared to the same period in 2019, with the increase in the rest of England at 56%.
The striking thing about the institution of lockdowns is the obvious inequality of asking people to stay at home, when a significant proportion of people in the UK live on the periphery of homelessness in irregular conditions such as in an ‘couch-surfing’ or over-density rental situation. Legislators who own their own home – especially if this is a large one in some leafy constituency – giving stay at home orders leaves a bad taste in the mouth, when one considers the parlous state of social housing and the private rental market. Research from the Social Market Foundation has demonstrated that ‘in England, 25% of privately rented homes fail to meet the decent homes standard, compared to 13% of social rented homes and 19% of owner-occupied homes. Some 670,000 privately rented houses have a Category 1 Hazard, a hazard that is deemed a serious and immediate risk to health’. Many people in deprived areas live in homes that are profoundly overpopulated and actively damaging to health, or were in precarious situations such as illegal subletting or a couch-surfing arrangement. Formal lockdowns and rules based on households presented a cheeringly middle-class image of domesticity which failed to take into account the parlous situation of housing across the country.
With the Ministry for Housing, Communities and Local Government now given the rather nu-speak title of ‘Department for Levelling Up’, the government needs to think carefully about how the after-effects of Covid-19 will be managed across deprived areas, those that were hit hardest both by the effects of the virus on health, and will continue to be affected by the long-term socioeconomic factors that lockdowns and insecurity of employment and housing only worsened. The data, at least on that point, is clear.