Explaining the deprivation gap in COVID-19 mortality rates: A decomposition analysis of geographical inequalities in England

Albani, Viviana; Welsh, Claire; Brown, Heather; Matthews, Fiona; Bambra, Clare

doi:10.1016/j.socscimed.2022.115319

Cited by 12 publications

(14 citation statements)

References 68 publications

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“… 25 Such an understanding would compel addressing the structural antecedents of distress among healthcare workers in both community and acute settings, such as improved working conditions and better delineation of responsibilities between clinicians and senior management. 26 Furthermore, structural and syndemic competencies are required for clinical care, prevention and when encountering pandemics. 27 Finally, we would argue, in line with Mendenhall et al, 27 that investing in interventions such as community support groups and community mental health interventions and ‘elevating the cultural, political, and social priorities of people and communities’ might help to mitigate the effects of syndemics on both patients and healthcare workers alike.…”

Section: Discussionmentioning

confidence: 99%

Work-related experiences of consultant psychiatrists during the COVID-19 response: qualitative analysis

et al. 2023

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Background Research has begun to draw attention to the challenges mental health professionals faced in delivering services during the COVID-19 pandemic response. However, few studies have examined the specific experiences of consultant psychiatrists. Aims To examine the work-related experiences and psychosocial needs of consultant psychiatrists situated in the Republic of Ireland arising from the COVID-19 response. Method We interviewed 18 consultant psychiatrists and analysed data using inductive thematic analysis. Results Work-related experience of participants was characterised by increased workload associated with assumption of guardianship of physical and mental health of vulnerable patients. Unintended consequences of public health restrictions increased case complexity, limited availability of alternative supports and hindered the practice of psychiatry, including inhibiting peer support systems for psychiatrists. Participants perceived available psychological supports as generally unsuitable for their needs given their specialty. Long-standing under-resourcing, mistrust in management and high levels of burnout exacerbated the psychological burden of the COVID-19 response. Conclusions The challenges of leading mental health services were evident in the increased complexity involved in caring for vulnerable patients during the pandemic, contributing to uncertainty, loss of control and moral distress among participants. These dynamics worked synergistically with pre-existing system-level failures, eroding capacity to mount an effective response. The longer-term psychological well-being of consultant psychiatrists – as well as the pandemic preparedness of healthcare systems – is contingent on implementation of policies addressing long-standing under-investment in the services vulnerable populations rely on, not least community mental health services.

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Section: Discussionmentioning

confidence: 99%

Work-related experiences of consultant psychiatrists during the COVID-19 response: qualitative analysis

et al. 2023

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“…In related work, we have empirically tested the contribution of the first four of these pathways (exposure, transmission, vulnerability, susceptibility) to explaining the deprivation gap in COVID-19 deaths during the first wave of the pandemic (January to July 2020) in England (Albani et al, 2022). We used decomposition methods to explicitly quantify the independent contribution of four of the inequality pathways (exposure, transmission, vulnerability, susceptibility) in explaining the more severe COVID-19 outcomes in 205 of the most deprived local authorities compared to the rest.…”

Section: The Syndemic Pandemicmentioning

confidence: 99%

Northern Exposure

Bambra¹,

MUNFORD²,

KHAVANDI³

et al. 2023

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“…Other important factors associated with infections noted in Alidadi and Sharifi (2022) include household crowding, use of public transport and older populations. Elsewhere in the literature, economic deprivation is a very important factor associated with various outcomes including infections, hospitalisations and deaths (Albani et al, 2022; García‐Peña et al, 2023). Analyses by Albani et al (2022) suggests that factors such as household crowding and poverty help to explain the impact in deprived communities.…”

Section: Theoretical Frameworkmentioning

confidence: 99%

“…Elsewhere in the literature, economic deprivation is a very important factor associated with various outcomes including infections, hospitalisations and deaths (Albani et al, 2022; García‐Peña et al, 2023). Analyses by Albani et al (2022) suggests that factors such as household crowding and poverty help to explain the impact in deprived communities. Relatedly, occupational structures are likely to be important with evidence that the proportion of people who work in health care and related occupations and those working in service sectors are significantly positively associated with infections, while the proportion working in professional and managerial occupations and with higher levels of education are negatively associated (López‐Gay et al, 2021; Tang et al, 2022).…”

Section: Theoretical Frameworkmentioning

confidence: 99%

Impacts of the COVID‐19 pandemic on ethnically diverse communities

O’Donnell

Evans

Reynolds

2023

Population Space and Place

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Ethnically diverse communities are potentially exposed to multiple and compounding impacts of COVID‐19, owing to social and cultural interactions, household crowding, employment in exposed occupations and other socioeconomic conditions. In this study, we quantify and analyse these impacts for local councils in Australia's two largest cities, Sydney and Melbourne across five outcomes: infections, excess deaths, the speed of vaccination, unemployment and breaches of public health orders issued by the Police. Residents of the most linguistically diverse councils in Sydney were 5.6 times more likely to have contracted COVID‐19 up to 1 December 2021 than residents of the least diverse councils and 2.9 times more likely in the most diverse councils in Melbourne. Excess deaths were 27% higher in diverse communities across 2020 and 2021, the time spent unvaccinated was 1.3 times higher and the increase in the unemployment rate was between 1.7 and 5.1 times higher depending on the city. Public health breaches were 2.2 times higher in the most diverse areas of Sydney. Spatial regression models indicate that the differences in infections, excess deaths, speed of vaccination and public health breaches are largely explained by the economic characteristics of local communities. These disproportionate impacts appear to reflect and reinforce social and economic inequalities and pose a threat to social cohesion.

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Explaining the deprivation gap in COVID-19 mortality rates: A decomposition analysis of geographical inequalities in England

Cited by 12 publications

References 68 publications

Work-related experiences of consultant psychiatrists during the COVID-19 response: qualitative analysis

Work-related experiences of consultant psychiatrists during the COVID-19 response: qualitative analysis

Northern Exposure

Impacts of the COVID‐19 pandemic on ethnically diverse communities

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