Health Inequalities and Ethnic Vulnerabilities During COVID-19 in the UK: A Reflection on the PHE Reports

Keys, C.; Nanayakkara, G.; Onyejekwe, Chisa; Sah, Rajeeb Kumar; Wright, Toni

doi:10.1007/s10691-020-09446-y

Cited by 27 publications

(27 citation statements)

References 26 publications

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“…Over a year into the COVID-19 pandemic, ethnic minority communities in the UK and elsewhere continue to be affected by a disproportionate burden of COVID-19 associated morbidity and mortality [1]. Increased COVID-19 risk has been attributed to a wide range of factors [2,3].…”

mentioning

confidence: 99%

Specific COVID-19 messaging targeting ethnic minority communities

Ala¹,

Edge²,

Zumla³

et al. 2021

EClinicalMedicine

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mentioning

confidence: 99%

Specific COVID-19 messaging targeting ethnic minority communities

Ala¹,

Edge²,

Zumla³

et al. 2021

EClinicalMedicine

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“…Strong community engagement is considered one of the most important strategies to combat infodemics (25). As in other countries, the COVID-19 pandemic in Melbourne disproportionately impacted those living in socially and economically vulnerable communities (26,27). These populations are exposed to signi cant vulnerabilities, including poverty, overcrowded and/or large household sizes, insecure employment, and poor access to accurate information in preferred language.…”

Section: Discussionmentioning

confidence: 99%

Rapid implementation of a community monitoring service for COVID-19: Staff and patient experiences and perceptions

Jessup

Awad

Beauchamp

et al. 2022

Preprint

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BackgroundThe coronavirus pandemic (COVID-19) has put unprecedented demand on health services. Provision of support and monitoring for patients with mild to moderate illness who are at risk of deterioration may allow hospitals to reduce the risk of exposure for health care workers, assist with reducing community spread, and improve capacity to accommodate those with more severe illness.MethodsThis is a data-based triangulated qualitative study using staff interviews and patient surveys to explore the experience of implementation and delivery of a COVID-19 community monitoring service. Interview questions were guided by the Consolidated Framework for Implementation Research (CFIR). Interviews were coded and analysed using a grounded inductive approach and final themes were related back to the CFIR. Patient experience was captured using a survey and descriptive statistics were used to describe categorical responses while content analysis was used to analyse free text responses.ResultsAll 15 staff in the service were interviewed and 271 patients were surveyed (42%). A total of four final overarching themes emerged, service commissioning enablers, service delivery benefits for patients, fragmentation of care, and workforce strengths, with subthemes aligned with 18 CFIR constructs in the staff interviews. Staff perception of patient experience was supported by results of the patient survey. ConclusionRapid commissioning of this community monitoring service was enabled through shared resources, engaging a ready-to go workforce of furloughed staff, dividing tasks amongst senior personnel and having a flexible approach that allows for ongoing improvements following implementation. Benefits for patients included early identification of deterioration, as well as provision of accurate and trustworthy information to isolate safely at home. The main challenges experienced by both staff and patients was the multiple agencies involved in patient monitoring, which may be addressed in the future by attributing responsibility for monitoring to a single agency.

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“…Worldwidewe have seendisadvantagedcommunities suffering higher than average COVID-19 morbidity and mortality (9)(10)(11)(12), in part because of higher rates of transmission due to poverty and large household sizes, and insecure employment with a high exposure risk (13)(14)(15). In Australia, the impact of the pandemic has been greatest in communities where structural inequalities and social and economic disadvantage have been greatest (16).…”

Section: Introductionmentioning

confidence: 99%

Frequent Hospital Users with Limited English are Vulnerable to COVID-19 Misinformation: Results from A Cross-sectional Survey

Jessup

Bramston

Putrik

et al. 2021

Preprint

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BackgroundSuccessful public health responses to pandemics rely on individuals being able to access, clearly understand and easily interpret relevant information about symptoms, prevention, testing and containment strategies. Accessing and interpreting information during the pandemic has been difficult for many populations, particularly those experiencing social or economic disadvantage. The aim of this study was to understand how a population of frequent hospital users originating, from a disadvantaged population, have accessed and interpreted information during the COVID pandemic in Melbourne.MethodsCross sectional telephone survey of 200 frequent hospital users (115 with limited English proficiency) informed by the World Health Organisation’s “Rapid, simple, flexible behavioural insights on COVID-19”. Primary outcome measures included knowledge of symptoms, preventive strategies, government restrictions aimed at containment, and belief in misleading information. Secondary outcome measure was perceived trustworthiness of information which was measured using content analysis of open-ended questions. ResultsOverall, the survey participants had poor understanding of misleading information (69%). 41.2% were unable to accurately identify symptoms, while 35.8% were unable to identify preventative strategies. Just under 1/3 (30.2%) were unable to describe government restrictions. English-speaking participants were almost three times (OR 2.69, 95%CI 1.47;4.91) more likely tohave adequate knowledge about symptoms, were twice as likely to understand local restrictions (OR 2.10 95%CI 1.06; 4.19) and were 11 times more likely to recognise information that was misleading or incorrect (OR 11.52 95%CI 5.39; 24.60) than those with limited English. 50% of those surveyed stated that theytrusted all information that they read or heard, with on 20% stating that they were uncertain or untrusting of some information.ConclusionLimited English proficiency was strongly associated with inadequate knowledge of COVID-19 and much greater likelihood of believing widely circulating misinformation. In order to reduce transmission, morbidity and mortality associated with COVID-19, health authorities must tailor health messaging to disadvantaged populations to ensure they have adequate access, and understanding, of the information.

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Health Inequalities and Ethnic Vulnerabilities During COVID-19 in the UK: A Reflection on the PHE Reports

Cited by 27 publications

References 26 publications

Specific COVID-19 messaging targeting ethnic minority communities

Specific COVID-19 messaging targeting ethnic minority communities

Rapid implementation of a community monitoring service for COVID-19: Staff and patient experiences and perceptions

Frequent Hospital Users with Limited English are Vulnerable to COVID-19 Misinformation: Results from A Cross-sectional Survey

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