Area level deprivation and monthly COVID-19 cases: The impact of government policy in England

Morrissey, Karyn; Spooner, Fiona; Salter, James; Shaddick, Gavin

doi:10.1016/j.socscimed.2021.114413

Cited by 45 publications

(60 citation statements)

References 32 publications

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“…Previous work has focused on comparing COVID-19 mortality rates between areas of England using set time periods without considering the evolution of the inequalities reported (21), or have identified inequalities in case rates and other metrics (13). Using mortality data removes some of the uncertainty surrounding early case ascertainment, since early in the English epidemic, testing was only being performed in hospitals on symptomatic individuals, and so many infections would not have been recorded.…”

Section: Resultsmentioning

confidence: 99%

“…Most countries employed national lockdowns of varying duration and severity to mitigate disease spread, alongside social distancing and hygiene-related advice. The factors used to determine when a lockdown should begin or cease were rarely transparent, but most appeared to reduce infection rates to some degree after a lag phase, and saw a rebound of varying size following their release (11)(12)(13). The first confirmed cases of COVID-19 were recorded in England in York in January 2020 and the first death in England was on March 5 th .…”

Section: Introductionmentioning

confidence: 99%

“…It has been noted that when national epidemic dynamics are used to examine population health, they can mask important sub-national variation in disease spread, thus mitigation strategies that rely solely on the national data to inform implementation timings could inadvertently worsen health inequalities across geographical areas (11,13). Previous descriptive studies and reports of inequalities in COVID-19 mortality have only focused on cumulative measures over set timespans, without documenting the disparities in evolution of mortality rates (5,14,15), have been restricted to higher geographies (18), or have not focussed on the effects of lockdowns (7,19).…”

Section: Introductionmentioning

confidence: 99%

“…Face-toface education was suspended and many workplaces closed down -and staff furloughedparticularly in the hospitality, travel and retail sectors. As nationally cases, hospitalisation and death rates started to fall the lockdown was gradually released over a period of several monthsculminating in the so-called 'Super Saturday' on 2020-07-04 when pubs, restaurants, hairdressers, and cinemas reopened -albeit with strict social distancing rules (13).…”

Section: Introductionmentioning

confidence: 99%

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Geographical inequalities in the evolution of the COVID-19 pandemic: An ecological study of inequalities in mortality in the first wave and the effects of the first national lockdown in England

Welsh

Albani

Matthews

et al. 2021

Preprint

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Objectives This is the first study to examine how geographical inequalities in COVID–19 mortality rates evolved in England, and whether the first national lockdown modified them. This analysis provides important lessons to inform public health planning to reduce inequalities in any future pandemics. Design Longitudinal ecological study Setting 307 Lower-tier local authorities in England Primary outcome measure Age-standardised COVID–19 mortality rates by local authority and decile of index of multiple deprivation. Results Local authorities that started recording COVID–19 deaths earlier tended to be more deprived, and more deprived authorities saw faster increases in their death rates. By 2020–04–06 (week 15, the time the March 23rd lockdown could have begun affecting deaths) the cumulative death rate in local authorities in the two most deprived deciles of IMD was 54% higher than the rate in the two least deprived deciles. By 2020–07–04 (week 27), this gap had narrowed to 29%. Thus, inequalities in mortality rates by decile of deprivation persisted throughout the first wave, but reduced somewhat during the lockdown. Conclusions This study found significant differences in the dynamics of COVID–19 mortality at the local authority level, resulting in inequalities in cumulative mortality rates during the first wave of the pandemic. The first lockdown in England was fairly strict – and the study found that it particularly benefited those living in the more deprived local authorities. Care should be taken to implement lockdowns early enough, in the right places – and at a sufficiently strict level – to maximally benefit all communities, and reduce inequalities.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Geographical inequalities in the evolution of the COVID-19 pandemic: An ecological study of inequalities in mortality in the first wave and the effects of the first national lockdown in England

Welsh

Albani

Matthews

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…Research has consistently shown that neighbourhood deprivation is associated with higher COVID-19 case rates [10][11][12], and recent work suggests this was more true between August and October 2020, than previously. However, this association with deprivation was altered after the first period of localised tiered restrictions, with the most deprived areas reporting lowest COVID-19 case rates in November and December [2]. As yet, there is a lack of work investigating the extent to which this reversal was reflected in mortality, and furthermore how this change was structured geographically.…”

Section: Introductionmentioning

confidence: 99%

Continuing inequalities in COVID-19 mortality in England and Wales, and the changing importance of regional, over local, deprivation

Griffith

Owen

Manley

et al. 2022

Preprint

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Background: Observational studies have highlighted that where individuals live is far more important for risk of dying with COVID-19, than for dying of other causes. Deprivation is commonly proposed as explaining such differences. During the period of localised restrictions in late 2020, areas with higher restrictions tended to be more deprived. We explore how this impacted the relationship between deprivation and mortality and see whether local or regional deprivation matters more for inequalities in COVID-19 mortality. Methods: We use publicly available population data on deaths due to COVID-19 and all-cause mortality between March 2020 and April 2021 to investigate the scale of spatial inequalities. We use a multiscale approach to simultaneously consider three spatial scales through which processes driving inequalities may act. We go on to explore whether deprivation explains such inequalities. Results Adjusting for population age structure and number of care homes, we find highest regional inequality in October 2020, with a COVID-19 mortality rate ratio of 5.86 (95% CI 3.31 to 19.00) for the median between-region comparison. We find spatial context is most important, and spatial inequalities higher, during periods of low mortality. Almost all unexplained spatial inequality in October 2020 is removed by adjusting for deprivation. During October 2020, one standard deviation increase in regional deprivation was associated with 2.45 times higher local mortality (95% CI, 1.75 to 3.48). Conclusions Spatial inequalities are greatest in periods of lowest overall mortality, implying that as mortality declines it does not do so equally. During the prolonged period of low restrictions and low mortality in summer 2020, spatial inequalities strongly increased. Contrary to previous months, we show that the strong spatial patterning during autumn 2020 is almost entirely explained by deprivation. As overall mortality declines, policymakers must be proactive in detecting areas where this is not happening, or risk worsening already strong health inequalities.

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Socioeconomic disadvantage and engagement with digital contact tracing for COVID-19 in Western Sydney: A secondary analysis of surveillance data

Silberberg,

Young,

Bag

et al. 2023

Australian and New Zealand Journal of Public Health

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Area level deprivation and monthly COVID-19 cases: The impact of government policy in England

Cited by 45 publications

References 32 publications

Geographical inequalities in the evolution of the COVID-19 pandemic: An ecological study of inequalities in mortality in the first wave and the effects of the first national lockdown in England

Geographical inequalities in the evolution of the COVID-19 pandemic: An ecological study of inequalities in mortality in the first wave and the effects of the first national lockdown in England

Continuing inequalities in COVID-19 mortality in England and Wales, and the changing importance of regional, over local, deprivation

Socioeconomic disadvantage and engagement with digital contact tracing for COVID-19 in Western Sydney: A secondary analysis of surveillance data

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