Health Inequalities in the Time of COVID-19: The Globally Reinforcing Need to Strengthen Health Inequalities Research Capacities

Abstract

The full impact of coronavirus disease 2019 (COVID-19) is yet to be well established; however, as the pandemic spreads, and early results emerge, unmet needs are being revealed, and pressing questions are being asked about who is most affected, how, where, and in what ways government responses might be exacerbating inequalities. A number of scholars have called for more in-depth critical research on COVID-19 and health inequalities to produce a strong empirical evidence based on these issues. There are also justifiable concerns about the scarcity of health-equity actions oriented analyses of the situation and calls for more empirical evidence on COVID-19 and health inequalities. A preliminary condition to establish this type of information is strong capacity to conduct health inequalities research. Worldwide, however, this type of capacity is limited, which, alongside other challenges, will likely hinder capacities of many countries to develop comprehensive equity-oriented COVID-19 analyses, and adequate responses to present and future crises. The current pandemic reinforces the pending need to invest in and strengthen these research capacities. These capacities must be supported by widespread recognition and concern, cognitive social capital, and greater commitment to coordinated, transparent action, and responsibility. Otherwise, we will remain inadequately prepared to respond and meet our society’s unmet needs.

COVID-19 Inequalities: Individual and Area Socioeconomic Factors (Aragón, Spain)

“…It will be necessary to monitor the measures implemented in order to know their impact on health inequalities in the short and medium term. Finally, we must not overlook the fact that a post-COVID scenario will probably lead to a new global economic crisis, especially if austerity measures are implemented again [ 14 , 40 ]. It is crucial, therefore, to learn from mistakes of the past and promote a change of scenario, where increasing social services for the whole population becomes a reality.…”

Inequalities in COVID-19 inequalities research: who had the capacity to respond?

“…In terms of study limitations, while our results are based only on empirical articles published in international academic journals, they provide a useful overview of the global dynamic and patterns within this newly emerging scientific field, and pose many interesting research questions that require further exploration. Further research is needed to expand on these findings, to establish more in depth understanding of why and how these trends and outcomes might have occurred, as well as the type of COVID-19 inequalities research that has been produced in different countries (3), as this may indicate priority areas for action. In addition, it would be important to assess the relationship between productivity research rates by country and other variables of interest, such as the share of the GDP invested in research and development, to further explore the determinants of these research capacities.…”

“…Collectively, what is clear is the need for every country to develop stronger capacity to collect timely, reliable, disaggregated by different social groups (e.g. social class, age, gender, ethnicity/race, geography), to establish comprehensive COVID-19 data collection systems to be able to report and monitor on health inequalities (3, 11, 12, 17, 18, 19, 20). In addition, ethical principles must be instilled in future research collaborations to ensure more equitable partnerships (12, 21, 22).…”

“…Since the start of the COVID-19 pandemic social inequalities have been exacerbated, there has been a heightened awareness of the need to empirically describe and analyse health inequalities (1, 2), and report on context-specific actions to effectively address them (2, 3). In many ways, the COVID-19 pandemic can be interpreted as a sort of natural experiment that has been testing countries’ capacities and scientific preparedness to actively and effectively respond to such crises, to gather and comprehensively analyse health and socio-demographic data, and to develop comprehensive equity-oriented COVID-19 analyses (3), as well as collaborate, at local, national and global levels for a common cause.…”

“…Prior to the pandemic, evidence demonstrated that inequalities existed in this type of research capacity globally (4), which has likely hindered many countries’ research capacity and preparedness to respond to the COVID-19 pandemic (3). At present, many research questions appear: What do we know about the emerging COVID-19 inequalities research field?…”