Pandemic inequalities: emerging infectious diseases and health equity

Abstract

The frequency and scale of Emerging Infectious Diseases (EIDs) with pandemic potential has been increasing over the last two decades and, as COVID-19 has shown, such zoonotic spill-over events are an increasing threat to public health globally. There has been considerable research into EIDs – especially in the case of COVID-19. However, most of this has focused on disease emergence, symptom identification, chains of transmission, case prevalence and mortality as well as prevention and treatment. Much less attention has been paid to health equity concerns and the relationship between socio-economic inequalities and the spread, scale and resolution of EID pandemics. This commentary article therefore explores socio-economic inequalities in the nature of EID pandemics. Drawing on three diverse case studies (Zika, Ebola, COVID-19), it hypothesises the four main pathways linking inequality and infectious disease (unequal exposure, unequal transmission, unequal susceptibility, unequal treatment) – setting out a new model for understanding EIDs and health inequalities. It concludes by considering the research directions and policy actions needed to reduce inequalities in future EID outbreaks.

Temporal Dynamics of Socioeconomic Inequalities in COVID-19 Outcomes Over the Course of the Pandemic—A Scoping Review

“…In this stage, socioeconomic differences in disease distribution may occur at random. However, as Bambra conceptualized paths of socioeconomic inequalities in emerging infectious diseases, unequal exposures due to different sets of resources and conditions may contribute to socioeconomic inequalities in health and disease [ 72 , 73 ]. In the case of the early COVID-19 pandemic, better-off populations may have been at higher risk due to their higher mobility.…”

“…A possible explanation for higher mortality rates in socioeconomically disadvantaged populations could be the well-described higher prevalence of chronic health conditions that are risk factors for severe and fatal COVID-19 in populations with a lower socioeconomic level. This leads to unequal susceptibility as described by Bambra [ 72 ]. Furthermore, populations with a lower socioeconomic level usually face greater barriers in accessing healthcare or even have geographical barriers, especially in rural regions [ 13 , 32 , 33 , 35 , 37 , 49 , 51 ].…”

Regional disparities in SARS-CoV-2 infections by labour market indicators: a spatial panel analysis using nationwide German data on notified infections

“…The study has several limitations: First, we again need to consider that work and employment are possibly one—though it is not the only factor that may explain regional variations of infection rates, and other factors equally deserve attention in future studies to understand varying infection risks [ 50 , 51 ]. Beside those just named above, these may also be more general aspects not necessarily related to socioeconomic deprivation, such as meteorological information (e.g., number of raining days or average temperature), sanitation or hygiene, public transport systems or policy interventions at the regional level.…”

Emergência E Ressurgimento De Doenças Infecciosas: Os Desafios Das Fronteiras Sanitárias

“…A investigação sobre microcefalia no Brasil, encontrou associações com as piores condições de vida da população, com uma taxa de prevalência cinco vezes maior na população de baixa renda do que na população com melhores condições de vida (Souza et al, 2018). Maior exposição às picadas do mosquito se deve, principalmente, ao saneamento precário e a superlotação nas comunidades brasileiras com baixa renda (Souza et al, 2018;Bambra, 2022).…”

“…A frequência e a escala das doenças Infecciosas emergentes com potencial pandêmico aumentaram nas últimas duas décadas, e como ficou claro com a COVID-19, são uma ameaça crescente para a saúde pública mundial (Bambra et al, 2022). Já as doenças reemergentes indicam uma mudança no comportamento epidemiológico de doenças conhecidas, que haviam sido contidas, mas que voltaram a configurar ameaça a saúde humana, como por exemplo o sarampo e recentemente, o surto da varíola do macaco (Wang et al, WHO, 2017;WHO, 2022).…”