The experiences of socially vulnerable groups in England during the COVID-19 pandemic: A rapid health needs assessment

Abstract

Objectives This rapid health needs assessment was undertaken to urgently identify the needs of socially vulnerable groups arising during the first wave of cases of the COVID-19 pandemic in England. The objective was to develop recommendations for policy makers and stakeholders to mitigate adverse impacts on socially vulnerable groups throughout the COVID-19 response and recovery period. Study design Rapid health needs assessment. Methods The needs assessment employed qualitative methods to systematically collect data about the knowledge and views of key informants through semi-structured interviews and focus groups. Participants were either topic experts providing services to socially vulnerable groups who routinely face barriers to healthcare access or experts by experience. Participants included people experiencing homelessness, sex workers, people from Gypsy, Roma and Traveller communities and people facing challenges due to their immigration status. Data was collected over a week period in April/May 2020 and followed by thematic analysis to examine interview transcripts. Results Forty-two participants were included in the study, half of whom were experts by experience. Challenges with accessing and following COVID-19 information and government guidance were described as affecting all groups, due to exclusion from digital technology, translated resources, tailored support and adequate housing. Altered delivery of healthcare services, such as the closure of outreach and drop-in services, remote consultations, and online patient registration, were noted by interviewees as worsening existing barriers to accessing healthcare. Being charged for NHS care remained a key fear for migrants. All groups’ access to income, education and social support were reported as being impacted by service closures and job losses, putting them at higher risk of destitution. Isolation, loneliness and deteriorating mental health were frequently reported. Conclusions This assessment has highlighted the disproportionate impact of the COVID-19 pandemic on socially vulnerable groups and demonstrated a plethora of unmet needs. As the effects of COVID-19 continue, it is imperative that the needs of these groups are urgently and explicitly addressed and prioritised. This is essential to promote engagement with test and trace services, enable isolation adherence, and achieve high vaccine uptake in socially vulnerable populations.

Perspectives on an enhanced ‘Improving Access to Psychological Therapies’ (IAPT) service addressing the wider determinants of mental health: a qualitative study.

“…Thirdly, modifying the assessment process to give service-users more information about what the support entails rather than focusing only on needs and risk, could help establish trust and empathy from the start [35]. Fourthly, to enable an accessible, holistic service, service-users could be given a choice of in-person or remote delivery, and digital education should be given accordingly [36,37]. As identi ed previously, recruitment to diversify the workforce should be prioritised to ensure the relevance and perceived accessibility of support for groups such as BAME [38].…”

A county-level analysis of association between social vulnerability and COVID-19 cases in Khuzestan Province, Iran

“…The analysis of infection and mortality rates has shown that specific individual and spatial characteristics, income levels, and social positions of people, especially multidimensional vulnerability criteria are associated with a higher or lower probability of infection with the COVID-19 virus [ 66 ][ 67 ]. Accordingly, the COVID-19 pandemic has had major impacts on life everywhere, but some countries and communities have been affected disproportionately [ 68 ]. When disasters of any kind occur, socially vulnerable people are at the greatest risk.…”

Desperately Seeking Intersectionality in Digital Health Disparity Research: Narrative Review to Inform a Richer Theorization of Multiple Disadvantage

“…The 17 peer-reviewed research papers (summarized in Table 1) comprised 1 (6%) systematic review [48], 1 (6%) narrative synthesis [49], 7 (41%) retrospective audits of medical records [56,57,[59][60][61][62]70], 3 (18%) quantitative surveys [5,50,58], and 5 (29%) qualitative studies based on semistructured interviews [5,51,52,54,55]. A further 37% (10/27) of the articles (Table 2) commented on others' research, reflected on findings from clinical practice, or proposed measures to reduce digital health disparities [11,21,22,[63][64][65][66][67][68][69].…”