Unequal pandemic, fairer recovery

July 6, 2021

This report, produced by the Health Foundation's COVID-19 impact inquiry, is a comprehensive review of the factors that fuelled the UK’s COVID-19 death toll.

It highlights that:

  • poor health and existing inequalities left parts of the UK vulnerable to the virus and defined the contours of its devastating impact.
  • the pandemic has revealed stark differences in the health of the working age population – those younger than 65 in the poorest 10% of areas in England were almost four times more likely to die from COVID-19 than those in wealthiest. Recovery needs to prioritise creating opportunities for good health – a vital asset needed to 'level up' and rebuild the UK economy.
  • government restrictions, although needed to limit COVID-19's spread, have had wide-ranging consequences: from unmet health needs and mental health problems to education gaps, lost employment and financial insecurity.
  • some groups – young people, disabled people, ethnic minority communities and care home residents – have been more affected than others. Prisoners, homeless people and people experiencing sexual exploitation have also faced particular challenges.
  • type and quality of work, housing conditions, and access to financial support to self-isolate all contributed to increased exposure to the virus among working age adults.
  • the legacy of the financial crisis has had a direct bearing on our experience of the pandemic. Deep-rooted issues – poor health, increased financial insecurity and strained public services – left the UK more vulnerable to COVID-19’s health and economic impacts.
  • in recovery, there is an opportunity to create a healthier, more resilient society. Government must address the root causes of poor health and invest in people and their communities – their jobs, housing, education and communities.
  • ensuring the recovery improves health – as well as the economy – requires cross-government action to level up health. This will pay dividends for the nation’s health and prosperity in the longer term.

The COVID-19 pandemic has had a profound impact on people’s health and their livelihoods. What started as a health crisis rapidly turned into an economic emergency, with government taking unprecedented action to protect the nation. Despite these efforts, by mid-March 2021 the pandemic had led to 119,000 excess deaths in the UK and in 2020 caused a 9.9% drop in GDP.

Behind these overall figures lie the unequal burdens carried by different population groups and regions. The measures taken to suppress the virus have also affected people differently – with both immediate and longer term consequences for their health and wellbeing.

Although the pandemic is still ongoing, this report explores these impacts and the range of different, intersecting factors influencing them. It provides an initial assessment of the effects of the pandemic using evidence available up to May 2021.

Drawing on a broad range of sources, the inquiry report considers two main questions:

  1. How were people’s experiences of the pandemic influenced by their pre-existing health and health inequalities?
  2. What is the likely impact of actions taken in response to the pandemic on the nation’s health and health inequalities – now and in the future?

The pandemic has shown that health and wealth are inextricably connected. A sustainable recovery therefore presents an opportunity to create a healthier and prosperous society, to reduce the stark inequalities exposed by the pandemic.

Although it is beyond the intended scope to propose specific recommendations, the findings of this inquiry can direct policymakers at national and local level to some core issues that need attention as they take the recovery forward.