This essay examines the implications of the COVID-19 pandemic for health inequalities. It outlines historical and contemporary evidence of inequalities in pandemics—drawing on international research into the Spanish influenza pandemic of 1918, the H1N1 outbreak of 2009 and the emerging international estimates of socio-economic, ethnic and geographical inequalities in COVID-19 infection and mortality rates. It then examines how these inequalities in COVID-19 are related to existing inequalities in chronic diseases and the social determinants of health, arguing that we are experiencing a syndemic pandemic. It then explores the potential consequences for health inequalities of the lockdown measures implemented internationally as a response to the COVID-19 pandemic, focusing on the likely unequal impacts of the economic crisis. The essay concludes by reflecting on the longer-term public health policy responses needed to ensure that the COVID-19 pandemic does not increase health inequalities for future generations.
- Health inequalities
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Twitter Clare Bambra @ProfBambra.
Funding CB is a senior investigator in the National Institute for Health Research (NIHR) ARC North East and North Cumbria, NIHR Policy Research Unit in Behavioural Science, NIHR School of Public Health Research, the UK Prevention Research Partnership SIPHER: Systems science in Public Health and Health Economics Research consortium, and the Norwegian Research Council Centre for Global Health Inequalities Research. JF is a senior investigator in the NIHR ARC East of England. FM is a senior investigator in the NIHR Policy Research Unit in Ageing and Frailty. The views expressed in this publication are those of the authors and not necessarily those of the funders.
Competing interests We have read and understood the BMJ Group policy on declaration of interests and declare the following interests: none.
Patient consent for publication Not required.
Data sharing statement Data sharing not applicable as no datasets generated and/or analysed for this study.
Provenance and peer review Not commissioned; internally peer reviewed.