Policy responses to the COVID-19 pandemic must consider the complex interplay between socio-economic status and health disparities, according to a recent analysis led by a team of University of Toronto researchers.
The researchers’ paper, published in the British Medical Journal, argues that poor, vulnerable and marginalized populations, and people with complex needs, are bearing the brunt of both the virus and the strategies used to contain it.
“Principles and methods drawn from decades of work showing that lower socio-economic status is associated with poorer health should guide efforts to monitor and mitigate the impact of the COVID-19 pandemic and our efforts to contain it,” said Geoff Anderson, professor at the Institute of Health Policy, Management and Evaluation (IHPME) at the Dalla Lana School of Public Health, and lead author on the paper.
While containment strategies such as physical distancing have helped to “flatten the curve” and reduce strain on Canada’s health-care system, they have also had negative impacts on employment, social interaction and family relationships. These impacts are likely to be worse for people in lower socio-economic groups, the researchers argue.
For example, a recent ICES report found Ontarians living in marginalized neighbourhoods – as measured by ethnic concentration, residential instability, material deprivation and income – are more likely to test positive for COVID-19.
“There are deaths and quality of life impacts of contracting COVID-19 and there are deaths and quality of life impacts associated with the emergency response measures put in place to prevent spread of COVID-19,” said Walter Wodchis, professor at IHPME and co-author on the paper.
“We must ensure that inequities in socio-economic status, age and ethnicity are measured and evaluated on both sides of this equation for appropriate policy responses,” said Wodchis, who is also a research chair in implementation and evaluation science at Trillium Health Partners’ Institute for Better Health.
What’s needed, according to the research team, which also included U of T President Emeritus David Naylor, a professor at the Faculty of Medicine, is timely, reliable data to identify those at increased risk, along with proactive policies that support at-risk groups and mitigate further inequity.
“A socio-economic status disparities lens would lead us to focus on protecting the most vulnerable members of our society and help countries to better, anticipate, mitigate and redress the inequitable health and social effects of the COVID-19 pandemic” said Patrick Feng, a co-author based in IHPME.