3: Silenced voices, unequal impact
Addressing health inequities and discrimination in co-producing health and care during the pandemic and beyond
The COVID-19 pandemic has shone a disturbing light on the stark inequities and discrimination that exists in the United Kingdom. Social, environmental, and economic inequalities in society have been exposed as disproportionately damaging to the health and wellbeing of a number of groups. Inequalities in COVID-19 mortality rates illustrate a similar social gradient to that seen for all causes of death and in the accessibility of healthcare (Marmot et al, 2020). The COVID-19 Marmot Review (Marmot et al, 2020) has illustrated that this inequity in society lies at the heart of why some groups have higher mortality rates and have been more severely affected by the pandemic than others. For example, Office for National Statistics, have shown the unequal mortality impact of the virus on Black and Asian groups (ONS 16 Oct, 2020a), those with disabilities (ONS 11 Feb, 2021), and those living in the most deprived areas (ONS 28 Aug, 2020b). Overall, the Marmot Review on the pandemic and health inequalities, has shown that the likelihood of mortality from COVID-19 is lower among people who are wealthy, working from home, living in good quality housing, White, and have no underlying health conditions (Marmot et al, 2020). This situation is why tackling discrimination and ensuring equity and social justice for excluded groups, including in the way we conduct research with these groups, is so essential in co-producing health and social care.
In the UK, as in other developed countries, public involvement is now established as a central aspect of health research policy (Boote et al, 2015) and practice (NHS Constitution, 2012).
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