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  • Author or Editor: Josephine Ocloo x
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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 (). The COVID-19 Marmot Review () 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 (), those with disabilities (), and those living in the most deprived areas (). 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 (). 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.

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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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The first of a two-volume set, this book explores the need to put co-production and participatory approaches at the heart of responses to the pandemic and demonstrates how to do this. It gives voice to a diversity of marginalised communities to illustrate how they have been affected and to demonstrate why co-produced responses are so important.

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In this edited collection, our aim was to illustrate the value and means of co-production or, more specifically, why it is valuable and how it can be done. It is worth noting that our starting point for achieving this aim was reflecting on who has been disproportionately disadvantaged by the pandemic and how discrimination, marginalisation, and exclusion increased their vulnerability to both the COVID-19 virus (in terms of mortality and morbidity) and the implications of responses to its spread (in terms of relative access to resources, support, and involvement in key decision-making processes in research, policy, and practice). Our attention then turned to how we could ensure this book became a platform for these people, groups, and communities to share their experiences, insights, and expertise. As was outlined in the introduction to this volume, co-production has over time been defined and conceptualised in different ways. What our ambition for this book reveals is that central to our conceptualisation and practice of co-production in health and social care research, policy, and practice is an egalitarian imperative. That is, our primary interest in and advocation for co-production is as a means to ensuring that collaborative endeavours that explicitly address inequities in power can support marginalised communities, citizens, patients, and services users to create, shape, and improve health and social care research, policy, and practice.

Collectively, co-production endeavours must actively seek to promote health equity, by addressing inequity, diversity, and exclusion, and recognise the significant role that the social determinants of health have in creating and perpetuating inequalities in health and access to care.

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Open access