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COVID-19 and Regional Inequalities in Health and Wealth

EPDF and EPUB available Open Access under CC-BY-NC-ND licence.

Whilst the COVID-19 pandemic affected all parts of the country, it did not do so equally. Northern England was hit the hardest, exposing more than ever the extent of regional inequalities in health and wealth.

Using original data analysis from a wide range of sources, this book demonstrates how COVID-19 has impacted the country unequally in terms of mortality, mental health and the economy.

The book provides a striking empirical overview of the impact of the pandemic on regional inequalities and explores why the North fared worse.

It sets out what needs to be learnt from the pandemic to prevent regional inequality growing and to reduce inequalities in health and wealth in the future.

Open access

This chapter describes the pre-pandemic context of inequalities in health and wealth in England. It provides a brief historical overview of the North–South regional health and economic divide. This chapter also introduces the reader to the core concepts and theories which underpin the rest of the book including: the deprivation amplification thesis, intersectionality, and the syndemic pandemic concept. It discusses common approaches in the field of health geography to understanding place-based health inequalities, including: compositional, contextual, relational and political economy approaches. It concludes by providing a summary for each of the following chapters of the book.

Open access

This discussion chapter places the results from the empirical analyses in Chapters Two–Four within the wider conceptual and empirical context. It sets out how the regional inequalities in health and wealth that have been identified during the pandemic reflect longer-term health divides across the country. Drawing on the conceptual material outlined in the introductory chapter, this chapter reflects on how, through the concepts of the syndemic pandemic, intersectionality and of deprivation amplification, COVID-19 had such an unequal regional impact.

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This chapter examines regional trends and inequalities in the ‘parallel pandemics’ of mental health, hospital pressure, and long COVID. Using mental health survey data, NHS prescribing data, NHS hospital data, and official estimates of long COVID prevalence, the chapter shows that these three parallel pandemics have been regionally unequal with worse outcomes in the North. In addition, the analyses reveal stark intersectional inequalities in self-reported mental health by ethnicity and gender in the North.

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This chapter examines the regional impact of the COVID-19 economic crisis. Through analysing ONS data it examines regional trends in furlough rates, unemployment rates, and wage levels. The chapter shows that the negative economic impacts of the pandemic were higher in the North. Productivity costs to the UK economy from higher COVID-19 mortality (Chapter Two), mental health morbidity (Chapter Three) are calculated and it is found that the North was disproportionately affected. The chapter also explores the differing levels of COVID-19 restrictions and finds harsher lockdown restrictions were experienced in the North.

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This chapter concludes by reflecting on what can be done to reduce health inequalities. Drawing on international case studies of when inequalities in health have been reduced, this chapter outlines what public policy response is needed now to reduce regional health inequalities so that they do not increase for future generations and in any future pandemics.

Open access

This chapter presents original analyses of regional inequalities in COVID-19 mortality in the first year (pre-vaccine) of the pandemic. Using mortality data and a conceptual model to guide the analyses, this chapter demonstrates that COVID-19 deaths were higher in the North of England. It also demonstrates that this higher mortality in the North was not just a case of higher levels of area-level deprivation, but a case of deprivation amplification.

Open access