eprintid: 10117384 rev_number: 18 eprint_status: archive userid: 608 dir: disk0/10/11/73/84 datestamp: 2021-02-26 16:43:37 lastmod: 2021-12-23 23:03:38 status_changed: 2021-02-26 16:43:37 type: working_paper metadata_visibility: show creators_name: Topriceanu, C-C creators_name: Wong, A creators_name: Moon, J creators_name: Hughes, A creators_name: Bann, D creators_name: Chaturvedi, N creators_name: Patalay, P creators_name: Conti, G creators_name: Captur, G title: Inequality in access to health and care services during lockdown – Findings from the COVID-19 survey in five UK national longitudinal studies ispublished: pub divisions: UCL divisions: B02 divisions: D14 divisions: GA3 divisions: G17 divisions: B03 divisions: C03 divisions: F24 note: This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions. abstract: Background: Access to health services and adequate care is influenced by sex, ethnicity, socio-economic position (SEP) and burden of co-morbidities. However, it is unknown whether the COVID-19 pandemic further deepened these already existing health inequalities. / Methods: Participants were from five longitudinal age-homogenous British cohorts (born in 2001, 1990, 1970, 1958 and 1946). A web and telephone-based survey provided data on cancelled surgical or medical appointments, and the number of care hours received during the UK COVID-19 national lockdown. Using binary or ordered logistic regression, we evaluated whether these outcomes differed by sex, ethnicity, SEP and having a chronic illness. Adjustment was made for study-design, non-response weights, psychological distress, presence of children or adolescents in the household, keyworker status, and whether participants had received a shielding letter. Meta-analyses were performed across the cohorts and meta-regression evaluated the effect of age as a moderator. / Findings: 14891 participants were included. Females (OR 1·40, 95% confidence interval [1·27,1·55]) and those with a chronic illness (OR 1·84 [1·65-2·05]) experienced significantly more cancellations during lockdown (all p<0·0001). Ethnic minorities and those with a chronic illness required a higher number of care hours during the lockdown (both OR ≈2·00, all p<0·002). Age was not independently associated with either outcome in meta-regression. SEP was not associated with cancellation or care hours. / Interpretation: The UK government’s lockdown approach during the COVID-19 pandemic appears to have deepened existing health inequalities, impacting predominantly females, ethnic-minorities and those with chronic illnesses. Public health authorities need to implement urgent policies to ensure equitable access to health and care for all in preparation for a second wave. date: 2020-09-14 date_type: published publisher: MedRxiv official_url: https://doi.org/10.1101/2020.09.12.20191973 oa_status: green full_text_type: pub language: eng primo: open primo_central: open_green verified: verified_manual elements_id: 1815449 doi: 10.1101/2020.09.12.20191973 lyricists_name: Conti, Gabriella lyricists_name: Hughes, Alun lyricists_name: Wong, Andrew lyricists_id: GCONT23 lyricists_id: ADHUG42 lyricists_id: AWKWO84 actors_name: Conti, Gabriella actors_id: GCONT23 actors_role: owner full_text_status: public place_of_pub: Cold Spring Harbor, NY, USA pages: 18 citation: Topriceanu, C-C; Wong, A; Moon, J; Hughes, A; Bann, D; Chaturvedi, N; Patalay, P; ... Captur, G; + view all <#> Topriceanu, C-C; Wong, A; Moon, J; Hughes, A; Bann, D; Chaturvedi, N; Patalay, P; Conti, G; Captur, G; - view fewer <#> (2020) Inequality in access to health and care services during lockdown – Findings from the COVID-19 survey in five UK national longitudinal studies. MedRxiv: Cold Spring Harbor, NY, USA. Green open access document_url: https://discovery.ucl.ac.uk/id/eprint/10117384/1/Topriceanu_etal_MedXRiv_2020_Inequality%20in%20access%20to%20health%20and%20care%20services%20during%20lockdown.pdf