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Inequality in access to health and care services during lockdown – Findings from the COVID-19 survey in five UK national longitudinal studies

Topriceanu, C-C; Wong, A; Moon, J; Hughes, A; Bann, D; Chaturvedi, N; Patalay, P; ... Captur, G; + view all (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

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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.

Type: Working / discussion paper
Title: Inequality in access to health and care services during lockdown – Findings from the COVID-19 survey in five UK national longitudinal studies
Open access status: An open access version is available from UCL Discovery
DOI: 10.1101/2020.09.12.20191973
Publisher version: https://doi.org/10.1101/2020.09.12.20191973
Language: English
Additional information: This version is the version of record. For information on re-use, please refer to the publisher’s terms and conditions.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Institute of Cardiovascular Science > Population Science and Experimental Medicine > MRC Unit for Lifelong Hlth and Ageing
UCL > Provost and Vice Provost Offices > UCL SLASH
UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of S&HS
UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of S&HS > Dept of Economics
URI: https://discovery.ucl.ac.uk/id/eprint/10117384
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