Working adults in England’s poorest areas four times more likely to die from Covid, report finds

Those employed in sectors which remained open throughout all three lockdowns were not only at highest risk of exposure, but also at higher risk of death due to existing poor health

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Working-age adults who live in England’s poorest areas are almost four times more likely to die from Covid-19 than those in the wealthiest parts of the country, a new report has found.

The mortality rate is 3.7 times higher for under-65s living in the poorest 10 per cent of neighbourhoods, according to research from the Health Foundation, which said that the “unequal burdens” of the pandemic have been “carried by different population groups and regions”.

The charity’s nine-month inquiry, which analysed data from the Office for National Statistics (ONS) and other sources, also found that six out of 10 people who died with Covid-19 between January and November 2020 were disabled.

In the opening months of the pandemic, 40 per cent of all UK deaths were among care home residents, the research showed. And black African men were 3.7 times more likely to die from Covid-19 than their white counterparts during the first wave, while Bangladeshi men were five times more at risk during the second wave.

The inquiry found that the way the UK recovered following the 2008 financial crisis had a “direct bearing” on the country’s resilience to the pandemic.

With public services “eroded” in the wake of the crash, stalling improvements in life expectancy and deepening inequalities over the next decade left the UK more vulnerable to the impacts of the pandemic, the Health Foundation said.

Factors such as the type and quality of people’s employment, housing conditions and access to financial support to self-isolate contributed to increased exposure to the virus among certain groups. Once exposed, people’s pre-existing physical and mental health made them more susceptible to severe outcomes.

Adults in their fifties and sixties living in the poorest areas were twice as likely to have at least two pre-existing long-term health conditions, such as lung disease or diabetes, according to analysis of primary care data.

“The pandemic has shown that health and wealth are inextricably connected,” the authors of the study wrote. “A sustainable recovery needs to create a stronger, more resilient economy and will require purposeful commitment to ‘level up’ health and reduce the stark inequalities exposed by the pandemic.”

Among workers, men in roles such as security guards, care workers and taxi drivers were more likely to die from Covid, the inquiry said. Those working in these types of sectors, which remained open throughout all three lockdowns, were not only at the highest risk of exposure, but also at higher risk of death due to existing poor health.

Low rates and coverage of statutory sick pay and difficulty in accessing isolation payments reduced people’s ability to self-isolate, increasing exposure and spread.

Figures from the ONS show there are 10.9 million key workers in Britain, only around 14 per cent of which are able to work from home. Many are low paid or on zero-hour contracts, meaning they cannot afford to self-isolate or quarantine without financial help.

Government payments worth £500 are available for those told to self-isolate, but Labour has previously said that eligibility is “restrictive”, with only one in eight people qualifying for the scheme.

The Health Foundation report also said that people from ethnic minority communities, the young or disabled, and those with mental health conditions in particular experienced “worsening and compounding inequalities” which increased their exposure to the virus and threatened their future health.

But the charity said these risks to health are “far from inevitable” and can be addressed by a recovery plan that focuses on fairness.

Director of health Jo Bibby said the shortcomings of the response to the 2008 financial crisis left a “legacy of deep-rooted issues” which made the UK more vulnerable to the pandemic.

“We cannot afford to make the same mistake twice,” she said. “Government must address the root causes of poor health and invest in jobs, housing, education and communities. This is the only way to create a healthier society that can meet the challenge ahead and better withstand future crises.

“Ministers across government should work together to put health at the heart of the forthcoming levelling up strategy, with clear targets and a regular, independent assessment of the nation's health laid before parliament.”

Polling for the charity in June found that eight in 10 people believe it is important for the government to address differences in health outcomes between those living in richer and poorer areas as the country rebuilds from the pandemic.

The Health Foundation is calling for the government to prevent “longer-term scarring effects" by tackling the healthcare backlog, increasing mental health support, protecting family finances, creating jobs, and helping people catch up on education and training.

And it wants to see better resilience for the longer term, including an adequate safety net, better protections for low-paid workers, and more investment in public services to focus on prevention.