The coronavirus pandemic poses clear and obvious dangers to the health of individuals who are infected with the virus. But worsening economic conditions and disruptions to NHS services will have important and far-reaching consequences for the health of the broader population.
New briefings from researchers at the Institute for Fiscal Studies (IFS) point out that:
The coronavirus pandemic is putting the NHS under unprecedented strain and leading to cancelled operations and disruptions to non-coronavirus emergency care. This will disproportionately affect older individuals, and those from less affluent backgrounds, both in the short and the medium term. This is because in normal times:
- Emergency hospital admissions per head are 10 times higher among those in their 90s than among those in their 30s, and 1.7 times higher among those from the most deprived areas than among those from the least deprived. These groups therefore will be hit hardest by disruptions to emergency care.
- Elective (pre-planned) admissions per head are more than 6 times higher among those in their 70s and 80s than among those in their 20s, and 4½ times higher than among those in their 30s. So older people will also be hit hardest by the (understandable) decision to cancel all non-urgent operations.
- Evidence suggests that staff disruptions – from increased rates of absence and healthcare staff working in unfamiliar settings – will have severe impacts on the quality of care provided and resultant patient outcomes.
In the medium and longer term, the economic downturn itself will have persistent negative health effects, with these effects being worse for some groups than others. For example, recent estimates suggest that the employment loss associated with the 2008 recession could have resulted in an additional 900,000 people of working age suffering from a chronic health condition, including mental health.
- We should be particularly worried about the consequences of worsening economic conditions for those with pre-existing poor mental health, and for young children and those currently in utero. Current policies – such as the Job Retention Scheme – will help many, but by no means all, in these groups.
- Effects will also vary across the country as some industries (and thus areas) are hit harder than others by social distancing measures and the associated economic downturn. Evidence shows that the detrimental impact of adverse economic shocks can persist for many years. Government policy has a key role to play in mitigating these impacts.
Combined, these effects are likely to exacerbate existing geographical and socioeconomic health inequalities.
George Stoye, an Associate Director at IFS and an author of one of the briefing notes, said:
“Huge amounts of resources have, for good reason, been re-organised and re-deployed to help the NHS treat patients suffering from the coronavirus. This will have consequences for the wider healthcare system, and for the quantity and quality of non-coronavirus care that can be provided. Wider emergency care will be hit by the need to divert resources to coronavirus patients, and the NHS has already postponed all non-urgent elective operations for at least the next three months. This will cause immediate distress to those affected and knock on effects on waiting times that could take years to unwind. The hardest hit will be those most likely to otherwise use hospital care, in particular older people, and those who are the least affluent and the least healthy to begin with.”
Heidi Karjalainen, a Research Economist at IFS and an author of one of the briefing notes, said:
"The health impacts of the economic downturn caused by the coronavirus pandemic will be felt long after the social distancing measures come to an end. Many of those who are most exposed to the economic shutdown – such as low income families, especially those with young children – are also most vulnerable to long-term effects on both physical and mental health. By making sure that the groups that are most at risk are also protected from the negative effects of a downturn, the government can help minimise the long-run detrimental health impacts that would otherwise occur.“