The UK has passed the grim milestone of 100,000 deaths from COVID-19. And as the latest lockdown drags on, the inequalities that have characterised the trajectory of the COVID-19 epidemic are becoming starker than ever.
When coronavirus first arrived in the UK in spring 2020, British politicians called for teamwork and unity. It was proposed that COVID-19, as a “common enemy”, would align Britain and other nations like never before. “We are all in this together,” went the common refrain.
Broad messages of togetherness and cooperation are crucial for the success of public health campaigns – but they also imply that everyone is equally able to meet such expectations. Yet the UK’s demographic diversity means not everyone shares similar experiences during the pandemic. Far from it.
These are the issues my team is exploring at the Department of Behavioural Science and Health at University College London. Since March, we have been running the COVID-19 Social Study, which tracks the everyday experiences of more than 70,000 people around the UK through regular online surveys.
Since the pandemic began, we've surveyed ordinary people to see how they're coping. People from poorer backgrounds, ethnic minorities and young people are suffering most.
Through studying these 70,000 people, we have found that someone’s experience of the crisis is largely dependent on their life situation prior to the lockdown. Our research shows that ethnic minorities, those who are financially vulnerable, those who come from lower socioeconomic positions and young people are struggling much more than those with greater social privilege.
This research supports the findings of other studies which show how COVID-19 has exacerbated societal inequalities, and it also identifies clear patterns of inequalities along racial lines.
Our research highlights how crucial it is for the UK government to follow behavioural scientists’ insights into individual experiences. Rules to manage this virus and corresponding rhetoric and communications need to suit the realities of the public if we want to increase compliance and trust in authorities.
People are looking to leaders for guidance and solutions that are feasible and sensitive to their needs. But our findings show that, at the moment, this is not happening.
Poorer mental health overall
Early on in the crisis, researchers warned of two parallel epidemics: that of COVID-19, and one of poor mental health. This was concerning given that conditions such as anxiety and depression were already significant problems among the population – a quarter of adults are thought to have at least one diagnosable mental health problem per year.
We have tracked mental health since the beginning of the first lockdown in the UK. Our data shows that individuals’ mental health is affected not only by experiencing adversities such as financial strain, unemployment, and infection with the virus, but also by worrying about these consequences.
Mental health status is also driven by our work and living situations. Again, we found that SEP played a significant role in this. When we assessed symptoms of depression in the early weeks of lockdown, we found that low SEP was significantly associated with severe symptoms of depression. Low household income, in particular, correlates with higher rates of depression and anxiety. Levels of anxiety and depression on average improved for adults in the UK across the first lockdown and the summer of 2020, but levels remained consistently higher among people with low household income.
Throughout the first lockdown, low income was also consistently linked with more severe mental health issues, such as suicidal ideation and self-harm. Those suffering socioeconomic disadvantage or unemployment were also more likely to report physical abuse. However, such experiences have remained relatively stable throughout the period, making their relationship with the pandemic unclear.
Mental health among ethnic minority groups
As we explored risk factors for poor mental health, we found clear inequalities not just in terms of SEP, but also according to ethnicity.
So far, our work has placed people in two groups: white ethnicity and those from black, Asian and other ethnic minority backgrounds. We recognise that this is not fully representative of the UK’s ethnic diversity and we intend to work on racial subgroups as the study progresses. However, with these groups in place, we have nonetheless been able to begin to unpack the disparities in experiences between white people and those from ethnic minority backgrounds.
We have found that people from ethnic minority backgrounds have had poorer experiences across almost all measures in our study. These include confidence in the government and belief that health services could cope with the crisis, as well as depression, anxiety, stress, thoughts of death, self-harm, abuse, life satisfaction, loneliness and happiness.