Inequalities in healthcare disruptions during the Covid-19 pandemic: Evidence from 12 UK population-based longitudinal studies
Inequalities in healthcare disruptions during the Covid-19 pandemic: Evidence from 12 UK population-based longitudinal studies
Abstract BackgroundHealth systems worldwide have faced major disruptions due to COVID-19 which could exacerbate health inequalities. The UK National Health Service (NHS) provides free healthcare and prioritises equity of delivery, but the pandemic may be hindering the achievement of these goals. We investigated associations between multiple social characteristics (sex, age, occupational social class, education and ethnicity) and self-reported healthcare disruptions in over 65,000 participants across twelve UK longitudinal studies. MethodsParticipants reported disruptions from March 2020 up to late January 2021. Associations between social characteristics and three types of self-reported healthcare disruption (medication access, procedures, appointments) and a composite of any of these were assessed in logistic regression models, adjusting for age, sex and ethnicity where relevant. Random-effects meta-analysis was conducted to obtain pooled estimates. ResultsPrevalence of disruption varied across studies; between 6.4% (TwinsUK) and 31.8 % (Understanding Society) of study participants reported any disruption. Females (Odd Ratio (OR): 1.27 [95%CI: 1.15,1.40]; I2=53%), older persons (e.g. OR: 1.39 [1.13,1.72]; I2=77% for 65-75y vs 45-54y), and Ethnic minorities (excluding White minorities) (OR: 1.19 [1.05,1.35]; I2=0% vs White) were more likely to report healthcare disruptions. Those in a more disadvantaged social class (e.g. OR: 1.17 [1.08, 1.27]; I2=0% for manual/routine vs managerial/professional) were also more likely to report healthcare disruptions, but no clear differences were observed by education levels. ConclusionThe COVID-19 pandemic has led to unequal healthcare disruptions, which, if unaddressed, could contribute to the maintenance or widening of existing health inequalities.
Patalay Praveetha、McElroy Eoin、Maddock Jane、Thompson Ellen J.、Santorelli Gillian、Captur Gabriella、Ploubidis George B.、Green Michael J.、Parsons Sam、Katikireddi Srinivasa Vittal、Kwong Alex S.F.、Chaturvedi Nish、Stevenson Anna J.、Di Gessa Giorgio、Steptoe Andrew、Steves Claire J.、Silverwood Richard J.
MRC Unit for Lifelong Health and Ageing, University College London||Centre for Longitudinal Studies, UCL Social Research Institute, University College LondonDepartment of Neuroscience, Psychology and Behaviour, University of LeicesterMRC Unit for Lifelong Health and Ageing, University College LondonDepartment of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King?ˉs College LondonBorn in Bradford, Bradford Institute for Health Research, Temple Bank House, Bradford Royal InfirmaryCentre for Longitudinal Studies, UCL Social Research Institute, University College LondonCentre for Longitudinal Studies, UCL Social Research Institute, University College LondonMRC/CSO Social & Public Health Sciences Unit, University of GlasgowCentre for Longitudinal Studies, UCL Social Research Institute, University College LondonMRC/CSO Social & Public Health Sciences Unit, University of GlasgowDivision of Psychiatry, University of Edinburgh||MRC Integrative Epidemiology Unit, University of BristolMRC Unit for Lifelong Health and Ageing, University College LondonDivision of Psychiatry, University of EdinburghInstitute of Epidemiology and Health Care, University College LondonInstitute of Epidemiology and Health Care, University College LondonDepartment of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King?ˉs College LondonCentre for Longitudinal Studies, UCL Social Research Institute, University College London
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Patalay Praveetha,McElroy Eoin,Maddock Jane,Thompson Ellen J.,Santorelli Gillian,Captur Gabriella,Ploubidis George B.,Green Michael J.,Parsons Sam,Katikireddi Srinivasa Vittal,Kwong Alex S.F.,Chaturvedi Nish,Stevenson Anna J.,Di Gessa Giorgio,Steptoe Andrew,Steves Claire J.,Silverwood Richard J..Inequalities in healthcare disruptions during the Covid-19 pandemic: Evidence from 12 UK population-based longitudinal studies[EB/OL].(2025-03-28)[2025-08-02].https://www.medrxiv.org/content/10.1101/2021.06.08.21258546.点此复制
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