Lessons in how to improve health inequalities in local councils in England

A recent in-depth study on local councils in England reveals a greater COVID-19 death toll in councils with high ethnic minority populations and those with large income inequalities.

Researchers found that councils with large ethnic minority populations and those with high income inequalities suffered a higher death rate during the first wave of COVID-19 in 2020.

Dr Silvia Gaia, from Essex Business School, led the study of 310 councils, which found that during the first wave of the pandemic, ethnic minorities experienced a higher level of mortality risk of COVID-19 than the white population in the UK.

“Our findings demonstrate that ethnic minorities contributed more to the death toll of the COVID-19 pandemic within local councils. This finding confirms voices which argue that ethnic minorities are more vulnerable to health crises and highlights the need for tailored policies which will protect these populations,” she said.

The paper highlights that ethnic minorities are likely to have poorer access to healthcare services and be subject to greater discrimination than white ethnic groups.

“We also show that this association is particularly strong in councils that exhibit high income inequalities. To that end, we show that it is how income is distributed within a community that determines individuals’ health,” she added.

The analysis identifies where the hotspots of COVID-19 excess mortality are, indicating what regions are in higher need of relevant resources, infrastructure, and other means of support to the more vulnerable parts of the population.

The regions which were found to be in greater need of intervention policies include: London, the West Midlands, the North-West, the North-East, West Yorkshire and South Yorkshire.

“This local analysis provides useful insights into the pandemic which can be of use to local authorities in their efforts to confront any successive waves of COVID-19,” said Dr Gaia.

Although reducing health inequalities is an objective that local councils are expected to pursue, the study shows that English local councils, particularly those with high-income inequality, have a way to go to eliminate health inequalities.

Dr Diogenis Baboukardos from Audencia Business School in France, who co-authored the research paper, stresses that the findings of this study call for immediate actions and long-term policies to address social and income inequalities, both of which affect population health conditions.

“Inequalities have important health implications for the population”, he said. “The study calls for actions to be taken at the local and national levels to overcome the effects of ethnic and income inequalities on population health”.

The paper, ‘Ethnic minorities, income inequalities and the COVID-19 pandemic: evidence from English local councils’, highlighted some counter-intuitive findings. One, that councils with a lower density tended to be affected more by COVID-19 mortality rates.

“This was counter-intuitive, as you would think that if you weren’t living in a busy place, you would be safer due to the fact that more social distancing would be possible,” said Dr Gaia.

And two, that the average level of income within a community does not necessarily ensure better health for its members. This finding is explained by income inequalities.

“It is not necessarily the average level of income, but it is how this income is distributed within a community that determines individuals’ health,” Dr Baboukardos added.

Regions with high income inequality can prove detrimental to the health of poor individuals as they see themselves positioned low in the social hierarchies of their region.