Covid-19: the disease of the deprived?

By - Integrated Care Journal

Covid-19: the disease of the deprived?

Vaccines are only a solution to the disease so long as people decide to have them. There is increasing concern that the virus could persist in certain parts of the country where people are refusing to be vaccinated.

Covid-19 is not a disease that affects everyone equally. The past year has exposed a chasm between the rich and the poor that has been steadily growing for years. This gap continues to manifest in the vaccination programme as we tentatively emerge from the pandemic.

The link between socioeconomic deprivation and vaccine uptake 

Public Health England data shows that six of the most deprived parts of England were in the bottom ten local areas for vaccine uptake among the over 80s. Most notably, while data from the Office for National Statistics (ONS) shows that 85 percent of adults are very likely to take up the vaccine, the remaining 15 percent skews heavily towards communities from ethnic minority backgrounds.

This statistic is telling of the intersectional nature of oppression. Systemic racism and disadvantage mean socioeconomic deprivation can be mapped directly onto areas where there are larger communities of ethnic minority backgrounds. As of 28 February, over 90 percent of white people over 80 had received the vaccine. A study conducted by the British Medical Journal notes that twice as many white people as Black people in eligible categories have been vaccinated.

How did we get here in the first place?

Much media attention has been given to the rising concern that BAME people are reticent to be vaccinated. Celebrity campaigns to address vaccine hesitancy are littering social media feeds and televisions. However, we are yet to understand the true gravity of the problem.

These communities are not simply reluctant based on misinformation: they have suffered a legacy of discrimination within healthcare for decades. It has become increasingly difficult to ask them to place their trust in a system that has systemically mistreated over sustained period. The lack of trust between BAME communities and the health system enables misinformation surrounding the safety of the vaccine to manifest in the forms of vaccine ‘reluctance’ or ‘hesitancy’.

While it is clear to all that there is a systemic problem around vaccine uptake, the consequences of these groups not taking the vaccine must be made known immediately so that more can be done to tackle the problem.

What are the consequences?

There is increasing concern that Covid-19 could become a disease endemic to more deprived communities within the UK, while more affluent areas will be able to avoid its impact.

Speaking on Radio 4’s Today programme in February, Dr Mike Tildesley, specialist on the modelling of infectious diseases at Warwick University, said he was concerned that the virus is going to linger in areas of deprivation.

When asked what he thought of Covid-19 becoming ‘a disease of the deprived’ he said: “This is a real concern actually for me and I know a number of other scientists have raised this, that we may end up in a situation where we have the 'vaccine rich' and as it were, who are able to access the vaccine who have taken up the vaccine and are at much lower risk. ”

Birmingham is emerging as a case study of this problem. Just six in ten over 80s in the more deprived area of Alum Rock have been vaccinated, while 95 percent of those of the same bracket a few miles north in Sutton Four Oaks have been vaccinated.

Speaking to PPP, Birmingham MP Liam Byrne said: "There's now a real risk that a pandemic of disease triggers a pandemic of poverty. The data is now clear: Covid is higher in the poorest places and that's where vaccination is lowest. Poor places now risk a curse of long Covid holding back their recovery unless we take strong action to avoid a K-shaped recovery where the rich and poor go in different directions."

Byrne’s concerns that the UK is heading for a K-shaped recovery are very real. Where standard growth theory argues that economies converge because poorer economies grow at a faster rate than richer economies per capita income, a K-shaped recovery refers to the scenario within recessions where certain communities overcome the recession, where others do not.

A K-shaped recovery poses a very troubling future for the UK: if the economy revitalises irregularly, the wealthy will benefit significantly while the poor will become poorer. Covid-19 becoming a disease of the poor therefore poses a very real threat.

The Government must do more to ensure the entirety of the UK can beat Covid-19. Vaccination is the key to overcoming the pandemic, but only if all of our citizens are equally protected.

Public Policy Projects is exploring health inequality in more depth in its State of the Nation report Addressing the National Syndemic: Closing the Gap in UK Health Inequality. For more information, please contact

References available upon request.

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