Inequalities in healthcare disruptions during the COVID-19 pandemic: evidence from 12 UK population-based longitudinal studies

  1. Jane Maddock
  2. Sam Parsons
  3. Giorgio Di Gessa
  4. Michael J Green
  5. Ellen J Thompson
  6. Anna J Stevenson
  7. Alex SF Kwong
  8. Eoin McElroy
  9. Gillian Santorelli
  10. Richard J Silverwood
  11. Gabriella Captur
  12. Nishi Chaturvedi
  13. Claire J Steves
  14. Andrew Steptoe
  15. Praveetha Patalay
  16. George B Ploubidis
  17. Srinivasa Vittal Katikireddi

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Abstract

We investigated associations between multiple sociodemographic characteristics (sex, age, occupational social class, education and ethnicity) and self-reported healthcare disruptions during the early stages of the COVID-19 pandemic.

Design

Coordinated analysis of prospective population surveys.

Setting

Community-dwelling participants in the UK between April 2020 and January 2021.

Participants

Over 68 000 participants from 12 longitudinal studies.

Outcomes

Self-reported healthcare disruption to medication access, procedures and appointments.

Results

Prevalence of healthcare disruption varied substantially across studies: between 6% and 32% reported any disruption, with 1%–10% experiencing disruptions in medication, 1%–17% experiencing disruption in procedures and 4%–28% experiencing disruption in clinical appointments. Females (OR 1.27; 95% CI 1.15 to 1.40; I 2 =54%), older persons (eg, OR 1.39; 95% CI 1.13 to 1.72; I 2 =77% for 65–75 years vs 45–54 years) and ethnic minorities (excluding white minorities) (OR 1.19; 95% CI 1.05 to 1.35; I 2 =0% vs white) were more likely to report healthcare disruptions. Those in a more disadvantaged social class were also more likely to report healthcare disruptions (eg, OR 1.17; 95% CI 1.08 to 1.27; I 2 =0% for manual/routine vs managerial/professional), but no clear differences were observed by education. We did not find evidence that these associations differed by shielding status.

Conclusions

Healthcare disruptions during the COVID-19 pandemic could contribute to the maintenance or widening of existing health inequalities.

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  1. Version published to 10.1136/bmjopen-2022-064981
  2. ScreenIT

    SciScore for 10.1101/2021.06.08.21258546: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Ethicsnot detected.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your data.

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • No funding statement was detected.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  3. Version published to 10.1101/2021.06.08.21258546v1 on medRxiv