Guest blog by Dr Gerry McCartney, Head of the Scottish Public Health Observatory, Public Health Scotland
Our top priority is protecting and improving the nation’s health throughout the coronavirus outbreak and after. While our NHS works steadily to care for those who have been infected and are vulnerable to infection, we are also ensuring that we look after those who are unintentionally being affected by the preventative response measures. This means working to ensure health inequalities, which existed before COVID-19 and will remain after it, and life expectancy trends aren’t made worse during this time. It’s also important that we ensure health and social care services are accessible, high quality and meet people’s needs now and in the future.
The lockdown and physical distancing policies that have been put in place have led to unprecedented changes across society. These include the closure of most workplaces, leisure spaces, restrictions on travel and meeting up with friends and family. These have been necessary to prevent our communities becoming overwhelmed with the spread of the virus in a short period of time. However, these changes also have an effect on our health and it’s important that we address any potential negative impacts, especially for people in our poorest areas who we know are disproportionately affected.
Impacts on health
The most profound impacts stem from the changes we’ve seen in the economy. Money has a significant influence on health and many people are facing incredibly challenging circumstances having lost work and income for some time now. Together with social isolation, this can also have an impact on mental health for both adults and children as stress and concern grows in the home. Those already on low incomes may experience the most severe impacts. There are positive actions already in effect through the process of furloughing and government funding to prevent redundancies, all of which will help to alleviate the financial strain individuals and families are facing.
Social isolation is especially challenging for those who normally rely upon the help of others or are not able to use the internet, which is how many of us are currently staying connected. For children, this means a disruption to education, friendship and family support networks which poses risks to the attainment gap. And, although we’re staying home to stay safe to protect ourselves and others, lockdown also increases the risk for gender-based violence and other forms of abuse. This is why we’ve recently contributed to new COVID-19 supplementary guidance for Equally Safe, Scotland’s strategy to tackle violence against women, children and young people to address increases in gender-based violence at this time.
Last but not least, health services have been necessarily re-orientated to deal with the surge in demand due to COVID-19. The NHS and the Scottish Government are working to ensure that health services are still operating and open to anyone who needs them and ensuring services are carried out in a safe way to protect those providing them and accessing them.
Build back better
Tackling inequalities in income, wealth and power is now, as it has always been, important to reduce avoidable years of life lost to illness and early death.
The risk to health and life we are all facing is such that the scale and intensity of government and public response and intervention is necessary. As we discuss the policies to protect and improve the nations’ health post-pandemic, equity will be at the heart of it. We have the opportunity to build the economy back better for everyone, to ensure we all have the income we need to live to a decent standard and reduce inequalities for the future.
So as well as leading the health protection response to the Covid-19 outbreak, we in Public Health Scotland are also contributing to what happens as we begin to emerge from this crisis in the months to come, by focusing a large area of work, involving key partners at national and local level, on social and systems recovery. This work has been established to support policy makers and practitioners to mitigate against the wider health consequences of COVID-19 such as the unintended consequences of physical distancing measures described here. This programme of work is framed around a rapid health impact assessment that we’ll continue to build on in the coming months to inform further work and recommendations.