BMJ Open (Oct 2022)

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

  • Andrew Steptoe,
  • Gabriella Captur,
  • George B Ploubidis,
  • Srinivasa Vittal Katikireddi,
  • Nishi Chaturvedi,
  • Praveetha Patalay,
  • Ellen J Thompson,
  • Claire J Steves,
  • Eoin McElroy,
  • Michael J Green,
  • Gillian Santorelli,
  • Giorgio Di Gessa,
  • Richard J Silverwood,
  • Jane Maddock,
  • Anna J Stevenson,
  • Alex SF Kwong,
  • Sam Parsons

DOI
https://doi.org/10.1136/bmjopen-2022-064981
Journal volume & issue
Vol. 12, no. 10

Abstract

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Objectives 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; I2=54%), older persons (eg, OR 1.39; 95% CI 1.13 to 1.72; I2=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; I2=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; I2=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.