How COVID-19 widened the gap between the haves and the have-nots

Last week, a report found that the government is set to miss its target to give everyone five more years of healthy life by 2030, and to reduce health inequalities between the richest and poorest. Life expectancy was already stalling before the pandemic, with some groups seeing the number of years they could expect to live free from disability already beginning to reverse. Sadly it seems these health inequalities are only going to get worse in the wake of the pandemic. But it was clear from early on that the necessary public health restrictions to stop the spread of the virus were going to have much wider impacts on people of all ages across society. At Ageing Better we set out to understand the effects of the pandemic on those in mid and later life so that we could inform the policy and practical responses and shape the longer term plans for recovery.

The most shocking and immediate impacts of COVID-19 were on people’s health and mortality. Researchers have calculated that the pandemic has wiped about a year off life expectancy at birth compared to 2019 (0.9 and 1.2 years for females and males respectively). The state of the nation’s health before COVID-19 hit may have been a major factor in the UK’s poor outcomes. Because the risk of developing dangerous symptoms of COVID-19 or dying from the disease are increased in people who have other serious health problems – such as heart or lung conditions, weakened immune systems, severe obesity, or diabetes.  The experience of lockdown has, for some people resulted in a decline in their physical health – one in five (22%) of those in their 50s and 60s report that their physical health is worse as a result of the pandemic, and a third say their mental health has worsened.

We found that while many have made positive changes such as eating more healthily or doing more and regular exercise, many have been smoking more, drinking more alcohol, and eating unhealthily. For some, a further challenge has been accessing health care, with 20% of people having a routine hospital appointment cancelled during the first lockdown. This points to an urgent need for government to renew its commitment to its goal of longer, healthier lives for all and taking bold action to improve the health of those in mid and later life in poorer communities. Designing cycling and walking strategies that get those in mid and later life active, ensuring the fitness and active leisure sector and local areas are resourced to provide community-based support to individuals to become active again and providing funding for adult weight management services are among the actions needed.

The pandemic has also highlighted the inseparable link between our health and our homes. A review we conducted with The King’s Fund shows that overcrowding in our homes – which tends to be more common among ethnic minority groups – has been associated with a greater chance of contracting the disease. And those pre-existing health conditions, that are directly associated with poor quality housing, were the very same conditions that put people at high risk of poor outcomes if they did contract the disease.  

Even though the vast majority of people said that their home met their needs during the first lockdown, some people struggled with a host of issues including a lack of space and privacy, noise levels and inadequate internet connection. Renters were more likely to cite problems in their homes than homeowners and they also found the lockdown more problematic in terms of their living conditions. As a result of the experience of lockdown, we found that many people are thinking more about whether their homes work for them. But there are considerable barriers to making the changes needed – especially for renters and those in social housing. For homeowners, financial considerations and not knowing what changes to make or how to go about arranging them are the paramount barriers. Our Good Home Inquiry will be making recommendations about what actions are needed to accelerate a major upgrade to our existing housing to make homes safer, healthier and more adaptable as we age. As the government considers its next move on changes to building regulations on accessible housing, the pandemic has further strengthened the case to raise standards – we must stop building homes that we can’t live in as we age.

For many, the most worrying issue of the pandemic has been the impact on their work or finances. As a result of the crisis, the increase in employment rates among 50-64 year olds has stalled, and there has been a significant impact on older workers’ finances. With older workers at greatest risk of long-term unemployment, it is unsurprising that two out of five older workers say that they are concerned that their finances will get worse as a result of the pandemic. IFS research that we funded also found that one in eight (13%) older workers have changed their retirement plans as a result of the pandemic, with 8% planning to retire later and 5% planning to retire earlier. Interestingly, those working from home are 5% more likely than other workers to now be planning to retire later.

The ONS has reported that occupations requiring higher qualifications and more experience were more likely to provide homeworking opportunities than elementary occupations – like cleaning or deliveries – and manual occupations. So the advent of home working, if it persists as a long-term change in the workplace, might make it easier or more appealing for some older people to stay in work. But they will almost certainly be those working in professions conducive to home-working – that is, those who are already better off. It will be critical for employers to maintain flexibility and ensure their recruitment is fair to people of all ages. The government is providing funding for employment support but this must be spent well. We must not repeat the failures of the Work Programme which left the over 50s without the tailored support and retraining support to return to work after redundancy. 

It has become somewhat of a truism to say that the community response has been the ‘silver lining’ of the pandemic. The real picture is more complicated. Survey data using the Natcen panel showed that feelings of connectedness in our communities were high over the first lockdown in March-April 2020, and that people felt more connected to their communities as a result of the experience of lockdown. But these feelings weren’t experienced equally. Not only did more of those who were living comfortably feel connected in their neighbourhoods than those who were finding it hard to get by (as measured by such things as the proportion who know people to say hello to, who have a sense of belonging and a good level of contact with others in their local area), but more of them also became more connected as a result of the experience of lockdown.

These data seem to suggest that lockdown has increased inequalities in the way people experience their communities – while in better-off communities the lockdown has strengthened neighbourliness, the lack of community infrastructure in poorer areas has left people feeling disconnected and without support. It is critical that investment in poorer areas as part of the levelling up agenda, supports the rebuilding of community infrastructure so that people in these areas are able to support one another.  

The overall picture is a grim one in which the better-off have faced far fewer challenges than those who were already struggling to get by. The crisis has highlighted and exacerbated existing inequalities: in health; in housing; in work; and in communities. Even as the vaccine brings hope, there is a huge amount to be done to tackle the potentially long lasting impacts on inequalities in how we age. If we are to build back better, tackling inequalities must be a central plank of the recovery.