Measuring geographical disparities in England at the time of COVID-19: results using a composite indicator of population vulnerability
Objectives The growth of COVID-19 infections in England raises questions about system vulnerability. Several factors that vary across geographies, such as age, existing disease prevalence, medical resource availability and deprivation, can trigger adverse effects on the National Health System during...
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| Format: | Article |
| Language: | English |
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BMJ Publishing Group
2020-09-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/9/e039749.full |
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| author | Daniel Lasserson Stuart Redding Catia Nicodemo Samira Barzin Nicolo' Cavalli Francesco Moscone Mujaheed Shaikh |
| author_facet | Daniel Lasserson Stuart Redding Catia Nicodemo Samira Barzin Nicolo' Cavalli Francesco Moscone Mujaheed Shaikh |
| author_sort | Daniel Lasserson |
| collection | DOAJ |
| description | Objectives The growth of COVID-19 infections in England raises questions about system vulnerability. Several factors that vary across geographies, such as age, existing disease prevalence, medical resource availability and deprivation, can trigger adverse effects on the National Health System during a pandemic. In this paper, we present data on these factors and combine them to create an index to show which areas are more exposed. This technique can help policy makers to moderate the impact of similar pandemics.Design We combine several sources of data, which describe specific risk factors linked with the outbreak of a respiratory pathogen, that could leave local areas vulnerable to the harmful consequences of large-scale outbreaks of contagious diseases. We combine these measures to generate an index of community-level vulnerability.Setting 91 Clinical Commissioning Groups (CCGs) in England.Main outcome measures We merge 15 measures spatially to generate an index of community-level vulnerability. These measures cover prevalence rates of high-risk diseases; proxies for the at-risk population density; availability of staff and quality of healthcare facilities.Results We find that 80% of CCGs that score in the highest quartile of vulnerability are located in the North of England (24 out of 30). Here, vulnerability stems from a faster rate of population ageing and from the widespread presence of underlying at-risk diseases. These same areas, especially the North-East Coast areas of Lancashire, also appear vulnerable to adverse shocks to healthcare supply due to tighter labour markets for healthcare personnel. Importantly, our index correlates with a measure of social deprivation, indicating that these communities suffer from long-standing lack of economic opportunities and are characterised by low public and private resource endowments.Conclusions Evidence-based policy is crucial to mitigate the health impact of pandemics such as COVID-19. While current attention focuses on curbing rates of contagion, we introduce a vulnerability index combining data that can help policy makers identify the most vulnerable communities. We find that this index is positively correlated with COVID-19 deaths and it can thus be used to guide targeted capacity building. These results suggest that a stronger focus on deprived and vulnerable communities is needed to tackle future threats from emerging and re-emerging infectious disease. |
| format | Article |
| id | doaj-art-4685fd212f8740e8a4b0c5f27a08a9ef |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-09-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-4685fd212f8740e8a4b0c5f27a08a9ef2025-01-08T13:50:08ZengBMJ Publishing GroupBMJ Open2044-60552020-09-0110910.1136/bmjopen-2020-039749Measuring geographical disparities in England at the time of COVID-19: results using a composite indicator of population vulnerabilityDaniel Lasserson0Stuart Redding1Catia Nicodemo2Samira Barzin3Nicolo' Cavalli4Francesco Moscone5Mujaheed Shaikh6Hospital at Home, Oxford University Hospitals NHS Trust, Oxford, Oxfordshire, UKCHSEO, University of Oxford, Oxford, UKCHSEO, University of Oxford, Oxford, UKMathematical Institute, Oxford University, Oxford, UKNuffield College, University of Oxford, Oxford, UKBrunel University of London, London, UKHertie School, Berlin, GermanyObjectives The growth of COVID-19 infections in England raises questions about system vulnerability. Several factors that vary across geographies, such as age, existing disease prevalence, medical resource availability and deprivation, can trigger adverse effects on the National Health System during a pandemic. In this paper, we present data on these factors and combine them to create an index to show which areas are more exposed. This technique can help policy makers to moderate the impact of similar pandemics.Design We combine several sources of data, which describe specific risk factors linked with the outbreak of a respiratory pathogen, that could leave local areas vulnerable to the harmful consequences of large-scale outbreaks of contagious diseases. We combine these measures to generate an index of community-level vulnerability.Setting 91 Clinical Commissioning Groups (CCGs) in England.Main outcome measures We merge 15 measures spatially to generate an index of community-level vulnerability. These measures cover prevalence rates of high-risk diseases; proxies for the at-risk population density; availability of staff and quality of healthcare facilities.Results We find that 80% of CCGs that score in the highest quartile of vulnerability are located in the North of England (24 out of 30). Here, vulnerability stems from a faster rate of population ageing and from the widespread presence of underlying at-risk diseases. These same areas, especially the North-East Coast areas of Lancashire, also appear vulnerable to adverse shocks to healthcare supply due to tighter labour markets for healthcare personnel. Importantly, our index correlates with a measure of social deprivation, indicating that these communities suffer from long-standing lack of economic opportunities and are characterised by low public and private resource endowments.Conclusions Evidence-based policy is crucial to mitigate the health impact of pandemics such as COVID-19. While current attention focuses on curbing rates of contagion, we introduce a vulnerability index combining data that can help policy makers identify the most vulnerable communities. We find that this index is positively correlated with COVID-19 deaths and it can thus be used to guide targeted capacity building. These results suggest that a stronger focus on deprived and vulnerable communities is needed to tackle future threats from emerging and re-emerging infectious disease.https://bmjopen.bmj.com/content/10/9/e039749.full |
| spellingShingle | Daniel Lasserson Stuart Redding Catia Nicodemo Samira Barzin Nicolo' Cavalli Francesco Moscone Mujaheed Shaikh Measuring geographical disparities in England at the time of COVID-19: results using a composite indicator of population vulnerability BMJ Open |
| title | Measuring geographical disparities in England at the time of COVID-19: results using a composite indicator of population vulnerability |
| title_full | Measuring geographical disparities in England at the time of COVID-19: results using a composite indicator of population vulnerability |
| title_fullStr | Measuring geographical disparities in England at the time of COVID-19: results using a composite indicator of population vulnerability |
| title_full_unstemmed | Measuring geographical disparities in England at the time of COVID-19: results using a composite indicator of population vulnerability |
| title_short | Measuring geographical disparities in England at the time of COVID-19: results using a composite indicator of population vulnerability |
| title_sort | measuring geographical disparities in england at the time of covid 19 results using a composite indicator of population vulnerability |
| url | https://bmjopen.bmj.com/content/10/9/e039749.full |
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