The social gradient of COVID-19

by Andrew Reid and Siggi Zapart

While COVID-19 does not discriminate, the impacts of the virus will not be equitably distributed. Vulnerable populations living in low socioeconomic disadvantaged communities will feel its health and educational impacts far more strongly than those living in more affluent areas.

 Health impacts
 Reduced access to essential healthcare

Some health experts suggest the COVID-19 pandemic could infect up to 70% of Australians. Based on estimates of current infection, more than 45,000 Australians will have COVID-19 by 10 April, 2020. At least 2,254 people would require ICU beds, (more than the current Australian capacity of 2,229). People in lower socioeconomic disadvantaged communities generally have poorer health and higher rates of heart and respiratory disease, and chronic illnesses. This means they could make up a large proportion of people likely to need ICU beds, and/or find it a lot harder to receive critical healthcare for their other illnesses in their local hospitals.

Furthermore, the Australian Government’s plan to implement a ‘whole-of-population telehealth’ approach will disadvantage vulnerable populations who do not have access to smartphones or computer technology due to lower income or education levels. The ‘whole-of-population telehealth’ includes phone and video mental health, allied health, and primary health consultations. Moreover, even those with internet access will be disadvantaged due to inferior NBN service types(see graph below). Research conducted in 2016 showed only 29% the most disadvantaged areas across Australia (SEIFA decile of 1) had fibre-to-the-premise (FTTP) – considered the best broadband technology solution available – or fibre-to-the-node (FTTN) connections. In the least disadvantaged(SEIFA decile of 10), 93 % had FTTP or FTTN. This is clear evidence that optimal NBN service increases as the SEIFA decile increases. Hence, even though telehealth is covered by Medicare, people living in disadvantaged suburbs are likely to miss out on the much needed essential services.

Impact on mental health

The continuing upward trend in the number of confirmed COVID-19 cases across Australia is causing increased anxiety and stress among disadvantaged communities. This is due to multiple and simultaneously occurring factors including, risk and uncertainty associated with the virus; feeling of powerlessness in the current situation; inconsistent messaging and confusion about social distancing measures; separation from loved ones due to quarantine or self-isolation; loss of freedom, and increased boredom; low income reducing to no income; and the type and condition of housing many people in these areas reside in. Most residents in these communities live in low-cost private rentals, social housing, and for some (many with disability, health or mental health issues, victims of domestic violence, people recently released from prison etc.) and social housing bedsits. The pandemic can potentially raise the Australian adult rates of poor mental health(currently 20%) and high or very high psychological distress (13%).

Educational impact

Across Australia, some states have closed schools, commencing school holidays early. Others like NSW have kept them open but encouraged parents to keep children at home. All schools are preparing for online learning, though at this stage, options for school attendance will be available for those that need it in some states.  However, given the low attendance rates (20-30% last week), it seems many parents think it safer to keep their children at home. For students in vulnerable communities, online learning could lead to increased barriers to education. Not all will have access to computers, the internet, or quality technology, such as wireless networks at home or quality NBN service. Many students might have mobile phones, but these may not be enough to engage with the curriculum or complete required tasks. Shools could send home lessons and resources for parents to use, but many parents in these communities would struggle, or not feel confident to teach their children at home.

In addition, the Federal Government’s closure of public libraries and community centres will hurt the educational outcomes of children in disadvantaged communities as these facilities provide a safe environment to facilitate lifelong learning. Public libraries offer free or affordable access to the internet, computers, printers, photocopiers, and a wide range of educational resources. Several community centres host Learning Clubs, i.e., after school programs designed to provide extra assistance to primary and secondary students in developing academic skills, such as homework, numeracy, and literacy. Not having access to these facilities and programs will prevent a large number of children in these disadvantaged communities from participating in learning, completing online school assignments, and having the right to a high-quality education experience.

So, a final note, although COVID-19 is impacting the entire population, those doing it tough already are and will continue to experience even more severe consequences as a result of the pandemic.

Community STaR event with Ian Webster (October 4, 2019)

 

CHETRE Community STaR presents..
‘Insights and reflections on poverty and mental health’
Speaker: Emeritus Professor Ian Webster AO

Professor Ian Webster is a physician and Emeritus Professor of Public Health and Community Medicine at the University of New South Wales and Patron of the Alcohol and other Drugs Council of Australia. He has held senior appointments in the Faculty of Medicine at the University of New South Wales and appointments at Monash, Sheffield and Sydney Universities. He is also a former Commissioner of the National Mental Health Commission and a tireless advocate for mental health and suicide prevention reform over many years. He has special expertise in working with disadvantaged people and the links between drug and alcohol use, chronic pain, suicide, mental illness, physical illnesses and dysfunctional communities. 

  • When: Friday, October 4, 2019
  • Time: 10:30am – 11:30am
  • Where: Miller Community Centre,
    18A Woodward Crescent, Miller, NSW 2168
  • RSVP essential by September 30 to Andrew Reid
  • e: Andrew.Reid@health.nsw.gov.au t: 02 87389310

Read the flyer here

Inequality and Mental Wellbeing Symposium

You are invited to the Inequality and Mental Wellbeing Symposium. It will focus on the impact of inequality on individual and community mental wellbeing and ways we can address this.

Keynote Speakers
Professor Fran Baum, Flinders University

Karen Walsh, CEO Shelter NSW

When
Tuesday 16th October 2018, 8.30am – 4.30pm

Where
Carnes Hill Community Centre – 600 Kurrajong Rd Carnes Hill, NSW 2171

Cost
$45 with scholarships available

For more information
Contact Gabi Martinez on 4621 8714 or email SWSLHD-WellbeingCollaboration@health.nsw.gov.au

To register visit https://www.eventbrite.com.au/e/inequality-and-mental-wellbeing-tickets-41373454115

 

Program