Pandemic Preparation - Must Do Better: Annette Hastings - June 2020

The nature and impacts of the Covid 19 crisis is exposing deep underlying fragilities in our economic and social systems. At the same time, as evidenced in SURF’s series of special bulletins, many under resourced communities and their organisations have responded very impressively to meeting immediate local challenges. Policy makers are increasingly interested in how it might be possible to sustain raised levels of collaborative community action, in a way that could rebalance local regeneration power, resources and decision making.

SURF is using its community focused, cross sector role and networks to better inform those considerations. One aspect of SURF’s broader contribution to building back better is a series of articles here in the SURF Journal.

Annette Hastings is Professor of Urban Studies in the School of Social and Political Sciences at the University of Glasgow. Annette’s research and teaching focuses on the drivers of urban inequality and approaches to tackling this, with a particular focus on the role of public services. She has led research projects for the Joseph Rowntree Foundation, AHRC, ESRC and Scottish Government and is a member of the Editorial Board of the journal Local Government Studies. She has given evidence on a number of occasions to the Scottish Parliament’s Local Government and Communities Committee on issues including regeneration, community empowerment and austerity.

Prior to joining the University in 1994, Annette worked for social housing organisations. She is currently a Director of SURF, Scotland’s Regeneration Forum. Annette was previously Independent Chair of the North Lanarkshire Fairness Commission and an External Advisor and member of the Joseph Rowntree Foundation Task Group established to develop an Anti-poverty Strategy for the UK.

The Scottish Government’s response to the pandemic formally identifies the need to advance equality – and the Scottish Parliamentary inquiry cites the need for a focus on COVID 19’s disparate impact on the poorest. Annette Hastings of the University of Glasgow argues that the amplification of inequalities could have been anticipated.

Pandemic Preparation: Must Do Better

Perhaps there was a moment in late March – the moment when it seemed that the whole world went into lockdown – that the mantra ‘We’re all in it together’ felt possible, accurate even. But when the news began to filter through that people in BAME communities and in deprived areas were dying at disproportionate rates – the inevitability of uneven impacts began to dawn. Now, in June, the evidence on unequal deaths just keeps on building[i], every day it seems, as does that on the uneven impacts of the economic lock down[ii].

It is, however, the specific evidence that shows how the pandemic is amplifying, and embedding even further, pre-existing inequalities which is arguably the most important and powerful.

For example, Dr Gerry McCartney of Health Scotland, in a presentation to the Poverty Alliance[iii], has shown that Scottish death rates from Covid-19 are even more skewed by deprivation than death rates are generally, and that additional Covid-19 deaths magnify already-existing differences in death rates across the social spectrum.

It’s worth looking at the detail of his analysis. Thus, he shows that, in 2018, people living in areas in the most deprived quintile in Scotland were 35% more likely to die than average – a startling statistic that we should take a moment to absorb and to acknowledge as the result of a longer run, more fundamental crisis than the current pandemic. However, he goes on to show that people in deprived areas were 53% more likely than average to die than from Covid-19, and the overall death rate in such areas – relative to the average – increased by 4% in March and April this year.

Advantage is, of course, the corollary of disadvantage. At the other end of the social spectrum, death rates in 2018 in the most affluent quintile were 27% lower than average. Covid-19 death rates diverged even more from the average (they were 32% lower) and the overall death rate dropped by 1%. In blunt summary, people in the most deprived areas are much more likely to die from Covid than people in the least deprived areas and what was already an excruciatingly large death inequality gap has just grown by a further 5%.

The disproportionate impacts of the economic lockdown on women are another important example – the IFS reports[iv] that women are more likely to have lost their jobs than men and are doing more unpaid labour at home. They are also reporting Domestic Abuse in increasing numbers. But, again, it is the effect on underlying structures of gender inequality that are most troubling. Across Europe, concerns are growing that hard won progress on addressing inequality is being reversed, with German Chancellor Angela Merkel pledging to fight the ‘re-traditionalisation’ of German society .[v] The Fawcett Society and Women’s Budget Group have raised fears[vi] that gendered inequality will influence who returns to the workplace and on what terms, accentuating in gender pay gaps accentuated and putting back gender equality by decades with a re-emerging two-tier workplace.

These stark analyses of the direct effects of the pandemic in intensifying inequalities in death rates and its indirect impacts on gender inequality takes us beyond simply acknowledging that there are some uneven impacts that deserve investigation. It suggests that crises such as these play into already existing inequalities in far reaching, fundamental ways.

However, my key point is that we should have anticipated from the outset that underlying inequalities render some groups much more vulnerable to the effects of a crisis than others. And that we should have planned accordingly. There is plenty of evidence from past crises to draw from, whether it is the downloading of austerity on poorer groups[vii] or the surge in gender-based violence[viii] that occurs in crises across the globe, regardless of whether the physical entrapment of lock down is a feature.

In the UK, criticism of the state of pandemic planning has focused on the preparedness of the healthcare system – the availability of specialist bed spaces, equipment, staff and of course PPE. There seems to have been little or no discussion of whether or not we were prepared for unequal death rates or for the inevitability that social and economic impacts would be experienced disproportionately by those who suffer most in any crisis.

The Scottish version of the Coronavirus Act offers, perhaps, a small exception. It stipulates[ix], in responding to pandemic, that “Scottish Ministers must have regard to opportunities to advance equality and non-discrimination”. Key word searches of the Westminster and NI versions of the Act suggest no such emphasis. Does this mean that Scotland will take uneven impacts and inequality more seriously than elsewhere in the UK? The Scottish Parliament has certainly launched an Inquiry[x] into the disproportionate impacts of the pandemic and its response. In England, meanwhile, calls continue[xi] for such an Inquiry, with anger and disappointment being voiced about a Public Health England report which failed to connect disparities to structural inequalities or – crucially – recommend mitigating actions.

I will conclude by seeming to contradict my initial contention: that we should have understood at the outset of the pandemic that uneven impacts were ‘inevitable’. Inequality of the nature and scale that we experience currently is not ‘inevitable’: it is there ready and waiting to be amplified by a crisis only because we allow it to be. Yes, pandemic planning should have a focus on mitigating uneven impacts. But it would be a far better plan to achieve a significant reduction in structural inequality before we face the next crisis.

This is the third of several reviews of the way in which the COVID19 crisis is exacerbating inequalities. SURF’s unique position as Scotland’s regeneration forum allows us to access the views of frontline workers, academics, policymakers, politicians and those people living and working in the communities which are being hardest hit. Our intention is not to only record the damage that is being caused – or to rejoice in the innovative and collective creativity of those who have stepped up to meet the challenges. We also want to present ideas and processes which will encourage debate about how our many national and local partner organisations should support and sustain the most effective of these responses to collaboratively build back better.

Among the themes to be explored in future postings will be the Digital Divide, Urban Planning, Food Poverty, and particular impacts on different communities.

SURF welcomes all feedback and suggestions for future areas you would like to see covered. Please email Elaine Cooper at Elaine@surf-old.local.