The COVID-19 pandemic has had a profound impact on people’s health and their livelihoods. By mid-March 2021, the pandemic had led to 119,000 excess deaths in the UK and in 2020 caused a 9.9% drop in GDP. The UK government and devolved governments have taken far-reaching action in attempts to suppress the virus: schools closed, routine health care suspended, and businesses and community facilities shut down.

People’s experiences of the pandemic have varied greatly. Not everyone faced the same risk of exposure to the virus nor equivalent severity in health outcomes. The measures taken to suppress the virus have affected people’s lives and livelihoods differently – with both immediate and longer term consequences for people’s health and wellbeing.

Although COVID-19 has been challenging for governments around the world, the UK entered the pandemic with life expectancy stalling for the first time in a century. A month before the first national lockdown, The Marmot Review 10 Years On – funded by the Health Foundation – showed that life expectancy had gone into reverse for the most socioeconomically deprived communities, revealing a growing gap in health between wealthy and deprived areas.

This report explores how the same factors contributing to this widening of health inequalities exposed the UK to a high death toll and reduced people’s ability to deal with the subsequent economic shock. Drawing on an extensive body of evidence, this report identifies what has driven such outcomes during the pandemic.

Scope and structure of this report

The factors shaping the UK’s overall experience of the pandemic are complex and multifaceted, and the pandemic is still ongoing. The COVID-19 impact inquiry provides an initial assessment of the effects of the pandemic using evidence available up to May 2021.

The inquiry set out to answer two key questions:

  • How were people’s experiences of the pandemic influenced by their pre-existing health and health inequalities?
  • What is the likely impact of actions taken in response to the pandemic on people’s health and health inequalities – now and in the future?

The inquiry did not set out to formulate specific policy recommendations but does highlight the need for action in two key areas to ensure the recovery creates a more resilient society that improves the nation’s health: immediate action to address the harm caused by the pandemic and prevent longer term scarring effects; building resilience for the longer term.

The COVID-19 impact inquiry

The Health Foundation launched this inquiry in October 2020 to gather, analyse and synthesise evidence and insight from an extensive range of sources, including:

  • submissions received from around 75 charities, patient representative groups and community organisations, through an open call and an in-house evidence review of an additional 600 papers
  • commissioned work to address gaps in the literature relating to the experience of specific population groups
  • a literature review of existing qualitative evidence, to understand the public experience of the pandemic
  • stakeholder meetings focused on disability and digital exclusion, as well as discussions and analyses of the impacts of the pandemic across the four UK nations
  • in-house Health Foundation data analysis.

Other sources of data were excluded, such as studies with a low sample size or qualitative data that could not be triangulated by other evidence. The literature review covers evidence up to May 2021 and more detail of this review and the analysis is available in the separate technical supplement.

Box 1: The Expert Advisory Panel

The inquiry has been guided and informed by an advisory panel with expert members from across the areas of inequalities, economics and the wider determinants of health. The members are:

  • Dame Clare Moriarty (Chair)
  • Lord Victor Adebowale CBE
  • Professor James Banks
  • Yvonne Coghill CBE
  • Professor George Davey Smith FRS
  • Sarah Davidson
  • Fozia Irfan
  • Polly MacKenzie
  • Professor Sir Michael Marmot
  • Auriol Miller
  • Professor James Nazroo
  • Dr Vanessa Pinfold
  • Yusuf Qureshi
  • Matthew Whitaker
Previous Next