Public perceptions

Approach to engaging with the public

The pandemic has significantly enhanced a national conversation about the health of the nation, including the wider factors that influence health and how outcomes are experienced unequally by different groups. The pandemic has led to some of the widest and most sustained polling to track people’s changing attitudes., To inform this inquiry, the Health Foundation worked with consulting company Kantar Public to explore public attitudes to, and experiences of, health inequalities and the COVID-19 pandemic.

Engagement with members of the public took place through:

  • A nationally representative survey comprising 1,228 interviews, undertaken during October and November 2020.
  • two-stage qualitative dialogue with 72 participants taking part in virtual workshops across five regions: Northern Ireland, Scotland, Wales, northern England and the Midlands, and the south east of England.

Views on government responses

Over the course of the research, public opinion on the government’s response to the pandemic seemed to shift. In October and November 2020, half the people surveyed felt that the UK government’s response to the pandemic was ‘fair’. But by the time of the workshops in February and March 2021, this had changed. This may reflect a shift in the public view of the pandemic over the Christmas period as the third round of lockdown restrictions were brought in across the country.

Where study participants lived also affected their perceptions of the government response. Some in the north of England felt that government decisions were London-centric and designed to protect the capital’s economy without enough consideration for other regions. In Wales and Scotland, the responses of devolved government were generally seen more positively.

Differential COVID-19 outcomes and impacts

At public workshops held in February and March 2021, participants were presented with statistics outlining the number of COVID-19 cases, hospitalisations and deaths. Many were shocked by the differential outcomes for older people, those from deprived areas and people from ethnic minority communities, but responses varied:

  • Age: Differences by age were the easiest for people to understand as they found it intuitive that the COVID-19 mortality rate would be higher among older people.
  • Deprivation: Most workshop participants generally understood why deprived areas might be worse affected by COVID-19 and assumed this was due to them having a greater population density and more social housing. 85% of survey participants identified the pandemic as having a greater negative impact on those in poorer areas of the UK.
  • Ethnicity: While 71% of survey participants assumed ethnic minority groups had had worse outcomes from COVID-19 because of factors relating to their physical health, when presented with the data most were unsure what was affecting the mortality rate among these groups.

The public appetite for action

Participants were surprised by wider information presented about the extent of current inequalities in life expectancy and health life expectancy in the UK. They saw addressing health inequalities as an important part of the government’s role in recovery. In general, participants saw three areas of policy as being particularly important.

“Participants were concerned by the disruption to children and young people’s education and saw funding catch-up tuition as a vital short-term policy response.”

  1. Education: Participants were concerned by the disruption to children and young people’s education and saw funding catch-up tuition as a vital short-term policy response – especially for secondary school-aged children close to sitting exams. In the long term, workshop participants (more often, those without a university education themselves) were particularly interested in strengthening vocational alternatives to university. Some wanted to improve vocational training, which they often thought was more applicable to work contexts than degrees. Changing syllabuses to include more life skills, such as healthy eating and managing finances, was another popular long-term policy among participants.
  2. Income: This was seen by many participants as a way of empowering individuals to make choices about their own lives in order to improve their health. There was strong support for a short-term policy of providing food aid for people unable to cover food bills. There were mixed opinions on making some temporary measures permanent, such as raising the level of Universal Credit. Some felt this would disincentivise work and not guarantee a better quality of life if the recipients spent funds inappropriately. Others thought that current Universal Credit rates were unable to support a good quality of life and that increasing them was important.
  3. Work: Some participants felt that continuing the furlough scheme was vitally important in the short term to ensure that people unable to work still receive an income and some level of job security. However, some raised concerns about how this would be paid for. Other popular long-term policies focused on reducing or eliminating zero-hours contracts and raising the living wage.
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