Mikolai Júlia, Keenan Katherine, Kulu Hill
University of St Andrews and ESRC Centre for Population Change, Irvine Building, North Street, St. Andrews, KY16 9AL, UK.
SSM Popul Health. 2020 Jul 2;12:100628. doi: 10.1016/j.ssmph.2020.100628. eCollection 2020 Dec.
The effects of COVID-19 are likely to be socially stratified. Disease control measures introduced during the COVID-19 pandemic mean that people spend much more time in their immediate households, due to lockdowns, the need to self-isolate, and school and workplace closures. This has elevated the importance of certain household-level characteristics for individuals' current and future wellbeing. The multi-dimensional poverty and health inequalities literature suggests that poor health and socio-economic conditions cluster in the general population, which may exacerbate societal inequalities over time. This study investigates how COVID-19-related health- and socio-economic vulnerabilities co-occur at the household level, and how they are distributed across household types and geographical areas in the United Kingdom. Using a nationally representative cross-sectional study of UK households and individuals and applying principal components analysis, we derived summary measures representing different dimensions of household vulnerabilities critical during the COVID-19 epidemic: health, employment, housing, financial and digital. Our analysis highlights four key findings. First, although COVID-19-related health risks are concentrated in retirement-age households, a substantial proportion of working-age households also face these risks. Second, different types of households exhibit different vulnerabilities, with working-age households more likely to face financial and housing precarities, and retirement-age households health and digital vulnerabilities. Third, there are area-level differences in the distribution of household-level vulnerabilities across England and the constituent countries of the United Kingdom. Fourth, in many households, different dimensions of vulnerabilities intersect; this is especially prevalent among working-age households. The findings imply that the short- and long-term consequences of the COVID-19 crisis are likely to significantly vary by household type. Policy measures that aim to mitigate the health and socio-economic consequences of the COVID-19 pandemic should consider how vulnerabilities cluster and interact with one another both within individuals and different household types, and how these may exacerbate already existing inequalities.
新冠疫情的影响可能存在社会分层现象。新冠疫情期间实施的疾病控制措施意味着，由于封锁、自我隔离的需要以及学校和工作场所关闭，人们在自己的直系家庭中度过的时间大幅增加。这提升了某些家庭层面特征对于个人当前和未来福祉的重要性。多维贫困与健康不平等的相关文献表明，健康状况不佳和社会经济条件差在普通人群中集中存在，随着时间推移可能会加剧社会不平等。本研究调查了与新冠疫情相关的健康和社会经济脆弱性在家庭层面是如何同时出现的，以及它们在英国家庭类型和地理区域中是如何分布的。通过对英国家庭和个人进行具有全国代表性的横断面研究，并应用主成分分析，我们得出了代表新冠疫情期间至关重要的家庭脆弱性不同维度的汇总指标：健康、就业、住房、财务和数字方面。我们的分析突出了四个关键发现。第一，虽然与新冠疫情相关的健康风险集中在退休年龄家庭，但很大一部分工作年龄家庭也面临这些风险。第二，不同类型的家庭表现出不同的脆弱性，工作年龄家庭更有可能面临财务和住房不稳定问题，而退休年龄家庭则面临健康和数字方面的脆弱性。第三，在英国的英格兰及其他组成国家，家庭层面脆弱性的分布存在地区差异。第四，在许多家庭中，不同维度的脆弱性相互交织；这在工作年龄家庭中尤为普遍。研究结果表明，新冠疫情危机的短期和长期后果可能因家庭类型而有显著差异。旨在减轻新冠疫情对健康和社会经济影响的政策措施应考虑到脆弱性在个体内部和不同家庭类型中是如何聚集和相互作用的，以及这些情况可能如何加剧现有的不平等。
