Abstract
The UK COVID-19 lockdown has included restricting social movement and interaction to slow the spread of disease and reduce demand on NHS acute services. It is likely that the impacts of restrictions will hit the least advantaged disproportionately and will worsen existing structural inequalities amongst deprived and ethnic minority groups. The aim of this study is to deliver rapid intelligence to enable an effective COVID-19 response, including co-production of interventions, that address key issues in the City of Bradford, UK, and nationally. In the longer term we aim to understand the impacts of the response on health trajectories and inequalities in these. In this paper we describe our approach and protocol. We plan an adaptive longitudinal mixed methods approach embedded with Born in Bradford (BiB) birth cohorts which have rich existing data (including questionnaire, routine health and biobank). All work packages (WP) interact and are ongoing. WP1 uses co-production and engagement methods with communities, decision-makers and researchers to continuously set (changing) research priorities and will, longer-term, co-produce interventions to aid the City's recovery. In WP2 repeated quantitative surveys will be administered during lockdown (April-June 2020), with three repeat surveys until 12 months post-lockdown with an ethnically diverse pool of BiB participants (parents, children aged 9-13 years, pregnant women: total sample pool N=7,652, N=5,154, N=1,800). A range of health, social, economic and education outcomes will be assessed. In WP3 priority topics identified in WP1 and WP2 will be explored qualitatively. Initial priority topics include children's mental wellbeing, health beliefs and the peri/post-natal period. Feedback loops will ensure findings are fed directly to decision-makers and communities (via WP1) to enable co-production of acceptable interventions and identify future priority topic areas. Findings will be used to aid development of local and national policy to support recovery from the pandemic and minimise health inequalities.
Highlights
The UK, alongside countries throughout the world, is facing an unprecedented national emergency due to the rapid spread of the COVID-19 virus
The increase in mortality in ethnic minority groups is likely to be due to a complex interplay of existing health co-morbidities and the pernicious social determinants of health including deprivation and poverty, which are more prevalent in these groups
As a result of the lockdown measures, schools have closed and many businesses have been unable to trade, resulting in high numbers of employed staff being ‘furloughed’, with other small businesses or self-employed workers unable to generate an income for prolonged periods
Summary
The UK, alongside countries throughout the world, is facing an unprecedented national emergency due to the rapid spread of the COVID-19 virus. Those living in deprived areas are bearing the brunt of the virus with increased mortality rates as a result of the disease compared with more affluent and White British populations[1]. The increase in mortality in ethnic minority groups is likely to be due to a complex interplay of existing health co-morbidities and the pernicious social determinants of health including deprivation and poverty, which are more prevalent in these groups. The immediate response to the threat of the virus has been a stringent lockdown (implemented on 23rd March 2020), effectively limiting people to their homes, followed by ongoing restrictions on daily life. In the second half of March 2020, the Department for Work and Pensions recorded 950,000 new Universal Credit claims, which is a significant increase, and suggests unemployment rose sharply even before more stringent lockdown restrictions were introduced[2]
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