Health Brief by EurActiv: Lessons on inequality from COVID-19

“The COVID pandemic is a health and social crisis [where] the poorest have suffered the worst consequences and have become even poorer,” said Kahina Rabahi, Policy & Advocacy Coordinator at the European Anti-Poverty Network (EAPN), speaking at a dedicated session of the COVI committee on Monday and Tuesday  (28 and 29 November).

Rabahi was referring in particular to single-parent families, people with disabilities, Roma and frontline workers such as carers and supermarket employees. 

Other representatives present at the COVI Commission pointed the finger at European governments for not having supported this part of the population enough, both financially and with access to care. 

And according to Rabahi, COVID-19 also proved “that the welfare state was in decline”.

Several European governments put in place allowances to support people in financial difficulty during the pandemic. In Austria, for instance, the fund for families in difficulty has made it possible to support households where one of the two parents has become unemployed. 

“But many people are excluded from these benefits,” Rabahi said, citing students, platform workers, sex workers, and artists among others.

These jobs are also usually done by women, migrants, or other people from a minority background who were already in a precarious situation after the 2008 financial crisis.

“Have the measures put in place by the different governments been discriminatory?” asked socialist MEP Sara Cerdas to the expert. “Yes and no,” Rabahi replied, adding: “If they did not exclude people from poverty, most of these measures were not adequate.”

Limited access to care

People in precarious financial situations also found it more difficult to protect themselves from the virus. For caregivers, the risk of infection was higher and for homeless people, it was almost impossible to get tested or vaccinated. 

In France, in the event of a cerebral vascular accident, belonging to the poorest quarter of households reduces the chances of high-quality treatment by 10% when compared to the wealthiest quarter of households, according to a report by the Directorate of Research, Studies, Evaluation and Statistics (Drees).

Such patterns are also borne out in more routine health care, such as dental and eye care, which is generally not covered by insurance. 

“Some poor people would rather have a tooth pulled than have it treated. One, because it costs more to treat, and two, because they wait too long and the extraction is no longer avoidable,” Rabahi said. 

The COVI committee also found that the pandemic has had a negative impact on the mental health of the most vulnerable households.

Increased bills and running costs as a result of the various lockdowns have created “additional stress” for families, according to centre-right MEP Cindy Franssen. 

Digital divide 

Members of the committee also highlighted another generator of inequality in access to care between the poor and the rich: The digital divide. The pandemic and restraint measures have encouraged the rise of digital technology, particularly in the field of health, where many services have been digitised. 

Patients can now make appointments with doctors, consult their medical test results or have remote consultations via online platforms. 

While this progress is “significant”, it is also a “real concern”, noted Kirsten Rennie to COVI, a senior research associate at the University of Cambridge School of Clinical Medicine.

“Access to online care doesn’t take into account the digital divide and access to data,” she added, citing as an example a large number of households where there is only one smartphone for everyone.

According to her, we must find a “remedy” to avoid leaving a part of the population on the sidelines. 

At the conclusion of the committee session, MEP Franssen said that we must “avoid the same mistakes” and ensure “basic access”, especially for those who do not have access to the same plethora of digital tools.

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