Scotland’s Wellbeing: The Impact of COVID-19 - Chapter 7: Unequal Impacts across the National Outcomes

Unequal Impacts across the National Outcomes

Overview

The impacts of the pandemic have been, and are likely to continue to be, borne unequally. Unequal outcomes between different groups already existed pre-COVID, and the effects of the pandemic have worsened this.

The pandemic has produced disproportionate impacts across a range of outcomes for a number of groups. These include households on low incomes or in poverty, low-paid workers, children and young people, older people, disabled people, minority ethnic groups and women. These groups also overlap, which may compound the impacts for some.

Inequalities in household income and wealth are anticipated to increase, as is the number of households in poverty, and unequal outcomes could potentially be exacerbated across a range of other areas. These include health, employment and education outcomes, children’s wellbeing, quality of and access to public services, participation in cultural pursuits and the outdoors, and the quality of local connections and support.

Scotland was already an unequal society before COVID-19 and emerging evidence suggests that COVID-19 has exacerbated many of these pre-existing inequalities. These unequal impacts have been highlighted throughout the report. This section looks at the multiple unequal impacts for particular groups of people in Scotland, including low-income households, low-paid workers, children and young people, older people, disabled people, minority ethnic groups and women.

These groups of people overlap – for example women, disabled people and those of many minority ethnicities are all more likely to be low earners – meaning that the effects will be compounded for some people. These multiple impacts may also store up future risks for some groups and have implications that will play out over the much longer term.

In addition to exacerbating pre-existing inequalities, the crisis has also created new groupings of people who are at risk of disproportionate impact (e.g. the shielding group) and groups facing particular challenges due to the social restrictions imposed in the face of the virus, e.g. people with learning disabilities or mental health conditions.

Conversely, some groups of people have been relatively less impacted by COVID-19 and others have seen some benefits. For example, some higher income households, have maintained their income while reducing their expenditure. Overall, the weight of evidence suggests that over the medium-term, inequalities in income and wealth are likely to increase.

Low income households

While the incomes of the poorest households have been cushioned during the crisis by the uplift in benefit payments, low income working households have suffered disproportionately from the employment effects of the crisis. Across the UK, over half of those in work and in the lowest income households had seen their work negatively affected in some way[i] by May 2020, compared to three-in-ten of workers in the highest income households.[ii]

Lower income households were also more likely to be facing financial strain[iii], when measured in July, and were more likely than richer households to have reduced savings and increased their debt, especially higher cost debt. One in four lower income households (UK-wide) had increased their use of consumer credit, compared to just one-in-eight high-income households.[iv] Financial strain and problem debt is also likely to increase in the future, as payment holidays end and as benefit levels are cut back (as currently planned) in April 2021. The latter is predicted to increase the number of households in poverty UK-wide next year, [v] affecting a range of wider outcomes linked to poverty – including health and wellbeing and children’s life chances.

Children in schools serving lower income households had less access to educational resources and less active help from schools during lockdown, and children from lower socio-economic groups spent less time on home learning, potentially resulting in a widening of the educational attainment gap in the future. [vi] Together with the likely increases in poverty, this will affect the future life chances of children, thus storing up risks for future generations.

In addition to financial strain, lower income households are also disproportionately likely to suffer health consequences from COVID-19. People on lower incomes are more likely to have underlying medical conditions that make them more at risk of serious illness from COVID – those in the bottom three income deciles are 50% more likely to have a health condition that puts them a greater risk than those in the top two deciles.[vii] Lower income groups are also at greater risk of suffering from depression, anxiety and loneliness, [viii] all of which have been impacted by the pandemic. [ix]

Low-paid workers

Low-paid workers have also been more detrimentally impacted by the economic consequences of the pandemic. Employees in the lowest earnings group (the bottom 10% of the weekly earnings distribution) are seven times more likely than those in the top 10% to work in a sector that was shut down during the pandemic. [x] UK-wide survey evidence from September showed that low-paid workers were more likely than others to have either stopped working, to have been furloughed or to have lost hours and pay over the crisis.[xi] The self-employed and people with less secure work arrangements have also suffered more from job loss or earnings reductions. [xii]

People in low-paid jobs are also less likely to be able to work from home due to the nature of their jobs. Fewer than one in five of those in the lowest earnings group and in non-shutdown sectors are in occupations that are amenable to working from home, compared to three in four of those in the top earnings group. [xiii] Key workers are also disproportionately concentrated in lower earning groups.

This potentially exposes lower earners to either job loss, because their jobs are untenable, or to a higher risk of infection from using public transport or in the workplace. Higher death rates from COVID-19 have been seen (in England and Wales) among men and women working in social care occupations, such as care workers and home carers, among men working in healthcare professions, such as nurses, and among men in elementary jobs, such as security guards. [xiv]

Women

Women have also been relatively more exposed to the negative economic impacts of the crisis because they are over-represented in shutdown sectors, because they earn less than men and because they have been more likely to bear the burden of additional caring responsibilities during the pandemic which can limit their employment options.

Analysis shows that mothers have been more exposed than fathers to job loss during the crisis, either as a result of the shutdown or due to an inability to keep working alongside increases in childcare responsibilities. This is particularly apparent for mothers with the lowest levels of qualification, for whom working from home is much less possible.^[xv] This risks widening gender disparities in pay and work over the longer term.

Living through the pandemic

“In Facebook groups I see mums asking for advice and they are working until midnight after putting kids to bed so that they can fit in their hours etc. I'm really, really worried about burnout for so many women. Because the majority of cases will be women. They have more flexible employers. They work part time so are expected to do it all. They are more involved with school work etc.”

“It was personally difficult to be managing a work from home environment alongside personal caring responsibilities. For me, I was also supporting and organising care for my elderly mother who is affected by dementia.”[xvi]

Voices from Scotland on COVID-19’s impact

Single mothers with low qualifications are particularly concentrated in shut down sectors[xvii] and survey data shows that single parents – overwhelmingly women – have experienced particularly large earnings losses during the crisis. The UK-wide Understanding Society survey showed that single parents’ earnings had, on average, fallen by more than double the amount experienced by two-parent households by the end of April. [xviii]

Women not in locked down sectors are twice as likely as men to be key workers and four times as likely to be in health and social care, putting them at greater risk of infection in work settings. Studies have also found that mental health during the pandemic has deteriorated more for women than for men, especially among young women. [xix]

A survey exploring people’s experience of the pandemic conducted in April and May, found that women were more likely than men to be working more hours than usual, to have cut back on essential items such as food and mortgage or rent payments, to be feeling more anxious and less happy, and to be worried about their or others mental health.[xx]

Evidence also suggests that domestic abuse incidents reported to the police went up during lockdown, although referrals to services went down during the early stage of lockdown before increasing, suggesting that access to support may have been reduced.

Qualitative evidence on the impact of the restrictions on people experiencing domestic abuse or other forms of violence against women and girls[xxi] suggested that referral rates reduced significantly during the initial weeks of lockdown and then gradually increased during later stages and throughout Phases 1 to 3[xxii]. All services reported victims experiencing significant mental health issues due to the impact of the pandemic and many observed significant increases in crisis work.

Children and young people

The majority of children of all ages missed out on attending education settings during lockdown, leading to a range of impacts, from a declining sense of fun and enjoyment of education, [xxiii] to increased levels of distress, worry and anxiety. [xxiv] Home schooling served children from poorer backgrounds less well, [xxv] potentially leading to longer term impacts on inequalities in attainment.

Certain groups of children faced more severe impacts from school closures, including children with special educational needs[xxvi]; disabled students[xxvii]; children who were previously excluded from school, groups with inconsistent attendance (such as Gypsy and Traveller children)[xxviii]; and families for whom English is an additional language. [xxix] Lockdown restrictions that limited home visits, together with school and early years closures, also made it more difficult to protect at-risk children and to identify and monitor safeguarding concerns, with potentially long term consequences and a potential increase in demand for support as lockdown is eased.[xxx]

Young people across the UK have also seen a greater deterioration in their mental health during the crisis than older groups, particularly among young women. Women aged 16-24 had 16% worse than average mental health scores before the crisis, which rose to 27% in April 2020[xxxi].

Young adults in work are also disproportionately impacted by the crisis. Workers under the age of 25 are twice as likely as those over 25 to work in shut down sectors[xxxii] and young people, particularly those with lower qualifications, are less likely to be able to work from home.

Young people have borne the brunt of the unemployment impacts to date – in August 2020, 526,000 people aged 16-24 UK-wide claimed unemployment related benefits, an increase of 124% from March 2020. [xxxiii] This year’s education leavers, particularly those with lower qualifications, will also likely face long term scarring of their career prospects due to entering the labour market during a recession.[xxxiv]

Older people

Older people and people with certain health conditions are more likely to experience severe symptoms and to die from COVID-19.^[xxxv] The greatest risk factor is age, while health conditions, such as dementia and Alzheimer’s disease, heart disease, chronic respiratory diseases, cerebrovascular disease (stroke) and diabetes are all associated with increased risk of death. [xxxvi] Some of these pre-existing health conditions are more prevalent among people in lower income groups, contributing to the socio-economic gradient seen in the disease.

Limitations in access to healthcare during the pandemic (due to reduced or postponed services or reluctance to attend due to concerns about virus risk) will also disproportionately affect older individuals, and those from less affluent backgrounds, because of the greater use of health services by these groups.^[xxxvii]

Survey evidence suggests that, alongside younger workers who have borne the brunt of employment impacts, older workers have also seen disproportionate negative impacts and are less likely to be working from home or expecting to do so in the future – one of the key ways in which workers can weather the crisis. [xxxviii]

Disabled people

Research among disabled people in Scotland who were shielding during the lockdown[xxxix] reported a range of concerns including lack of access to the support they needed, difficulties accessing food and medicine, concern about the loss of health care appointments and treatments, mental health impacts due to isolation from friends and family, and worries about coming out of lockdown. [xl]

Living through the pandemic

“Most offers of help and support were through telephone helplines, excluding the deaf population who were left unable to contact people for help and support – feedback locally and nationally, the same message, that they felt even more cut off from their communities.”[xli]

Voices from Scotland on COVID-19’s impact

Pre-pandemic, disabled people were more likely to experience isolation and loneliness than others and for some, social contact has reduced even further. Glasgow Disability Alliance research during lockdown found eight in 10 respondents worried about isolation and nine in 10 worried about their physical or mental health.[xlii] Many also reported barriers to accessing mental health support.

Some survey data also suggests that disabled people and people clinically at risk from COVID-19 have been more likely to face redundancy[xliii] during the crisis. [xliv]

Minority ethnic groups

Minority ethnic groups are being disproportionately affected by the economic crisis because of their employment and household circumstances. Ethnic minorities are overrepresented among key workers, for example, and some groups, such as Pakistanis and Bangladeshis, are concentrated in passenger transport and food and beverage sectors, which are among those hardest hit by the crisis. UK wide analysis showed people from minority ethnic groups are overrepresented in jobs with a higher risk of exposure to COVID-19, accounting for 20% of workers in the most at risk occupations, while only accounting for 11% of the working population.[xlv]

UK-wide survey data also shows that employees from minority ethnic groups are more likely than others to have found themselves out of work as a result of the crisis[xlvi] - especially Bangladeshis, who are the most likely of all ethnic groups to have lost their jobs, while Black Africans are the most likely to be working fewer hours and earning less and least likely to have been furloughed. [xlvii]

People from minority ethnic groups are also particularly at risk from income shocks because they are more likely to rent than to own their homes – and so will have been less able to take advantage of mortgage holidays. Pre-pandemic, ethnic minority people were more likely to say that they were struggling financially and to be behind on bills or housing payments. Survey data (UK-wide) suggests minority ethnic people feel that they are at greater risk of falling into arrears due to the pandemic and are more concerned about being able to make ends meet. [xlviii]

Minority ethnic people are also at greater risk of severe illness and death from COVID-19. Analysis by the National Records of Scotland showed that deaths amongst people in the South Asian ethnic group were almost twice as likely to involve COVID-19 as deaths in the White ethnic group, after accounting for other factors.[xlix] A Public Health England review also found that people of Black, Asian and other minority ethnic groups may be more exposed to COVID-19, due to factors associated with ethnicity, such as occupation, population density, use of public transport, household composition and housing conditions, and had a greater risk of severe infection due to more commonly having underlying health conditions that heightened risk.[l] Survey data also shows disproportionate impacts on mental health, for Pakistani and Bangladeshi men in particular.[li] Evidence on the experiences of refugee, migrant and asylum seeking families during the lockdown also paints a picture of significant hardship, with difficulties evident across a range of areas, including employment, housing, education and health.[lii]

[i] Including either being furloughed, out of work or having their hours reduced.

[ii] https://www.resolutionfoundation.org/publications/the-living-standards-audit-2020/

[iii] Based on a composite score including assessment of current financial situation; how much of a struggle to pay for food and other necessities; how much of a struggle to pay bills and other commitments; arrears (including payment holidays) on bills and household commitments.

[iv] https://www.resolutionfoundation.org/app/uploads/2020/06/Rainy-Days.pdf

[v] https://www.resolutionfoundation.org/publications/the-living-standards-audit-2020/

[vi] https://www.ifs.org.uk/uploads/Edited_Final-BN288%20Learning%20during%20the%20lockdown.pdf

[vii] https://www.ifs.org.uk/publications/14879

[viii] https://b6bdcb03-332c-4ff9-8b9d-28f9c957493a.filesusr.com/ugd/3d9db5_c2d0874d37b24bb5a9d535bf0e7f4f32.pdf

[ix] https://www.gov.scot/publications/impact-covid-19-wellbeing-scotland/; https://www.ons.gov.uk/peoplepopulationandcommunity/wellbeing/articles/coronavirusanddepressioninadultsgreatbritain/june2020

[x] https://www.ifs.org.uk/uploads/Covid-19-and-inequalities-IFS.pdf

[xi] https://www.resolutionfoundation.org/publications/jobs-jobs-jobs/

[xii] https://www.ifs.org.uk/uploads/Covid-19-and-inequalities-IFS.pdf

[xiii] https://www.ifs.org.uk/uploads/Covid-19-and-inequalities-IFS.pdf

[xiv] https://www.transport.gov.scot/publication/covid-19-public-attitudes-survey-data-wave-9/https://www.ons.gov.uk/peoplepopulationandcommunity/healthandsocialcare/causesofdeath/bulletins/coronaviruscovid19relateddeathsbyoccupationenglandandwales/deathsregisteredbetween9marchand25may2020

[xv] https://www.ifs.org.uk/uploads/Covid-19-and-inequalities-IFS.pdf

[xvi] Close the Gap/Engender Women, Caring and Furloughing during Covid-19

[xvii] https://www.ifs.org.uk/uploads/Covid-19-and-inequalities-IFS.pdf

[xviii] https://www.understandingsociety.ac.uk/2020/05/29/new-covid-data-shows-that-lowest-paid-and-single-parents-are-hit-hardest-by-loss-of-earnings

[xix] https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366%2820%2930308-4/fulltext#%20; https://www.ifs.org.uk/publications/14876

[xx] https://www.gov.scot/publications/impact-covid-19-wellbeing-scotland/

[xxi] https://www.gov.scot/publications/coronavirus-covid-19-domestic-abuse-forms-violence-agains-women-girls-during-phases-1-2-3-scotland-route-map-22-11-august-2020

[xxii] See https://www.gov.scot/collections/coronavirus-covid-19-scotlands-route-map/ for details of Scotland’s route map

[xxiii] https://www.childrensparliament.org.uk/our-work/children-and-coronavirus/

[xxiv] https://www.mentalhealth.org.uk/publications/impacts-lockdown-mental-health-children-and-young-people

[xxv] https://www.suttontrust.com/wp-content/uploads/2020/04/COVID-19-Impact-Brief-School-Shutdown.pdf

[xxvi] https://www.ipsos.com/sites/default/files/ct/news/documents/2020-10/nbi_2020-press_release_-2020-10-27-v1_canada_0.pdf

[xxvii] https://cypcs.org.uk/wpcypcs/wp-content/uploads/2020/07/independent-cria.pdf

[xxviii] https://www.gov.scot/binaries/content/documents/govscot/publications/research-and-analysis/2020/09/the-impacts-of-covid-19-on-equality-in-scotland/documents/full-report/full-report/govscot%3Adocument/Covid%2Band%2BInequalities%2BFinal%2BReport%2BFor%2BPublication%2B-%2BPDF.pdf

[xxix] https://cypcs.org.uk/wpcypcs/wp-content/uploads/2020/07/independent-cria.pdf

[xxx] https://www.eif.org.uk/report/covid-19-and-early-intervention-understanding-the-impact-preparing-for-recovery

[xxxi] https://www.ifs.org.uk/publications/14876

[xxxii] https://www.ifs.org.uk/uploads/Covid-19-and-inequalities-IFS.pdf

[xxxiii] https://commonslibrary.parliament.uk/research-briefings/sn05871/

[xxxiv] https://www.resolutionfoundation.org/app/uploads/2020/05/Class-of-2020.pdf

[xxxv]https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/908434/Disparities_in_the_risk_and_outcomes_of_COVID_August_2020_update.pdf

[xxxvi] https://www.nrscotland.gov.uk/files//statistics/rgar/2019/rgar-2019.pdf

[xxxvii] https://www.ifs.org.uk/publications/14798

[xxxviii] https://www.resolutionfoundation.org/app/uploads/2020/05/Young-workers-in-the-coronavirus-crisis.pdf

[xxxix] Including both people who were shielding because they had received a Chief Medical Officer (CMO) letter and those who had not received a letter but had chosen to shield.

[xl] https://inclusionscotland.org/shielding-report/

[xli] Social Renewal Advisory Board. Community Listening Events. 2020.

[xlii] https://gda.scot/wp-content/uploads/2020/09/GDA%E2%80%93Supercharged-Covid-19Report.pdf

[xliii] Including people who have already been made redundant, are in a formal redundancy process or who have had informal discussions with their employer about redundancy.

[xliv]https://www.citizensadvice.org.uk/Global/CitizensAdvice/Work%20Publications/An%20unequal%20crisis%20-%20final%20(1).pdf

[xlv]https://www.ons.gov.uk/employmentandlabourmarket/peopleinwork/employmentandemployeetypes/articles/whichoccupationshavethehighestpotentialexposuretothecoronaviruscovid19/2020-05-11

[xlvi] https://www.ippr.org/blog/minority-ethnic-groups-face-greater-problem-debt-risk-since-covid-19

[xlvii] https://www.resolutionfoundation.org/publications/the-living-standards-audit-2020/

[xlviii] https://www.ippr.org/blog/minority-ethnic-groups-face-greater-problem-debt-risk-since-covid-19

[xlix] https://www.nrscotland.gov.uk/files/statistics/covid19/ethnicity-deceased-covid-19-june20.pdf

[l]https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/892376/COVID_stakeholder_engagement_synthesis_beyond_the_data.pdf

[li]https://www.understandingsociety.ac.uk/sites/default/files/downloads/general/ukhls_briefingnote_covid_ethnicity_final.pdf

[lii], https://policyscotland.co.uk/early-insights-covid-19-response-july-2020-refugee-and-migrant-families