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The Covid crunch: impact on economy and health

20 November 2020

The UK entered its first recession in 11 years in August. Journalist Juliette Astrup explores the impact on families and children, and on services and community practitioners themselves.

The Covid-19 pandemic has created a two-headed crisis of epic proportions. While coronavirus has caused a health emergency, the unprecedented measures taken to try to check its spread have triggered a socioeconomic crisis that is also a threat to the nation’s health.

After two successive quarters of negative GDP growth, including the record 20.4% drop recorded by the Office for National Statistics (ONS) from April to June (ONS, 2020a), the UK economy officially entered recession for the first time in just over a decade. The effects are being felt viscerally in homes up and down the country.

Although the latest figures (ONS, 2020b) indicate an upturn, the return of local lockdowns and stringent social distancing in higher-risk areas will inevitably have an impact. In addition, the nationwide furlough scheme and its successor, the Job Support Scheme, seem likely to slow but not stop new waves of job losses.

Who will be hit hardest?

Analysts at the Centre for Economic Performance judge from past downturns that this recession will also have ‘a disproportionate impact on the most vulnerable: the poorest, the youngest, the least educated and ethnic minorities’ (Bell et al, 2020).

This recession does have some features that distinguish it from its predecessors, according to David Finch, senior fellow at the Health Foundation. For one thing, it is more ‘sector-specific’, he says, given that the Covid response measures are hitting certain regions and industries harder than others.

The worst-affected sectors include hospitality, ‘where a temporary crisis has been created, and retail, where lockdown accelerated longer-term shifts in shopping habits, expediting job losses’, David says.

‘Young people are being hit hardest by the unemployment that’s come through so far,” he adds. ‘They were more likely to be furloughed and are still at higher risk of unemployment. Young parents, especially those in part-time work, are particularly vulnerable to falling into poverty if they become unemployed.’

Another distinguishing feature of the Covid recession is that its effects are even spreading into less deprived areas, according to David, who reports a ‘big increase’ in the number of claims for universal credit in parts of the UK that have traditionally weathered past economic storms relatively well.

‘We need to ensure that the current infrastructure is geared towards emerging inequalities and the type of economic shock we’re experiencing now,’ he says.

Janet Taylor, chair of the CPHVA Executive, observes that the socioeconomic effects of Covid-19 are a serious concern, both professional and personal, for many community practitioners (CPs).

‘For a lot of our families, it will mean financial insecurity and having to rethink their careers, particularly those in sectors such as hospitality, which tend to be lower-paid,’ Janet says. ‘We will see more people becoming reliant on foodbanks and other services.”

She adds: ‘While vulnerable families will certainly be among those who need more help, this is hitting everybody – there will be “middle-class” clients, who maybe had their own businesses and have suddenly found that they’re gone. Practitioners won’t be immune either – they might find themselves becoming the main breadwinner.’

Effects on families

The median household income in the UK fell by an estimated 4.5% over the 12 months to May 2020 (Resolution Foundation, 2020). The largest annual decline since the 1970s was driven by redundancies, reductions in working hours and pay cuts for employees on furlough.

‘Early estimates suggested that 300,000 children had been pushed into poverty by the disruptive effects of lockdown,’ says Anne Longfield, children’s commissioner for England. ‘Expanded welfare spending has partially mitigated the impact on households, but this still leaves an estimated 200,000 more children in poverty. Reduced family incomes and restrictions on movement have increased children’s food insecurity. The Trussell Trust reported an 89% increase in need for emergency food parcels in April 2020 compared with the same month last year.’

She continues: ‘At the end of April, 350,000 children were in a household where someone had been forced to skip a meal in the preceding week and 249,000 were in families that had accessed foodbanks.’

But the ramifications of poverty go well beyond the immediate harm to children’s physical health, notes Anne, who says: ‘We know that what happens in the early years can have a lasting effect on children’s development – not just their educational development but also their mental health and wellbeing. This includes their ability to build positive relationships and regulate their emotions and behaviour.’

Janet agrees, noting that there has been ‘a massive strain on mental health, particularly when financial worries are compounded by all the issues that come with the pandemic. Parents are worrying about childcare and about going to work and being exposed to the virus. Mums who’ve been pregnant during Covid have faced additional stresses. Some have had quite a traumatic time. They will be now more isolated at home without the usual support groups and social activities.’

Sadly, some children will inevitably be exposed to further harm when there is upheaval in the home.

‘We know that the lockdown resulted in an increase in domestic violence,’ Janet says. ‘This “behind closed doors” issue is a real concern for health visitors, especially in parts of the UK where face-to-face visits are still limited.’

‘Early estimages suggested that 300,000 children had been pushed into poverty by the disruptive effects of lockdown’

Strain on services

The historical context of the Covid recession is significant. Several key health services were already under financial stress before the arrival of coronavirus. A review published in February, when confirmed cases of infection were only in double figures, concluded that, in England, ‘health is getting worse for people in more deprived districts’ – and that the ‘inequalities are increasing’ (Marmot et al, 2020).

Massive cuts to public health budgets and local authority funding meant that services were already ‘very much under pressure’ before the pandemic struck, according to David.

‘Over a decade of austerity we have seen a disinvestment in those upstream services that keep people healthy,’ he says. ‘There has been a shift towards spending on crisis management, with services having to focus on acute need.’

Health visiting and school nursing services in particular have experienced an upheaval. Practitioners in these sectors are facing both the ongoing challenge of working under Covid restrictions and the consequences of their redeployment during the national lockdown. For instance, a recent survey of health visitors in England found that their redeployment between 19 March and 3 June had resulted in significant and lasting rises in caseloads for many (University College London, 2020).

‘The workloads of health visitors, perinatal and infant mental health teams, and other early-years services are likely to have increased substantially, as they “play catch-up” with babies and young children who may not have been seen for months,’ Anne reports.

She is among those calling for more resources ‘to allow missed health contacts and other outreach from early-years services to take place, and to fully restore health visiting services’. Whether the funding materialises remains to be seen. Provision is a particular concern in England, according to the Institute for Fiscal Studies: local authorities – which are now responsible for commissioning 0 to 19 services – are facing greater spending demands at a time when their incomes are being decimated (Ogden and Phillips, 2020).

 

 

What next for CPs?

As Janet observes, services are ‘easy to step down, but hard to rebuild’. And she notes that the lockdown step-down could yet present a longer-term threat.

‘We need to ensure that councils facing financial pressure don’t treat this as an opportunity to make cuts and drop things that we know to be critical to the health and wellbeing of clients – especially now,’ Janet stresses. ‘This is a chance to do things differently: we must work within the constraints of the pandemic, but be sure that services are reinstated and resourced to enable them to properly support those need them more than ever.’

She adds that the priority must be to keep channels of communication open. ‘This is more important than ever. We need to build relationships with clients through every medium, so that they’re able to open up about what’s going on. Then we can signpost help and information, whether that’s from Citizens Advice, their local trust, public health websites, charities or foodbanks. As health visitors and community practitioners, you will be aware of what’s available in your area.’

A fast recovery from the Covid recession looks increasingly unlikely as tougher measures return to combat the resurgence of the virus. CPs and other professionals and charities across this space will doubtless continue to give their best, but the extent to which children and families can be protected from the resulting harms is another unknown, among many. 


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References:

Bell B, Codreanu M, Machin S. (2020) What can previous recessions tell us about the COVID-19 downturn? CEP COVID-19 analysis. See: http://cep.lse.ac.uk/pubs/download/cepcovid-19-007.pdf (accessed 15 October 2020).

Office for National Statistics. (2020a) GDP first quarterly estimate, UK: April to June 2020. See: ons.gov.uk/economy/grossdomesticproductgdp/bulletins/gdpfirstquarterlyestimateuk/apriltojune2020 (accessed 11 October 2020).

Ogden K, Phillips D. (2020) The financial risk and resilience of English local authorities in the coronavirus crisis. See: https://www.ifs.org.uk/publications/14893 (accessed 11 October 2020).

Marmot M, Allen J, Boyce T, Goldblatt P, Morrison J. (2020). Health equity in England: the Marmot review 10 years on. See: http://www.instituteofhealthequity.org/resources-reports/marmot-review-10-years-on/the-marmot-review-10-years-on-full-report.pdf (accessed 11 October 2020).

Office for National Statistics. (2020b) Coronavirus and the impact on output in the UK economy: August 2020. See: ons.gov.uk/economy/grossdomesticproductgdp/articles/coronavirusandtheimpactonoutputintheukeconomy/august2020 (accessed 11 October 2020).

Resolution Foundation. (2020) The Living Standards Audit 2020. See: resolutionfoundation.org/publications/the-living-standards-audit-2020 (accessed 11 October 2020).

UCL. (2020) Vulnerable families at risk as health visitor workloads increase. See: https://www.ucl.ac.uk/news/2020/jul/vulnerable-families-risk-health-visitor-workloads-increase (accessed 11 October 2020).

 

 

 

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