Dataset Information

A framework for identifying and mitigating the equity harms of COVID-19 policy interventions.

ABSTRACT:

Background

Coronavirus disease 2019 (COVID-19) is a global pandemic. Governments have implemented combinations of "lockdown" measures of various stringencies, including school and workplace closures, cancellations of public events, and restrictions on internal and external movements. These policy interventions are an attempt to shield high-risk individuals and to prevent overwhelming countries' healthcare systems, or, colloquially, "flatten the curve." However, these policy interventions may come with physical and psychological health harms, group and social harms, and opportunity costs. These policies may particularly affect vulnerable populations and not only exacerbate pre-existing inequities but also generate new ones.

Methods

We developed a conceptual framework to identify and categorize adverse effects of COVID-19 lockdown measures. We based our framework on Lorenc and Oliver's framework for the adverse effects of public health interventions and the PROGRESS-Plus equity framework. To test its application, we purposively sampled COVID-19 policy examples from around the world and evaluated them for the potential physical, psychological, and social harms, as well as opportunity costs, in each of the PROGRESS-Plus equity domains: Place of residence, Race/ethnicity, Occupation, Gender/sex, Religion, Education, Socioeconomic status, Social capital, Plus (age, and disability).

Results

We found examples of inequitably distributed adverse effects for each COVID-19 lockdown policy example, stratified by a low- or middle-income country and high-income country, in every PROGRESS-Plus equity domain. We identified the known policy interventions intended to mitigate some of these adverse effects. The same harms (anxiety, depression, food insecurity, loneliness, stigma, violence) appear to be repeated across many groups and are exacerbated by several COVID-19 policy interventions.

Conclusion

Our conceptual framework highlights the fact that COVID-19 policy interventions can generate or exacerbate interactive and multiplicative equity harms. Applying this framework can help in three ways: (1) identifying the areas where a policy intervention may generate inequitable adverse effects; (2) mitigating the policy and practice interventions by facilitating the systematic examination of relevant evidence; and (3) planning for lifting COVID-19 lockdowns and policy interventions around the world.

SUBMITTER: Glover RE

PROVIDER: S-EPMC7280094 | biostudies-literature | 2020 Dec

REPOSITORIES: biostudies-literature

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Publications

A framework for identifying and mitigating the equity harms of COVID-19 policy interventions.

Glover Rebecca E RE van Schalkwyk May C I MCI Akl Elie A EA Kristjannson Elizabeth E Lotfi Tamara T Petkovic Jennifer J Petticrew Mark P MP Pottie Kevin K Tugwell Peter P Welch Vivian V

Journal of clinical epidemiology 20200609

<h4>Background</h4>Coronavirus disease 2019 (COVID-19) is a global pandemic. Governments have implemented combinations of "lockdown" measures of various stringencies, including school and workplace closures, cancellations of public events, and restrictions on internal and external movements. These policy interventions are an attempt to shield high-risk individuals and to prevent overwhelming countries' healthcare systems, or, colloquially, "flatten the curve." However, these policy interventions ...[more]

PMID: 32526461

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Dataset Information

A framework for identifying and mitigating the equity harms of COVID-19 policy interventions.

Background

Methods

Results

Conclusion

Publications

A framework for identifying and mitigating the equity harms of COVID-19 policy interventions.

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