Areas of enduring COVID-19 prevalence: drivers of prevalence and mitigating strategies
Abstract Background UK local authorities that experienced sustained high levels of COVID-19 between 1st March 2020 and 28th February 2021 were described by the UK Scientific Advisory Group for Emergencies as areas of enduring prevalence. This research was carried out in order to examine the views of...
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| Format: | Article |
| Language: | English |
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BMC
2023-06-01
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| Series: | BMC Public Health |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12889-023-15723-7 |
| _version_ | 1797795468020809728 |
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| author | Catherine Lewis Sheena Johnson Angelique Hartwig Janet Ubido Anna Coleman Nicola Gartland Atiya Kamal Amit Gaokar Christopher J. Armitage David Fishwick Martie van Tongeren |
| author_facet | Catherine Lewis Sheena Johnson Angelique Hartwig Janet Ubido Anna Coleman Nicola Gartland Atiya Kamal Amit Gaokar Christopher J. Armitage David Fishwick Martie van Tongeren |
| author_sort | Catherine Lewis |
| collection | DOAJ |
| description | Abstract Background UK local authorities that experienced sustained high levels of COVID-19 between 1st March 2020 and 28th February 2021 were described by the UK Scientific Advisory Group for Emergencies as areas of enduring prevalence. This research was carried out in order to examine the views of local authority Directors of Public Health, who played a crucial role in the local response to COVID-19, on reasons for sustained high levels of prevalence in some areas, alongside an investigation of the mitigation strategies that they implemented during the course of the pandemic. Methods Interviews were conducted with Directors of Public Health in 19 local authority areas across England, between July and November 2021. This included nine areas identified as areas of enduring prevalence and ten ‘comparison’ areas. Results The outcomes of this study suggests that the geographical differences in prevalence rates are strongly influenced by health inequalities. Structural factors including deprivation, employment, and housing, due to their disproportionate impact on specific groups, converged with demographic factors, including ethnicity and age, and vaccination rates, and were identified as the main drivers of enduring prevalence. There are key differences in these drivers both within and, to a lesser extent, between local authorities. Other than these structural barriers, no major differences in facilitators or barriers to COVID-19 mitigation were identified between areas of varying prevalence. The main features of successful mitigation strategies were a locally tailored approach and partnership working involving local authority departments working with local health, community, voluntary and business organisations. Conclusions This study is the first to add the voices of Directors of Public Health, who played a crucial role in the local COVID-19 response. Areas of enduring prevalence existed during the pandemic which were caused by a complex mix of structural factors related to inequalities. Participants advised that more research is needed on the effectiveness of mitigation strategies and other measures to reduce the impact of structural inequalities, to better understand the factors that drive prevalence. This would include an assessment of how these factors combine to predict transmission and how this varies between different areas. |
| first_indexed | 2024-03-13T03:18:25Z |
| format | Article |
| id | doaj.art-ab403fd76123493ea4a4384a4d54ffe6 |
| institution | Directory Open Access Journal |
| issn | 1471-2458 |
| language | English |
| last_indexed | 2024-03-13T03:18:25Z |
| publishDate | 2023-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj.art-ab403fd76123493ea4a4384a4d54ffe62023-06-25T11:31:12ZengBMCBMC Public Health1471-24582023-06-0123111710.1186/s12889-023-15723-7Areas of enduring COVID-19 prevalence: drivers of prevalence and mitigating strategiesCatherine Lewis0Sheena Johnson1Angelique Hartwig2Janet Ubido3Anna Coleman4Nicola Gartland5Atiya Kamal6Amit Gaokar7Christopher J. Armitage8David Fishwick9Martie van Tongeren10Division of Population Health, Health Services Research & Primary Care, University of ManchesterAlliance Manchester Business School, University of ManchesterAlliance Manchester Business School, University of ManchesterDivision of Population Health, Health Services Research & Primary Care, University of ManchesterDivision of Population Health, Health Services Research & Primary Care, University of ManchesterDivision of Population Health, Health Services Research & Primary Care, University of ManchesterBirmingham City UniversityRochdale Borough CouncilManchester Centre for Health Psychology, University of ManchesterHealth and Safety Executive (HSE)Division of Population Health, Health Services Research & Primary Care, University of ManchesterAbstract Background UK local authorities that experienced sustained high levels of COVID-19 between 1st March 2020 and 28th February 2021 were described by the UK Scientific Advisory Group for Emergencies as areas of enduring prevalence. This research was carried out in order to examine the views of local authority Directors of Public Health, who played a crucial role in the local response to COVID-19, on reasons for sustained high levels of prevalence in some areas, alongside an investigation of the mitigation strategies that they implemented during the course of the pandemic. Methods Interviews were conducted with Directors of Public Health in 19 local authority areas across England, between July and November 2021. This included nine areas identified as areas of enduring prevalence and ten ‘comparison’ areas. Results The outcomes of this study suggests that the geographical differences in prevalence rates are strongly influenced by health inequalities. Structural factors including deprivation, employment, and housing, due to their disproportionate impact on specific groups, converged with demographic factors, including ethnicity and age, and vaccination rates, and were identified as the main drivers of enduring prevalence. There are key differences in these drivers both within and, to a lesser extent, between local authorities. Other than these structural barriers, no major differences in facilitators or barriers to COVID-19 mitigation were identified between areas of varying prevalence. The main features of successful mitigation strategies were a locally tailored approach and partnership working involving local authority departments working with local health, community, voluntary and business organisations. Conclusions This study is the first to add the voices of Directors of Public Health, who played a crucial role in the local COVID-19 response. Areas of enduring prevalence existed during the pandemic which were caused by a complex mix of structural factors related to inequalities. Participants advised that more research is needed on the effectiveness of mitigation strategies and other measures to reduce the impact of structural inequalities, to better understand the factors that drive prevalence. This would include an assessment of how these factors combine to predict transmission and how this varies between different areas.https://doi.org/10.1186/s12889-023-15723-7Community engagementCOVID-19DeprivationEmploymentHealth inequalitiesPartnership working |
| spellingShingle | Catherine Lewis Sheena Johnson Angelique Hartwig Janet Ubido Anna Coleman Nicola Gartland Atiya Kamal Amit Gaokar Christopher J. Armitage David Fishwick Martie van Tongeren Areas of enduring COVID-19 prevalence: drivers of prevalence and mitigating strategies BMC Public Health Community engagement COVID-19 Deprivation Employment Health inequalities Partnership working |
| title | Areas of enduring COVID-19 prevalence: drivers of prevalence and mitigating strategies |
| title_full | Areas of enduring COVID-19 prevalence: drivers of prevalence and mitigating strategies |
| title_fullStr | Areas of enduring COVID-19 prevalence: drivers of prevalence and mitigating strategies |
| title_full_unstemmed | Areas of enduring COVID-19 prevalence: drivers of prevalence and mitigating strategies |
| title_short | Areas of enduring COVID-19 prevalence: drivers of prevalence and mitigating strategies |
| title_sort | areas of enduring covid 19 prevalence drivers of prevalence and mitigating strategies |
| topic | Community engagement COVID-19 Deprivation Employment Health inequalities Partnership working |
| url | https://doi.org/10.1186/s12889-023-15723-7 |
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