Health inequalities are likely to widen without action to support those most vulnerable to the economic and other effects of social distancing measures, argue Margaret Douglas and colleagues.

Countries worldwide have implemented strict controls on movement in response to the covid-19 pandemic. The aim is to cut transmission by reducing close contact, but the measures have profound consequences. Several sectors are seeing steep reductions in business, and there has been panic buying in shops. Social, economic, and health consequences are inevitable.

The health benefits of social distancing measures are obvious, with a slower spread of infection reducing the risk that health services will be overwhelmed. But they may also prolong the pandemic and the restrictions adopted to mitigate it. Policy makers need to balance these considerations while paying attention to broader effects on health and health equity.

Who is most at risk?

Several groups may be particularly vulnerable to the effects of both the pandemic and the social distancing measures. Table 1 summarises several mechanisms through which the pandemic response is likely to affect health: economic effects, social isolation, family relationships, health related behaviours, disruption to essential services, disrupted education, transport and green space, social disorder, and psychosocial effects. Figure 1 shows the complexity of the pathways through which these effects may arise. Below we expand on the first three mechanisms, using Scotland as an example. The appendix on bmj.com provides further details of mechanisms, effects, and mitigation measures.

Cite as

Douglas, M., Katikireddi, S., Taulbut, M., McKee, M. & McCartney, G. 2020, 'Mitigating the wider health effects of covid-19 pandemic response', BMJ, 369, article no: m1557. https://doi.org/10.1136/bmj.m1557

Downloadable citations

Download HTML citationHTML Download BIB citationBIB Download RIS citationRIS
Last updated: 29 June 2022
Was this page helpful?