Areas of enduring COVID-19 prevalence: drivers of prevalence and mitigating strategies

Lewis, Catherine and Johnson, Sheena and Hartwig, Angelique and Ubido, Janet and Coleman, Anna and Gartland, Nicola and Kamal, Atiya and Gaokar, Amit and Armitage, Christopher J. and Fishwick, David and van Tongeren, Martie (2023) Areas of enduring COVID-19 prevalence: drivers of prevalence and mitigating strategies. BMC Public Health, 23. p. 1203. ISSN 1471-2458

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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.

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.

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.

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.

Item Type: Article
Identification Number:
20 April 2023Accepted
21 June 2023Published Online
Uncontrolled Keywords: Community engagement, COVID-19, Deprivation, Employment, Health inequalities, Partnership working
Subjects: CAH04 - psychology > CAH04-01 - psychology > CAH04-01-01 - psychology (non-specific)
CAH15 - social sciences > CAH15-04 - health and social care > CAH15-04-03 - health studies
Divisions: Faculty of Business, Law and Social Sciences > College of Psychology
Depositing User: Gemma Tonks
Date Deposited: 11 Jul 2023 12:55
Last Modified: 11 Jun 2024 13:02

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