People in Scotland’s poorest areas treated in intensive care because of severe covid-19 are more likely to die than those from wealthier neighbourhoods, a study has found.

Researchers found that patients from the most economically disadvantaged postcodes had a higher chance of being admitted to critical care – and intensive care units in these areas were more likely to be full.

The team, from the universities of Glasgow and Edinburgh, say the results show the need to direct more staffing and funding to ICUs in deprived areas.

Lead researcher Dr Nazir Lone, senior lecturer at the University of Edinburgh and Honorary Consultant in Critical Care at NHS Lothian, said: “A number of factors could be driving this link between poverty and severe disease, including poor housing, increased use of public transport and financial pressures to continue working.

“The most deprived communities, and the hospitals that serve them, will need extra support as the pandemic continues.”

Questioned about the research today, First Minister Nicola Sturgeon said the findings were being taken “extremely seriously” but said the reasons for the disparities were not yet fully understood.

The study was published in The Lancet Regional Health – Europe journal.

Using anonymous health records and data on postcode incomes, researchers found that people on low incomes were overrepresented in admissions to critical care units between March and June.

One quarter of admissions were from the most deprived areas, compared to 13% from the wealthiest.

The death rate for the least well-off was found to be 34%, compared to around 28% for all other groups.

Meanwhile hospitals in the most deprived health board areas were also more likely to see higher surges in demand for ICU beds and to be operating over normal capacity for longer periods.

Across Scotland, the number of patients in hospital ICUs outstripped pre-pandemic levels of critical care beds for 25 days over April, peaking at 145% of normal capacity.

But this was even more pronounced in areas of high deprivation, which were over capacity for longer periods of time and reached 165% of usual levels.

The study authors argue that a ‘more targeted’ approach to allocating funds to the NHS is needed.

Co-author Dr Joanne McPeake, from the University of Glasgow, said: “While we move through this pandemic, it is increasingly important to understand how this virus affects different groups in order for informed decisions to be taken on mitigating risks.

“This data will help inform how we support different communities in both the short and long-term, in order to adequately ensure that socioeconomic inequalities are not exacerbated further.”

Asked about the effects of the virus on people living in poverty today, Nicola Sturgeon said: “In short, we take it extremely seriously as we do all aspects of this virus and will continue to try to ensure that our response is tailored accordingly, and our understanding is flexible as our understanding of all of these factors continues to develop.”

The issue had been raised by Scottish Labour leader Richard Leonard, who asked: “How seriously is the government taking the unequal impact of covid on those in Scotland living in deepest poverty?”

Nicola Sturgeon replied: “I am aware of the research published in the Lancet. These findings are not new – we have been aware for most of the past ten months that there has been a disproportionate impact of this virus on people living in deprived areas and a disproportionate impact when it comes to people being seriously ill and hospitalised, going into intensive care or perhaps dying.

“What has not been fully understood is what the reasons for that are, and this is also true for some of our BAME communities.”

The First Minister went on to say: “The developing understanding suggests that that is less to do with clinical issues and more to do with societal circumstances – so exactly the factors Richard Leonard alluded to; housing conditions and the broader conditions of particular areas.

“There is a lot of work ongoing to continue to try to understand that but right from the start of the pandemic, we have tried to factor that into our responses, so much of the work we have done to provide additional financial support has been geared towards those living in poverty and conditions of deprivation.”

 

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