Health and socio-economic consequences of the COVID-19 pandemic have been exacerbated by central government-imposed austerity budgeting by local authorities and the health service. This book, part of the Social Determinants of Health series, extends the ideas developed in the previous volumes by reviewing the impact of COVID-19 on local and national governance from the perspectives of public health, social care and economic development. Drawing on case studies from across the UK and beyond, it explores the pandemic and other ‘wicked’ issues including climate change, homelessness, unemployment and domestic abuse through the lens of relationalism, and proposes necessary system changes.

The COVID-19 pandemic has disproportionately affected those population sectors that experience inequality. Specifically, marginalized racial and ethnic populations with pre-existing health conditions, those living in poverty, those possessing a low education level, hourly wage employees, etc. have experienced an excess burden of COVID-19 morbidity and mortality compared to their White counterparts in developed countries. The interaction of the social determinants of health with a novel virus has made visible the inequities that have been hidden or accustomed to in many communities globally. As we work to end the current pandemic, we must consider the post-COVID-19 pandemic era and address the social determinants of health so that populations start from a place of health, as opposed to a place of disease for the next public health challenge. Syndemic research has demonstrated the interaction among socio-cultural factors, socio-economic factors, structural factors, and individual factors (collectively referred to as the social determinants of health) and infectious disease epidemics (e.g., COVID-19, AIDS) and social epidemics (e.g., structural racism). These interactions can exacerbate and sustain adverse health outcomes for marginalized populations. How can communities improve the social determinants of health for impoverished populations? The importance of doing so would have implications not only for the health status of communities but could also improve economic conditions for these geographic areas. Addressing the social determinants of health for marginalized populations has the potential to improve health for all.

"The novel coronavirus of 2019 (COVID-19) has caused one of the largest pandemics in human history. COVID-19 was declared a global pandemic in March 2020. The worldwide COVID health crisis has affected virtually every aspect of daily life, namely the conditions in which we are born, grow, learn, work, and age. For the last three years, for instance, we have engaged in social distancing, remote meetups and seemingly endless Zoom calls. We have also changed how we view healthcare, with many increasing their use of telemedicine. Many have also abandoned city living for a more comfortable life in suburban, peri-rural and rural environments, with greater access to trees and parkland. Travel has been significantly impacted-disrupting existing social networks but also potentially deepening more localized social networks. For some, these changes were only in initial lockdown period(s); for others, these changes may be ongoing. The idea for our book emerged from overwhelming evidence that the pandemic intersects with nearly every social determinant of population health and aggravating existing inequalities in social conditions and health outcomes"--

Employing a sociological and broader social sciences approach, this volume draws on a variety of contexts, including the COVID-19 pandemic, to explore wider trends in healthcare and the impact they may have on historically disadvantaged communities.

Social determinants of health – broadly defined as the conditions in which people are born, grow, live, work and age, and people’s access to power, money and resources – have a powerful influence on health inequities. In 2021, the Seventy-fourth World Health Assembly adopted resolution WHA74.16 on addressing social determinants of health, which encouraged Member States to integrate social determinants of health into public policies and programmes and adopt multisectoral approaches. The resolution requested the Director-General to develop an “Operational framework ... for the measurement, assessment and addressing, from a cross-sectorial perspective, of the social determinants of health and health inequities”. This Operational framework for monitoring social determinants of health equity provides countries with critical guidance on monitoring the social determinants of health and actions addressing them, and using data for policy action across sectors to improve health equity. The publication is meant as a resource for national governments and their partners. It was drafted under the guidance of an expert group and with internal contributions across the three levels of WHO, as well as through formal consultation with Member States, and was endorsed at the Seventy-sixth World Health Assembly.