In the last issue of the IJHPE, I wrote about Sir Michael Marmot’s review (Marmot et al. 2020) which showed that in the last ten years reducing inequality in health and life expectancy in the UK has stalled. That was in early March just as Covid-19 was emerging to become the biggest pandemic in living memory. Writing this in May, less than two months later the impact of the virus in almost every country across the world is immediate and devastating with far-reaching implications for the health of populations and the economies of all countries. In the UK, many thousands have lost loved ones and the longterm impact on health and wellbeing is immeasurable. Like most people in the UK I have watched the news feeds, read the articles and listened to the politicians, statisticians and experts from a wide range of disciplines on a daily or even hourly basis. Explained to the general public via graphs and slides, modelling and predications have been used to provide evidence for a strict lockdown and a general curtailing of normal life and liberty. We have watched with trepidation the news footage of overwhelmed health services in other European countries that are ahead of the UK in the spread of the Coronavirus. Writing in the fourth month of the pandemic and some countries are starting to tentatively relax lockdown restrictions on the populace. However, in the absence of effective treatments or vaccine, Covid-19 will be with us for the foreseeable future. Decisions made by politicians and their advisors will be criticised and dissected and the data and modelling which informed those decisions will be scrutinised with the benefit of hindsight for years to come here in the UK and in other countries. The probable scale of the impact of Covid-19 on populations and economies around the globe is vast. However, whilst we can say with confidence that the virus is no respecter of wealth or social standing, there are emerging data in England and other countries showing a greater impact in the most deprived communities that will widen the inequality gap. In the UK, Office for National Statistics data show that the most deprived areas in England have suffered the most and behind the figures will be the usual indicators of poor housing, overcrowding, worklessness, poverty and underlying health issues. Key workers in low-paid jobs who are unable to work from home are at greater risk of infection and there is already evidence including from the USA that those from Black, Asian and minority ethnic backgrounds are being disproportionately hit harder by the virus. This global pandemic has illustrated just how small our planet is and that no nation is immune to the actions of others. The quest for a vaccine and for effective treatments should be an internationally driven endeavour and we cannot afford for the race to become politicised. It is vital that any vaccine found to be effective can be produced in volume at a price (i.e. at cost) that the poorest countries can afford. There have been promising signs that scientists around the world are collaborating in their research and this could ultimately result in one of the greatest positive health impacts in a generation. Treatments using drugs already licensed for other diseases are being trialled in several INTERNATIONAL JOURNAL OF HEALTH PROMOTION AND EDUCATION 2020, VOL. 58, NO. 4, 223–225 https://doi.org/10.1080/14635240.2020.1771035

中文翻译：

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健康不平等——Covid-19 将扩大差距

在上一期 IJHPE 中，我写了 Michael Marmot 爵士的评论（Marmot 等人，2020 年），该评论表明，在过去十年中，减少英国健康和预期寿命不平等的工作已经停滞不前。那是在 3 月初，当时 Covid-19 正在成为人们记忆中最大的流行病。在不到两个月后的 5 月写下这篇文章，该病毒对世界上几乎每个国家的影响都是直接和毁灭性的，对所有国家的人口健康和经济产生深远影响。在英国，成千上万的人失去了亲人，对健康和福祉的长期影响是无法估量的。像大多数英国人一样，我看过新闻提要，阅读文章并听取政客的意见，每天甚至每小时都有来自广泛学科的统计学家和专家。通过图表和幻灯片向公众解释，建模和预测已被用于为严格封锁和普遍限制正常生活和自由提供证据。我们惊恐地看着其他欧洲国家在冠状病毒传播方面领先于英国的医疗服务不堪重负的新闻镜头。在大流行的第四个月写作，一些国家开始试探性地放松对民众的封锁限制。但是，在缺乏有效治疗方法或疫苗的情况下，在可预见的未来，Covid-19 将与我们同在。政治家及其顾问做出的决定将受到批评和剖析，在英国和其他国家/地区，这些决定所依据的数据和模型将经过事后多年的审查。Covid-19 对全球人口和经济的影响可能规模巨大。然而，尽管我们可以自信地说，这种病毒与财富或社会地位无关，但英格兰和其他国家的新数据显示，对最贫困社区的影响更大，这将扩大不平等差距。在英国，国家统计局的数据显示，英格兰最贫困的地区遭受的苦难最多，而这些数字背后往往是住房条件差、人满为患、失业、贫困和潜在健康问题的常见指标。无法在家工作的低薪工作的主要工人感染的风险更大，包括来自美国在内的证据表明，来自黑人、亚裔和少数族裔背景的人受到病毒的打击更大。这场全球大流行表明我们的星球是多么的渺小，任何国家都不能幸免于其他国家的行为。寻求疫苗和有效治疗方法应该是一项国际驱动的努力，我们不能让这场竞赛变得政治化。至关重要的是，任何被发现有效的疫苗都可以以最贫穷国家能够承受的价格（即成本）大量生产。有迹象表明，世界各地的科学家正在合作开展研究，这可能最终导致一代人对健康产生最大的积极影响。使用已获准治疗其他疾病的药物的治疗正在多份国际健康促进与教育杂志 2020 年卷中进行试验。58，没有。4, 223–225 https://doi.org/10.1080/14635240.2020.1771035