Social determinants of health – raising the bar for MS during COVID-19

A huge wealth of information has come out of the COVID-19 pandemic, with the MS Register team analysing The impact of COVID-19 in patients with MS, the hidden cost of MS and future plans for an MS pregnancy study, and other patterns across COVID-19 and social determinants of health, lower income, mental health difficulties and risks of severity with COVID-19 arising over the past months.

Globally, according to the IMF’s World Economic Outlook projections and data from World Bank’s PovcalNet, “Covid-19 is likely to cause the first increase in global poverty since 1998.” with predictions that 49 million people will be pushed into extreme poverty in 2020 as a result of the pandemic (Forbes, 28.05.20). Within the UK, Poverty and Social Exclusion (PSE) have researched the impact of COVID-19 on UK households, with key findings including:

• 3.1 million households are in serious financial difficulty
• 4.8 million households are struggling to make ends meet
• 7 million have lost a significant part of their earnings
• 7.7 million households anticipate some fall in income in the next 3 months
• 10.4 million households are potentially exposed financially

At the start of May, Prof Gavin Giovannoni highlighted the poor health outcomes associated with poverty in his BartsMS blog, citing recent data from the Office of National Statistics (ONS) and noting that

‘On average the most deprived areas of the country had more than double the death rate [from COVID-19] than people in the least deprived areas.’

We know from the UK MS Register that ‘people with MS and their families are having to fund up to 75% of non-medical costs from their own pockets’ and this financial strain, within the societal impact of COVID-19 will be having an impact on those living with MS.

This wealth of new information provides a strong basis for the workstream to build on to both understand the depth of the challenge, and to create some tools and strategies to support patients who may need additional support or be at risk of ‘falling off the radar’ of healthcare services.