January Capability Event - Tackling Inequality

For our first Capability Building Event of 2024, we explored how pre-existing inequalities are exacerbated during emergencies, looking at lessons from national and international responses, and discussing how others are working to mitigate gaps in support for groups who are disproportionately impacted.

For our first session, we welcomed two guests to share their insight and experiences:

  • Sophie talked us through the international humanitarian response cycle and the International Coordination Mechanisms, which play a vital role in providing the systems needed for cross-sector working.

    With Sophie’s work having a strong focus on the rights of Disabled People, she noted examples of collective response where the specific needs of individuals haven’t been met, including medical aid shipments that don’t include the vital medication that many with pre-existing conditions need, and a lack of assistive and accessible technology, support and communication which has led to inequalities being exacerbated.

    She also explained more about specific examples, particularly involving emergency shelters.

    • In Ukraine, air raid shelters had not been adapted for those with limited mobility such as the elderly or people with disabilities, leaving those who already faced huge challenges, unable to seek safety.

    • Similarly, following the earthquake in Turkey, many who were elderly or disabled stayed away from emergency shelters as they felt they were inaccessible and weren’t confident their needs would be met there.

    Sophie went on to describe how the 2019 IASC guide ‘Inclusion of Persons with Disabilities in Humanitarian Action' was a breakthrough for inclusive action. The aims of the guide include engaging with those most affected, and ensuring that people have a role in decision making and can feedback, whether that is through increased employment of people with disabilities, or processes to embed representation throughout the programme cycle, including in design.

  • Professor Clare Bambra joined us to explain some of the findings of her research alongside Professor Sir Michael Marmot on health inequalities for the UK Covid-19 Public Inquiry.

    Clare began by explaining some of the health inequalities that existed prior to the pandemic, such as how those from the most deprived communities have a lower life expectancy than those from less-deprived areas. She then presented some of the factors that contributed to health inequalities present during the pandemic:

    • Occupation: ONS data has shown a sizeable difference in mortality rate between those in the three highest ranked occupational groups (managers, directors, professional and technical occupations), and those in other professions such as care and service providers and plant/machine operatives.

    • Ethnicity: There were also large differences in mortality across ethnic groups. In the pre-vaccine period, Asian/Asian British people had more than 2.5 times the mortality rate of white/white British people. Black/Black British mortality rates were also almost double.

    • Regional: Mortality rates in the North East, North West and Yorkshire and the Humber were higher than elsewhere in England. Regionally, there was also an ‘amplification of deprivation effect’ – a deprived area in the North generally had a higher mortality rate compared to a deprived area in the South. For affluent areas, there was little difference regionally.

    During her research for the UK Covid-19 Public Inquiry, Clare looked at literature from previous emergencies. This showed a continued North-South divide with regards to health inequalities in the UK, as well as significant differences across ethnicities and in socio-economic backgrounds. It was therefore concluded that it was predictable that a shock like Covid-19 would have adverse unequal impacts. This can also be applied to other emergencies more broadly and so steps should be taken now in the planning and preparedness for future emergencies to begin to mitigate the disproportionate impacts that certain groups consistently face. Clare went on to conclude that pre-existing health inequalities were only considered in a minimal way, and largely only in relation to age and clinical risk factors.

“Barriers weren’t considered, and therefore enablers weren’t put in place.”

The second session built on the earlier conversation, giving time for peer learning and sharing of experiences, as partners explained some of the successes and challenges in their own work to mitigate the gaps in support. We also discussed how partners use data to identify those who could be most at-risk during an emergency and how this informs their work.

Key Themes

Questions to Consider:

LRF - How can this knowledge be used to inform planning for other types of emergencies? How are you connecting with communities to understand why they experience greater impacts?

VCS - Which groups within your community have previously been disproportionately impacted by emergencies? Have you incorporated this learning into planning for future crises?

Questions to Consider:

LRF – How do you involve community leaders or representatives from disproportionately impacted groups in your emergency planning to share their experiences?

VCS - How could you support communities to amplify their voices in preparedness, response and recovery and encourage better representation?

Questions to Consider:

LRF - What data do you use, and how can this be complemented with the experiences of those in communities?

VCS - How could stories of lived experience be shared with those such as the LRF to help inform their plans?

Questions to Consider:

All - Which groups within your community do you believe would be at greater risk in an emergency? What are you basing this on?

All - Have you included considerations for them in your preparedness planning?

Questions to Consider:

All - How could you improve your communication output to ensure it is accessible to more people?

LRF - When providing resources to partners in communities, do you offer it in several languages/formats so it is easily shared?

VCS - Could resources translated or interpreted by partners within your networks be shared to avoid duplication of work for others?

We encourage you to consider the questions above for your own organisation, community or network. Within the Partnership, we are continuing to look at the disproportionate impact of emergencies on communities and how we can all strive to do more. We will be returning to this conversation at future meetings.

Resources and Recommended Reading

Georgia Allen