Appraising Social Distributions To Guide Levelling Up Health And Wellbeing During Covid-19 Recovery

Research Question How can the costs and outcomes of COVID-19 and the policy response be appraised in a way that shows differences between population groups. The answer is contingent on the definition of relevant outcomes to inform policy. With improving health and wellbeing across society as a goal, evidence based policy relies on understanding the pathways by which COVID-19 and the COVID-19 policy responses affect these outcomes. In order for appraisal to reflect differences between social groups, it is vital to consider where direct impacts or pathways differ between population groups. Where inequality is identified, and where there are trade-offs between outcomes, evidence based policy relies on value judgements to reflect the degree of priority given to reducing inequality and improving outcomes. This scoping study will initiate a map for those undertaking economic evaluations related to COVID-19 that will support the inclusion of inequality impacts in appraisal. Background Existing health inequalities, the elimination of which is an objective in public funding, may have been exacerbated in avoidable ways by COVID-19 and the policy response to COVID-19. As unprecedented levels of public funds are shifted towards COVID-19 policy, further information on the costs and benefits of these activities is required to identify and prioritise those that offer value for money and provide proportionate benefits to disadvantaged groups. Our understanding of the disease and of how policy responses operate differently for different groups is developing over time. Health economic models of the impact of COVID-19 and associated policies must evolve with this to reflect how interventions are understood to effect changes in relevant costs and outcomes across population groups. Aims and objectives We will map current understanding of how COVID-19 and associated policies impact on health and wellbeing via direct impacts on health conditional on individual risk factors, and direct impacts on social determinants of health. We will scope out the level of evidence for differences in the direct impacts and the pathways from social determinants of health to final outcomes between population groups. Methods We will review economic evaluations of COVID-19 and similar pandemics. The results will summarise the social determinants of health captured, the outcomes included, the modelled pathways, the sources of evidence, the relative valuation of outcomes, and how differences between population groups was reflected. We will present the results to stakeholders, including members of the public, directors of public health and social services, experts in economic evaluation, public health and health inequality, and members of the Department of Health and Social Care and arms lengths bodies. Using the results of the review and consultation feedback we will construct an online resource for economic evaluation related to COVID-19. This will summarise the aspects of health and social determinants of health affected by COVID-19, indicating where evidence exists for unequal impacts and where evidence of inequality impact is lacking. Updatable searches and links to existing evidence sources will be provided.