By exploiting existing faults in the health system, the pandemic highlights structural flaws in the health system that disproportionately impact the most vulnerable communities in our society. 

As a result of the pandemic, global frailties have been exposed and marginalised communities entrenched in inequities engrained in social infrastructure. Those of a low socioeconomic background are more likely to contract COVID-19 due to a plethora of disadvantages arising from the social determinants of health, including poor housing, lower incomes and poor access to healthcare. Due to fewer educational qualifications, these individuals are more likely to be affected by the recent surge in unemployment, further exacerbating the socio-economic disparity on a global scale. Economic consequences include an increase in social welfare payments, fiscal injections into healthcare, and investments in workforce training. 

The pandemic has also aroused a climate of anxiety and panic, consequently having detrimental impacts on the mental health of Australians. Particularly susceptible groups include those with pre-existing mental health problems, healthcare workers, the unemployed, and quarantined individuals. With forecasted increases in unemployment, the Australian health sector must make a sustained and purposeful long-term investment in support services, which will have flow on effects on productivity, health outcomes, and the quality of health services. 

Moreover, deleterious impacts on mental health outcomes in Australia have been observed as a consequence of the pandemic. A national survey conducted by the Medical Journal of Australia estimates a minimum two-fold increase in the prevalence of mental health issues compared to non-pandemic circumstances, disproportionately impacting the unemployed, carers of family members, marginalised minorities and single person households [1]. This overwhelming social instability has been a key contributor to global political movements and civil unrest that threatens social cooperation. 

Further social impacts include a concerning rise in domestic violence incidents due to mandatory isolation and self-quarantine. In a survey of 15000 women in May 2020 by the Australian Institute of Criminology, 11.6% reported experiencing at least one form of emotionally abusive, harassing or controlling behaviour [2].

In response to an increase in psychological distress and a lack of stability, there has been an increase in alcohol consumption reported during the pandemic. The Australian National University estimates a 20.2% rise in alcohol consumption by Australians, attributed to stress, boredom and increased time spent at home [3]. This maladaptive coping method demonstrates the variability of health behaviour in unforeseen circumstances and presents long-term health complications for these individuals, in particular those with a pre-existing alcohol use disorder. 

On the bright side, stringent impositions on mobility and travel have resulted in unanticipated reduction in greenhouse gases globally. Attributed to a fall in petrol consumption, a decline in air travel, and reduced industrial production, Australia’s national emissions fell by 8% in the June quarter of 2020, estimated to be its lowest level since 1998 [4]. This has contributed to a fall in air and noise pollution globally. However, the surge in use of disposable masks and PPE has contributed to the burden of plastic waste, with hospitals in Wuhan producing 240 metric tonnes of medical waste per day during the peak of the outbreak in comparison to 50 tonnes prior [5]. Nonetheless, it is important to acknowledge that the decline in global emissions is likely to be temporary, as these changes do not reflect the restructuring of energy systems but rather a manifestation of unprecedented social circumstances.

Ultimately, while the pandemic has brought the social and environmental challenges faced by marginalised members of society to the forefront, this can be seen as a reminder of the potential for reform. 

By Jessica Xue
Podcast Producer, The Global Health Chat
AMSA Journal of Global Health
[email protected]

Reference List:

1. Fisher J, Tran TD, Hammarberg K, Sastry J, Nguyen H, Rowe H, et al. Mental health of people in Australia in the first month of COVID-19 restrictions: a national survey. Med J Aust [Internet]. 2020 June [cited 2021 June 4]. Available from: https://www.mja.com.au/journal/2020/mental-health-people-australia-first-month-covid-19-restrictions-national-survey
2. Boxall H, Morgan A, Brown R. The prevalence of domestic violence among women during the COVID-19 pandemic. Canberra: Australian Institute of Criminology; 2020 July. 19 p. Report No.:28
3. Biddle N, Edwards B, Gray M, Sollis K. Alcohol consumption during the COVID-19 period: May 2020. Canberra: Australian National University; 2020 June. 19 p. 
4. Department of Industry, Science, Energy and Resources.  Quarterly Update of the National Greenhouse Gas Inventory: March 2020. Canberra: Department of Industry, Science, Energy and Resources’ 2020 Aug. 53 p. Report No.:43
5. Zambrano-Monserrate M, Ruano MA, Sanchez-Alcalde L. Indirect effects of COVID-19 on the environment. Sci Total Environ [Internet]. 2020 Aug [cited 2021 June 4]. Available from: https://www.sciencedirect.com/science/article/pii/S0048969720323305?via%3Dihub DOI: 10.1016/j.scitotenv.2020.138813