COVID-19 and health inequalities: The impact of social determinants of health on individuals affected by poverty

Abstract

Objective

This study focuses on the impact of social determinants of health (employment, housing, access to education, and food) on individuals affected by poverty during the COVID-19 pandemic in Tyrol, Austria.

Methods

A qualitative research design was employed to explore the individual experiences of the pandemic, poverty, job loss, and precariousness. Biographical narrative and episodic problem-based interviews were used in combination. A total of 151 participants were recruited using various non-random sampling methods. The data were analyzed through inductive qualitative content analysis to identify relevant thematic complexes resulting from the reconstructions.

Results

The main driver of challenges faced by individuals living in poverty is their precarious financial situation. Poverty negatively affects physical and mental health, the quality of food, housing conditions, medication expenses, access to healthcare, to relevant digital resources, and health literacy. Informal social support plays a crucial role for people in poverty, but it diminishes over time, leading to social exclusion. The COVID-19 pandemic has exacerbated poverty-related challenges and intensified social disconnection and marginalization. Addressing poverty requires comprehensive interventions at both the individual and structural levels.

Conclusions

The COVID-19 pandemic has highlighted the critical role of social determinants of health, including poverty, distress, employment, social participation, and digital exclusion. These factors pose immediate risks to individuals' health and can contribute to negative long-term health issues. State and institutional support are crucial in preventing and combating poverty, social disparities, health inequalities, and negative health outcomes.

Public interest abstract

This study highlights the negative impact of poverty on an individual's biopsychosocial health, which has been exacerbated by the COVID-19 pandemic. Financial distress, uncertainty, and employment disruptions caused by the pandemic had a negative impact on social participation and quality of life, thereby decreasing overall well-being. Individuals affected by poverty experience adverse health outcomes such as distress, exhaustion, and hopelessness. The pandemic has further reduced the availability of public-funded professional support, leaving individuals with limited resources for essentials such as food, heating, rent, and social participation. Therefore, increased public funding for health and social services and accessible low-threshold financial aid are essential for improving well-being of those affected. Furthermore, poverty is a complex issue that necessitates public support to combat and prevent its effects in the sense of social justice and health equity. To address negative health outcomes and provide targeted support, we must tackle the social determinants of health.