The Health Foundation has warned that the government’s delayed contact tracing app has the potential to exacerbate existing health inequalities, leaving some people at greater risk of COVID-19 than others.
The independent charity has today (3 June) released new polling data with Ipsos MORI* that reveal the UK public’s awareness of and attitudes towards the planned smartphone app. In addition to the telephone-based NHS Test and Trace service launched on 28 May, the app – which is yet to be rolled out – is intended to help reduce the spread of COVID-19.
While more than six in ten people (62%) say they are likely to download the app once it is released, the polling reveals a significant 'digital divide' along the lines of occupation, educational level and age.
Almost three quarters (73%) of people in managerial, administrative or professional jobs say they are likely to download the app, but among the routine and manual workers, state pensioners and the unemployed, this figure falls to just half (50%).
While 71% of those with a degree say they are likely to download the app, this falls to 63% for those with A-levels or equivalent only, 59% for those with GCSEs or equivalent, and 38% among those with no formal qualifications.
The polling also identifies variation in smartphone ownership as a significant issue, with almost one in five people aged over 65 years old (17%) not owning a device and therefore not in a position to download the app. People in routine and manual jobs, state pensioners and the unemployed are also more likely not to own a smartphone than those in managerial, administrative or professional jobs (8% versus 4%).
Those without access to the app will not receive the same level of benefit in terms of up-to-date information about their risk of infection from contact with others.
The Health Foundation has also warned that the app might have unintended negative consequences. If there are false alerts from the app, these might impact more severely on certain population groups, such as people who cannot work at home or who have mental health needs. False alerts might arise, for example, if smartphones connect to neighbours’ phones through thin walls.
The potential negative impact of this digital divide must be considered against a backdrop of significant and growing socioeconomic and health inequality in the UK which has left those living in poorer areas at significantly increased risk from COVID-19. Recent data have shown that those in the most deprived areas are twice as likely to die from the virus.**
Adam Steventon, Director of Data Analytics at the Health Foundation, said:
'The NHS contact tracing app could play a critical role in the fight against COVID-19, expanding the number of people who are traced and speeding up the process. With a virus that is transmitted as quickly as coronavirus, this kind of instant contact tracing could prove invaluable.
'But there’s a significant risk that many will be left behind. The impact of COVID-19 is already being felt unequally across society and appears to be having a disproportionate impact on people living in more deprived areas, older people, and some ethnic minorities. Within that context, it’s especially concerning that people in lower paid jobs and those with less formal education say they are less likely to download and use the app, and of course not everyone has a smartphone.
'NHSX must ensure that the benefits of the app are experienced by the communities who need these the most, while ensuring that the potential negative consequences of the app, such as false alerts, do not fall on those least able to withstand them. It is also vital that those who do not have access to the app are protected as a priority by the government’s wider Test and Trace system, and that a more comprehensive strategy to tackle health inequalities is put in place.'
Adam Steventon sets out three key tests for the government's contact tracing app.
* A nationally representative sample of 1,983 people, aged 18 and over in Great Britain, were interviewed via telephone on the Ipsos MORI CATI Omnibus survey between 1 and 10 May 2020. Quotas were set and data weighted to ensure a nationally representative sample of people aged 18 and over. Quotas were set on age, gender, government office region and working status. Data have been weighted to the known offline population proportions for age within gender, government office region and working status and social grade. Percentages have been rounded to the nearest whole percentage.
** ONS data published on COVID-19 related deaths by ethnic group in England and Wales (between 2 March 2020 and 10 April 2020) showed a higher rate of COVID-19 related deaths among black and minority ethnic groups compared to the white population. Accounting for age, men and women in the black community were over four times (4.2 and 4.3 times respectively) as likely to die from COVID-19. Men of Bangladeshi and Pakistani origin were 3.6 times more likely to have a COVID-19-related death, while the figure for women was 3.4 times more likely.
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