In October 2020, we launched our COVID-19 impact inquiry to explore the pandemic’s implications for health and health inequalities in the UK. As part of the inquiry, we’re gathering evidence from a wide range of sources to consider how experiences of the pandemic were influenced by people’s existing health conditions and inequalities, and what this means for the nation’s health – now and in the future. 

Fozia Irfan is Director of Children and Young People at Children in Need, and a member of the expert advisory panel for the inquiry. We spoke about how COVID-19 is exposing existing inequalities and creating new ones, the disproportionate impact it’s having on some groups, and her hope that learning from the inquiry will help build a more equal society in the future.    

What social issues concerned you before COVID-19 started, which have come to the forefront during the pandemic? 

For me the biggest issue has always been inequality, in all its different forms. Before starting my role with Children in Need, I worked for a place-based funder, providing grants to grassroots charities and community groups – the organisations tackling social issues like loneliness, unemployment and homelessness on a daily basis. They do vital work, but as funders we were always aware that we were helping to address the symptoms of a problem, not the causes, which usually come back to poverty and inequality.  

That’s really become more evident during the pandemic. We all know inequality exists in our society, but the pandemic has made it much more visible – exposing existing inequalities and creating new ones. People can see how deeply inequality is embedded in our economic system, in our social system, and in our health system. 

Which aspects of COVID-19’s impact in the UK have you been most aware of? 

One positive is that it’s made us all much more aware of the importance of connections, and how people interact socially. The flip side of that is the isolation that people have been feeling. The links between isolation and people’s mental health have become even more apparent. And some groups are affected more than others – such as those living alone, single mothers, as well as those with existing mental health issues. 

The pandemic has made clear how interconnected the systems within our society are, and how that affects people’s daily lives. To tackle the inequalities that have been highlighted by the pandemic, we’re going to need to work within that complexity – that's been a key lesson for me.  

Which groups are you most concerned about? 

I worry most about young people. We're probably not going to understand the true impact of the pandemic on young people for quite a long time. There are obvious immediate impacts in terms of mental health, work and isolation. But then there are the longer-term effects: the disruption to young people's education, and how that’s impacted their thinking about university, or apprenticeships. And then how that affects their prospects for employment. It's a chaotic and anxiety-inducing time to be a young person.  

What do you think the long-term effects of the pandemic might be for society in general? 

With any societal shock you have to look at the negatives and the positives. The negatives are very apparent. Like the fact that we're heading into a recession. That’s going to lead to higher unemployment and affect people’s ability to live healthy lives – economic and health issues are interconnected. The financial implications of this pandemic are going to be felt by society for a while, in a range of ways.  

The sector that I'm most concerned about is the charity sector. Community groups have been at the forefront of the local response during the pandemic. Charities have faced a massive surge in demand for their services, while at the same time dealing with a catastrophic fall in their income. The sector is on the brink of survival at the moment, and the impact of losing so many charities, who are the social glue of communities, could be felt for generations.  

But we have to hold on to the positives. The pandemic has led to much more open and constructive conversations about really important issues, racial inequality for example. I think people are seeing in a very tangible way that many of the vital services in health and social care (that we’re currently relying on) are facilitated by people from different minoritised communities. So, there's a re-evaluating of the role of minoritised communities in this country – not just in terms of their value, but the particular obstacles people face and the additional burdens they carry that affect their social mobility.  

These conversations are really important and probably much more explicit than they've ever been before. It leaves me hopeful that we've started talking about disproportionate impact, including the disproportionate impact of COVID-19 itself on different ethnicities. Hopefully, we can start tackling some of it.  

How do you think the COVID-19 impact inquiry will contribute to recovery and rebuilding after the pandemic? 

The inquiry aims to build a robust understanding of how COVID-19 has impacted the UK, and how we can rebuild in a way that gives everyone the same opportunities for health and wellbeing. That's about having a solid understanding of what the data tells us, but also what communities are telling us, so that we can get an accurate picture. Through the call for evidence we’re hoping to receive evidence on how existing circumstances have shaped experiences of the pandemic across themes such as young people, digital exclusion and mental health.

This isn't just an academic exercise looking at health inequalities. We’ll be considering all the social issues that interconnect with health. We want to understand just how the pandemic, and the wider governmental and societal response, have further exposed existing inequalities in our society. And then we want to summarise that evidence in a way that’s useful to everyone, and see it used to bring about change in society.  

Because the charitable sector is chronically underfunded, there are very few organisations with the ability and capacity to do this type of work. The fact that the Health Foundation is putting its own resources and expertise into this will provide a foundation for all charities and public bodies to use in their work. Whether that’s informing how services are delivered to better address immediate health inequalities, or guiding long-term social policy that will enhance social mobility for different communities, I hope the work of this inquiry will provide the evidence needed to make change happen.  


Findings from the Health Foundation COVID-19 impact inquiry are due to be shared in summer 2021. 

Fozia will be speaking at Build back fairer: Inequalities and COVID-19 in England – a  jointly hosted webinar by the Health Foundation and the UCL Institute for Health Equity on 15 December 2020. Register to attend.

This content originally featured in our email newsletter, which explores perspectives and expert opinion on a different health or health care topic each month.

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