Long COVID and Health Inequalities: What's Next for Research and Policy Advocacy?

Baz, S., Woodrow, M., Clutterbuck, D., Fang, C., Mullard, J., Banerjee, A., Barley‐McMullen, S., Carpentieri, J., Donskoy, A., Faux‐Nightingale, A., Lewis‐Jackson, S., O'Hara, M., Rai, T., Sherwood, O., Smyth, N., Stanley, Kirsty, Welsh, V., Mir, G. and Alwan, N. 2024. Long COVID and Health Inequalities: What's Next for Research and Policy Advocacy? Health Expectations. 27 (5) e70047. https://doi.org/10.1111/hex.70047

TitleLong COVID and Health Inequalities: What's Next for Research and Policy Advocacy?
TypeJournal article
AuthorsBaz, S., Woodrow, M., Clutterbuck, D., Fang, C., Mullard, J., Banerjee, A., Barley‐McMullen, S., Carpentieri, J., Donskoy, A., Faux‐Nightingale, A., Lewis‐Jackson, S., O'Hara, M., Rai, T., Sherwood, O., Smyth, N., Stanley, Kirsty, Welsh, V., Mir, G. and Alwan, N.
Abstract

Introduction
Organised by the ‘Qualitative Long Covid Network’, a workshop for qualitative Long COVID (LC) researchers, LC charity representatives and people with LC took place in June 2023, where research on the intersectional inequalities affecting LC prevalence, recognition and care was shared and discussed.

Methods
Five key themes were drawn up from presentations, discussions and reflections during the workshop, which are presented in this study.

Results
The following five themes are discussed: the unfairness of LC, difficulties in accessing care, mistrust of the healthcare system, a lack of understanding of LC and experiences of stigma and discrimination. Factors that widen or narrow inequalities related to LC were identified.

Conclusion
A call to action is proposed to investigate and address inequalities through a robust LC research agenda that speaks with conviction to policy and decision-makers. We argue that there needs to be a strong investment in research and evidence-based policy and practice to mitigate the worst effects of the condition and address the inequalities in experience, treatment and support, which are experienced more often and more acutely by some of society's most vulnerable and disadvantaged individuals.

Patient and Public (PPI) Contribution
Projects included in this article had PPI ongoing activity to inform their research. A member of the CONVALESCENCE PPI group presented at the QLC Network ‘Long Covid and Health Inequalities’ workshop, as did members of Long COVID Kids, Long COVID Support and Long COVID SOS charities. They were all invited to be co-authors of this article.

Article numbere70047
JournalHealth Expectations
Journal citation27 (5)
ISSN1369-6513
1369-7625
Year2024
PublisherWiley
Publisher's version
License
CC BY 4.0
File Access Level
Open (open metadata and files)
Digital Object Identifier (DOI)https://doi.org/10.1111/hex.70047
PubMed ID39358980
Publication dates
Published online02 Oct 2024
Licensehttp://creativecommons.org/licenses/by/4.0/

Related outputs

People from ethnic minorities seeking help for Long Covid: a qualitative study.
Nina Smyth, Damien Ridge, Tom Kingstone, Dipesh P Gopal, Nisreen Alwan, Alexa Wright, Ashish Chaudhry, Sophie Clark, Rebecca Band and Carolyn A. Chew-Graham 2024. People from ethnic minorities seeking help for Long Covid: a qualitative study. British Journal of General Practice. Advanced online publication. https://doi.org/10.3399/bjgp.2023.0631

The spectrum of care within a university context: the differing roles of carers in supporting students who self-harm
Edwards-Bailey, Laura, Smyth, Nina, Cartwright, Tina and Mackenzie, Jay-Marie 2023. The spectrum of care within a university context: the differing roles of carers in supporting students who self-harm. International Journal of Care and Caring. 7 (4), pp. 708-734. https://doi.org/10.1332/239788221x16890865425257

A qualitative exploration of student self-harm and experiences of support-seeking within a UK university setting
Edwards-Bailey, L., Cartwright, T., Smyth, N. and Mackenzie, J.-M. 2023. A qualitative exploration of student self-harm and experiences of support-seeking within a UK university setting. Counselling Psychology Quarterly. 36 (4), pp. 638-662. https://doi.org/10.1080/09515070.2022.2146054

Editorial: Nature-based social prescriptions for improving health and wellbeing
Wood, C., Chalmin-Pui, Lauriane Suyin, Smyth, N. and Rajcani, Jakub 2022. Editorial: Nature-based social prescriptions for improving health and wellbeing. Frontiers in Psychology. 13 1095064.

Exploring the lived experience of Long Covid in black and minority ethnic groups in the UK: Protocol for qualitative interviews and art-based methods
Smyth, N., Alwan, N., Band, R., Chaudhry A, Chew-Graham, C., Gopal, D., Jackson, M., Kingston, T., Wright, A. and Ridge, Damien T. 2022. Exploring the lived experience of Long Covid in black and minority ethnic groups in the UK: Protocol for qualitative interviews and art-based methods. PLoS ONE. 17 (10) e0275166. https://doi.org/10.1371/journal.pone.0275166

Increased Wellbeing following Engagement in a Group Nature-Based Programme: The Green Gym Programme Delivered by the Conservation Volunteers
Smyth, N., Thorn, L., Wood, C., Hall, D. and Lister, C. 2022. Increased Wellbeing following Engagement in a Group Nature-Based Programme: The Green Gym Programme Delivered by the Conservation Volunteers. Healthcare. 10 (6) e978. https://doi.org/10.3390/healthcare10060978

A cross-sectional study of physical activity behaviour and associations with wellbeing during the UK coronavirus lockdown
Wood, C., Barton, J. and Smyth, N. 2022. A cross-sectional study of physical activity behaviour and associations with wellbeing during the UK coronavirus lockdown. Journal of Health Psychology. 27 (6), pp. 1432-1444. https://doi.org/10.1177/1359105321999710

Smaller Cortisol Awakening Responses Are Associated with Greater Visual Dependence in Postural Control
Smyth, N., Milani, M., Thorn, L., Flynn, M., Golding, J.F., Evans, P. and Clow, A. 2021. Smaller Cortisol Awakening Responses Are Associated with Greater Visual Dependence in Postural Control. Healthcare. 9 (6) 723. https://doi.org/10.3390/healthcare9060723

Added Value Report: University of Westminster Transformation in Students Project
Linceviciute, S., Ridge, Damien T., Smyth, N., Cartwright, T., Sebah, I., Bryant, K. and Woolston, J. 2021. Added Value Report: University of Westminster Transformation in Students Project. London University of Westminster. https://doi.org/10.34737/v4qqx

Working conditions and wellbeing in UK social workers
Ravalier, J., Wainwright, E., Clabburn, O. and Smyth, N. 2021. Working conditions and wellbeing in UK social workers. Journal of Social Work. 21 (5), pp. 1105-1123. https://doi.org/10.1177/1468017320949361

It made me feel brighter in myself”- The health and well-being impacts of a residential front garden horticultural intervention
Chalmin-Pui, L.S., Roe, J., Griffiths, A., Smyth, N., Heaton, T., Clayden, A. and Cameron, R. 2021. It made me feel brighter in myself”- The health and well-being impacts of a residential front garden horticultural intervention. Landscape and Urban Planning. 205 103958. https://doi.org/10.1016/j.landurbplan.2020.103958

Co-Creating and Evaluating an App-Based Well-Being Intervention: The HOW (Healthier Outcomes at Work) Social Work Project
Ravalier, J., Wainwright, Elaine, Smyth, N., Clabburn, Oliver, Wegrzynek, Paulina and Loon, Mark 2020. Co-Creating and Evaluating an App-Based Well-Being Intervention: The HOW (Healthier Outcomes at Work) Social Work Project. International Journal of Environmental Research and Public Health. 17 (23), p. e8730. https://doi.org/10.3390/ijerph17238730

Salivary Bioscience, Human Stress and the Hypothalamic–Pituitary–Adrenal Axis
Smyth, N. 2020. Salivary Bioscience, Human Stress and the Hypothalamic–Pituitary–Adrenal Axis. in: Granger D. and Taylor M. (ed.) Salivary Bioscience Springer. pp. 89-114

Nursing assistants’ experiences of administering manual restraint for compulsory nasogastric feeding of young persons with anorexia nervosa
Kodua, M., Mackenzie, J.-M. and Smyth, N. 2020. Nursing assistants’ experiences of administering manual restraint for compulsory nasogastric feeding of young persons with anorexia nervosa. International Journal of Mental Health Nursing. 29 (6), pp. 1181-1191. https://doi.org/10.1111/inm.12758

The effect of the visual exercise environment on the response to psychological stress: a pilot study
Wood, C., Flynn, M., Law, R., Naufahu, J. and Smyth, N. 2020. The effect of the visual exercise environment on the response to psychological stress: a pilot study. Anxiety, Stress and Coping. 33 (6), pp. 716-729. https://doi.org/10.1080/10615806.2020.1770231

Effectiveness of stress relieving strategies in regulating patterns of cortisol secretion and promoting brain health
Smyth, N., Rossi, E. and Wood, C. 2020. Effectiveness of stress relieving strategies in regulating patterns of cortisol secretion and promoting brain health. in: Clow, A. and Smyth, N. (ed.) Stress and Brain Health Across the Life Course UK Elsevier. pp. 219-246

Salivary cortisol as a non-invasive window on the brain
Smyth, N. 2020. Salivary cortisol as a non-invasive window on the brain. in: Clow, A. and Smyth, N. (ed.) Stress and Brain Health: Across the Life Course Elsevier. pp. 1-16

Psychological stress reactivity and future health and disease outcomes: A systematic review of prospective evidence
Turner, A.I., Smyth, N., Hall, S.J., Torres, S.J., Hussein, M., Jayasinghe, S.U., Ball, K. and Clow, A. 2020. Psychological stress reactivity and future health and disease outcomes: A systematic review of prospective evidence. Psychoneuroendocrinology. 114 104599. https://doi.org/10.1016/j.psyneuen.2020.104599

The health impact of nature exposure and green exercise across the life course: a pilot study
Wood, C. and Smyth, N. 2020. The health impact of nature exposure and green exercise across the life course: a pilot study. International Journal of Environmental Health Research. 30 (2), pp. 226-235. https://doi.org/10.1080/09603123.2019.1593327

The Current and Retrospective Intentional Nature Exposure Scales: Development and Factorial Validity
Wood, C., Barron, D. and Smyth, N. 2019. The Current and Retrospective Intentional Nature Exposure Scales: Development and Factorial Validity. International Journal of Environmental Research and Public Health. 16 (22) 4443. https://doi.org/10.3390/ijerph16224443

Endurance exercise reduces cortisol in Parkinson's disease with mild cognitive impairment
Smyth, N., Skender, E., David, F.J., Munoz, M.J., Fantozzi, G., Clow, A., Goldman, J.G. and Corcos, D.M. 2019. Endurance exercise reduces cortisol in Parkinson's disease with mild cognitive impairment. Movement Disorders. 34 (8), pp. 1238-1239. https://doi.org/10.1002/mds.27719

Attenuated cortisol reactivity to psychosocial stress is associated with greater visual dependency in postural control
Smyth, N., Flynn, M., Rajcani, J., Hucklebridge, F., Thorn, L., Wood, C., Golding, J., Evans, P. and Clow, A. 2019. Attenuated cortisol reactivity to psychosocial stress is associated with greater visual dependency in postural control . Psychoneuroendocrinology. 104, pp. 185-190. https://doi.org/10.1016/j.psyneuen.2019.02.028

Salience versus magnitude in the measurement of the cortisol awakening response
Evans, P., Smyth, N., Thorn, L., Hucklebridge, F. and Clow, A. 2019. Salience versus magnitude in the measurement of the cortisol awakening response. Psychoneuroendocrinology. 103, pp. 249-258. https://doi.org/10.1016/j.psyneuen.2019.01.023

Repressors exhibit lower cortisol reactivity to group psychosocial stress
Oskis, A., Smyth, N., Flynn, M. and Clow, A. 2019. Repressors exhibit lower cortisol reactivity to group psychosocial stress. Psychoneuroendocrinology. 103, pp. 33-40. https://doi.org/10.1016/j.psyneuen.2018.12.220

Enhancing well-being and building resilience in people living with cancer part 2: a central role for nurses
Booth, S., Ryan, R., Clow, A., Smyth, N., Sharpe, S. and Spathis, A. 2018. Enhancing well-being and building resilience in people living with cancer part 2: a central role for nurses. Cancer Nursing Practice. 17 (5). https://doi.org/10.7748/cnp.2018.e1596

Physical fitness and prior physical activity are both associated with less cortisol secretion during psychosocial stress
Wood, C., Clow, A., Hucklebridge, F., Law, R. and Smyth, N. 2018. Physical fitness and prior physical activity are both associated with less cortisol secretion during psychosocial stress. Anxiety, Stress and Coping. 31 (2), pp. 135-145. https://doi.org/10.1080/10615806.2017.1390083

Hormonal measurement in psychobiological research
Clow, A., Hucklebridge, F. and Smyth, N. 2018. Hormonal measurement in psychobiological research. in: Murphy, P.N. (ed.) The Routledge International Handbook of Psychobiology London Routledge. pp. 95-108

Enhancing well-being and resilience in people living with cancer. Part 1
Booth, S., Ryan, R., Clow, A., Smyth, N., Sharpe, S. and Spathis, A. 2018. Enhancing well-being and resilience in people living with cancer. Part 1. Cancer Nursing Practice. 17 (5). https://doi.org/10.7748/cnp.2018.e1484

Salivary diurnal cortisol profiles in patients suffering from chronic breathlessness receiving supportive and palliative care services: a cross-sectional study
Ryan, R., Clow, A., Spathis, A., Smyth, N., Barclay, S., Fallon, M. and Booth, S. 2017. Salivary diurnal cortisol profiles in patients suffering from chronic breathlessness receiving supportive and palliative care services: a cross-sectional study. Psychoneuroendocrinology. 79, pp. 134-145. https://doi.org/10.1016/j.psyneuen.2017.01.025

Putting the stress on conspiracy theories: examing associations between psychosocial stress, anxiety, and belief in conspiracy theories
Swami, V., Furnham, A., Smyth, N., Weis, L., Ley, A. and Clow, A. 2016. Putting the stress on conspiracy theories: examing associations between psychosocial stress, anxiety, and belief in conspiracy theories. Personality and Individual Differences . 99, pp. 72-76. https://doi.org/10.1016/j.paid.2016.04.084

Assessment of the cortisol awakening response: Real-time analysis and curvilinear effects of sample timing inaccuracy
Smyth, N., Thorn, L., Hucklebridge, F., Clow, A. and Evans, P. 2016. Assessment of the cortisol awakening response: Real-time analysis and curvilinear effects of sample timing inaccuracy. Psychoneuroendocrinology. 74, pp. 380-386. https://doi.org/10.1016/j.psyneuen.2016.09.026

Relationship between post-awakening salivary cortisol and melatonin secretion in healthy participants
Ramachandran, N., Smyth, N., Thorn, L., Eardley, A.F., Evans, P. and Clow, A. 2016. Relationship between post-awakening salivary cortisol and melatonin secretion in healthy participants. Stress. 19 (2), pp. 260-263. https://doi.org/10.3109/10253890.2016.1146671

Hair cortisol concentrations in relation to ill-being and well-being in healthy young and old females
Smyth, N., Bianchin, M., Thorn, L., Hucklebridge, F., Kirschbaum, C., Stalder, T. and Clow, A. 2016. Hair cortisol concentrations in relation to ill-being and well-being in healthy young and old females. International Journal of Psychophysiology. 102, pp. 12-17. https://doi.org/10.1016/j.ijpsycho.2016.03.001

Post awakening cortisol and melatonin secretion are not related
Ramachandran, N., Smyth, N., Thorn, L., Eardley, A.F., Evans, P. and Clow, A. 2015. Post awakening cortisol and melatonin secretion are not related. Psychoneuroendocrinology. (61), p. 65. https://doi.org/10.1016/j.psyneuen.2015.07.568

Assessment of the cortisol awakening response: expert consensus guidelines
Stalder, T., Kirschbaum, C., Kudielka, B.M., Adam, E.K., Pruessner, J.C., Wüst, S., Dockray, S., Smyth, N., Evans, P., Hellhammer, D.H., Miller, R., Wetherell, M.A., Lupien, S., Clow, A. and Jens C. Pruessner 2015. Assessment of the cortisol awakening response: expert consensus guidelines. Psychoneuroendocrinology. PNEC (63), pp. 414-432. https://doi.org/10.1016/j.psyneuen.2015.10.010

Detailed time course of the cortisol awakening response in healthy participants
Smyth, N., Thorn, L., Hucklebridge, F., Evans, P. and Clow, A. 2015. Detailed time course of the cortisol awakening response in healthy participants. Psychoneuroendocrinology. 62, pp. 200-203. https://doi.org/10.1016/j.psyneuen.2015.08.011

Post awakening salivary cortisol secretion and trait well-being: The importance of sample timing accuracy
Smyth, N., Thorn, L., Hucklebridge, F., Evans, P. and Clow, A. 2015. Post awakening salivary cortisol secretion and trait well-being: The importance of sample timing accuracy. Psychoneuroendocrinology. 58, pp. 141-151. https://doi.org/10.1016/j.psyneuen.2015.04.019

Anxious attachment style predicts an enhanced cortisol response to group psychosocial stress
Smyth, N., Thorn, L., Oskis, A., Hucklebridge, F., Evans, P. and Clow, A. 2015. Anxious attachment style predicts an enhanced cortisol response to group psychosocial stress. Stress. 18 (2), pp. 143-148. https://doi.org/10.3109/10253890.2015.1021676

Salivary cortisol as a biomarker in social science research
Thorn, L., Smyth, N., Hucklebridge, F., Evans, P. and Clow, A. 2013. Salivary cortisol as a biomarker in social science research. Social and Personality Psychology Compass. 7 (9), pp. 605-625. https://doi.org/10.1111/spc3.12057

Delays of 5–15 min between awakening and the start of saliva sampling matter in assessment of the cortisol awakening response
Smyth, N., Clow, A., Thorn, L., Hucklebridge, F. and Evans, P. 2013. Delays of 5–15 min between awakening and the start of saliva sampling matter in assessment of the cortisol awakening response. Psychoneuroendocrinology. 38 (9), pp. 1476-1483. https://doi.org/10.1016/j.psyneuen.2012.12.013

Cortisol secretion in saliva and hair: methodological considerations and relationships with state and trait well-being
Smyth, N. 2013. Cortisol secretion in saliva and hair: methodological considerations and relationships with state and trait well-being. PhD thesis University of Westminster School of Social Sciences, Humanities and Languages https://doi.org/10.34737/8z18y

Knowledge of lung cancer symptoms and risk factors in the UK: development of a measure and results from a population-based survey
Simon, A.E., Juszczyk, D., Smyth, N., Power, E., Hiom, S., Peake, M.D. and Wardle, J. 2012. Knowledge of lung cancer symptoms and risk factors in the UK: development of a measure and results from a population-based survey. Thorax. 67 (5), pp. 426-432. https://doi.org/10.1136/thoraxjnl-2011-200898

Practice Nurses' views of their role in the management of Chronic Fatigue Syndrome/Myalagic Encephalitis: a qualitative study
Chew-Graham, C., Dixon, R., Shaw, J.W., Smyth, N., Lovell, K. and Peters, S. 2009. Practice Nurses' views of their role in the management of Chronic Fatigue Syndrome/Myalagic Encephalitis: a qualitative study. BMC Nursing. 8 (2). https://doi.org/10.1186/1472-6955-8-2

Permalink - https://westminsterresearch.westminster.ac.uk/item/wx2w6/long-covid-and-health-inequalities-what-s-next-for-research-and-policy-advocacy


Share this

Usage statistics

7 total views
2 total downloads
These values cover views and downloads from WestminsterResearch and are for the period from September 2nd 2018, when this repository was created.