COVID-19 and the Inverse Care Law
25.04.2021 – A study of ISPM Bern / FOPH / ETH Zurich illustrates the inverse care law Julian Tudor Hart proposed 50 years ago.
Julien Riou, Radoslaw Panczak, Matthias Egger and colleagues from the Federal Office of Public Health (FOPH) and ETH Zürich analysed 2.5 mio tests, 400,000 positive tests, 18,000 hospital and 1,800 ICU admissions, and 6,000 deaths. People of lower socioeconomic position were tested less, but they were more likely to test positive, be admitted to hospital or the ICU, and more likely to die.
The results illustrate the “inverse care law” proposed by Julian Tudor Hart 50 years ago: “the availability of good medical care tends to vary inversely with the need for it in the population served”. Tudor Hart worked for 30 years as a general practitioner in Wales and became involved in epidemiological research.
The study made use of Swiss-SEP index, a measure of socioeconomic position of 1.27 million Swiss neighbourhoods, based on rent per square meter, education and occupation of household heads, and crowding which was developed at ISPM Bern. The authors conclude that governments and health care systems should take measures to reduce health inequalities in response to the SARS-CoV-2 pandemic.
The preprint can be accessed here. Note that preprints are preliminary reports of work that have not been certified by peer review.