Contact tracing app has potential to exacerbate existing health inequalities

The Health Foundation has warned that the government’s delayed contact tracing app has the potential to exacerbate existing health inequalities.

This could leave some people at greater risk of COVID-19 than others.

On 3rd June, The Health Foundation released new polling data with Ipsos MORI revealing the UK public’s awareness of and attitudes towards the planned smartphone app.

The app – which is yet to be rolled out, is to work alongside the telephone-based NHS Test and Trace service on the 28th May and is intended to help reduce the spread of COVID-19.

According to The Health Foundation:

‘More than six in ten people 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 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.’

‘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.

Almost one-in-five people aged over 65 years old do not own a device and are 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.

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.

For example, false alerts from the app 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 if smartphones connect to neighbours’ phones through thin walls.

The potential negative impact of this digital divide must be considered against a backdrop of supposed growing socioeconomic and health inequality in the UK which has purportedly left those living in poorer areas at significantly increased risk from COVID-19.

Recent data has 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.”