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605 Socio-political determinants of health inequalities during the COVID-19 pandemic: Under 5s and their families living in temporary accommodation in a socially diverse and deprived population—Newham, East London
  1. Diana Margot Rosenthal1,
  2. Marcella Ucci2,
  3. Andrew Hayward3,
  4. Ashlee Teakle4,
  5. Sarah O’Toole5,
  6. Lydia Whitaker6,
  7. Hanan Hauari6,
  8. Katie Hollingworth6,
  9. Claire Cameron6,
  10. Antoinette Schoenthaler7,
  11. Monica Lakhanpaul8,
  12. Celine Lewis9,
  13. Michelle Heys9
  1. 1Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, UK; UCL Collaborative Centre for Inclusion Health, London, UK
  2. 2Bartlett School of Environment, Energy and Resources, University College London Institute for Environmental Design and Engineering, London, UK
  3. 3University College London Institute of Epidemiology and Health Care, London, UK; UCL Collaborative Centre for Inclusion Health, London, UK
  4. 4Public Health, London Borough of Newham, London, UK
  5. 5Dept. Civil, Environmental and Geomatic Engineering, University College London, London, UK
  6. 6Thomas Coram Research Unit, Social Research Institute, University College London Institute of Education, London, UK
  7. 7Institute for Excellence in Health Equity, NYU Grossman School of Medicine, Center for Healthful Behavior Change, NYU Langone Health, New York, NY, USA
  8. 8Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, UK
  9. 9Population, Policy and Practice Research and Teaching Department, University College London Great Ormond Street Institute of Child Health, London, UK; North Thames Genomic Laboratory Hub, Great Ormond Street Hospital, London, UK


Aims Children experiencing homelessness while living in temporary accommodation (TA) have a higher life-long risk of developing chronic conditions, repeated cycles of homelessness and adverse childhood experiences. The COVID-19 pandemic has disproportionally negatively impacted vulnerable populations. The study objective was to quantitively explore the distribution of the socio-political determinants of health inequalities during the pandemic for families with children under age five (under5s) living in TA in comparison to families not living in TA (non-TA) taking London Borough of Newham (LBN) as a case study. LBN has one of the most socially deprived and diverse populations in the UK: 1 in 2 children live in poverty, 1 in 11 children live in TA, over 100 languages are spoken, and LBN has the second highest COVID-19 mortality rate in England.

Methods A cross-sectional survey of families with under5s in LBN during the pandemic using validated measures. Snowball sampling was used to recruit families including parents/carers of under5s and expectant parents from September-December 2020. The LBN Public Health Team asked their child-facing services (midwives, health visitors, children centre staff, and voluntary sector) to distribute information sheets and links to a Qualtrics online survey in different languages via email/phone invitation to eligible participants. Participants were also recruited via promotion on LBN Council’s media outlets. Using descriptive and univariate analyses, socio-demographics, food security, and housing environment were compared between TA and non-TA families.

Results From the survey sample(n=2054), 2024 reported their housing status, of which 84(4.15%) households were currently living in TA, which was roughly similar to the wider population of LBN who live in TA(4.84%). 35.44% of the TA sample reported living in TA for 2 or more years, and 24.05% reported 12 months to 2 years.

Compared to non-TA families, TA families were of a lower socio-economic background, more likely to have no recourse to public funds (NRPF) and be unemployed, non-white British ethnicity, non-UK born, single-parent households, and food insecure. In housing, TA families were exposed to more environmental hazards including overcrowding, dampness/mould growth, pests/vermin. They reported the need for major house repairs, no digital connectivity, broken large electrical appliances, and no access to outdoor space (figure 1). TA families were less likely to access antenatal care and immunisation services (table 1).

Abstract 605 Figure 1

Comparisons Between TA and Non-TA Families: Socio-political Determinants

Abstract 605 Table 1

Health care access: comparison of non-TA and TA families n (%)

Conclusion TA children were increasingly disadvantaged among multiple domains: socio-demographics, food insecurity, inadequate/poor housing, health service access. Therefore, the need is urgent to minimise the potential lifelong health impacts of these socio-political determinants of health experienced by this vulnerable group in addition to tackling the immediate risks arising from issues such as digital exclusion and poor housing conditions, which were likely exacerbated during the pandemic. The future of the pandemic is uncertain and future lockdowns are possible, so all families must have digital access now that many vital health services and schooling are online, even some exclusively. The time families spend in TA must be reduced, and the co-production of interim solutions and future policies to ensure a minimum set of housing standards for TA should be made a priority to address these inequalities and inequities.

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