Impact of Covid-19 Pandemic on Health Inequality in the Southern European Countries

The number of studies produced and disseminated on the various aspects of the recent pandemic has been abundant. Above all, what has been missing is a comparative reflection on the effects of the pandemic on health systems (HS) and health inequalities (HI) and on the two-way relationships between the pandemic and inequalities. Thus, the central theme is to explore how the Covid-19 pandemic has transformed or is transforming the HS of Southern Europe. This paper, based on the international literature, aims to analyse the impact of Covid-19 pandemic on HS and HI in four Southern European countries – Spain, Greece, Italy and Portugal. In particular, it focuses on how the pandemic disproportionately has hit the most disadvantaged communities and created new inequalities among population groups made more vulnerable by the difficulty of following the containment measures imposed by health authorities. In summary, here are some of the results of the study: the immediate effects of Covid-19 were reflected in an excessive mortality rate; the level of unmet health needs has increased, in particular: cancer patients were diagnosed late, a drastic reduction in cancer-related surgeries, elective surgeries were suspended, inpatient and outpatient mental health services were also suspended during the pandemic; elderly residents of nursing homes have suffered the effects of Covid-19 most severely, and it is precisely there that the highest number of deaths was recorded in the first wave. Among the categories most affected, in all four countries, there are refugees, asylum seekers and international emigrants, with disadvantaged socioeconomic conditions and high levels of job insecurity, housing precariousness, and social marginalization: all risk factors associated with poor health. The incidence of Covid-19 on these vulnerable social groups are a good example of the intersectionality of different dimensions of social inequalities that intersect, accumulate and worsen.