The lockdowns of varying degrees currently being experienced in Melbourne and Sydney highlight the deep fissures and inequalities prevalent in large cities. Rather than a tale of two cities, it’s a tale of two halves within each city.
While these generalisations are very broad, they are indicative of a number of factors that start with the socioeconomic status (SES) variation across different suburbs within the city. This is not a simple case of rich vs poor; of course there is plenty of variation between and within suburbs. However, for the purpose of this exercise, it is helpful to consider two “halves” of the city – lower and higher SES, and then look at the other related factors in people’s lives.
|Factor||One half||The other half|
|Socioeconomic status (SES)||lower||higher|
|More common type of work||blue collar||white collar|
|Ability to work from home, or work at all||harder||easier|
|Density of people living in a single residence||higher||lower|
|Likelihood of being vaccinated||lower||higher|
Again, to qualify this table: I’m not suggesting that everyone in higher SES suburbs are white collar workers who can work from home, live in larger houses and are vaccinated. Rather, there is nuance in the differences. So someone in a higher SES suburb is more likely to have white collar work; a white collar worker is more likely to be able to work from home etc.
Now, consider the multiplier effect of these factors. People who are lower SES are more likely to be blue collar workers who need to travel for work. The more people move around, the greater their COVID transmission risk, so the higher transmission risk will be among blue collar workers. They are on average not as well-educated and may not have English as their first language, which means they may be more susceptible to misinformation about vaccination, which means they may be less likely to vaccinate. Because of their work, they may not be able to take time off to vaccinate either.
Because people in lower SES suburbs are more likely to live in higher density housing (think large government housing apartment buildings and multicultural communities with larger families and multiple generations all living together – and again, this is something that is more common in some suburbs), risk of infection spread is higher. And these are people who already need to travel for work.
The mental health toll of lockdown will also be higher with so many people living together in close quarters and unable to spend as much time outdoors. This is especially the case if they need to home isolate after being in an exposure site. The lockdown experience in a leafy suburb where more people live in larger houses with gardens and fewer people per house is completely different.
It’s clear that these factors all carry a multiplier effect: lower SES, travelling around the city for work, not vaccinated, living with others in close quarters. A quadruple (or more) whammy. Another factor is compliance with regulations, and there is certainly variability in this across suburbs.
The net result is that in some suburbs, COVID will spread more rapidly than in others. And from those suburbs, it can spread outwardly more easily because their populations are more mobile.
Rather than use this as a launching pad into “systemic inequality”, what I’d rather address are the policy implications in dealing with COVID outbreaks and getting us closer to the vaccination targets and opening up.
The biggest lesson here is that vaccination rates across the country or even the state are too broad a measure. Rather, we need to consider the finer granularities of suburbs and LGAs. When taking population density, movement and demographics into account, it’s possible that a lower or higher vaccination rate is needed in different suburbs to achieve the same target COVID spread risk.
Because lower SES suburbs carry higher risk of infection spreading, messaging to those suburbs needs to be targeted and in appropriate languages other than English as necessary. In close-knit communities, partnering with community leaders to get the message out can be more effective to increase acceptance.
While eligibility for vaccination is now being broadened, supplies are still short. Rather than prioritising on age bands (some of which may be related to mobility and contact with others) and whoever is fastest to book an appointment, we should consider prioritising on risk factors that directly relate to occupations, travel, and SES. To put it bluntly, vaccinating a retired couple from a leafy suburb who walk regularly in the park and have a small social circle will protect the two of them. Vaccinating an Uber driver who drives all around town, working two shifts to support their family of six which includes their grandparents will protect their family, as well as everyone they come in contact with.
With national vaccination targets as a key path to opening up and learning to “live with COVID”, vaccination is no longer just about the person being vaccinated. It’s also about everyone they come in contact with. Every single person vaccinated is a step close to the target that affect all of us.
Sledgehammer policies like mass lockdowns have now reached the point where they are causing more damage then benefit. It’s time for some fine-honed social marketing and sensible thinking to bring everyone on the journey while taking into account the full diversity of our country.