Micro level: essential mobilities and health inequalities

In the UK, the lockdown order ‘Stay at Home, Protect the NHS, Save Lives’ had divergent effects for different communities, casting light on a decade of widening health inequalities (Marmot, 2020). Health inequalities comprise differences in health status, and access to and quality' of care and structural determinants of health, for example access to employment and housing (Smith et al., 2016). COVID further exposed health inequalities in UK society', making the marginal and unsafe nature of particular groups’ lives more visible, laying bare the links between power and the differential access to and use of health resources. At the local level, these differentials involved particular bodies restricted to particular spaces that have been experiencing poorer health outcomes and inadequate access to health resources for decades (Marmot, 2020). Despite the UK government’s assurance that ‘we are all in this together’, numerous commentators emphasised that, although we may be weathering the same storm, we are not ‘all in the same boat’ (Glasgow Disability Alliance, 2020). The crisis also inverted the logics of im/mobility, revealing the power differentials that accumulate in a situation where some essential things, people and ideas must move to save lives, while the majority of other things, people and ideas must not move to preserve public health (Dobusch and Kreissl, 2020).

Delivery drivers, public transport and warehouse workers, porters and other low-paid employees were suddenly re-labelled as ‘key workers’. Indeed, those structurally trapped in poorly paid jobs with low job security and prestige were required to move about towns and cities delivering the very services that had locked them into disadvantage by the intersection of class and ethnic inequalities, which produced higher death rates for these workers (Public Health England, 2020; Bhatia, 2020). These ‘essential’ groups are on the receiving end of significant disparity with respect to material resources, housing, access to green space and private transport. The life-threatening effects of this ‘essential mobility’ reach deep into the family unit because self-isolation is predicated upon the availability of space. Public health advice stated that if one is potentially infected (because one is moving about in the wider world where the coronavirus is also circulating), at home one should not share a bathroom, bedroom, or kitchen space with family members. Similarly, access to the outdoors and green space - so important for physical and mental health - is limited for those in lower socio-economic groups. Mortality rates in areas of the greatest deprivation were double those in more affluent areas (Public-Health England, 2020: 32).

Indeed, the category ‘key worker’ represented only one example of how the dominant discourse of mobility as desirable and necessary (Urry, 2007) was scrambled and flipped on its head by the COVID lockdown. The prison system, fearing mass contagion, fast tracked prisoners for early release while rough sleepers were pulled off the streets and sequestered in hotels (Pleace, 2020). Neighbours informed on one another if they suspected too much outdoor exercise, while members of the ‘kinetic elite’ (Cresswell, 2010) — cabinet aides and chief medical officers — continued to travel the length of the country to second homes, breaching guidance to ‘Stay at Home’ (Bland, 2020; Carrell, 2020). Differential mobilities exposed class divisions and furthered a moral accounting of travel, its rationale and distance. Yet these everyday mobilities and immobilities also imposed starker choices as the means by which that essential movement was channelled: the public transportation systems linking home and work became sites of disease transmission themselves.

In early May, the UK government’s public messaging was revised, and England was told to ‘Stay Alert’. From a blanket ban enforced by authorities, responsibility shifted to individual members of the public for weighing their gradient of risk and policing their activity accordingly. Yet this daily self-governance also sidestepped questions concerning which bodies could move, be cared for and provide care, and what resources might be utilised to enable this to happen, both locally and internationally. Ultimately, the easing of restrictions heightened temporal and spatial anxieties for at-risk groups dealing with the crisis. ‘High-risk’ people remained ‘shielded’ in an enforced ‘stillness’ (Cresswell, 2012), even as society accelerated around them and equitable access to scarce resources remained an ongoing challenge. (The shielding programme was paused from 1 August with the caveat that it might return as part of future localised lockdowns.)

Risk and protection, access to healthcare and testing, paid work and social welfare are all deeply inflected with questions of mobility and therefore the inequalities and power differentials they produce. In this sense, the crisis and the UK government’s variegated response has amplified existing (mobility) inequalities rather than mitigating them, as evidenced most recently by the architecture of the new test-and-trace system. The scheme’s initial launch relied heavily on the assumption that test subjects would be highly mobile and capable, in their own cars, to get themselves to drive-through testing centres.

 
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