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COVID-19 Pandemic and Health Inequalities in Southern European Countries – until January 2, 2023

Editors: Mauro Serapioni, Pedro Hespanha

Deadline for submissions: January 2, 2023

Keywords: health systems; inequalities; pandemic; political policy; Southern Europe.

The number of studies produced and disseminated on the various aspects of the recent pandemic has been abundant, yet they are not always based on rigorous research given the urgent nature of the issue and the need to analyze what was happening. Above all, what has been missing is a comparative reflection on the effects of the pandemic on health systems and health inequalities and on the two-way relationships between the pandemic and inequalities (Cash-Gibson, et al., 2021; Ferreira, 2021; Mishra et al., 2021). Although these effects are quite distinct from those of the financial and economic crisis of the last decade (Serapioni and Hespanha, 2019), we are aware that strong relationships exist, not only between the two processes that generate inequalities in societies on the European periphery but also between the policies for containing the crisis (Lucchese and Pianta, 2020). Whereas during the financial crisis there were significant budget cuts in health care and social protections and limitations in access to rights that aggravated the inequalities, during the pandemic crisis the aggravation of inequalities occurred for the most part as a result of the containment policies used to get the disease under control (Bambra et al., 2020), namely the measures to limit access to health care for a significant part of the population – in the form of closing health centers for in-person appointments, the postponement of appointments or providing treatment and diagnostic procedures to non-priority patients, and the legitimate fear of contagion within hospitals – with considerable impacts for certain pathologies (Giannopoulou and Tsobanoglou, 2020). As a point in common, both the pandemic and the financial and economic crisis dramatically shed light on the extent to which the neoliberal wave has left health care systems powerless to respond to emergencies (Giroux, 2021).

As the theme of health inequalities is quite broad and diversified, it has become a challenge for those who study the field (Ferreira, 2021). The very concept of inequalities is imprecise and ambiguous in its object: are these inequalities based on income, access to health care, or incidence of morbidity and mortality? In the case of COVID-19, the relationship between the disease and the inequalities is ambivalent. On the one hand, one’s social condition determines, for the most part, a person’s risk of incidence for the virus, accessibility to health care, and the effectiveness of lockdown (Alves et al., 2021); on the other hand, the virus tends to increase inequalities by reducing one’s income or the capacity to work for the person who becomes infected or cannot work due to the lockdown (Marí-Dell’Olmo et al., 2021). Additionally, in the case of those inequalities created by the COVID-19 pandemic, it has become more difficult to arrange appropriate and credible sources given that the universe of services and agents intervening in the fight against the virus does not produce or disseminate information that is useful for the construction of indicators suitable for measuring inequalities. It is important to avoid considering COVID-19 as a unique situation of risk that demands a priority response, thus harming other social groups, other pathologies and other health care actions that were given priority before the pandemic appeared. As has been widely observed, this situation has affected population groups at greater risk who already struggle for access to health care services (Jensen et al., 2021).

The theme proposed for this issue, therefore, stems from the following question: How has the COVID-19 pandemic transformed, or how is it transforming, the health care systems of southern Europe? Articles submitted to this issue of e-cadernos CES are asked to respond by analyzing the transformations occurring in society and identifying the critical pressure points of the health systems highlighted by the impact of the pandemic, and in so doing, contribute to a critical reflection on those public policies capable of tackling the emerging problems to be confronted.

With this in mind, we suggest that the submitted articles reflect the following plan: at the beginning, a reconstruction should be made which presents the situation of the health system of the country/countries in focus (Greece, Italy, Portugal and/or Spain) before the pandemic followed by an analysis of the emergency interventions developed during the health crisis by the various spheres of governance. Next should be a description of the lines of intervention planned out and implemented by the Health Ministries and the degree to which the recommendations and support from international organizations (namely the World Health Organization and the European Union) were integrated. Also to be mentioned is the degree of decentralization of the provision of health services between organizations of civil society and the private sector.

e-cadernos CES is a peer-reviewed, online and entirely open access journal, published by the Centre for Social Studies of the University of Coimbra (Portugal). It is currently indexed in CAPES, DOAJ, EBSCO, ERIH Plus and Latindex. For more information on the publication consult:

All texts should be original and submitted in their complete version, in Portuguese, English, Spanish, or French. They must not exceed 60,000 characters (with spaces), including footnotes and bibliographical references. For the final section, @cetera, other texts may be presented (up to 35000 characters maximum), such as interviews and debates (up to 25,000 characters maximum), or unpublished book reviews (up to 5,000 characters maximum). The submitted manuscripts must not have been otherwise published in full or in part (in both print or digital format, in Portugal or abroad, in Portuguese or in any other language), or be presently under submission to any other publication.

Detailed guidelines for submitting texts are available at Manuscripts should be sent by email to and authors should clearly identify the thematic issue in question – “COVID-19 Pandemic and Health Inequalities”.

All manuscripts will be subject to the double-blind peer review process.


Alves, Joana; Soares, Patrícia; Rocha, João Victor; Santana, Rui; Nunes, Carla (2021), “Evolution of Inequalities in the Coronavirus Pandemics in Portugal: An Ecological Study”, The European Journal of Public Health, 31(5), 1069-1075.

Bambra, Clare; Riordan, Ryan; Ford John; Matthews, Fiona (2020), Journal of Epidemiology & Community Health, 74(11), 964-968.

Cash-Gibson, Lucinda; Pericàs, Juan; Martinez-Herres, Heliana; Benach, Joan (2021), “Health Inequalities in the Time of COVID-19: The Globally Reinforcing Need to Strengthen Health Inequalities Research Capacities”, International Journal of Health Services, 51(3), 300-304.

Ferreira, Francisco (2021) “Inequality in the Time of COVID-19”, Finance and Development, June, 20-23.

Giannopoulou, Ioanna; Tsobanogloul, George O. (2020), “COVID-19 Pandemic: Challenges and Opportunities for the Greek Health Care System”, Irish Journal of Psychological Medicine, 37, 226-230.

Giroux, Henry (2021), “The Covid Pandemic is Expousing the Plague of Neoliberalism”, in Norman K. Denzin; Michael D. Giardina (eds.), Collaborative Future in Qualitative Inquiry. New York: Routledge.

Jensen, Nele; Kelly, Anna Horton; Avendano, Mauricio (2021), “The COVID-19 Pandemic Underscores the Need for an Equity-Focused Global Health Agenda”, Humanities and Social Sciences Communications, 8, 15.

Lucchese, Matteo; Pianta, Mario (2020), “The Coming Coronavirus Crisis: What Can We Learn?”, Intereconomics, 55(2), 98-104.

Marí-Dell’Olmo, Merc; Gotsens, Mercè; Pasarín, M. Isabel; Rodríguez-Sanz, Maica; Artazcoz, Lucía; Garcia de Olalla, Patricia; Rius, Cristina; Borrell, Carme (2021), “Socioeconomic Inequalities in COVID-19 in a European Urban Area: Two Waves, Two Patterns”, International Journal of Environmental Research and Public Health, 18(3), 1256.

Mishra, Vaibhav; Seyedzenouzi, Golnoush; Almohtadi, Ahmad; Chowdhury, Tasnim; Khashkhusha, Arwa; Axiaq, Ariana; Wong, Wing Yan Eliszaberh; Harky, Amer (2021), “Health Inequalities During COVID-19 and Their Effects on Morbidity and Mortality”, Journal of Healthcare Leadership, 13, 19-26.

Serapioni, Mauro; Hespanha, Pedro (eds.) (2019), “Crisis, Austerity and Health Inequalities in Southern European Countries”, e-cadernos CES, 31.

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