Policy Briefing- Was there an association between police enforcement and health vulnerabilities during the Covid-19 pandemic?
Category: Policy briefings
27 October 2026
During the Covid-19 pandemic, unprecedented public health restrictions were introduced across the UK and police were given powers to issue Fixed Penalty Notices (FPNs) to people believed to have breached Covid regulations. In Scotland, more than 20,000 Covid-related FPNs were issued during this period.
In a new study using linked police and health administrative data, findings show that individuals who were fined by the police for breaching Covid regulations were significantly more likely to have accessed health services for conditions relating to mental health, alcohol misuse or substance use than a matched group of people who were not fined.
The results highlight an important and previously under-recognised justice inequality, raising important considerations for future public health emergency planning.
Key statistics
- More than 20,000 Covid-related FPNs were issued in Scotland during the pandemic.
- Around 19% of Covid-related FPN recipients had a recorded health vulnerability.
- Covid-related FPN recipients were approximately 4 times more likely to have had contact with mental health services.
- Covid-related FPN recipients were approximately 7 times more likely to have had contact with alcohol or drug treatment services.
Key findings
Recipients of Covid-related FPNs were more likely to have health vulnerabilities. Almost one in five people who received a Covid-related FPN had accessed health services for a mental health, alcohol-related or drug-related condition in the year before receiving a fine. This compared to less than one in twenty people in a matched control group who did not receive a Covid-FPN.
Enforcement was associated to longstanding vulnerabilities. Half of FPN recipients with health vulnerabilities had health service contact both before and during the pandemic, most commonly for two or three different health conditions.
The greatest risks were seen during the first lockdown. The link between health vulnerabilities and police enforcement was strongest during the initial lockdown period, when restrictions were most stringent and policing powers were most widely used.
Those who needed ongoing support for their health vulnerabilities were disproportionately affected. Compared to the control group, those who had accessed health services before and during the pandemic had a higher relative likelihood of being a Covid-FPN recipient.
Why these findings matter for policy
Although Covid-19 regulations applied equally across the population, enforcement outcomes were not experienced equally. People living with mental illness, drug dependency or alcohol-related conditions often faced additional challenges during the pandemic, including reduced service provision, worsening health conditions and increased social isolation. These factors may have affected both their vulnerability and their exposure to enforcement measures.
The findings demonstrate that:
- Enforcement measures can unintentionally exacerbate existing inequalities.
- Health vulnerabilities may affect people's ability to comply with emergency regulations.
- Public health and justice outcomes are closely interconnected.
- Some vulnerable groups may benefit more from support-led responses than punitive approaches.
The research highlights the importance of considering how emergency powers affect different population groups and ensuring that future responses recognise the role of health vulnerabilities when designing and implementing enforcement policies.
Policy implications
The study identifies several areas where future emergency response planning could be strengthened:
- Incorporate vulnerability into emergency preparedness
Future public health emergency frameworks should recognise the specific challenges faced by people experiencing mental ill health and addictions, with targeted support measures developed alongside enforcement approaches.
- Embed equality assessments in enforcement policies
Assessments of proposed enforcement measures should consider how they may affect vulnerable groups before implementation. Health vulnerabilities should be considered alongside other demographic characteristics.
- Strengthen collaboration between policing and health services
Improve referral pathways and information sharing between key services and develop alternative responses for individuals experiencing mental health or substance related crisis.
- Prioritise support-led approaches
Where appropriate, enforcement should remain a last resort when engaging with vulnerable individuals, supported by expanded access to health and social care services during emergencies.
- Improve monitoring and evaluation
Linked administrative data should be used routinely to examine the impacts of enforcement policies and identify any unintended consequences for vulnerable populations.
