Protecting Vulnerable Older Adults during the COVID-19 Pandemic
Editor’s Note: This article is adapted from graduate thesis work conducted in 2020. This article first appeared at In Public Safety.
By Joyce Holmes-Jordan
Graduate, Master’s in Emergency & Disaster Management, American Military University
As of October 21, there were 8.2 million confirmed cases of the coronavirus COVID-19 and over 221,000 deaths in the United States, whereas the global toll has reached over 40 million cases with over 1.1 million deaths, according to the Johns Hopkins Coronavirus Resource Center. As with many crises and disasters, during this pandemic minorities, the elderly, the poor and other disadvantaged individuals have suffered a disproportionate number of those deaths.
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The COVID-19 pandemic has put a spotlight on political apathy, poor preparation, improper responses, and social disparities that are derailing even the best efforts to prepare, protect, and empower these vulnerable segments of the population. This is particularly true of older adults who are a highly vulnerable cohort.
Left unaddressed, these conditions will continue to undermine the ability of communities to withstand and survive future public health crises or disasters. This knowledge should provide compelling reasons to further investigate ways of reducing social disparities by protecting and empowering community residents.
In any given disaster or public health crisis, the incidence of death and injury is often highest among persons 60 years of age and older due to a combination of factors including poor physical or psychological health, low economic status and poor mobility. Social disparities involving income, ethnicity, age, citizenship status, and location can increase vulnerability.
Community Impacts of Public Health Crises and Disasters
It is a commonly held belief that the only consequences of a pandemic or disaster are physical, such as sickness or death. However, there are additional outcomes besides the loss of homes and property in a natural disaster. They include the psychological and sociological consequences such as mental and emotional distress and the economic implications such as loss of employment or lack of business continuity.
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In a public health crisis such as a pandemic, it is crucial to examine, determine, and analyze the social inequities in a community to formulate a proper response. This includes identifying residents who are elderly, infirmed, fiscally disadvantaged, or non-English speakers. Failure to address social inequities or disparities reduce survivability and resilience outcomes within vulnerable population segments.
Preparing for disasters or public health crises can leave gaps in communication, social connections, and personal planning. This can result in inadequate access to transportation, medications, medical care, and essential medical equipment or supplies.
A community’s ability to rebound from a catastrophic event requires strong social capital involving a broad spectrum of actors including local, state and federal policymakers, emergency management officials, and the vulnerable citizens who stand the most to gain from a solution.
It also takes heightened awareness and comprehensive collaboration among communities to develop a framework that identifies the vulnerabilities of the senior members of the community and the robustness of their social capital.
Strong Social Capital Is Key to Community Resilience
Social capital is composed of relationships that provide valuable resources to individuals and communities through social networks. The process of accumulating the needed social capital consists of friendship, goodwill, mutual understanding, solidarity, and social relations. When properly nurtured, social capital can create viable social networks.
Social capital is also defined as community resources, their accessibility, and their use in carrying out directed actions. When there is adequate social capital, a high-functioning community response can bolster individual and community resilience. Represented within social capital are one or more of the following attributes:
- Sense of belonging
- Network bonding
- Feelings of trust and safety
- Citizen power
- Values, norms, outlook in life
One step in mitigating the consequences of these risk factors during or after a disaster or public health crisis is to clearly define and properly apply social capital to protect and empower the elderly and their communities. This process has the potential to reduce their vulnerabilities and improve their resilience.
Elder Populations Are Vulnerable
A pandemic or other public health crisis can create social divisions that threaten community stability and continuity. It is critical that the entire community is involved in the planning and action initiatives since these stakeholders ultimately shoulder the responsibility for their community’s safety, survival, and restoration after a catastrophic event.
Older adults are particularly vulnerable. Some examples of the numerous and complex vulnerabilities in elder populations include:
- Chronic medical conditions (diabetes, chronic obstructive pulmonary disease (COPD), cardiovascular diseases (heart attack or stroke)
- Disability and impairment (multiple sclerosis, dementia, severe arthritic conditions, blindness or deafness, or bed-ridden)
- Living alone
- Overall unpreparedness
- Resistance to accepting help
Additional vulnerabilities include poverty and poor access to transportation, critical information or medical care.
In addition, the COVID-19 pandemic is creating a secondary crisis in the form of a “social recession,” manifesting in increased isolation and loneliness, and further compromising mental and physical health especially among poor, infirmed, or minority older adults. This “social recession” can lead to vulnerability to depression and anxiety, hasten physical decline, and promote adverse health behaviors such as poor nutrition, substance abuse, thoughts of suicide, increased inactivity, and poor sleep quality.
Additionally, social disparities such as poverty and racism further hinder proper response and sadly are rarely fully addressed by people of privilege or power, including some who are responsible for a community’s public safety and security. As a result, these vulnerable segments of the community are at higher risk of remaining disproportionally poor and routinely ignored.
Such neglect can erode public trust, which in turn, can produce undue confusion, anxiety, and delayed crisis or disaster response. Yet to their benefit, many older adults have innate survivor qualities that are protective and empowering. Harnessing these survivor attributes such as the ability to regulate emotions, leadership, problem-solving, actively attending to individual mental, physical and spiritual well-being, and caring about and helping others, can help activate social capital when it is most needed.
Building a Model to Minimize Disparities
The crucial missing piece is creating robust social conditions in which older adults and other vulnerable adult populations can operate and contribute to the resilience of their communities while maximizing their chances of survival in the aftermath of a disaster or public health crisis.
Emergency, disaster, and public health management officials must work to minimize disparities by developing, documenting, and implementing a conceptual model that includes:
- Simplifying complex and crucial components of the different stages of a crisis or disaster, with priority consideration for time constraints and full understanding by vulnerable community members
- Quantifying disaster events for future research and developing “lessons learned” or after-action reports based on facts, not speculation or opinion
- Developing a more coordinated and integrated response to and facilitate recovery from a public health crisis or disaster
- Incorporating a master group of diverse community members, including older adults, who come together and engage in planning, mitigation, response and recovery processes and policies
Ultimately, with the understanding that “all disasters are local, and so are many resources” community officials must implement the policies, processes, and practices that help to ensure robust social capital, strong community resilience capacity, and inclusion of vulnerable population segment of a community. These should include:
- Expedient, honest, transparent, up-to-date communication to community residents
- A current assessment of community hazard risks and the capacities to mitigate them with special consideration for segments of the community that have less social capital, fiscal resources, or protective physical infrastructure available to them; and
- Updated preparedness and mitigation plans that are quickly implementable.
One recommendation for future study is an in-depth examination surrounding the inclusion, protection, empowerment, and building up of the assets of older community-dwelling adults. Within this type of research lies the potential to close existing disaster or public health crisis management gaps, while fulling developing a “whole community” approach. Utilizing existing and cross-disciplined solutions, adapting and making them accessible through global networks, and applying them to multi-incident scenarios can facilitate this sweeping venture.
At its best, a community is comprised of individuals and organizations that are connected, trusting, and committed to each other and their community, and have a common mission. That mission is the protection and empowerment of its members in good and bad times.
The highest priority in the management of every emergency, public health crisis, or disaster is to seek the full restoration of all those affected. This goal requires exercising the four Cs: Cooperation, Commitment, Connection, and Community. This is a vision that must become and remain crystal clear.
While local, state, and federal administrative and emergency management officials certainly strive to fully grasp and act on the systemic poverty, social isolation, racism, and economic disparity affecting their jurisdictions, community members must represent part of the solution too by actively building strong community cohesiveness.
About the Author: Joyce Holmes-Jordan was born and raised in Washington D.C. She earned her MA in Emergency and Disaster Management in 2020 from American Military University and earned her Bachelor of Science degree in Animal Science from Tuskegee University. Prior to her graduation from AMU, Holmes-Jordan served as co-owner and emergency coordinator for a childcare center in Greensboro, North Carolina. For her Master’s thesis, Holmes-Jordan conducted a case study on the 1995 Chicago heatwave. The research focused on the complexities of the historic and ever-present disparities of vulnerable urban populations. Going forward, Holmes-Jordan aspires to address the protection and empowerment of urban community-dwelling older adults during disasters or public health crises through personal and community education and preparedness initiatives. Holmes-Jordan is a member of the North Carolina Emergency Management Association (NCEMA).