Locked down by inequality: Why place matters for older people during COVID-19

Authors: Tine Buffel, Patty Doran, Mhorag Goff, Luciana Lang, Chris Phillipson, Sophie Yarker (University of Manchester, Manchester, UK) and Camilla Lewis (Newcastle University, Newcastle upon Tyne, UK)

Older people have borne the brunt of deaths from COVID-19, whether in hospital or in care homes and the full scale of related changes will not be known for some time. For now, it is evident that the coronavirus emergency sits alongside a crisis in many of the communities in which older people live.

Over the last ten years, inequalities have increased within and between neighbourhoods, especially in areas affected by cuts in government spending. By reviewing research on the role of place and neighbourhood in later life, and the relationship between neighbourhood deprivation and the impact of COVID-19, a group of researchers from the Manchester Urban Ageing Research Group (MUARG) argue that an age-friendly strategy should target interventions in low income communities, and vulnerable groups of older people within them.

Place matters

Where you live matters greatly for your quality of life in older age; it matters also for whether you are protected from COVID-19.

The Marmot Review, examining changing health inequalities between 2010-2020, highlighted the increase in deprivation affecting many parts of England. Area deprivation is also associated with higher levels of social exclusion in later life, for example to services, participation in leisure activities, and relationships with friends and family. Quality of life will also be affected by housing conditions – especially important given restrictions imposed by social distancing.

Nearly three-quarters of a million people 75 and over live in what are termed 'non-decent homes' – a higher proportion than any other age group. The most common reason is the presence of a serious hazard posing a risk to the occupants' health or safety, such as inadequate heating or a fall hazard. Over a million over- 55s are living in a home with at least one such problem.

Changing communities

The physical and emotional challenges that come with social distancing prompt us to ask fundamental questions about the changing nature of our communities. Social infrastructure, commonly understood as places where people meet, has a huge impact over community life. The loss or disinvestment in these spaces through processes of austerity have been felt the hardest in low income neighbourhoods.

Roughly at the same time as COVID-19 started to spread across the country, the Office of National Statistics (ONS) provided an update on its review of trends in social capital in the UK. The results provide evidence of less positive engagement with neighbours, less help being given to groups such as older people, and a reduced sense of belonging to the communities in which we live.

COVID-19 underlines the degree to which social processes relating to inequality and discrimination contribute to the distribution of illness and deaths within society. But the majority of attention has focused on growing disparities between income groups, rather than the various ways in which the pandemic, combined with austerity measures, is affecting all social groups.

Community development policy

We propose an age-friendly strategy to support older people and communities based around the following themes:

1. Prioritising areas of multiple deprivation in future government spending;
2. Developing locally-based partnerships working across organisational boundaries;
3. Challenging social inequality, stigma, and discrimination;
4. Changing the narrative on ageing and combatting ageism; and
5. Integrating social science research with policy.

Disinvestment in social infrastructure has resulted in the closure of libraries, day care and community centres. Such resources are essential for providing informal spaces for people to meet, and support and empower vulnerable groups.

Areas of multiple deprivation must be prioritised in future government spending. Such funding will need to be complemented by a national strategy to tackle health inequalities, drawing on lessons from the Marmot Review, and studies showing the detrimental impact of neighbourhood deprivation on older people’s quality of life.

The social sciences can bring an invaluable perspective to this debate and inform public policy. Developing a COVID-19 recovery plan and targeting older people at risk of isolation in  socially excluded neighbourhoods must be an essential part of the government’s strategy.

 

Access the article published by these authors in Quality in Ageing and Older Adults journal:
Covid-19 and inequality: developing an age-friendly strategy for recovery in low income communities