Managing the ‘stress test', planning for the future

Symptomatic individuals in their seventies are twenty times more likely to require hospitalisation than younger adults

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The Covid-19 pandemic has highlighted the rights and health of older persons in society. The infection has spread across the world, infecting people of all ages. Yet it is older people and those with underlying medical conditions who are at higher risk of serious illness and death from Covid-19. 

As of the end of 2020, 88 percent of Covid-19 related deaths in the WHO European Region were in persons aged 65 and over. Symptomatic individuals in their seventies are twenty times more likely to require hospitalisation than younger adults, and case fatality rates suggest a notable increase in risk after age 60, with progressively worse outcomes at older ages. 

Among these, older people from lower socio-economic status have experienced a worsening of their living conditions, being confined to overcrowded or deprived houses and confronted with housing and food insecurity. 

Not so apparent are the wider effects: health care denied for conditions unrelated to COVID-19; neglect and abuse in institutions and care facilities; an increase in poverty and unemployment; the dramatic impact on well-being and mental health; social isolation and exclusion, stigma and discrimination.

Covid-19 indeed impacted on the needs and issues facing older persons and the UN recently held an EGM. Titled, Building Forward Better for Older Persons post COVID-19, the meeting reflected on the needs of older persons, those who have faced specific and differentiated challenges during the pandemic, will continue to require an informed, inclusive and targeted response as countries engage in recovery efforts.

In the policy brief The Impact of Covid-19 on Older Persons, the UN Secretary-General identified some of the issues that policies will need to pay attention to in ensuring the full inclusion of older persons in recovery efforts. These include, but are not limited to, strengthening health care and social protection systems, improving access to care and support. The latter includes long-term care, addressing ageism in all its forms, closing the digital divide, strengthening services to prevent and protect older persons from violence and abuse, and promoting the disaggregation of relevant data so that policies are evidence-based. 

The brief further acknowledged that some sub-groups of older persons, such as those in humanitarian crises or convicted older adults, would require targeted action. Further, policies must integrate the intersectional discrimination faced by many older persons.

One prominent figure who participated in the EGM was London Business School’s professor Andrew Scott. Professor Scott’s work focuses on the economics of longevity and he is the co-author of The 100 Year Life and The New Long Life. He is co-founder of The Longevity Forum, a member of the WEF council on Healthy Ageing and Longevity and a consulting scholar at Stanford University’s Center on Longevity. Andrew is also the recipient of an ESRC grant for researching the economic longevity dividend.

Professor Scott was asked by the UN’s Department of Economic and Social Affairs (Ageing) to prepare a background paper for the UN EGM. Titled, Older Persons and the Post-Covid-19 Agenda, Professor Scott observes that the Covid-19 pandemic has been a “multidimensional shock affecting the lives of billions of people. It has exerted a disproportionate impact on the health, lives, rights, and welfare of older people.”

In sum, professor Scott acknowledged in his paper that Covid-19 has acted as an “accelerant” and a “stress test” concerning how prepared individuals and countries are for an ageing society.

Furthermore, the following observations were made:

  • The rights and needs of older persons need to be protected in a post-pandemic world of fewer resources. With an estimated ninety million people (many of them old) pushed into extreme deprivation the need to protect the vulnerable has increased.
  • Post pandemic policies aimed at ‘building back better’ are an opportunity to bring about the deep-seated social and economic adjustments that a rising number of older people require.
  • The pandemic has revealed a number of policy and institutional weaknesses that need to be corrected. The diversity in outcomes for older people across countries creates an opportunity to identify best practice in a range of ageing related issues.
  •  The pandemic represents an opportunity to change the narrative around ageing by reducing ageism, raising awareness of diversity in ageing, redefining ‘old’ and informing people of longevity trends and the importance of healthy ageing.
  • Governments have adopted policies that have led to substantial falls in economic growth in order to save lives. This reveals how much they value older lives. Consistency requires they continue to invest financially in the needs of older people post-pandemic.
  • The pandemic has shown that in the context of an ageing society a healthy economy requires a healthy population. Focusing on a life cycle perspective to ensure that the current young become the healthiest and most productive future old is crucial.
  • That requires investing in healthy ageing and tackling the socio-economic inequalities that have been revealed by the crisis.
  • Post pandemic governments will need to invest in pro-growth policies to bolster a weakened economy. Given the growing proportion of older people, this will require integrating ageing into economic development.
  • Employment policies aimed at older workers are needed in order to produce growth and to minimise the long-term consequences of Covid-19 on older people.
  • The contribution of older people extends substantially beyond the economy which needs to be incorporated into responses to rebuild after the crisis.

Overall, delineating the situation for older persons is incredibly diverse, representing as it does the varied needs of diverse groups across many different countries. 

The recent EGM covered this breadth of topics and the presentations are available on the EGM link. Identifying the key groups at risk and the major issues to tackle has to be an important ambition, post Covid-19.

 

For further reading:

EGM on Building Forward Better for Older Persons post COVID-19, 2-5 March 2021

Setting the stage: Building Forward Better for Older persons post COVID-19

Experts (key background paper, prepared by LBS professor Andrew Scott):

Andrew Scott, Professor of Economics at London Business School – Background paper

UN DESA (Ageing) Policy Brief: The Impact of Covid-19 on Older Persons

Early healthcare investment is our best chance at healthy ageing: https://www.london.edu/think/cleaning-up-the-oceans