The Discursive Nature of Senior Social Vulnerability
November 30, 2020
An astute colleague of mine shared the following sobering factoid with our team a couple of months ago:
Approximately 5,400 seniors in Massachusetts nursing homes died, apart from their loved ones, over a four-month period from COVID-19. That’s equivalent to a fully loaded 737-jet crashing every day for a month.
Alarming, sensational, and viscerally reactionary in its framing, the above revelation gave our team cause to pause and think. Current data exposes that 40% of all COVID related cases occurred within the confines of nursing homes. Socially, the demographic grouping of seniors put them at the epicenter of susceptibility. From a business standpoint, the firmographic segmentation brings the industry of senior living to the forefront of concern and care. Simply, this is the tip of the iceberg of a multiplicity of discussions about senior social vulnerability.
If COVID – or prevention thereof – is the diagnosis, then social isolation is inevitably the prescription. However, the taxonomic analysis of social isolation and its subsidiaries of adverse events make for a non-congruent and messy reality; senior social vulnerabilities exacerbated by COVID are discursive in nature – expansive in scope and digressing from subject to subject.
The Overwhelming Conversation of Social Vulnerability
The World Health Organization defines vulnerability as the degree in which a population, individual, or organization is unable to anticipate, cope with, resist and recover from the impacts of disasters. Therefore, to discuss the impact of COVID on already in place social vulnerabilities is synonymous with discussing types of topics all at once, yet somehow maintain a sense of focus and clarity. The following infographic displays tiers and subsets of vulnerabilities. It illustrates how a multitude of factors can complicate a conversation of COVID as it relates to those that are vulnerable in niche ways.
Where things become even trickier is the problem-solving side of the discourse; how do we as a society develop solutions for COVID prevention to as many people as fast as possible while still factoring in the specificity of all vulnerabilities the individual may be subjected to? For those of us who have had our keen eyes and ears on the news media as we watch experts and policymakers alike wrangle for answers can readily recognize that one-size-fits-all methodologies are not readily consumed (mask wearing), nor do piecemeal tactics (mandating gathering sizes) garner mass adherence.
In a word, the conversation is overwhelming. However, we cannot withstand COVID resurgence after COVID resurgence. We can also not assume a vaccine is a silver bullet to eradicate COVID to erroneously go back to ‘normal’.
Redefining Public Health for Seniors
Let’s go back to that notion of a 737-jet crashing every day. When the unthinkable becomes a reality, shock can morph into an unsettling acceptance of reality where would’ve-could’ve-should’ve blame-worthy diatribes befall all of us, not just the experts and policymakers. Remember when our marching orders were to simply ‘flatten the curve’ and keep the spreaders at bay? The senior population – the ones most adversely affected by COVID – can look longingly at a calendar and be crestfallen with cause as they realize there were precise dates where the current COVID state of affairs could have been vastly different.
Yes, COVID is and was a tempest. Now, the journey necessitates itself to recover from potential worsening disaster. The silver lining to these dark clouds is redefining public health for seniors, and by immediate extension, public health for all.
Civic public health organizations carry the mantra to ‘prevent, promote, protect’. In a large part, many of the functions that can help seniors endure in a COVID world are already in place; telehealth, visiting nurses, PACE (programs for all-inclusive care for the elderly), remote patient monitoring, to name a few.
Public health is ‘the science and art of preventing disease, prolonging life and improving quality through organized informed choices of society, organizations, communities and individuals’, as defined by the CDC. Social vulnerabilities for seniors are nothing new. The fact that COVID has exasperated these will ultimately lead to better policy and better care from public health entities.
A Vaccine is Nigh
On October 2, the National Academy of Medicine revealed its recommendations for COVID-19 vaccine distribution. The report proposes distributing a vaccine in four phases in order of priority:
- Health-care workers
- Emergency responders
- People with underlying conditions
- Older adults living in group settings
The third and fourth phase of this list should look familiar to you by now and is the raison d’être of this month’s blog. For the first time in history, the recommendations above – commissioned by the National Institutes of Health and the US Centers for Disease Control and Prevention – state that priority be given to people who score high on the CDC’s Social Vulnerability Index. The goal: to rectify the pandemic’s disproportionate burden and work toward a new commitment to promoting health equity.
Like many public goods that are availed to us, fairness is key yet not always practiced. When a vaccine does become available, it will require for the vast majority of us the opportunity to express civic responsibility; allow those that have these vulnerabilities maintain a front-of-line standing. Disparities of care can absolutely be avoided by allowing those in need access to this lifesaving remedy.
A solid argument can be made that the American COVID response could have prevented the death toll equivalent of a 737-jet crashing daily. It is given that the conversation of senior social vulnerability is both complex and overwhelming, but one that can be championed. It is abundantly clear that our very next line of COVID defense – the vaccine – ought to be administered primarily to those that need it most.
Director of Business Development