Support and exclusion for older adults during Covid-19: is the neighbourhood always best placed?

By Sophie Yarker, Chris Phillipson, Camilla Lewis, Tine Buffel & Patty Doran, University of Manchester, UK

Older people have borne the brunt of deaths from Covid-19, whether in hospital or in care homes. At the same time, the coronavirus emergency sits alongside a crisis in many of the communities in which older people live.

Geography matters greatly for the 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 and amenities, participation in cultural and leisure activities, and relationships with friends and family.

Based on the available research, it is hardly surprising that the Office for National Statistics (ONS) has reported that those living in the poorest parts of England and Wales are dying at twice the rate from Covid-19 compared with those in more affluent areas.

As the impact of coronavirus grows, older populations who are social distancing may be doubly locked down – suffering the effects of social isolation whilst living in places affected by substantial cuts to public services. For older people living in low income communities, who are already more at risk of social isolation, a declining community and voluntary sector will mean less support available on their doorstep and less opportunities for social and civil participation. Far from being a ‘great equalizer’ Covid-19 highlights the seriousness of the crisis facing our already most besieged communities.

However, other stories of community are emerging, ones of neighbours offering support to one another and of a renewed sense of community spirit in the face of the Covid-19 pandemic. A geographical lens allows us to explore the lived experience between these two positions of pessimism and hope, allowing us to tease out the complex and relational geographies of support and exclusion for older people at this time.

The emergence of neighbourhood mutual aid groups, for example, are undoubtedly a welcome source of support for many. At the same time, our ongoing research into how different groups of older people are experiencing lockdown measures shows that some may feel alienated by these hyper-locally based activities. Initial interviews with organisations representing older LGBT adults living in Greater Manchester has shown that some people can be uncomfortable identifying themselves within their neighbourhoods, preferring instead to draw on the support offered by multigenerational LGBT networks that stretch across the city region, something the closing of physical meeting spaces has made more difficult. Online spaces have become an increasingly important space to maintain these networks but they may not be accessible to all, due to digital exclusion and resistance to such platforms.

Spaces outside of the local community are often an important source of social support for many ethnic minority older adults too. Research into the use of important social infrastructure amongst older members of the South Asian community community demonstrated the distances people were willing to travel out of their local area to visit specialist food retailers and markets, not only to purchase culturally specific produce, but also to socialise and interact with those with a shared cultural heritage. The coinciding of Ramadan with the lockdown has been particularly challenging for those older people who would normally attend the Mosque several times per day, not only for prayer but to also meet with friends and extended family. Even if these public spaces begin to gradually re-open, their accessibility through public transport, for those older people not being advised to shield at home, stands to be significantly diminished.

Therefore, many older people are effectively being cut off from the spaces of support and social connection that are so important to their wellbeing, sense of belonging and connection and this may continue for some time.

A geographical analysis therefore highlights the need to understand how spatial inequalities will shape older people’s everyday experiences of social distancing but also allows us to recognise the different geographies and networks of support for older people that extend beyond the immediate neighbourhood. Against a generalised view of older people we often seen media and government discourse we must recognise the diversity of experience of Covid-19 for older adults and, as we start to plan for a future living with the virus, we must be mindful of the different social needs of individuals and find new ways of being able to meet them.

About the authors: Dr Sophie Yarker, Prof Chris Phillipson, Dr Camilla Lewis, Dr Tine Buffel & Dr Patty Doran, are all members of The Manchester Urban Ageing Research Group at The University of Manchester. The research of group members spans inequalities in later life, social exclusion and poverty, rural/urban boundaries, ageing and mobility, ethnicity, migration and healthcare systems, housing design and climate change, comparative studies and developing age-friendly cities. Working closely with partners in government and third sector organisations our research supports the promotion of age-friendly environments at global, EU, national and local level.