Covid-19 Will Change How We Address Aging, Equity and Longevity—Three Lessons from the Pandemic

Editor’s Note: This column is spon­sored by the AARP Thought Leadership and International team. Thought Leadership and International seeks to position AARP as a global thought leader by identifying emerging trends around the world, cultivating and elevating new ideas and sparking new solutions that empower people around the world to make the most of a longer and healthier life.

As it says on ASA’s website, We Are an Aging Society. With life expectancies on the rise and fertility rates declining, the growth of the older population is steadily outpacing that of younger generations. In 30 years, the number of people around the world older than age 65 is expected to reach 1.6 billion—or 17 percent of the world’s population. In countries where people are aging well, more than half of children born today will live to 100. Longer lives are a triumph of medicine, public health, technology and international development.

Older people are a key driver of economic growth, innovation and new value creation. According to AARP’s Longevity Economic Outlook, in the United States, people ages 50 and older contribute $8.3 trillion to the economy. A number that is projected to triple to $28.2 trillion by 2050. 

But 2020 was beyond challenging. The COVID-19 pandemic devastated older adults and communities of color in the United States. People older than age 80 died at five times the average rate. Black, Latino and American Indian/Alaska Native people are disproportionately more likely to get infected, hospitalized and die from COVID-19. These disparities are not random. COVID-19 only exacerbated what have been longstanding structural issues.

‘Closing the disparities gap would generate an additional $8 trillion to GDP by 2050.’

If we do not confront the undercurrents of ageism and racism embedded in our nation’s DNA, we cannot hope to level the inequalities endemic to society. As we turn toward recovery, we must rebuild our health and social systems to be more equitable. What follows are three realities we need to tackle  to address systematic disparities that could inhibit our ability to return to “normal” in a post-COVID world:   

Lesson 1: COVID-19 exposed the challenges in long-term care facilities.

This pandemic has exposed the underlying and systematic challenges facing our long-term care system, as well as those facing millions of family caregivers. While less than 1 percent of the U.S. population lives in nursing homes and other long-term care facilities, more than 40 percent of all COVID-related deaths occurred there. In a May 2020 report, the U.N. noted that, beyond a fatality rate five times the global average, older people are subject to a broad range of COVID-19-related issues, including lack of access to healthcare, discrimination in medical care and more. The World Health Organization found that, in many countries, more than 40 percent of COVID-related deaths have been in long-term care facilities, with figures being as high as 80 percent in some high-income countries.

But the long-term care crisis is not new. COVID-19 only exacerbated what have been longstanding structural issues, whether it be fragmentation, lack of investments in alternative options to nursing homes, lack of meaningful benefits for direct care workers or support for family caregivers.   

It is a decades-old problem, and older people who need care, particularly people of color, have been marginalized. According to AARP’s Nursing Home COVID-19 Dashboard, more than 100,000 nursing home residents and staff have died of causes related COVID-19 in the United States. Nursing home staff are more likely to be women, people of color and immigrants. Recent data from the Kaiser Family Foundation found that nursing homes with a relatively high share of Black or Hispanic residents were more likely to report COVID-19 related deaths than nursing homes with a lower share of Black and Hispanic residents.

This presents an opportunity to reform our system to design and deliver services and supports that are  “person- and family-centered,” expand home and community options as a meaningful and cost-effective alternative to nursing home care, as well as provide additional support and relief to the millions of family caregivers who serve as the backbone of our health and long-term care systems.

Lesson 2: Addressing the societal and structural issues of ageism means a better world for all of us.  

Whether it’s age discrimination in medical care, scaling back clinical and social services due to local shutdowns or underlying conditions that put them at greater risk of infection, older adults around the world are the bullseye for the COVID-19 arrow.

But older people, especially older people of color, have always been marginalized, devalued and discriminated against because of their age. A report from 2018 found that age discrimination against workers ages 50 and older cost the economy $850 billion. The potential economic contribution of the older population could increase by $3.9 trillion annually in a no-age-bias economy, which would mean a contribution of $32.1 trillion to GDP by 2050. These findings are confirmed by the Organisation for Economic Co-operation and Development (OECD), which calculates that eliminating factors such as discrimination and ageism would raise the GDP per capita in OECD countries by 19 percent over the next 30 years.

Lesson 3: We need to address growing inequality to prevent a future fallout.

We can’t talk about COVID-19 without discussing racial and socioeconomic disparities. Communities of color continue to feel the double whammy of the pandemic on their health and in their wallets.

On the health side, Blacks, Latinos and American Indian/Alaska Natives are being hospitalized and dying at higher rates due to COVID-19. On the economic side, of the millions of Americans out of work, job losses have hit Latino and Black communities disproportionally, with lower-wage workers ages 50 and older being the most vulnerable.

Preserving these disparities, which have only been exacerbated by COVID-19, stifles economic growth. The Kellogg Foundation reports that closing the disparities gap would generate an additional $8 trillion to GDP by 2050, increase federal tax revenues by $450 billion and expand state and local tax revenues by $100 billion annually. As we start to recover, we need to ensure that everyone has the opportunity to live a longer, healthier and more productive life. This is not just a moral imperative, it’s also an economic necessity.

Any desire to get back to a level of “normal” must be accompanied by the recognition that normal excluded many in our pre-COVID world, and disparities and inequality were common practice. It is time to reimagine and build a future that is more equitable, one where race and other sociodemographic factors do not determine health and economic outcomes or the opportunity to live longer, healthier and more productive lives. Equity will enable not only greater prosperity, but also the means to withstand, hold steady and come out strong in future crises.

Jean Accius, PhD, is senior vice president of AARP Global Thought Leadership in Washington, DC.