Equity for Older Adults and Those in Congregate Sites: Lessons from the First Year of a Local Public Health COVID-19 Response

Abstract

This paper presents lessons on the equity of healthcare and health for older people that emerged from the experience of a COVID-19 incident commander during the pandemic. The lessons include the value of ongoing investment in trustworthy cross-sector relationships and value-added roles for learners; the importance of working together for the common good which can provide a deep well to draw upon during a crisis; in such times, the vulnerable often become more vulnerable and need extra attention thus meeting the needs of older people requires consideration of age, disability, and congregate living status; an equity lens and cultural humility foster new opportunities for community health and systems thinking, and when balanced with on-the-ground work and relationships, make it possible to take on seemingly intractable problems; in order to advance community health and equity, it is vital to meet both immediate needs and to focus on strategic efforts to simultaneously transform systems and structures; developing new knowledge creates opportunities for broader sharing; interprofessional teams enable collective action in a complex problem; transparency and continuous communication are important always, but vital in a crisis; and proactive investment in public health infrastructure could mitigate a future crisis. While the pandemic produced loss and pain for millions, the transportable lessons about investing in system science, equity-focused, cross-sector infrastructure, and relationships can inform the future of public health and health care policy, grounded in lived experience, to inform the re-emergence of collective efforts to foster health equity for older people and other vulnerable populations.

Integrated, Personalized Care for Older People

“…Another analysis commissioned for the NASEM report (Stange, 2021), and an article in a previous issue of this journal (Gullett, 2021), highlight how the pandemic has uncovered the disastrous effects of decades of disinvestment in primary care and overspending on healthcare infrastructure that fragments care, reduces its accessibility for the most vulnerable, and reduces the resilience of people and systems attempting to integrate care for whole people.…”

“Here it was waiting for me:” Diabetes Diagnosis Pathways and Implications for Health Policy

“…Another analysis commissioned for the NASEM report (Stange, 2021), and an article in a previous issue of this journal (Gullett, 2021), highlight how the pandemic has uncovered the disastrous effects of decades of disinvestment in primary care and overspending on healthcare infrastructure that fragments care, reduces its accessibility for the most vulnerable, and reduces the resilience of people and systems attempting to integrate care for whole people.…”