Blog Harvey A. Friedman Center for Aging Health Equity

COVID-19 double jeopardy: The intersection of race and age

Written by Emma Swinford, Natalie Galucia and Nancy Morrow-Howell
Harvey A. Friedman Center for Aging at the Institute for Public Health, Washington University in St. Louis

The American Society on Aging recently released a statement, which begins, “Age offers no immunity to racism and violence.” In fact, age often magnifies the impact of structural inequalities like racism. Older adults of color are more likely to face increased later-life vulnerabilities, which often stem from a lifetime’s worth of experiences with systemic inequities and discrimination.

In gerontology, “double jeopardy” is a term used to describe the outcomes of the intersection of age with another social indicator that has put people at risk for discrimination throughout their lives, like gender or race. The term “cumulative advantage” (or disadvantage) refers to the process through which various social and economic forces accumulate and progress across an individual’s life course to produce disparities in older adulthood.

The early lives of many of today’s Black older adults were harmed by Jim Crow laws and persistent racism, discrimination and segregation. The legacies of early-life inequities in housing, education and employment follow older adults of color as they age, leaving many increasingly vulnerable to health and economic instability. Black older adults are more likely to struggle with physical, mental and cognitive health issues than their white counterparts. Despite being an invaluable segment of the U.S. workforce, they are also more likely to struggle financially. Nearly 20% of African-Americans over the age of 65 live below the Federal Poverty Line, a statistic that ties directly back to cumulative disadvantage.

Economic insecurity puts older adults of color in a particularly precarious situation in the time of COVID-19. Reverberations of the virus’ economic shock affect older black workers and caregivers. Members of intergenerational households and custodial grandparents—who are more likely to be minority—often risk increased exposure to the coronavirus.

Data showing the massive disparities in coronavirus death rates have been reported widely. CDC data indicates that while African-Americans make up only about 13% of the U.S. population, they account for nearly a quarter of COVID-19 related deaths. A report from the Brookings Institution notes that exploring this data by age tells an equally disturbing story. Across age brackets, COVID-19 death rates for African-Americans most closely resemble the death rates of white Americans a decade older. For example, the death rate for an African-American individual between 55-64 is higher than that of white persons aged 65-74.

These data are alarming, yet they are not new.  Particularly in times of crisis (Hurricane Katrina and the Chicago Heat Wave, for example) we have seen older adults of color bear the brunt of negative health and financial fallouts. As we work through this current crisis, it is imperative to consider how double jeopardy affects people, to focus on the intersection of race and age, and to center the advancement of equity throughout the life course.

There has never been a stronger argument for, or a more urgent time to, make racial equity in aging a priority. The American Society on Aging offers several strategies to help further racial equity in the aging field:

  • Ensure real-time reporting of data on racial and ethnic disparities in COVID-19 infections, testing rates, hospitalizations and deaths—with an eye toward immediate and localized action solutions
  • As service providers, quickly survey clients and workers to examine their needs and preferences, and any disparities in access to services and develop a care plan to provide adequate COVID-19 supports.
  • Implement a racial equity lens in all aspects of service delivery, workforce development and government interventions in aging and long-term services and supports.
  • Advocate for government funding that boosts the aging and long-term-care sectors and the direct care workforce.
  • Everyone—governments, charities and individuals—should financially support those organizations rooted in communities of color that are well-positioned to assist older people of color and their families.
  • Support older people, family caregivers and direct care workers who are immigrants, as these cohorts face additional biases and hurdles.
  • Provide additional assistance such as paid leave, childcare, transportation, hazard pay and other resources to help all low-wage workers and low-income families.

The coronavirus and systemic racism are intimately intertwined, and addressing both of these issues is a deeply urgent, deeply important task.  As we work towards becoming a society in which people of all racial backgrounds and ages can thrive, we endorse action, resource allocation and unwavering attention towards eliminating health disparities.