Pandemics: Historical Perspective and Vulnerabilities Among Minority Elderly

While infectious organisms surround us, critical circumstances need to occur for a pandemic to develop, such as that of the novel coronavirus disease 2019 (COVID-19), declared by the World Health Organization in March 2020. Prior pandemics had many feautres in common with COVID-19. Pandemics can expose weaknesses in public health response systems, as well as vulnerabilities in the populations who are most susceptible to adverse outcomes, and can lead to scapegoating of specific groups and attempts to conceal the disease. COVID-19 has disproportionately impacted the mental and physical health of minority seniors, and caused significant economic hardships. Long-standing social determinants of mental and physical health have led to health disparities highlighted by COVID-19, and demonstrate the complex intersection of health, medical comorbidities, and barriers to access to culturally competent physical and mental healthcare. The pandemic has caused significant mental health problems even among those who were spared the infection, primarily manifested as social isolation, depression, anxiety and opioid use disorders. Public health measures, including screening, vaccinations, and access to quality healthcare can all mitigate adverse outcomes. Similarly, best practices that include collaborations between social service agencies and faith-based groups are effective strategies to bring these mitigating strategies nearer to the minority seniors who are most in need. Addressing vaccine hesitancy is a critical component of ending this pandemic. Future research should bring together practitioners, public health agencies, and community-based organizations for the collaborative design and implementation of effective, culturally competent interventions to address the medical, psychosocial, and behavioral health needs of ethnic/racial minority older adult communities in the face of COVID-19 and other chronic health conditions. Using the Social Determinants Of Health framework as a guide, clinicians and researchers can work to address structural and systemic racism and poverty and create targeted interventions to COVID-19 and to prevent future pandemics.