ABSTRACT
Although prevalent in the 1990s, research on social and economic determinants of elder abuse, including race, ethnicity, and culture, has lagged in recent years, compromising understanding of elder abuse as a public health problem calling for systems responses. The COVID-19 pandemic has highlighted the tragic impact of substantial disruptions in access to care across fragmented health systems and community-based settings on vulnerable older adults and, in such crisis conditions, the persistence of both violations of older adults' human rights and historical inequities in their treatment. Older adults have been disproportionately affected by COVID-19, particularly older Black/African Americans and Latinx and those living in congregate settings such as nursing homes, assisted living facilities, and prisons, as reflected in reporting of cases, hospitalizations, and deaths. American Indian reservations and indigenous and tribal communities are also struggling with the effects of the pandemic on the health and economic security of their members. The pandemic is exposing challenges that have heretofore been ignored or covered up, or have remained otherwise invisible, such as institutional neglect, poverty, deprivation, and isolation, yet have deepened suffering of older adults. However, little is yet known about older persons' experience of abuse, neglect, and violence during pandemic crisis conditions, such as sheltering-in-place, quarantines or lockdowns, or situations of scarce resources including intensive care unit beds, medical equipment, and personal protective equipment. The risks created by these conditions and their palpable urgency call for critical examination of the contribution of structural inequities to older adults' heightened risk in disaster and post-disaster environments and the disproportionate impact of crisis conditions (Institute of Medicine [IOM], Crisis standards of care: A systems framework for catastrophic disaster response: Volume 1: Introduction and CSC framework. The National Academies Press, Washington, DC, 2012. https://doi.org/10.17226/13351) upon the human rights of diverse older adult populations and communities. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
ABSTRACT
This collection of articles takes up a thematic focus on law, medicine, and bioethics in the contexts of the pandemic environment, including a range of issues concerning democracy, climate change and adaptive governance, structural inequities and health disparities, and social justice. Drawing on interdisciplinary perspectives, contributors to the collection of articles engage with the transformations in psychological and social life being wrought by the pandemic experience, challenging theorizing embedded in neoliberal paradigms that heighten suffering and risks of harm for vulnerable communities, and proposing alternative theoretical frameworks relevant to the global world and global health as radicalized by pandemic threats. (PsycInfo Database Record (c) 2021 APA, all rights reserved) Impact Statement Public Significance Statement-This article serves a critically important public interest at this time in the unfolding history of psychology and the relationship of psychology to the experience of the global world in the COVID-19 pandemic environment as it has impacted diverse societies and peoples. The authors highlight the expanding role and responsibility of psychology in engaging in interdisciplinary dialogues across the domains of law, medicine, and bioethics and their influence on democratic systems of governance. (PsycInfo Database Record (c) 2021 APA, all rights reserved)
ABSTRACT
The COVID-19 pandemic ("the pandemic") has magnified the critical importance of public policy deliberation in public health emergency circumstances when normal health care operations are disrupted, and crisis conditions prevail. Adopting the lens of syndemic theory, the disproportionate impact of the pandemic on vulnerable older adults suggests that the pandemic has heightened pre-existing precarities and racial inequities across diverse older adult populations, underlining the urgency of needed policy reforms. While the pandemic has called attention to systemic failures in U.S. public health emergency planning at both federal and state levels of government, the important role of civil society in influencing policy decision making and advocating for legal and ethics reforms and social change in a democracy calls for more open dialogue in aging, public health and legal communities and constituencies. To foster this dialogue, one public health lawyer, who is also a bioethicist and gerontological social work researcher and served as chair of the New York State Bar Association Health Law Section COVID Task Force in 2020 ("Task Force"), shares her first-person perspectives on the process of leading the development of a statewide bar's recommendations for policy reforms, including the challenges and conflicts encountered. A hospital-based attorney and clinical bioethicist brings a clinical ethics perspective to the discussions. This first-person contribution discusses the power of constituencies to influence policy deliberation in a democracy, and the implications of the Task Force recommendations for future aging and public health policy, particularly in view of the high suffering burdens and trauma older persons and older people of color have borne during the pandemic.