Health, Illness and Medicine – The Double Exclusion of Older Adults During the Covid-19 Pandemic
Alexander Seifert, University of Applied Sciences and Arts Northwestern Switzerland (FHNW)
During the current worldwide Covid-19 pandemic, older adults are particularly excluded from in-person society. To begin with, adults aged 70 years and older belong to the vulnerable group and often experience critical courses of Covid-19 due to multimorbidity and pre-existing health conditions . At the same time, however, older adults belong to the population group who are often excluded from digital services, because they opt to not use the internet or lack a smartphone with which to use video-chat apps to be virtually connected with their children and relatives. Therefore, older adults who are frail and are not ‘online’ struggle with a double burden of social exclusion. This missing participation also includes various specifically useful online services and content, such as health information, digital social events and social networking, and online shopping opportunities. Non-participation in the digital world could lead to a feeling of social exclusion in times of physical distancing.
Digital technologies pervade all aspects of our lives. In recent years, we have seen the digitalisation of everyday life by high levels of technological innovation. The internet is one of the most important examples of modern digital technology. As internet access has become widespread across the globe, a digital gap between younger and older adults has been observed today in empirical studies . Young age groups are currently embracing the internet, whereas adults who have not grown up using these technologies have been observed to use the internet less. For example, one representative study in the US found that only 67% of people 65 years and older were online .
While the gap in internet use between emerging and advanced economies has narrowed in recent years, there are still regions in the world, especially within developing countries, where significant numbers of older citizens do not use the internet . The situation is not as different in Europe as one might suppose: a representative survey conducted across Switzerland and 16 European Union countries showed that only 49% of people aged 50 years and older used the internet . The findings indicated that internet use among older adults was influenced by personal factors, such as age, gender, education, and income. The study showed that people above the age of 80 years spent less time online than people in a slightly lower age group (i.e., 65–79 years). Men and older adults with higher educational and economic status were more likely to use the internet. In addition, individuals’ health, prior experience with technology, social salience (internet use among the members of one’s social network), and contextual factors, such as country-specific wealth and communication technology infrastructure, were predictors of internet usage by older adults .
Access to the internet, or the lack of it, is only one aspect of participation in the digital world. DiMaggio et al.  coined the term digital inequalities to describe this multidimensional digital divide, subdividing it into usage, skills, social support, and self-perception. Usage refers to the variety of different purposes one might have for accessing online content, while skills refers to individuals’ internet-specific knowledge. Social support refers to the intensity of support obtained from offline and online networks. Self-perception refers to an individual’s personality and his or her attitudes toward internet use. Digital inequality thus refers not only to being ‘in’ or ‘out’ in terms of access to digital technologies, but also to participating either actively or passively in the digital society.
Despite the positive outcomes of social participation of people worldwide in the digital world during the Covid-19 pandemic, older adults are at risk of feeling excluded from it . From a sociological perspective, social exclusion is ‘a multidimensional, relational process of progressive social disengagement, one having interrelated negative consequences for quality of life and well-being of the individual as well as for the quality of society in terms of social cohesion’ . In the case of internet participation, exclusion means exclusion from a society that is dominated by the internet and digital technologies in many areas of everyday life. The exclusion from participation in these areas of everyday life in some cases leads to a subjective feeling of social exclusion.
Technology and a focus on digital events as a means of social participation during the Covid-19 pandemic has the potential to perpetuate ageism – that is, older non-users of technology are viewed as outsiders, in addition to the already prevailing view of older adults as rendered frail and physically isolated by the Covid-19 pandemic. If inclusion in society nowadays means active participation in the digital world, then older adults who are not online or not active on the internet are at risk of social exclusion. As an increasing number of service providers have to change from personal to virtual information and service provision on an online-only basis, older citizens who are offline could become increasingly disadvantaged as the internet’s societal pervasiveness progresses. Society must therefore work together to minimise the risk of social exclusion in relation to digital content on the internet, especially regarding important health information or initiatives for social participation in times of physical distancing.
This means that everyone can help to avoid this double exclusion of older adults by, first, being sensitive about the digital divide, and providing social interaction via ‘old’ technologies such as telephone or letters; and, second, being creative in bridging the digital divide by, for example, buying a smartphone for their older parents with pre-installed vide-chat apps and sending it to the parents with a point-by-point introduction via telephone. Today being ‘creative’ is not only about being creative on the web with home-office videos, but also in connecting older adults with society in offline ways. Little steps, such as ringing parents or older neighbours by telephone, or dropping postcards into their letterbox asking them to tick a box concerning the kind of help they most need or asking them if they want help with the purchasing of food, can achieve this. Let’s not socially isolate older adults in times of physical distancing; the digital way is one way to connect, but not the way for everyone – we must keep this in mind.
 Remuzzi A. and Remuzzi, G. (2020) ‘COVID-19 and Italy: What next?’. The Lancet. https://doi.org/10.1016/S0140-6736(20)30627-9
 Hunsaker A. and Hargittai E. (2018) ‘A review of Internet use among older adults’. New Media Soc 20(10): 3937-3954. https://doi.org/10.1177/1461444818787348
 Anderson M. and Perrin A. (2017, May 17) ‘Tech adoption climbs among older adults’. Pew Research Center.
 Poushter J., Bishop C. and Chwe, H. (2018, June 19) ‘Social media use continues to rise in developing countries but plateaus across developed ones’. Pew Research Center.
 König R., Seifert A. and Doh M. (2018) ‘Internet use among older Europeans: An analysis based on SHARE data’. Universal Access Inf 17:621–633. https://doi.org/10.1007/s10209-018-0609-5
 DiMaggio P., Hargittai E., Celeste C. and Shafer S (2004) ‘Digital inequality: From unequal access to differentiated use’. In: Neckermann KM (Ed.), Social Inequality. Russell Sage Foundation, New York, NY, pp. 335–400.
 Seifert A., Hofer M. and Rössel J. (2019) ‘Older adults’ perceived sense of social exclusion from the digital world’. Educ Gerontol. 44:12, 775–785 https://doi.org/10.1080/03601277.2019.1574415
 Böhnke P. and Silver H. (2014) ‘Social Exclusion’. In: Michalos AC (Ed.), Encyclopedia of quality of life and well-being research. Springer, Dordrecht, pp. 6064–6069.
Comment on this article – log in with your ESA username and password: a comment field will appear.