How to prevent diseases, enhance connections, and better serve their minority populations

This article is the seventh in a weekly joint series on “The COVID-19 Pandemic and the Future of Aging” from the Milken Institute Center for the Future of Aging and Next Avenue. The articles are Q and As with thought leaders in fields ranging from health care to retirement planning to work to intergenerational relationships.

Milken Institute Center for the Future of Aging: Given that chronic diseases like hypertension and diabetes are so prevalent and related to COVID-19 risks, how can we strengthen efforts at disease prevention?

Richard Ashworth: Two things will be critical as we move forward: a consumer-first approach and expanding digital resources.

Understanding the consumer and targeting interventions are keys to rethinking prevention and risk reduction. COVID-19 will bring significant, long-term change across the health-care industry. Starting with the consumer will help us get it right.

We must rethink health-care delivery, from primary care to lifestyle interventions such as physical activity. High-risk patients may avoid activities that could expose them to COVID-19, such as fitness classes, social gatherings, and routine doctors’ visits. While delaying some of these activities for a short time may be okay, longer delays increase risk. 

Physical activity is key to managing chronic disease. A recent study indicated that just two weeks of inactivity (or a 75 percent step reduction) can decrease muscle strength by 8 percent. Regular exercise boosts the immune system, supports balance and strength, and improves mental health. Keeping older adults moving is critical to managing chronic disease.  

At Tivity Health, we regularly survey our SilverSneakers members. In one survey, 74 percent of respondents said they are using video calls or live streaming for medical appointments, socializing, or fitness. While 90 percent said they plan to exercise in the next three months, 68 percent said it will be at home. 

Digital solutions will almost certainly be at the center of preventive health for those with chronic illnesses going forward. Solutions designed with the consumer in mind will generate the patient engagement needed to improve their health. 

Distancing can lead to social isolation of older adults. What can be done to enhance connection and prevent negative effects on mental and physical health?

In a recent Tivity Health survey of approximately 5,000 people 65 and older, three times as many reported feeling isolated compared to before the pandemic. And they ranked inability to visit with family and friends as the number one thing disrupting their lives. 

We need to change the mindset around supporting older adults during this crisis and beyond. 

Physical distancing doesn’t have to mean social distancing. Friends, family members, and support networks within the community must reach out and develop new means of connection when in-person contact is not an option. 

Taking the time to train and support older adults in using technology—from smartphones to video conferencing—will help them find new ways to connect. 

As we strive to protect elders from COVID-19, we must engage them as valued contributors to our families, communities, and workplaces. And we must prioritize access for this population when a vaccine becomes available so they can return to the lifestyles they enjoy. 

With innovations driving rapid change in health-care delivery and services, what are the most significant impacts of COVID-19 that you foresee for older adults, their health and well-being, and the health-care system?

The convergence of COVID-19 and social justice issues is amplifying the devastating impact of health disparities on them, particularly those in minority populations. It is our responsibility as health-care professionals, and it is good business and policy, to address these issues across the industry.

We know that those 65 and older are at a higher risk of dying from COVID-19. But Black Americans aged 65 to 74 have died of COVID-19 five times as often as whites, and Hispanic and Native American populations have also been disproportionately impacted.

Older adults and minority groups are also disproportionately affected by chronic diseases, including hypertension, diabetes, and obesity. 

For minorities from rural areas, it is even more difficult because they may lack access to health care, healthy food, and transportation. They may also experience other non-medical factors that influence their overall health. 

These social determinants of health are driving health inequity, and we must do more to mitigate the impact.  

Trends in Medicare Advantage health plans from private insurers provide a starting point. Fifty percent of their beneficiaries live on less than $24,500 a year; 28 percent of them represent minority populations. 

The government’s Centers for Medicare and Medicaid Services expanded the kinds of interventions that can be covered under Medicare Advantage supplemental benefits, giving health plans and providers more ways to solve for health disparities.  

COVID-19 has dramatically increased telehealth adoption. While telehealth addresses some barriers to care, such as transportation, there are implementation challenges. Solving infrastructure issues such as reliable internet access and supporting those with hearing or vision impairment and language barriers will move us toward more equity in telehealth adoption. 

We have a unique opportunity to leverage technology, regulatory changes, the spotlight on racial injustice, and the flexibility that so many organizations have demonstrated during COVID-19 to take broad-based action. It is critical that we seize the moment to improve the health and well-being of America’s older adults who have historically been overlooked.