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The effects of restricted access to healthcare on vulnerable people: an analysis of the determinants of health outcomes among older adults during the COVID-19 pandemic

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Abstract

This study investigates how restrictions in healthcare access in European countries during the COVID-19 pandemic affected health outcomes among a key group of vulnerable people: older adults. This group is vulnerable in that older adults are more susceptible to social changes and less capable of adapting, either because of individual characteristics or pre-existing structural inequalities. We employ multi-level modelling using data from the SHARE and SHARE Corona surveys. The findings show that older adults have, on average, perceived a worsening in general and mental health, especially among women and those to whom medical care was restricted. Those whose health status was already poor and those who contracted COVID-19 were most strongly associated with worsened perceptions of general health. Social distancing, loss of employment, and previous depressive episodes were the strongest predictors of worsening mental health. Hence, the pandemic appears to have exacerbated inequalities in health outcomes. Our findings corroborate national-level studies from both within and outside the EU, particularly concerning the gender dimension, access to healthcare, and pre-existing socio-economic inequalities. We conclude with some policy implications and the necessity to craft preventive policies to make the social system more resilient in responding to future crises.

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Data availability

The data that support the findings of this study are available from the SHARE Research Data Centre. R Codes are available from the authors upon request.

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Acknowledgements

The authors would like to thank the editors of the journal and two anonymous reviewers for their constructive feedback. Our thanks also go to Eszter Sandor, Ekaterina Bobrovnikova, Gabija Skardžiūtė and Ellen Rahm for comments and contributions to a previous iteration of this study. Any remaining error is our own.

Funding

This work was funded by service contract with Eurofound no. 21–3030-21 ‘Economic and social inequalities in Europe in the aftermath of the COVID-19 pandemic’.

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  1. Public Policy and Management Institute (PPMI), Gedimino Pr. 50, 01110, Vilnius, Lithuania

    Vaida Gineikytė Kanclerė, Luka Klimavičiūtė & Marco Schito

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  1. Vaida Gineikytė Kanclerė
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V.G.-K. reviewed the literature and oversaw the project; L.K. addressed the context, as well as the wider implications, and oversaw the statistical analyses; M.S. conducted the analyses and prepared the manuscript's tables and figures. All authors contributed to writing and reviewing the manuscript.

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Correspondence to Marco Schito.

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Kanclerė, V.G., Klimavičiūtė, L. & Schito, M. The effects of restricted access to healthcare on vulnerable people: an analysis of the determinants of health outcomes among older adults during the COVID-19 pandemic. J Econ Inequal (2024). https://doi.org/10.1007/s10888-024-09622-z

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