Equity for Older Adults and Those in Congregate Sites: Lessons from the First Year of a Local Public Health COVID-19 Response

This paper presents lessons on the equity of healthcare and health for older people that emerged from the experience of a COVID-19 incident commander during the pandemic. The lessons include the value of ongoing investment in trustworthy cross-sector relationships and value-added roles for learners; the importance of working together for the common good which can provide a deep well to draw upon during a crisis; in such times, the vulnerable often become more vulnerable and need extra attention thus meeting the needs of older people requires consideration of age, disability, and congregate living status; an equity lens and cultural humility foster new opportunities for community health and systems thinking, and when balanced with on-the-ground work and relationships, make it possible to take on seemingly intractable problems; in order to advance community health and equity, it is vital to meet both immediate needs and to focus on strategic efforts to simultaneously transform systems and structures; developing new knowledge creates opportunities for broader sharing; interprofessional teams enable collective action in a complex problem; transparency and continuous communication are important always, but vital in a crisis; and proactive investment in public health infrastructure could mitigate a future crisis. While the pandemic produced loss and pain for millions, the transportable lessons about investing in system science, equity-focused, cross-sector infrastructure, and relationships can inform the future of public health and health care policy, grounded in lived experience, to inform the re-emergence of collective efforts to foster health equity for older people and other vulnerable populations.