Social Exclusion before and during the COVID-19 Pandemic: A Longitudinal Study of Older Adults in the United States

Background and Purpose: The COVID-19 pandemic has had a negative impact on the daily lives of older adults. Older adults were generally more vulnerable to infectious disease than other age groups. To contain the spread of COVID-19, mandatory social distancing was introduced. However, social distancing policies reduced direct contact between people and led to an increase in non-face-to-face or noncontact interactions. Ultimately, the COVID-19 pandemic and social distancing efforts worsened social exclusion defined as interrelated and multidimensional disadvantages that contribute to individual marginalization. Several studies have analyzed the impact of COVID-19 on specific quality-of-life subdomains such as physical and psychological distance and isolation, the disruption of meaningful relationships, and poor digital literacy. However, there is a lack of empirical evidence on the impact of COVID-19 on social exclusion—interrelated and multidimensional disadvantages that contribute to individual marginalization—among older adults in the United States. Thus, this study examined differences in the level of social exclusion among American older adults before and during the pandemic.

Method: Data were from the 2016 and 2020 waves of the Health and Retirement Study (n=656). Social exclusion was categorized into four dimensions and domains (resources, participation, health, and living) based on the Bristol Social Exclusion Matrix. Fixed effects models were conducted to identify within-individual changes between the two waves.

Results: Social exclusion among older adults worsened during the pandemic. Specifically, participation and resources decreased, and health also deteriorated over time. Further, social exclusion during the COVID-19 pandemic was largely driven by the participation dimension, likely reflecting the impact of compulsory and external regulations such as lockdowns and social distancing, which restricted social participation among older adults.

Conclusions and Implications: This study has implications for the field of social work, which is likely to face other population-wide challenges in the future, such as new infectious diseases or the impacts of climate change. Thus, we should learn from our experience with the COVID-19 pandemic and prepare for future crises. This study emphasizes the importance of awareness among policymakers and practitioners regarding social exclusion, highlighting the needs for improving policies and interventions to mitigate social exclusion among older adults. Policymakers and social workers should ensure that older adults have access to resources and services to prevent social exclusion. Social work practice and interventions should focus on promoting social connectivity among older adults. This could include measures to increase social participation opportunities, such as expanding access to technology to participate in virtual activities. Also, social workers should identify those who are at risk for social exclusion and provide necessary support. Future research is needed to identify effective interventions and explore the role of social workers in addressing social exclusion. Further, researchers need to consider the long-term impact of health problems on social exclusion, addressing health disparities and improving access to health care for older adults.