Effects of the COVID-19 pandemic on the psychosocial health and well-being of older adults in Uganda.

Since the World Health Organization (WHO) declared COVID-19 a global pandemic on March 11, 2020, governments and public health authorities worldwide have implemented preventive measures such as social distancing, self-isolation, and frequent handwashing, among others, to preventthevirus'sspread. Whiletheseactionsareessential,ithasbecomeapparentthatpeoplein pre-existing disadvantaged situations (e.g., lacking access to safely managed water, sanitation, hygiene, etc.) have found it challenging to adhere to the recommended guidelines. Indeed, there are growing concerns that the guidelines may have exacerbated existing health inequalities, creating a disproportionate burden of COVID-19-related health and wellbeing issues for disadvantaged populations. The UN Research Roadmap (https://bit.ly/3C5T5Ps) identifies women and older adults as some of the world’s most vulnerable populations and sub-Saharan Africa as one of the world’s most vulnerable regions. Yet little attention has been paid to examining the impacts on older adults in sub–Saharan Africa. Drawing on feminist political ecologies of health, this research examines older adults’ experiences of COVID-19-related health and wellbeing outcomes in Uganda. We surveyed 288 older adults across four communities in Uganda to ascertain (1) their access to resources for everyday living, such as water, sanitation, hygiene, food, housing, wealth, and employment status during the COVID-19 pandemic, (2) how access to these resources influence their attitudes and practices towards COVID-19 preventive measures, and (3) the impacts of the COVID-19 pandemic on their general health and wellbeing. The findings show that most respondents were more concerned about factors relating to the access to resources for everyday living than the COVID-19 virus itself. For example, most survey respondents ranked lack of income (n=104; 36.1%) at the household level and inadequate access to water (n=41; 20.2%) at the community level as their major challenges during the pandemic. In addition, many reported living under conditions of food insecurity (53.8%), water insecurity (31.9%), poverty (60.4%), and lacked access to handwashing facilities (66.7%). We also observed that both the poor socio-economic conditions and the effects of the COVID-19 pandemic have negatively affected older adults’ general health (emotional distress=87.2%). Overall, older women (88.2%) were more likely to report being emotionally distressed compared to older men (85.3%). Our findings confirm existing concerns that disadvantaged groups may suffer multiple jeopardies resulting from the direct and indirect effects of the pandemic. We therefore argue that policymakers' failure to address these existing social conditions may undermine efforts to tackle emerging zoonotic diseases linked with climate change, biodiversity loss, and other challenges of the Anthropocene.