Individual and neighborhood level inequalities in the provision of elderly care during the COVID-19 pandemic

By: Dominik Dietler, Jonas Björk, and Marianne Granbom

Elderly care in Sweden is designed to be universal and based on need, yet substantial inter‑municipal variation in care coverage persists. The COVID‑19 pandemic further strained this system by disrupting service provision, increasing social isolation, and discouraging care‑seeking among older adults. These developments heighten concerns about unmet care needs and widening inequities among frail older populations.

This study investigates how neighborhood‑level socioeconomic conditions shape inter‑ and intra‑municipal heterogeneity in elderly care provision, considering individual‑level indicators such as frailty and living situation. Focusing on adults aged 65 years and older between 2018 and 2024, we identify highly frail individuals using comorbidity profiles and household composition, and assess their level of received elderly care. We quantify unmet needs by examining the prevalence of no or minimal care among frail individuals across neighborhoods and evaluate how the COVID‑19 pandemic altered existing inequalities in elderly care provision.