Risky business: how older ‘at risk’ people in Denmark evaluated their situated risk during the COVID-19 pandemic

By Amy Clotworthy and Rudi G.J. Westendorp

Center for Healthy Aging (CEHA), Department of Public Health, University of Copenhagen

The COVID-19 pandemic has presented us with a unique opportunity to examine how societies perceive urgent biological risk, and how they manage population groups who may be susceptible to such risks (cf. Alaszewski 2015). When the World Health Organization declared a pandemic in March 2020 (WHO 2020), the Danish prime minister and health authorities immediately assumed a protective approach to reduce potential harms to both population health and the healthcare sector. There was also a call to protect those who were considered to be most susceptible to COVID-19 and have a higher risk of developing serious consequences and possibly dying from infection; i.e., people with compromised immune systems or chronic illnesses (e.g., cardiometabolic disease, lung disease, diabetes) as well as people age 65+ and especially 80+ (DHMA 2020).

From a biopolitical perspective, old age is often an area of concern. It requires security mechanisms to be installed to improve existing life by eliminating accidents; i.e., “the random element” (Foucault 2003: 246–248) in the life course. However, the coronavirus is more than just a random accident to be prevented. Thus, despite having promoted a neoliberal emphasis on citizens’ freedom of choice and self-governance since the 1990s, the Danish state’s response to the pandemic was to revert back to its strategy from the 1930s: to manage and protect ‘the elderly’ and other ‘weak’ social groups in a way that would ensure their survival. As such, government officials and health authorities made certain blanket decisions not simply for the ‘common good’ of the population but for older people’s ‘own good’. But how did people age 65+ experience these forms of biopolitical control and evaluate their own risk during the pandemic?

As part of the interdisciplinary project, ‘Standing together – at a distance: how Danes are living with the corona crisis’, based at the University of Copenhagen’s Department of Public Health, we conducted telephone interviews with 33 people across Denmark, including 8 women and 6 men between the ages of 65 and 83. Our analysis of these interviews indicate that older people reclaimed their agency by determining their own situated risk; i.e., “risks as they are actually understood and contextualized by people in social settings” (Boholm 2003: 166). Particularly when certain political decisions became confusing or unclear, older people acted as ‘rational actors’ by evaluating the official discourses based on their own lived experience. For example, Ingo (age 70) said, “I’ve had three small strokes, so I know very well what it’s like to be close to death. But I don’t [take precautions] because I’m afraid of dying of corona. I just protect myself as best I can” (interview; 22 April).

They also negotiated their political belonging (Thelen & Coe 2019) by judging the fairness of certain political decisions; e.g., Anders (age 76) considered the government’s plans to re-open society “unsafe” (17 April), and Jørgen (age 72) said that packing everyone over a certain age together implied “there’s not much to talk about” (5 May). However, our interlocutors did not allow such unfairness to exclude them from the political collective. By questioning the government’s ‘unclear’ decisions and deciding for themselves which protective measures to follow, they resisted the tacit forms of biopower (Rabinow & Rose 2006). Moreover, older people also acted with a form of relational autonomy: their evaluations of their own risk and the protective practices in which they engaged were not purely individualistic. Rather, these ‘at risk’ people chose to govern themselves and comply with certain precautions in order to protect their co-citizens’ health and thereby contribute to ‘the common good’.

Floor stickers leading to the check-out in a Danish grocery store say, “Take good care of each other
by maintaining distance” (Photo by Amy Clotworthy; 3 April 2020).

The rational, relational autonomy that our interlocutors demonstrated is something that governments should consider when faced with future public-health crises. Although people age 65+ are indeed more susceptible to infection from the COVID-19 virus, not all people over this chronological age are ‘at risk’ to the same degree. Moreover, older adults have a right to self-determination even during a pandemic, and individuals who are ‘at risk’ should be able to claim that designation for themselves (after consultation with their primary healthcare provider). Going forward, it is important that risk analyses of public-health crises consider older people’s lived experiences, their essential value to society, and the potential effects of specific restrictions on their mental health and well-being.

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WORKS CITED:

Alaszewski, A. 2015. “Anthropology and risk: insights into uncertainty, danger and blame from other cultures – A review essay” in Health, Risk & Society 17(3–4): 205–225.

Boholm, Å. 2003. “The cultural nature of risk: Can there be an anthropology of uncertainty?” in Ethnos 68(2): 159–178.

Clotworthy, A., Dissing, A.S., Nguyen, T.-L., Jensen, A.K., Andersen, T.O., Bilsteen, J.F., Elsenburg, L.K., Keller, A.C., Kusumastuti, S., Mathisen, J., Mehta, A.J., Pinot de Moira, A., Rod, M.H., Skovdal, M., Strandberg-Larsen, K., Willaing, I., Varga, T.V., Vinther, J.L., Xu, T., Hoeyer, K., and Rod, N.H. 2020. “’Standing together – at a distance’: Documenting changes in mental-health indicators in Denmark during the COVID-19 pandemic” in Scandinavian Journal of Public Health, 1–9. https://doi.org/10.1177/1403494820956445.

DHMA 2020. Danish Health and Medicines Authority (Sundhedsstyrelsen): “Hvad kan ældre og personer med kronisk sygdom gøre for at beskytte sig mod corona­virus/COVID-19?” (What can the elderly and people with chronic illness do to protect themselves against coronavirus/COVID-19?); https://www.sst.dk/da/Nyheder/2020/Hvad-kan-aeldre-og-personer-med-kronisk-sygdom-goere-for-at-beskytte-sig-mod-coronavirus-COVID-19 (last accessed 15 July 2020).

Foucault, M. 2003. ‘Society Must Be Defended’: Lectures at the Collège de France, 1975–76 (translated by David Macey). New York, N.Y., USA: Picador.

Rabinow, P. and Rose, N. 2006. “Biopower Today” in BioSocieties 1: 195–217.

Thelen, T. and Coe, C. 2019. “Political belonging through elderly care: Temporalities, representations and mutuality” in Anthropological Theory 19(2) 279 – 299.

WHO, World Health Organization 2020. “WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020”; https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19—11-march-2020 (last accessed 8 April 2020).

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Amy Clotworthy holds a Ph.D. in ethnology and a Master’s degree in applied cultural analysis, both from the University of Copenhagen. In her position at the interdisciplinary Center for Healthy Aging (CEHA), she teaches and conducts research on how health and social policies targeting older people influence the sociocultural dynamics of later life. With an emphasis on everyday health practices, her research also investigates how the Danish healthcare sector, hospitals, and municipal authorities can improve professional practices by recognising the complexity of older people’s life histories as well as the individual needs and priorities they express in their personal narratives.

Rudi G.J. Westendorp is Professor of Medicine at Old Age at the Faculty of Health and Medical Sciences at the University of Copenhagen (Denmark). In this capacity, he performs state-of-the-art and interdisciplinary research within the Department of Public Health and the Center for Healthy Aging (CEHA). He was a founding director of the Leyden Academy on Vitality and Aging at Leiden University (the Netherlands).

This blog post is a teaser for a longer article to be published in vol 41, issue 2 of the Journal of Anthropology and Aging in November 2020.

This is the twentieth post in The Age of COVID-19 series, co-edited by Celeste Pang, Cristina Douglas, Janelle Taylor and Narelle Warren. Please send your contribution to Narelle.Warren@monash.edu

All contributions will also be published on Somatosphere

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