Maria Brandén. Foto: Clément Morin/Stockholms universitet.
Maria Brandén. Photo: Clément Morin/Stockholm University.

“Elderly people who live with somebody of working age, meaning somebody under the age of 66, have a much higher risk of dying from COVID-19. These findings persisted even after we took into account income, country of birth, education and other mortality in this group,” said Maria Brandén, main author of the study and Associate Professor in Sociology at the Stockholm University Demography Unit, Department of Sociology, and the Institute for Analytical Sociology at Linköping University. 

The elderly who live with younger people do not generally die earlier than other elderly people, but it is specifically the COVID-19 mortality that is higher in the group that lives in multigenerational households. This group includes all of the elderly people in Stockholm County who share households with somebody of working age, which can be either somebody from the same family or somebody who does not belong to the family. 

“It’s been discussed in the general debate that it’s dangerous to live across generational boundaries during the pandemic, and these results support this notion, which makes the findings important in themselves. The explanation of the higher mortality from COVID-19 may simply lie in the fact that these elderly individuals have a greater risk of being exposed to the virus by the people of working age who they live with, compared with the elderly people who live with other old people,” said Maria Brandén.  

Crowded living conditions not a risk factor in themselves for the elderly – but elderly housing is

Based on this study, the researchers cannot, however, say that crowded living conditions have any direct effect on the risk of dying from COVID-19 for the elderly. The elderly who live in crowded conditions indeed have a higher mortality from COVID-19 – but they also have a higher mortality from all other causes. 

“This indicates that it’s not a COVID-19 effect, but that the elderly who live in crowded conditions might more often be in poor health. I was a little surprised by this, that crowded living conditions in themselves resulted in no direct increase in risk of dying from COVID-19,” said Maria Brandén. 

Elderly people who live alone in their own housing, ie not in elderly housing, also have a higher risk of dying in COVID-19, compared with elderly people who live with other elderly people. But the group living alone also has a higher mortality rate for other reasons, which indicates that there is not a COVID-19 effect in that case either.

The study also confirms what has been reported in the media, namely that the risk of dying from COVID-19 is higher for those who live in homes for the elderly compared with those who live in regular households – a full four fold higher. However, at elderly homes, the risk of dying from other causes is also strongly elevated, which is usually attributed to those who live in elderly homes in Sweden having very poor health. 

“Our interpretation is therefore that only a small part of the higher mortality for this group can be explained by COVID-19,” said Maria Brandén.  

More about the research

Maria Brandén, Siddartha Aradhya, Martin Kolk, Juho Härkönen, Sven Drefahl, Bo Malmberg, Mikael Rostila, Agneta Cederström, Gunnar Andersson, Eleonora Mussino, ”Residential context and COVID-19 mortality among adults aged 70 years and older in Stockholm: a population-based, observational study using individual-level data”, Lancet Healthy Longevity, DOI: https://doi.org/10.1016/S2666-7568(20)30016-7

Facts: How the study was done

The researchers investigated what mortality from COVID-19 looks like for everyone aged 70 and up in Stockholm County up to and including 7 May 2020. In total, 274,712 individuals in this age group lived in the county during the period of study, and of them, 38,500 people lived with a person of working age, meaning somebody under the age of 66.

In total, 1,301 individuals who were aged 70 or older died from COVID-19 in Stockholm County, according to the cause of death register of the National Board of Health and Welfare. Of those who died from COVID-19 in this age group, 200 lived with somebody under the age of 66. 

The researchers combined data on the deaths with information from the statistics agency, Statistics Sweden, on country of birth, income, level of education, age of any cohabitants in the household and what kind of housing the individuals lived in (regular housing or elderly housing). 
The research is being funded by Forte, the Swedish Research Council for Health, Working Life and Welfare, and Riksbankens Jubileumsfond.