computer generated image of virus

Project: Who are given specialised care during the Covid-19 pandemic? (BioAge(in)Work)

The project aims to deepen the knowledge of how publicly funded healthcare assesses the need for care interventions for individuals who contract Covid-19. How the concept of biological age is understood and used in these assessments is in particular focus.

Project information

Project name
Who are given specialised care during the Covid-19 pandemic? Biological age as an assessment reference for people in various ages in decisions on care or nursing interventions (BioAge(in)Work)
Project manager
Clary Krekula
Other project members
Anna-Liisa Närvänen, Linda Hiltunen
Participating organizations
Linnaeus University; community organizations (e.g. actors in regional operations, employer organisations, trade unions, professionals in healthcare/care, and pensioner organisations); reference group (representatives from the Riksdag, the professional field, the management of health and medical care at regional level, and the scientific field)
The Swedish Research Council (Vetenskapsrådet)
1 Dec 2022–31 Dec 2026
Social work (Department of Social Work, Faculty of Social Sciences)

More about the project

According to the Swedish Health and Medical Care Act, healthcare is to be provided on the same terms for the whole population in the country and those who are most in need of healthcare are given priority. On account of the Covid-19 pandemic, healthcare resources became strained and the issue of prioritisation was brought to the fore, not least within intensive care but also within home care and sheltered housing-related care.

In order to meet the greatly increased care need, the National Board of Health and Welfare presented new guidelines for the prioritisation of resources within health and medical care in general and for intensive care in particular. The topical publication – Nationella principer för prioritering inom intensivvård under extraordinära förhållanden (2020) – stresses the human dignity principle, which involves that prioritisation of care resources must not be based on the patient’s chronological age. However, it is fully permitted to take biological age into account as a basis for assessment, which means that assessments of care measures can be made based on the patient’s biological condition in relation to the patient benefit.

Chronological and biological age respectively

This idea of chronological and biological age respectively was presented in 1995 in the prioritisation investigation (SOU 1995:5), where biological age, as opposed to chronological age, is presented as non-discriminatory in the distribution of rights and welfare resources. Thus, the concept of biological age has been used within health and medical care for more than two decades when making care-related prioritisations.

Within the frame of this project, we study how biological age is used as an assessment reference and what the consequences of this may be for the concerned parties. More precisely, the project aims to contribute with knowledge about how the concept of biological age circulates, is interpreted, and is used during the Covid-19 pandemic, and what consequences this has for:

  1. concerned staff groups
  2. patients/users of different ages, and
  3. the concerned units’ professional ethics

Documents, talks, and interviews

The project combines different scientific methods. As a first step, an analysis will be conducted of public documents that shed light on how assessments of care resources should be made in relation to biological age during the Covid-19 pandemic at the national and regional level.

In addition, focus group talks will be held with politicians and concerned professionals who have implemented the national guidelines for care need prioritisations in three of the regions in the country. Individual interviews with health and medical staff in the three chosen regions will also be made, to shed light on issues relating to moral stress in the practical work and how this affects the possibilities of the professionals to maintain good professional ethics. The study focuses on active professionals in emergency healthcare, primary care, home care, and sheltered housing.

Critical age studies

The project is part of the research field critical age studies. The scientific contribution is to present the concept of biological age as a figure of thought and point of departure for social organisation, which also has consequences, not least in the distribution of health and medical care resources. During the Covid-19 pandemic, it became clear that the healthcare system could not provide the same care for everyone, which means that the assessment processes for how care resources are distributed and prioritised based on biological age must be studied from a scientific perspective.

The project is part of the research in the Social work, disability and ageing (SODA) research group.