Coresidence increases the risk of testing positive for COVID-19 among older Brazilians

Background Brazil is among the countries hit hardest by COVID-19, and older adults are among the vulnerable groups. Intergenerational coresidence and interdependence among family members, both prevalent in Brazil, likely increase social and physical contact and thus potential infection. Methods Using nationally representative data from the COVID-19 module of the Brazilian National Household Sample Survey (Pesquisa Nacional por Amostra de Domicilios), collected between July and November of 2020, we examined the association between living arrangements and exposure to and testing for COVID-19 among 63,816 Brazilians aged 60 years and older. We examine whether living arrangements influence self-reported COVID-19 symptoms as an indicator of subjective health assessment, testing as an indicator of health care service use, and a positive COVID-19 test result as an objective indicator of exposure to the disease. Results Living arrangements shape older adults' vulnerabilities to COVID-19 exposure and testing. Specifically, those living alone were more likely to report having symptoms and having had a test for COVID-19. However, older adults in multigenerational and skipped generation households were more likely than solo-dwellers to test positive for COVID-19. Those with symptoms were more likely to test, regardless of their living arrangement. Among older adults without symptoms, those living alone had a higher probability of testing than those living in multigenerational or skipped-generation households. Conclusions Overall, our findings suggest that coresidence with younger family members puts older adults' health at risk in the context of COVID-19. As younger Brazilians are increasingly vulnerable to COVID-19 and experiencing severe outcomes, policy makers need to be more attentive to the health needs of households that comprise older and younger cohorts, which are also more prevalent in poor and marginalized segments of the population.

Automated summary

The study finds that living arrangements affect older adults' susceptibility to COVID-19 exposure and testing. Those living alone are more likely to report symptoms and undergo COVID-19 testing. However, older adults in multigenerational and skipped generation households are more likely to test positive for COVID-19 than solo-dwellers. Older adults with symptoms are more likely to get tested, regardless of their living arrangements. Among older adults without symptoms, those living alone have a higher probability of being tested compared to those living in multigenerational or skipped-generation households.