Delayed Medical Care of Underserved Middle-Aged and Older African Americans with Chronic Disease during COVID-19 Pandemic

Edward K Adinkrah; Sharon Cobb; Mohsen Bazargan

doi:10.3390/healthcare11040595

Delayed Medical Care of Underserved Middle-Aged and Older African Americans with Chronic Disease during COVID-19 Pandemic

Healthcare (Basel). 2023 Feb 16;11(4):595. doi: 10.3390/healthcare11040595.

Authors

Edward K Adinkrah¹, Sharon Cobb², Mohsen Bazargan^{1

3}

Affiliations

¹ Department of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), 1731 E. 120th St., Los Angeles, CA 90059, USA.
² Mervyn M. Dymally School of Nursing (MMDSON), CDU, Los Angeles, CA 90059, USA.
³ Department of Family Medicine, University of California Los Angeles (UCLA), Los Angeles, CA 90059, USA.

Abstract

Background: While African American middle-aged and older adults with chronic disease are particularly vulnerable during the COVID-19 pandemic, it is unknown which subgroups of this population may delay seeking care. The aim of this study was to examine demographic, socioeconomic, COVID-19-related, and health-related factors that correlate with delayed care in African American middle-aged and older adults with chronic disease. Methods: In this cross-sectional study, 150 African American middle-aged and older adults who had at least one chronic disease were recruited from faith-based organizations. We measured the following exploratory variables: demographic factors (age and gender), socioeconomic status (education), marital status, number of chronic diseases, depressive symptoms, financial strain, health literacy, COVID-19 vaccination history, COVID-19 diagnosis history, COVID-19 knowledge, and COVID-19 perceived threat. The outcome was delay in chronic disease care. Results: According to the Poisson log-linear regression, higher level of education, higher number of chronic diseases, and depressive symptoms were associated with a higher level of delayed care. Age, gender, COVID-19 vaccination history, COVID-19 diagnosis history, COVID-19 perceived threat, COVID-19 knowledge, financial strain, marital status, and health literacy were not correlated with delayed care. Discussion: Given that higher healthcare needs in terms of multiple chronic medical diseases and depressive symptomatology but not COVID-19-related constructs (i.e., vaccination history, diagnosis history, and perceived threat) were associated with delayed care, there is a need for programs and interventions that assist African American middle-aged and older adults with chronic disease to seek the care that they need. More research is needed to understand why educational attainment is associated with more delayed care of chronic disease in African American middle-aged and older adults with chronic illness.

Keywords: COVID-19; disease management; ethnic groups; health service utilization.

Grants and funding

As scholars of the Clinical Research Education and Career Development (CRECD) program at Charles R. Drew University of Medicine and Science (CDU), the research efforts of Adinkrah, and Cobb were supported by the NIMHD/NIH, award number R25 MD007610 (PI: M. Bazargan). In addition, this study was supported by the National Institute of Minority Health and Health Disparities under award number U54MD007598 (PI: J. Vadgama).