{"id":5806,"date":"2023-03-29T08:55:36","date_gmt":"2023-03-29T06:55:36","guid":{"rendered":"https:\/\/www.jphres.org\/?p=5806"},"modified":"2023-04-02T13:59:21","modified_gmt":"2023-04-02T11:59:21","slug":"disruption-of-medical-care-among-individuals-in-the-southeastern-united-states-during-the-covid-19-pandemic","status":"publish","type":"page","link":"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2497\/","title":{"rendered":"Disruption of medical care among individuals in the southeastern United States during the COVID-19 pandemic"},"content":{"rendered":"<div class=\"item doi\"><span class=\"value\"><a href=\"https:\/\/doi.org\/10.4081\/jphr.2021.2497\">https:\/\/doi.org\/10.4081\/jphr.2021.2497<\/a><\/span><\/div>\n<ul class=\"item authors\">\n<li><span class=\"name\"><strong>Bin Ni<\/strong><br \/>\n<\/span><span class=\"affiliation\">Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.<\/span><span class=\"orcid\"><br \/>\n<a href=\"https:\/\/orcid.org\/0000-0001-7148-4653\" target=\"_blank\" rel=\"noopener\">https:\/\/orcid.org\/0000-0001-7148-4653<\/a><\/span><\/li>\n<li><span class=\"name\"><strong>Erin Gettler<\/strong><br \/>\n<\/span><span class=\"affiliation\">Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.<\/span><span class=\"orcid\"><br \/>\n<a href=\"https:\/\/orcid.org\/0000-0003-1071-9898\" target=\"_blank\" rel=\"noopener\">https:\/\/orcid.org\/0000-0003-1071-9898<\/a><\/span><\/li>\n<li><span class=\"name\"><strong>Rebecca Stern<\/strong><br \/>\n<\/span><span class=\"affiliation\">VUMC, United States.<\/span><span class=\"orcid\"><br \/>\n<a href=\"https:\/\/orcid.org\/0000-0002-6807-5100\" target=\"_blank\" rel=\"noopener\">https:\/\/orcid.org\/0000-0002-6807-5100<\/a><\/span><\/li>\n<li><span class=\"name\"><strong>Heather M. Munro<\/strong><br \/>\n<\/span><span class=\"affiliation\">Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, United States.<\/span><\/li>\n<li><span class=\"name\"><strong>Mark Steinwandel<\/strong><br \/>\n<\/span><span class=\"affiliation\">Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University Medical Center, Nashville, TN, United States.<\/span><\/li>\n<li><span class=\"name\"><strong>Melinda C. Aldrich<\/strong><br \/>\n<\/span><span class=\"affiliation\">Division of Genetic Medicine, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.<\/span><span class=\"orcid\"><br \/>\n<a href=\"https:\/\/orcid.org\/0000-0003-3833-8448\" target=\"_blank\" rel=\"noopener\">https:\/\/orcid.org\/0000-0003-3833-8448<\/a><\/span><\/li>\n<li><span class=\"name\"><strong>Debra L. Friedman<\/strong><br \/>\n<\/span><span class=\"affiliation\">Division of Pediatric Hematology\/Oncology, Department of Pediatrics, Vanderbilt University Medical Center, Nashville, TN, United States.<\/span><\/li>\n<li><span class=\"name\"><strong>Maureen Sanderson<\/strong><br \/>\n<\/span><span class=\"affiliation\">Department of Family and Community Medicine, Meharry Medical College, Nashville, TN , United States.<\/span><span class=\"orcid\"><br \/>\n<a href=\"https:\/\/orcid.org\/0000-0002-3914-6870\" target=\"_blank\" rel=\"noopener\">https:\/\/orcid.org\/0000-0002-3914-6870<\/a><\/span><\/li>\n<li><span class=\"name\"><strong>David Schlundt<\/strong><br \/>\n<\/span><span class=\"affiliation\">Department of Psychology, Vanderbilt University, Nashville, TN, United States.<\/span><span class=\"orcid\"><br \/>\n<a href=\"https:\/\/orcid.org\/0000-0001-7069-9644\" target=\"_blank\" rel=\"noopener\">https:\/\/orcid.org\/0000-0001-7069-9644<\/a><\/span><\/li>\n<li><span class=\"name\"><strong>David M. Aronoff<\/strong><br \/>\n<\/span><span class=\"affiliation\">Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.<\/span><span class=\"orcid\"><br \/>\n<a href=\"https:\/\/orcid.org\/0000-0003-4587-6121\" target=\"_blank\" rel=\"noopener\">https:\/\/orcid.org\/0000-0003-4587-6121<\/a><\/span><\/li>\n<li><span class=\"name\"><strong>Deepak K. Gupta<\/strong><br \/>\n<\/span><span class=\"affiliation\">Division of Cardiovascular Medicine, Department of Medicine; Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, TN, United States.<\/span><\/li>\n<li><span class=\"name\"><strong>Martha J. Shrubsole<\/strong><br \/>\n<\/span><span class=\"affiliation\">Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.<\/span><\/li>\n<li><span class=\"name\"><strong>Loren Lipworth<\/strong><br \/>\n<\/span><span class=\"affiliation\">Vanderbilt Translational and Clinical Cardiovascular Research Center; 9Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States.<\/span><span class=\"orcid\"><br \/>\n<a href=\"https:\/\/orcid.org\/0000-0001-7528-9775\" target=\"_blank\" rel=\"noopener\">https:\/\/orcid.org\/0000-0001-7528-9775<\/a><\/span><\/li>\n<\/ul>\n<h3 class=\"label\">ABSTRACT<\/h3>\n<p><strong>Background:\u00a0<\/strong>Widespread disruptions of medical care to mitigate COVID-19 spread and reduce burden on healthcare systems may have deleterious public health consequences.<br \/>\n<strong><br \/>\nDesign and Methods:\u00a0<\/strong>To examine factors contributing to healthcare interruptions during the pandemic, we conducted a COVID-19 impact survey between 10\/7-12\/14\/2020 among participants of the Southern Community Cohort Study, which primarily enrolled low-income individuals in 12 southeastern states from 2002-2009. COVID survey data were combined with baseline and follow-up data.<br \/>\n<strong><br \/>\nResults:\u00a0<\/strong>Among 4,463 respondents, 40% reported having missed\/delayed a health appointment during the pandemic; the common reason was provider-initiated cancellation or delay (63%). In a multivariable model, female sex was the strongest independent predictor of interrupted care, with odds ratio (OR) 1.63 (95% confidence interval [CI] 1.40-1.89). Those with higher education (OR 1.27; 95% CI 1.05-1.54 for college graduate vs \u2264high school) and household income (OR 1.47; 95% CI 1.16-1.86 for &gt;$50,000 vs &lt;$15,000) were at significantly increased odds of missing healthcare.\u00a0 Having greater perceived risk for acquiring (OR 1.42; 95% CI 1.17-1.72) or dying from COVID-19 (OR 1.25; 95% CI 1.04-1.51) also significantly increased odds of missed\/delayed healthcare. Age was inversely associated with missed healthcare among men (OR for 5-year increase in age 0.88; 95% CI 0.80-0.96) but not women (OR 0.97; 95% CI 0.91-1.04; p-interaction=0.04). Neither race\/ethnicity nor comorbidities were associated with interrupted healthcare.<br \/>\n<strong><br \/>\nConclusions:\u00a0<\/strong>Disruptions to healthcare disproportionately affected women and were primarily driven by health system-initiated deferrals and individual perceptions of COVID-19 risk, rather than medical co-morbidities or other traditional barriers to healthcare access.<\/p>\n<h3 class=\"label\">REFERENCES<\/h3>\n<div class=\"value\">\n<p>Czeisler M, Marynak K, Clarke KEN, et al. Delay or Avoidance of Medical Care Because of COVID-19-Related Concerns &#8211; United States, June 2020. MMWR Morb Mortal Wkly Rep 2020;69:1250-7. DOI:\u00a0<a href=\"https:\/\/doi.org\/10.15585\/mmwr.mm6936a4\">https:\/\/doi.org\/10.15585\/mmwr.mm6936a4<\/a><\/p>\n<p>Miller MJ, Xu L, Qin J, Hahn EE, et al. 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Available from:\u00a0<a href=\"https:\/\/www.commonwealthfund.org\/publications\/2021\/feb\/impact-covid-19-outpatient-visits-2020-visits-stable-despite-late-surge\">https:\/\/www.commonwealthfund.org\/publications\/2021\/feb\/impact-covid-19-outpatient-visits-2020-visits-stable-despite-late-surge<\/a><\/p>\n<\/div>\n","protected":false},"excerpt":{"rendered":"<p>https:\/\/doi.org\/10.4081\/jphr.2021.2497 Bin Ni Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States. https:\/\/orcid.org\/0000-0001-7148-4653 Erin Gettler Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States. https:\/\/orcid.org\/0000-0003-1071-9898 Rebecca Stern VUMC, United States. https:\/\/orcid.org\/0000-0002-6807-5100 Heather M. Munro Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University &#8230; <a title=\"Disruption of medical care among individuals in the southeastern United States during the COVID-19 pandemic\" class=\"read-more\" href=\"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2497\/\" aria-label=\"More on Disruption of medical care among individuals in the southeastern United States during the COVID-19 pandemic\">Read more<\/a><\/p>\n","protected":false},"author":3,"featured_media":0,"parent":0,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"footnotes":""},"class_list":["post-5806","page","type-page","status-publish"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.2 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Disruption of medical care among individuals in the southeastern United States during the COVID-19 pandemic - Journal of Public Health Research<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.jphres.us.com\/index.php\/jphres\/article\/view\/2497\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Disruption of medical care among individuals in the southeastern United States during the COVID-19 pandemic - Journal of Public Health Research\" \/>\n<meta property=\"og:description\" content=\"https:\/\/doi.org\/10.4081\/jphr.2021.2497 Bin Ni Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States. https:\/\/orcid.org\/0000-0001-7148-4653 Erin Gettler Division of Infectious Diseases, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States. https:\/\/orcid.org\/0000-0003-1071-9898 Rebecca Stern VUMC, United States. https:\/\/orcid.org\/0000-0002-6807-5100 Heather M. Munro Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University ... 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Munro Vanderbilt Institute for Clinical and Translational Research, Vanderbilt University ... 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