Dataset Information

Health service inequalities during the COVID-19 pandemic among elderly people living in large urban and non-urban areas in Florida, USA.

ABSTRACT: Objective: Health inequalities were often exacerbated during the emerging epidemic. This study examined urban and non-urban inequalities in health services among COVID-19 patients aged 65?years or above in Florida, USA, from 2 March to 27 May 2020.

Methods: A retrospective time series analysis was conducted using individual patient records. Multivariable Poisson's and logistic models were used to calculate adjusted incidence of COVID-19 and the associated rates of emergency department visits, hospitalizations, and deaths.

Results: As of 27 May 2020, there were 13,659 elderly COVID-19 patients (people aged 65?years or above) in Florida and 14.9% of them died. Elderly people living in small metropolitan areas might be less likely to be confirmed with COVID-19 infection than those living in large metropolitan areas. The emergency department visit and hospitalization rates decreased significantly across metropolitan statuses for both men and women. Those patients living in small metropolitan or rural areas were less likely to be hospitalized than those living in large metropolitan areas (35% and 34% vs 41%). Elderly women aged 75?years or above living in rural areas had 113% higher adjusted incidence of COVID-19 than those living in large metropolitan areas, and the rates of hospitalizations were lower compared with those counterparts living in large metropolitan areas (29% vs 46%; odds ratio: 0.37 (0.25-0.54), p?
Conclusion: For elderly people living in Florida, USA, those living in small metropolitan or rural areas were less likely to receive adequate health care than those living in large or medium metropolitan areas during the COVID-19 pandemic.

SUBMITTER: Yu X

PROVIDER: S-EPMC7691940 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Health service inequalities during the COVID-19 pandemic among elderly people living in large urban and non-urban areas in Florida, USA.

Yu Xinhua X

SAGE open medicine 20201124

<h4>Objective</h4>Health inequalities were often exacerbated during the emerging epidemic. This study examined urban and non-urban inequalities in health services among COVID-19 patients aged 65 years or above in Florida, USA, from 2 March to 27 May 2020.<h4>Methods</h4>A retrospective time series analysis was conducted using individual patient records. Multivariable Poisson's and logistic models were used to calculate adjusted incidence of COVID-19 and the associated rates of emergency departme ...[more]

PMID: 33282304

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Project description:BackgroundResearch conducted in urban areas has highlighted the impact of housing instability on people who inject drugs (PWID), revealing that it exacerbates vulnerability to drug-related harms and impedes syringe service program (SSP) use. However, few studies have explored the effects of houselessness on SSP use among rural PWID. This study examines the relationship between houselessness and SSP utilization among PWID in eight rural areas across 10 states.MethodsPWID were recruited using respondent-driven sampling for a cross-sectional survey that queried self-reported drug use and SSP utilization in the prior 30 days, houselessness in the prior 6 months and sociodemographic characteristics. Using binomial logistic regression, we examined the relationship between experiencing houselessness and any SSP use. To assess the relationship between houselessness and the frequency of SSP use, we conducted multinomial logistic regression analyses among participants reporting any past 30-day SSP use.ResultsAmong 2394 rural PWID, 56.5% had experienced houselessness in the prior 6 months, and 43.5% reported past 30-day SSP use. PWID who had experienced houselessness were more likely to report using an SSP compared to their housed counterparts (adjusted odds ratio [aOR] = 1.24 [95% confidence intervals [CI] 1.01, 1.52]). Among those who had used an SSP at least once (n = 972), those who experienced houselessness were just as likely to report SSP use two (aOR = 0.90 [95% CI 0.60, 1.36]) and three times (aOR = 1.18 [95% CI 0.77, 1.98]) compared to once. However, they were less likely to visit an SSP four or more times compared to once in the prior 30 days (aOR = 0.59 [95% CI 0.40, 0.85]).ConclusionThis study provides evidence that rural PWID who experience houselessness utilize SSPs at similar or higher rates as their housed counterparts. However, housing instability may pose barriers to more frequent SSP use. These findings are significant as people who experience houselessness are at increased risk for drug-related harms and encounter additional challenges when attempting to access SSPs.

Dataset Information

Health service inequalities during the COVID-19 pandemic among elderly people living in large urban and non-urban areas in Florida, USA.

Publications

Health service inequalities during the COVID-19 pandemic among elderly people living in large urban and non-urban areas in Florida, USA.

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