Dataset Information

Delayed medical care and underlying health in the United States during the COVID-19 pandemic: A cross-sectional study.

ABSTRACT: This study assesses the association between underlying health conditions and delaying medical care during the COVID-19 pandemic. An online cross-sectional survey administered by OutbreaksNearMe.org on Momentive.ai collected self-reported data from April 27 to June 2, 2020 and May 10 to June 13, 2021. We used weighted multivariable logistic regressions to assess the association between delaying care and self-reported health status, adjusting for demographics. Of 312,661 total responses (99.6% completion rate), 17.1% reported delayed medical care. Compared to good health, those with poor health were more likely to delay care (AOR = 2.62, 95% CI [2.47, 2.78]). Individuals with any underlying condition (AOR = 1.62, 95% CI [1.58, 1.65]) and each of the conditions were more likely to delay care. Differences in delaying care were observed across region, year, and demographics. Our finding is that those at higher risk of severe COVID-19 were more likely to delay medical care in 2020 and 2021, which could exacerbate existing health conditions and existing disparities.

SUBMITTER: Gertz AH

PROVIDER: S-EPMC9254505 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Delayed medical care and underlying health in the United States during the COVID-19 pandemic: A cross-sectional study.

Gertz Autumn H AH Pollack Catherine C CC Schultheiss Marinanicole D MD Brownstein John S JS

Preventive medicine reports 20220705

This study assesses the association between underlying health conditions and delaying medical care during the COVID-19 pandemic. An online cross-sectional survey administered by OutbreaksNearMe.org on Momentive.ai collected self-reported data from April 27 to June 2, 2020 and May 10 to June 13, 2021. We used weighted multivariable logistic regressions to assess the association between delaying care and self-reported health status, adjusting for demographics. Of 312,661 total responses (99.6% com ...[more]

PMID: 35813398

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Project description:Americans are increasingly relying on crowdfunding to pay for the costs of healthcare. In medical crowdfunding (MCF), online platforms allow individuals to appeal to social networks to request donations for health and medical needs. Users are often told that success depends on how they organize and share their campaigns to increase social network engagement. However, experts have cautioned that MCF could exacerbate health and social disparities by amplifying the choices (and biases) of the crowd and leveraging these to determine who has access to financial support for healthcare. To date, research on potential axes of disparity in MCF, and their impacts on fundraising outcomes, has been limited. To answer these questions, this paper presents an exploratory cross-sectional study of a randomized sample of 637 MCF campaigns on the popular platform GoFundMe, for which the race, gender, age, and relationships of campaigners and campaign recipients were categorized alongside campaign characteristics and outcomes. Using both descriptive and inferential statistics, the analysis examines race, gender, and age disparities in MCF use, and tests how these are associated with differential campaign outcomes. The results show systemic disparities in MCF use and outcomes: people of color (and black women in particular) are under-represented; there is significant evidence of an additional digital care labor burden on women organizers of campaigns; and marginalized race and gender groups are associated with poorer fundraising outcomes. Outcomes are only minimally associated with campaign characteristics under users' control, such as photos, videos, and updates. These results corroborate widespread concerns with how technology fuels health inequities, and how crowdfunding may be creating an unequal and biased marketplace for those seeking financial support to access healthcare. Further research and better data access are needed to explore these dynamics more deeply and inform policy for this largely unregulated industry.

Project description:BackgroundIn the United States (US), Medical Examiners and Coroners (ME/Cs) have the legal authority for the management of mass fatality incidents (MFI). Yet, preparedness and operational capabilities in this sector remain largely unknown. The purpose of this study was twofold; first, to identify appropriate measures of preparedness, and second, to assess preparedness levels and factors significantly associated with preparedness.MethodsThree separate checklists were developed to measure different aspects of preparedness: MFI Plan Elements, Operational Capabilities, and Pre-existing Resource Networks. Using a cross-sectional study design, data on these and other variables of interest were collected in 2014 from a national convenience sample of ME/C using an internet-based, anonymous survey. Preparedness levels were determined and compared across Federal Regions and in relation to the number of Presidential Disaster Declarations, also by Federal Region. Bivariate logistic and multivariable models estimated the associations between organizational characteristics and relative preparedness.ResultsA large proportion (42%) of respondents reported that less than 25 additional fatalities over a 48-hour period would exceed their response capacities. The preparedness constructs measured three related, yet distinct, aspects of preparedness, with scores highly variable and generally suboptimal. Median scores for the three preparedness measures also varied across Federal Regions and as compared to the number of Presidential Declared Disasters, also by Federal Region. Capacity was especially limited for activating missing persons call centers, launching public communications, especially via social media, and identifying temporary interment sites. The provision of staff training was the only factor studied that was significantly (positively) associated (p < .05) with all three preparedness measures. Although ME/Cs ranked local partners, such as Offices of Emergency Management, first responders, and funeral homes, as the most important sources of assistance, a sizeable proportion (72%) expected federal assistance.ConclusionsThe three measures of MFI preparedness allowed for a broad and comprehensive assessment of preparedness. In the future, these measures can serve as useful benchmarks or criteria for assessing ME/Cs preparedness. The study findings suggest multiple opportunities for improvement, including the development and implementation of national strategies to ensure uniform standards for MFI management across all jurisdictions.

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Dataset Information

Delayed medical care and underlying health in the United States during the COVID-19 pandemic: A cross-sectional study.

Publications

Delayed medical care and underlying health in the United States during the COVID-19 pandemic: A cross-sectional study.

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