Department of Epidemiology and Public Health, University College London, London, UK
Department of Sociology, Manchester Institute for Collaborative Research on Ageing, The University of Manchester, Manchester, UK.
J Epidemiol Community Health. 2021 Nov;75(11):1070-1077. doi: 10.1136/jech-2021-216405. Epub 2021 May 4.
People with specific health profiles and diseases (such as diabetes, lung and heart conditions) have been classified as 'clinically vulnerable' (CV) to COVID-19, that is, at higher risk of severe illness and mortality from COVID-19, and were targeted for shielding. However, there is as yet little evidence on how the pandemic and shielding impacted the health and social well-being of CV older people.
We used data from wave 9 (2018/2019) and the first COVID-19 substudy (June/July 2020) of the English Longitudinal Study of Ageing. Using logistic and linear regression models, we investigated associations between being CV and health and social well-being during the pandemic, while controlling for prepandemic levels of the outcome variables. We also explored the interactions between CV and age group (50s, 60s, 70s, 80+), and between CV and shielding.
CV people were more likely to report worse health and social well-being outcomes during the pandemic, even taking into account prepandemic differences. However, changes in health were not uniform across different age groups, and CV respondents were generally at greater risks of deterioration in health and social well-being compared with those not CV in the same age group. CV respondents who were shielding reported worse outcomes compared with those not CV and not shielding.
While policies focusing on shielding CV older people reduce rates of hospitalisation and death from COVID-19, policymakers should also pay attention to understanding and addressing the wider needs of this group if their long-term health and social well-being are not to be compromised.
患有特定健康状况和疾病的人(如糖尿病、肺部和心脏疾病)被归类为 COVID-19 的“临床脆弱”(CV),即患 COVID-19 重症和死亡的风险较高,并被列为需要保护的对象。然而,目前关于大流行和保护措施如何影响 CV 老年人的健康和社会福祉的证据还很少。
我们使用了英国老龄化纵向研究的第 9 波(2018/2019 年)和 COVID-19 第一次子研究(2020 年 6 月/7 月)的数据。我们使用逻辑和线性回归模型,调查了在大流行期间 CV 与健康和社会福祉之间的关联,同时控制了结局变量的大流行前水平。我们还探讨了 CV 与年龄组(50 多岁、60 多岁、70 多岁、80 多岁)之间的交互作用,以及 CV 与保护措施之间的交互作用。
即使考虑到大流行前的差异,CV 患者在大流行期间更有可能报告健康和社会福祉状况较差的结果。然而,不同年龄组之间的健康变化并不均匀,与同一年龄组中没有 CV 的人相比,CV 患者在健康和社会福祉方面恶化的风险通常更大。正在接受保护的 CV 受访者报告的结果比没有 CV 和没有接受保护的受访者更差。
虽然关注保护 CV 老年人的政策可以降低 COVID-19 的住院率和死亡率,但政策制定者还应注意了解和满足这一群体的更广泛需求,以避免其长期健康和社会福祉受到影响。