Department of Social Medicine, National Center for Child Health and Development, Tokyo 157-0074, Japan.
Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan.
Int J Environ Res Public Health. 2023 Feb 2;20(3):2682. doi: 10.3390/ijerph20032682.
This limited study examined how low household income affected avoidant behaviors to seek medical care during the pandemic. We investigated an association between household income below the relative poverty line and refraining from seeking medical care (RSMC) in a longitudinal study during the COVID-19 pandemic. We conducted an analysis of a population-based internet cohort in Japan. Individuals aged 20 to 79 years old living in Japan participated in the internet surveys between 2020 and 2021. The primary outcome was the RSMC of regular visits and new symptoms in 2021. A total of 19,672 individuals were included in the analysis. Household income below the relative poverty line in 2020 was significantly associated with refraining from seeking regular medical visits for men and women (for men, odds ratio: 1.28; confidence interval: 1.19, 1.83; for women, odds ratio: 1.42; confidence interval: 1.14, 1.82) in 2021, after accounting for RSMC in 2020. Relative poverty in 2020 was also associated with the RSMC of new symptoms among men (for males, odds ratio: 1.32; confidence interval: 1.05, 1.66) in 2021 after adjusting for covariates. The study suggested the need to alleviate the financial burden of vulnerable people seeking medical care and advocate for making necessary medical visits, even in a pandemic.
这项有限的研究考察了低收入家庭如何在大流行期间避免寻求医疗。我们在 COVID-19 大流行期间的纵向研究中调查了家庭收入低于相对贫困线与避免就医（RSMC）之间的关联。我们对日本基于人群的互联网队列进行了分析。年龄在 20 至 79 岁之间、居住在日本的个人参加了 2020 年至 2021 年的互联网调查。主要结果是 2021 年定期就诊和新症状的 RSMC。共有 19672 人纳入分析。2020 年家庭收入低于相对贫困线与 2021 年男性和女性避免定期就医就诊显著相关（男性，优势比：1.28；置信区间：1.19，1.83；女性，优势比：1.42；置信区间：1.14，1.82），考虑到 2020 年的 RSMC。2020 年的相对贫困也与 2021 年男性新症状的 RSMC 相关（对于男性，优势比：1.32；置信区间：1.05，1.66），在调整了协变量后。该研究表明，需要减轻弱势群体就医的经济负担，并倡导在大流行期间进行必要的就医。
