Adinkrah Edward K, Cobb Sharon, Bazargan Mohsen
Department of Family Medicine, Charles R. Drew University of Medicine and Science (CDU), 1731 E. 120th St., Los Angeles, CA 90059, USA.
Mervyn M. Dymally School of Nursing (MMDSON), CDU, Los Angeles, CA 90059, USA.
Healthcare (Basel). 2023 Feb 16;11(4):595. doi: 10.3390/healthcare11040595.
While African American middle-aged and older adults with chronic disease are particularly vulnerable during the COVID-19 pandemic, it is unknown which subgroups of this population may delay seeking care. The aim of this study was to examine demographic, socioeconomic, COVID-19-related, and health-related factors that correlate with delayed care in African American middle-aged and older adults with chronic disease. In this cross-sectional study, 150 African American middle-aged and older adults who had at least one chronic disease were recruited from faith-based organizations. We measured the following exploratory variables: demographic factors (age and gender), socioeconomic status (education), marital status, number of chronic diseases, depressive symptoms, financial strain, health literacy, COVID-19 vaccination history, COVID-19 diagnosis history, COVID-19 knowledge, and COVID-19 perceived threat. The outcome was delay in chronic disease care. According to the Poisson log-linear regression, higher level of education, higher number of chronic diseases, and depressive symptoms were associated with a higher level of delayed care. Age, gender, COVID-19 vaccination history, COVID-19 diagnosis history, COVID-19 perceived threat, COVID-19 knowledge, financial strain, marital status, and health literacy were not correlated with delayed care. Given that higher healthcare needs in terms of multiple chronic medical diseases and depressive symptomatology but not COVID-19-related constructs (i.e., vaccination history, diagnosis history, and perceived threat) were associated with delayed care, there is a need for programs and interventions that assist African American middle-aged and older adults with chronic disease to seek the care that they need. More research is needed to understand why educational attainment is associated with more delayed care of chronic disease in African American middle-aged and older adults with chronic illness.
虽然患有慢性病的非裔美国中老年人在新冠疫情期间特别脆弱，但尚不清楚该人群中的哪些亚组可能会延迟就医。本研究的目的是调查与患有慢性病的非裔美国中老年人延迟就医相关的人口统计学、社会经济、新冠相关和健康相关因素。在这项横断面研究中，从宗教组织招募了150名患有至少一种慢性病的非裔美国中老年人。我们测量了以下探索性变量：人口统计学因素（年龄和性别）、社会经济地位（教育程度）、婚姻状况、慢性病数量、抑郁症状、经济压力、健康素养、新冠疫苗接种史、新冠诊断史、新冠知识和新冠感知威胁。结果是慢性病护理延迟。根据泊松对数线性回归，较高的教育水平、较多的慢性病数量和抑郁症状与较高的延迟护理水平相关。年龄、性别、新冠疫苗接种史、新冠诊断史、新冠感知威胁、新冠知识、经济压力、婚姻状况和健康素养与延迟护理无关。鉴于多种慢性疾病和抑郁症状方面较高的医疗需求而非与新冠相关的因素（即疫苗接种史、诊断史和感知威胁）与延迟护理相关联，需要有项目和干预措施来帮助患有慢性病的非裔美国中老年人获得他们所需的护理。需要更多研究来理解为何教育程度与患有慢性病的非裔美国中老年人更多地延迟慢性病护理相关。
