Department of Epidemiology and Biostatistics, CUNY Graduate School of Public Health and Health Policy, City University of New York, New York, NY, USA.
CUNY Institute for Implementation Science in Population Health, City University of New York, New York, NY, USA.
J Urban Health. 2023 Oct;100(5):962-971. doi: 10.1007/s11524-023-00752-9. Epub 2023 Aug 15.
We examined the impact of the first year of the COVID-19 pandemic on unmet healthcare need among New Yorkers and potential differences by race/ethnicity and health insurance. Data from the Community Health Survey, collected in 2018, 2019, and 2020, were merged to compare unmet healthcare need within the past 12 months during the pandemic versus the 2 years prior to 2020. Univariate and multivariable logistic regression models evaluated change in unmet healthcare need overall, and we assessed whether race/ethnicity or health insurance status modified the association. Overall, 12% of New Yorkers (N = 27,660) experienced unmet healthcare during the 3-year period. In univariate and multivariable models, the first year of the pandemic (2020) was not associated with change in unmet healthcare need compared with 2018-2019 (OR = 1.04, p = 0.548; OR = 1.03, p = 0.699, respectively). There was no statistically significant interaction between calendar year and race/ethnicity, but there was significant interaction with health insurance status (interaction p = 0.009). Stratifying on health insurance status, those uninsured had borderline significant lower odds of experiencing unmet healthcare need during 2020 compared to the 2 years prior (OR = 0.72, p = 0.051) while those with insurance had a slight increase that was not significant (OR = 1.12, p = 0.143). Unmet healthcare need among New Yorkers during the first year of the pandemic did not differ significantly from 2018-2019. Federal pandemic relief funding, which offered no-cost COVID-19 testing and care to all, irrespective of health insurance or legal status, may have helped equalized access to healthcare.
我们考察了 COVID-19 大流行第一年对纽约居民未满足的医疗需求的影响，以及按种族/民族和医疗保险状况的潜在差异。利用 2018 年、2019 年和 2020 年收集的社区健康调查数据，将大流行期间过去 12 个月内和 2020 年前两年内未满足的医疗需求进行合并比较。使用单变量和多变量逻辑回归模型评估整体上未满足的医疗需求的变化，并评估种族/民族或医疗保险状况是否改变了这种关联。总体而言，在三年期间，有 12%的纽约居民（N=27660）经历过未满足的医疗需求。在单变量和多变量模型中，与 2018-2019 年相比，大流行的第一年（2020 年）与未满足的医疗需求变化无关（比值比=1.04，p=0.548；比值比=1.03，p=0.699）。日历年度与种族/民族之间没有统计学上显著的交互作用，但与医疗保险状况存在显著交互作用（交互作用 p=0.009）。按医疗保险状况分层，与前两年相比，未参保者在 2020 年经历未满足医疗需求的可能性略低（比值比=0.72，p=0.051），而参保者的可能性略有增加，但不显著（比值比=1.12，p=0.143）。大流行第一年纽约居民的未满足医疗需求与 2018-2019 年没有显著差异。联邦大流行救济资金为所有人提供了免费的 COVID-19 检测和治疗，无论其医疗保险或法律地位如何，这可能有助于平等获得医疗保健。
