School of Population and Global Health, The University of Western Australia, Clifton Street Building, Clifton Street, Nedlands, Western Australia, 6009, Australia.
School of Management and Marketing, Curtin University, Kent Street, Bentley, Western Australia, 6102, Australia.
Health Promot Int. 2024 Aug 1;39(4). doi: 10.1093/heapro/daae096.
This study examined changes in physical and mental health quality-of-life and health services access before and after the onset of the COVID-19 pandemic among individuals of lower and higher socio-economic status (SES) in Australia. Difference-in-differences and logistic regression models were undertaken using data from the Household, Income and Labour Dynamics in Australia (HILDA) survey and government data on COVID-19 lockdowns between January 2020 and February 2021. Individuals from higher SES reported larger decreases in mental health quality-of-life scores than those from lower SES after the onset of the pandemic. Those from lower SES reported less disruption with any health services (24.2% vs 30.4%; OR = 0.68; p < 0.001), specifically dental services (8.2% vs 15.4%; OR = 0.51; p < 0.001) and allied health services (5.9% vs 8.5%; OR = 0.60; p < 0.001), compared with those from higher SES. Additional days under lockdown were associated with reduced access to all health services (OR = 1.19). Furthermore, long-term health conditions (higher SES: OR = 1.54) and scores indicative of poorer physical (lower SES: OR = 1.17; higher SES: OR = 1.07) and mental health (lower SES: OR = 1.16; higher SES: OR = 1.12) were associated with increased health services disruption. While individuals from higher SES were more likely than those from lower SES to experience greater relative declines in mental health and increased disruption with health services access, individuals with a greater apparent need for health services, regardless of SES, may have faced inequalities in accessing these services during the COVID-19 pandemic.
本研究考察了在澳大利亚，COVID-19 大流行前后，社会经济地位（SES）较低和较高的个体的身心健康、生活质量和卫生服务可及性的变化。本研究使用了来自澳大利亚家庭、收入和劳动力动态调查（HILDA）的数据和关于 COVID-19 封锁的政府数据，采用了差分法和逻辑回归模型。SES 较高的个体在大流行后报告的心理健康生活质量评分下降幅度大于 SES 较低的个体。SES 较低的个体报告在任何卫生服务（24.2%比 30.4%；OR=0.68；p<0.001）、特定于牙科服务（8.2%比 15.4%；OR=0.51；p<0.001）和联合健康服务（5.9%比 8.5%；OR=0.60；p<0.001）的中断情况较少，与 SES 较高的个体相比。封锁天数的增加与卫生服务可及性降低有关（OR=1.19）。此外，长期健康状况（SES 较高：OR=1.54）和表明较差的身体（SES 较低：OR=1.17；SES 较高：OR=1.07）和心理健康（SES 较低：OR=1.16；SES 较高：OR=1.12）的评分与卫生服务中断增加有关。虽然 SES 较高的个体比 SES 较低的个体更有可能经历更大的心理健康相对下降和卫生服务获取中断增加，但无论 SES 如何，那些对卫生服务有更大明显需求的个体在 COVID-19 大流行期间可能面临获取这些服务的不平等。
