• Author
    Sabrina Rainsbury Silva
  • Discovery PI

    Lauren Wisk, PhD

  • Project Co-Author

  • Abstract Title

    Healthcare Disruptions and Health Outcomes Among U.S. Adults With Chronic Conditions and Disabilities During the COVID-19 Pandemic

  • Discovery AOC Petal or Dual Degree Program

    Healthcare Improvement & Health Equity Research

  • Abstract

    Key words: Disability, healthcare access, COVID-19

    Background: Individuals with chronic conditions or disabilities (CCD) have increased healthcare needs while facing baseline disparities in healthcare access and health outcomes. During times of system crisis, this population may be particularly vulnerable to disrupted care and worsened health. Here, we use the COVID-19 pandemic as a lens to better understand how healthcare disruptions under crisis conditions may differentially affect individuals with CCD and contribute to disparities in health outcomes.

    Objective: To examine how healthcare crisis conditions contribute to health disparities impacting individuals with CCD. 

    Methods: We analyzed baseline data from a nationally administered online survey deployed between May and September 2020 (N=1,236). CCD status was defined using standard measures of chronic conditions and functional impairment. Our primary outcome was healthcare disruptions, defined through disruptions to appointments and medications. Our secondary outcome was self-reported health measures including general health status, frequent mental distress, frequent physical distress, and depression/anxiety symptoms. We used logistic regression models and mediation analyses to analyze associations. 

    Results: Respondents with CCD were more likely to report appointment disruptions (72.5% vs. 43.0%) and medication disruptions (28.8% vs. 14.3%). CCD status was associated with both disruptions to appointments (OR 3.00, 95% CI 2.30–3.92) and medications (OR 2.80, 95% CI 2.00–3.97). CCD was also associated with worse health outcomes, including poorer self-rated health and higher rates of mental and physical distress, depression, and anxiety. Healthcare disruptions partially mediated these relationships, accounting for 5–12% of the overall association between CCD status and poor outcomes.

    Conclusions: Healthcare disruptions during crisis conditions disproportionately affected individuals with CCD and were associated with worse health outcomes. These findings suggest that disruptions to care represent a notable pathway through which health disparities are exacerbated during crises, underscoring the need to prioritize continuity of care for individuals with CCD.

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