Investigating the Association Between Race and Healthcare Seeking Behavior among Patients Diagnosed with COVID-19 Open Access

Barclay, Robert (Summer 2022)

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The COVID-19 pandemic has significantly disrupted global health systems, presenting new barriers in healthcare access, introducing new inequities in healthcare, and exacerbating existing disparities in health outcomes. One such consequence of the pandemic is delayed or forgone healthcare. Previous research demonstrates that delayed healthcare is associated with worse health, lower quality of life, and increased incidence of chronic illness, and various social determinants of health such as race, gender have been previously identified as factors associated with delayed or canceled healthcare appointments. There is scant research investigating such inappropriate healthcare seeking behavior during the pandemic and its resultant social disparities. We constructed a survey to collect data on health history, socioeconomic status, and pandemic-related impacts from members of a large, integrated healthcare system in the Southeastern United States (KPGA) who had been diagnosed with COVID-19. This survey data was then merged with the members’ electronic medical records from KPGA. To measure the relationship between race (non-Hispanic Black versus non-Hispanic white) and healthcare seeking behavior, we conducted utilized multivariable regression modeling. In our analysis, we found that Black race was associated with inappropriate healthcare seeking behavior, in addition to higher educational attainment, exercising fewer than 150 minutes per week, obesity, diabetes, flu vaccine compliance, providing care for a loved one during the pandemic, and reporting at least one social impact because of the pandemic. Our findings indicate that race was associated with inappropriate healthcare seeking behaviors after controlling for various factors, and that further investigation of the social impacts of the COVID-19 pandemic is warranted.

Table of Contents

Literature Review. 1

Methods. 9

Results. 20

Discussion. 30

Conclusion. 33

References. 35

Appendix 1 – Survey. 47

Appendix 1 – Supplementary Tables. 58

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