Evidence map›Paper›PMID 40817069›Full record

ArticleBMC medicine2025

Trends and disparities in health status and health care in the United States during COVID-19 pandemic.

Zhiyuan Wu, Frank Qian, Siyu Zou, Xinye Zou, Ruolin Zhang, Xiuhua Guo, Haibin Li

Abstract read
In one paragraph

Article in BMC medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Trends in cardiometabolic disease and health-related quality of life in the United States, 2001-2022.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
    Article
  2. EQ-5D-5L population norms for Singapore: a household survey-based analysis.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2026
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Zhiyuan Wu *Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
Frank Qian *Section of Cardiovascular Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of Medicine, Boston, MA, USA.
Siyu ZouDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Xinye ZouCambridge Institute of Public Health, Department of Public Health and Primary Care, University of Cambridge, Cambridge, CB20SR, UK.
Ruolin ZhangHarvard T.H. Chan School of Public Health, Harvard University, Boston, MA, USA.
Xiuhua GuoDepartment of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.
Haibin LiDepartment of Cardiology, Beijing Chaoyang Hospital, Capital Medical University, No. 8 Gongti Nanlu, Chaoyang District, Beijing, 100020, China. lihb@mail.ccmu.edu.cn.

Funding

Clinical Research Incubation Project, Beijing Chao-Yang Hospital, Capital Medical University CYFH202310National Natural Science Foundation of China 82103942
6 · The paper itself

Abstract

backgroundConcerns exist over a possible worsening of disparities in health status and health care access across racial/ethnic and income groups during the COVID-19 pandemic. We aimed to characterize trends in racial/ethnic and income differences in self-reported measures of health status and health care access among US adults.

methodsThis serial cross-sectional nationally representative study included adults (age ≥ 18 years) participating in the National Health Interview Survey (NHIS) from 2019 to 2022. Self-reported health status (poor or fair health status, functional limitation, clinician-diagnosed depression or anxiety disorders) and health care access and affordability were collected.

resultsOur analysis included 107,230 adults (mean [SE] age, 48.1 [0.1] years, 51.6% women), of whom 6.1% were Asian, 12.1% were Black, 17.3% were Latino/Hispanic, and 64.5% were White. Black individuals with low income had the highest prevalence of poor or fair health status (30.9% [95% CI, 27.8%-34.3%] in 2019 and 28.4% [95% CI, 25.1% to 32.0%] in 2022), and these racial/ethnic gaps did not change significantly, irrespective of income levels. The prevalence of clinician-diagnosed depression or anxiety disorders increased from 2019 to 2022 for all racial/ethnic groups, especially for Whites (from 32.6% [95% CI, 30.8%-34.4%] to 38.2% [95% CI, 36.4% to 40.1%], P < 0.001). There was no significant change in functional limitations during the pandemic. Latino/Hispanic individuals with low income had the highest estimated prevalence of limited health care access from 2019 to 2022. Health insurance access and affordability significantly improved for White individuals with low income from 2019 to 2022 (P < 0.001), but not for other racial/ethnic groups. Racial/ethnic gaps in health care access and affordability did not change significantly, irrespective of income levels.

conclusionsIn a serial cross-sectional survey study of US adults during the COVID-19 pandemic, prevalence of clinician-diagnosed depression or anxiety disorders significantly increased. Racial and ethnic differences in health status and health care access either persisted or widened over time.

Indexed as

COVID-19Healthcare DisparitiesHealth Services AccessibilityHealth Status DisparitiesAdultAgedCross-Sectional StudiesEthnicityFemaleHealth StatusHumansMaleMiddle AgedPandemicsSARS-CoV-2United StatesCOVID-19Depression/anxiety disordersHealth care accessHealth inequalityHealth status

Identifiers

PMID40817069
PMCPMC12357392

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.