ArticleAnnals of epidemiology2025
Chronic conditions, disability, and COVID-19 testing and vaccination: A national Rapid Acceleration of Diagnostics-Underserved Populations analysis.
Article in Annals of epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeWe investigated the impact of chronic conditions on COVID-19 testing, vaccination, and related challenges, with a focus on the interaction effect of disability.
methodsThis cross-sectional, cross-consortium analysis was conducted as part of the National Institutes of Health Rapid Acceleration of Diagnostics-Underserved Population (RADx-UP) initiative. Data were self-reported via standardized RADx-UP common data elements. Multivariable generalized estimating equation models with a logit link adjusted for sociodemographic variables, health insurance, health status, housing, and United States region were utilized.
resultsParticipants were from 28 states (n = 8813), enrolled between February 2021-March 2022 with a mean age of 49 years, 60.4 % female, 30.8 % Hispanic, and 25.5 % Black, non-Hispanic. Over 30 % were living with three or more chronic conditions and 22.1 % reported some type of disability. Odds of COVID-19 testing (aOR:1.95; 95 %CI:1.75, 2.17), vaccination (aOR:1.63; 95 %CI:1.31, 2.03), food insecurity (aOR:1.43; 95 %CI:1.21, 1.68), housing insecurity (aOR:1.42; 95 %CI:1.10, 1.82), healthcare access challenges (aOR:1.60; 95 %CI:1.38, 1.86) and transportation challenges (aOR:1.48; 95 %CI:1.21, 1.81) increased as number of chronic conditions increased. The effect of chronic conditions on probability of COVID-19 testing (p = 0.157) and vaccination (p = 0.147) did not differ by disability, but the effect on probability of experiencing COVID-19-related challenges did differ by disability (p < 0.001). For those with functional and employment disability, the more chronic conditions one had, the more likely they were to experience food insecurity (aOR:1.94; 95 %CI:1.33, 2.82) and issues accessing healthcare (aOR:2.21; 95 %CI:1.19, 4.14) and transportation (aOR:2.33; 95 %CI:1.11, 4.89).
conclusionsTesting and vaccination sites may have been accessible to various populations and/or adults with chronic conditions may have had heightened awareness of potential vulnerability to COVID-19, which could have led to similar testing and vaccination behaviors across different disability statuses. However, disability may still exacerbate daily-life challenges in those living with chronic conditions during public health crises.
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