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Sharma A. Middle-Aged and Older Adult Employment and the Perceived Risk of Running Out of Money During COVID-19: A Dynamic Panel Data Analysis. THE GERONTOLOGIST 2024; 64:gnae040. [PMID: 38712919 DOI: 10.1093/geront/gnae040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Indexed: 05/08/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The coronavirus disease of 2019 (COVID-19) adversely affected the health of middle-aged and older adults and altered their economic outlook. Several national polls revealed older adults felt stress about money and many reported difficulties in paying expenses during 2021. Although such descriptive reports have raised awareness, peer-reviewed studies utilizing panel data can offer additional insight. As such, the purpose of this study was to contribute to this growing literature by examining the demographic, economic, and health factors associated with employment and the perceived risk of running out of money for middle-aged and older adults during the pandemic. RESEARCH DESIGN AND METHODS This study utilized the April-May 2020, April-May 2021, and March 2022 waves of the Understanding America Study. Next, a dynamic panel data model was formulated to account for reverse causality and unobserved heterogeneity with a sample of 2,302 adults between the ages of 50 and 74. RESULTS Employment (-2.77, p < .05) was negatively associated with the perceived risk of running out of money. Male, higher education levels, currently married, and health insurance status also exhibited a negative association. Meanwhile, a positive association was found for non-White (6.79, p < .01). DISCUSSION AND IMPLICATIONS Financial well-being is an important consideration in later life and what role employment played during the COVID-19 pandemic is a worthwhile examination. A better understanding of which factors may be associated with the perceived risk of running out of money during the pandemic can be useful when devising policies which address financial security for middle-aged and older adults.
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Affiliation(s)
- Andy Sharma
- Public Policy Studies, Northwestern University, Chicago, Illinois, USA
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Mendez I, Strassle PD, Ponce S, Le R, Stewart AL, Nápoles AM. Age-related differences in the association between financial hardship and weight change during the COVID-19 pandemic. Heliyon 2024; 10:e30917. [PMID: 38779010 PMCID: PMC11108839 DOI: 10.1016/j.heliyon.2024.e30917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 05/06/2024] [Accepted: 05/08/2024] [Indexed: 05/25/2024] Open
Abstract
Objective To examine the association of financial hardship with weight changes in the US during the COVID-19 pandemic. Methods We used data from the COVID-19's Unequal Racial Burden survey, a nationally representative, cross-sectional, online survey of diverse adults living in the US, 12/2020-2/2021. This study included 1000 Asian, Black, Latino (half Spanish-speaking), and White adults and 500 American Indian or Alaska Native, Native Hawaiian or Pacific Islander, and multiracial adults (5500 total). Age-specific (18-39, 40-59, ≥60) associations between financial hardship domains and weight change were estimated using multinomial logistic regression, adjusted for demographic and health characteristics. Results Financial hardship during the COVID-19 pandemic was prevalent across all age groups (18-39: 76.2 %; 40-59: 75.6 %; ≥60: 50.6 %). Among adults aged 18-39 and ≥ 60 years old, food insecurity was significantly associated with weight loss (18-39: aOR = 1.42, 95 % CI = 1.04, 1.95; ≥60: aOR = 3.67, 95 % CI = 1.50, 8.98). Among all age groups, unmet healthcare expenses was also associated with weight loss (18-39: aOR = 1.31, 95 % CI = 1.01, 1.70; 40-59: aOR = 1.49, 95 % CI = 1.06, 2.08; ≥60: aOR = 1.73, 95 % CI = 1.03, 2.91). Among adults aged 18-39 and ≥ 60 years old, lost income was significantly associated with weight gain (18-39: aOR = 1.36, 95 % CI = 1.09-1.69; ≥60: aOR = 1.46, 95 % CI = 1.04, 2.06), and among adults 40-59 years old, experiencing increased debt was significantly associated with weight gain (aOR = 1.50, 95 % CI = 1.13, 1.99). Conclusions For those aged 18-39 and ≥ 60 years old experiencing financial hardship during the COVID-19 pandemic was associated with both weight loss and weight gain. Less correlation was observed among adults aged 40-59.
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Affiliation(s)
- Izabelle Mendez
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, MD, USA
- Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Paula D. Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, MD, USA
| | - Stephanie Ponce
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, MD, USA
| | - Randy Le
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, MD, USA
| | - Anita L. Stewart
- University of California San Francisco, Institute for Health & Aging, Center for Aging in Diverse Communities, USA
| | - Anna M. Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institute of Health, Bethesda, MD, USA
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Freeman JJ. Post lockdown: What did we learn? Proc AMIA Symp 2024; 37:413. [PMID: 38628345 PMCID: PMC11018078 DOI: 10.1080/08998280.2024.2325282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 02/26/2024] [Indexed: 04/19/2024] Open
Affiliation(s)
- Jennifer J. Freeman
- Baylor Scott & White All Saints Medical Center, Fort Worth, Texas, USA
- Burnett School of Medicine at TCU, Fort Worth, Texas, USA
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Chopyk DM, Dedhia PH. Pandemic impact: Decline in endocrine operations hits vulnerable populations harder. Am J Surg 2024; 228:20-21. [PMID: 37806891 DOI: 10.1016/j.amjsurg.2023.10.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 10/10/2023]
Affiliation(s)
- Daniel M Chopyk
- Department of Surgery, The Ohio State University Wexner Medical Center and James Cancer Hospital and Solove Research Institute, 395 W. 12Th Avenue, Suite 670, Columbus, OH, USA
| | - Priya H Dedhia
- Division of Surgical Oncology, The Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, USA; Translational Therapeutics Program, The Ohio State University and Arthur G. James Comprehensive Cancer Center, Columbus, OH, USA.
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Mendez I, Strassle PD, Rodriquez EJ, Ponce S, Le R, Green A, Martinez E, Pérez-Stable EJ, Nápoles AM. Racial and ethnic disparities in the association between financial hardship and self-reported weight change during the first year of the pandemic in the U.S. Int J Equity Health 2024; 23:12. [PMID: 38254081 PMCID: PMC10804602 DOI: 10.1186/s12939-023-02093-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/30/2023] [Indexed: 01/24/2024] Open
Abstract
Studies have shown that financial hardship can impact weight change; however, it is unclear what the economic impact of the COVID-19 pandemic has had on weight change in U.S. adults, or whether racial-ethnic groups were impacted differentially. We estimated the association between financial hardship and self-reported weight change using data from the cross-sectional COVID-19's Unequal Racial Burden (CURB) survey, a nationally representative online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Latino (English- and Spanish-speaking), Native Hawaiian/Pacific Islander, White, and multiracial adults conducted from 12/2020 to 2/2021. Financial hardship was measured over six domains (lost income, debt, unmet general expenses, unmet healthcare expenses, housing insecurity, and food insecurity). The association between each financial hardship domain and self-reported 3-level weight change variable were estimated using multinomial logistic regression, adjusting for sociodemographic and self-reported health. After adjustment, food insecurity was strongly associated with weight loss among American Indian/Alaska Native (aOR = 2.18, 95% CI = 1.05-4.77), Black/African American (aOR = 1.77, 95% CI = 1.02-3.11), and Spanish-speaking Latino adults (aOR = 2.32, 95% CI = 1.01-5.35). Unmet healthcare expenses were also strongly associated with weight loss among Black/African American, English-speaking Latino, Spanish-speaking Latino, and Native Hawaiian/Pacific Islander adults (aORs = 2.00-2.14). Other domains were associated with weight loss and/or weight gain, but associations were not as strong and less consistent across race-ethnicity. In conclusion, food insecurity and unmet healthcare expenses during the pandemic were strongly associated with weight loss among racial-ethnic minority groups. Using multi-dimensional measures of financial hardship provides a comprehensive assessment of the effects of specific financial hardship domains on weight change among diverse racial-ethnic groups.
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Affiliation(s)
- Izabelle Mendez
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA.
| | - Paula D Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA
| | - Erik J Rodriquez
- Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland), USA
- Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA
| | - Stephanie Ponce
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA
| | - Randy Le
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA
| | - Alexis Green
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA
| | - Emma Martinez
- Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland), USA
| | - Eliseo J Pérez-Stable
- Division of Intramural Research, National Heart, Lung and Blood Institute, National Institutes of Health, Bethesda, Maryland), USA
- Office of the Director, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA
| | - Anna M Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, Maryland), USA
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Ponce SA, Green A, Strassle PD, Nápoles AM. Positive and negative aspects of the COVID-19 pandemic among a diverse sample of US adults: an exploratory mixed-methods analysis of online survey data. BMC Public Health 2024; 24:22. [PMID: 38166883 PMCID: PMC10762906 DOI: 10.1186/s12889-023-17491-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 12/14/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND The COVID-19 pandemic had a profound social and economic impact across the United States due to the lockdowns and consequent changes to everyday activities in social spaces. METHODS The COVID-19's Unequal Racial Burden (CURB) survey was a nationally representative, online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Latino (English- and Spanish-speaking), Native Hawaiian/Pacific Islander, White, and multiracial adults living in the U.S. For this analysis, we used data from the 1,931 participants who responded to the 6-month follow-up survey conducted between 8/16/2021-9/9/2021. As part of the follow-up survey, participants were asked "What was the worst thing about the pandemic that you experienced?" and "Was there anything positive in your life that resulted from the pandemic?" Verbatim responses were coded independently by two coders using open and axial coding techniques to identify salient themes, definitions of themes, and illustrative quotes, with reconciliation across coders. Chi-square tests were used to estimate the association between sociodemographics and salient themes. RESULTS Commonly reported negative themes among participants reflected disrupted lifestyle/routine (27.4%), not seeing family and friends (9.8%), and negative economic impacts (10.0%). Positive themes included improved relationships (16.9%), improved financial situation (10.1%), and positive employment changes (9.8%). Differences in themes were seen across race-ethnicity, gender, and age; for example, adults ≥ 65 years old, compared to adults 18-64, were more likely to report disrupted routine/lifestyle (37.6% vs. 24.2%, p < 0.001) as a negative aspect of the pandemic, and Spanish-speaking Latino adults were much more likely to report improved relationships compared to other racial-ethnic groups (31.1% vs. 14.8-18.6%, p = 0.03). DISCUSSION Positive and negative experiences during the COVID-19 pandemic varied widely and differed across race-ethnicity, gender, and age. Future public health interventions should work to mitigate negative social and economic impacts and facilitate posttraumatic growth associated with pandemics.
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Affiliation(s)
- Stephanie A Ponce
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - Alexis Green
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
| | - Paula D Strassle
- Division of Intramural Research , National Institute on Minority Health and Health Disparities, 11545 Rockville Pike, 2 White Flint North, Room C13, Rockville, MD, 20818, USA.
| | - Anna María Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, Bethesda, MD, USA
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Ponce SA, Wilkerson M, Le R, Nápoles AM, Strassle PD. Inability to get needed health care during the COVID-19 pandemic among a nationally representative, diverse population of U.S. adults with and without chronic conditions. BMC Public Health 2023; 23:1868. [PMID: 37752511 PMCID: PMC10523792 DOI: 10.1186/s12889-023-16746-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 09/12/2023] [Indexed: 09/28/2023] Open
Abstract
BACKGROUND Delays in health care have been observed in the U.S. during the COVID-19 pandemic; however, the prevalence of inability to get needed care and potential disparities in health care access have yet to be assessed. METHODS We conducted a nationally representative, online survey of 5,500 American Indian/Alaska Native, Asian, Black/African American, Latino (English- and Spanish-speaking), Native Hawaiian/Pacific Islander, White, and multiracial adults between 12/2020-2/2021 (baseline) and 8/16/2021-9/9/2021 (6-month follow-up). Participants were asked "Since the start of the pandemic, was there any time when you did not get medical care that you needed?" Those who responded "Yes" were asked about the type of care and the reason for not receiving care. Poisson regression was used to estimate the association between sociodemographics and inability to receive needed care; all analyses were stratified by chronic condition status. Chronic conditions included: chronic obstructive pulmonary disease (COPD), heart conditions, type 2 diabetes, chronic kidney disease or on dialysis, sickle cell disease, cancer, and immunocompromised state (weakened immune system). RESULTS Overall, 20.0% of participants at baseline and 22.7% at follow-up reported not getting needed care. The most common reasons for being unable to get needed care included fear of COVID-19 (baseline: 44.1%; follow-up: 47.2%) and doctors canceled appointment (baseline: 25.3%; follow-up: 14.1%). Routine care (baseline: 59.9%; follow-up: 62.6%) and chronic care management (baseline: 31.5%; follow-up: 30.1%) were the most often reported types of delayed care. Fair/poor self-reported physical health was significantly associated with being unable to get needed care despite chronic condition status (≥ 1 chronic condition: aPR = 1.36, 95%CI = 1.04-1.78); no chronic conditions: aPR = 1.52, 95% CI = 1.28-1.80). The likelihood of inability to get needed care differed in some instances by race/ethnicity, age, and insurance status. For example, uninsured adults were more likely to not get needed care (≥ 1 chronic condition: aPR = 1.76, 95%CI = 1.17-2.66); no chronic conditions: aPR = 1.25, 95% CI = 1.00-1.56). CONCLUSIONS Overall, about one fifth of participants reported being unable to receive needed care at baseline and follow-up. Delays in receiving needed medical care may exacerbate existing conditions and perpetuate existing health disparities among vulnerable populations who were more likely to have not received needed health care during the pandemic.
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Affiliation(s)
- Stephanie A Ponce
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Miciah Wilkerson
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Randy Le
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Anna María Nápoles
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA
| | - Paula D Strassle
- Division of Intramural Research, National Institute on Minority Health and Health Disparities, National Institutes of Health, Bethesda, MD, USA.
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