In response to NOT-MD-20-019, this administrative supplement will examine the effects of the COVID-19 outbreak and related local public health mandates (e.g., Shelter in Place) in a population of women heavily affected by health disparities. Our parent study of health literacy and health care utilization among women in the criminal probation system (R01MD010439) maintains a cohort of 370 women, 73% of whom are African American and 82% of whom have one or more chronic health condition. Emerging research indicates that these characteristics are linked with disparities in COVID-19 risk, infection, and mortality. Our community- based study, located in Oakland (Alameda County), California, adapted to the formal Shelter-in-Place order, beginning March 17, 2020, by modifying data collection from in-person interviews to telephone-based interviews. Given the public health crisis and reports from participants about its immediate impacts, we began collecting data in May 2020 to systematically assess the medical and social consequences of the outbreak. Coupling these new data with 12 months of longitudinal data obtained prior to the COVID-19 outbreak, we propose to conduct a series of rigorous analyses to address the following Specific Aims: (1) To assess changes in health care access and utilization associated with the COVID-19 outbreak and related local public health mandates (e.g., shelter in place) (2) To examine how health literacy and social determinants (e.g., housing, income) are associated with adherence to public health mandates and participation in COVID-19 screening. The proposed supplement furthers the objectives of NOT-MD-20-019 by addressing the urgent need to understand how COVID-19 and related public health mandates are contributing to health disparities.
This study will assess how COVID-19 impacts health care access and utilization in a group of women who have high levels of chronic illness and social disadvantages such as homelessness. It will also examine conditions that contribute to their ability to follow public health mandates like sheltering in place and social distancing.
|Conroy, Amy A; McKenna, Stacey A; Comfort, Megan L et al. (2018) Marital infidelity, food insecurity, and couple instability: A web of challenges for dyadic coordination around antiretroviral therapy. Soc Sci Med 214:110-117|