背景:COVID-19大流行在获取食物方面带来了挑战,水,药物,和医疗保健服务,其中一些与较低的自评健康(SRH)相关。这些挑战已经在美国记录在案,但目前尚不清楚大流行如何影响人们获得食物,水,药物和医疗保健服务,以及这些挑战如何与该组中的SRH相关,在大流行之前,人们经历了巨大的健康差距和有限的资源。
目的:评估获取食物的挑战之间的关联水,healthcare,以及COVID-19大流行期间的药物和波多黎各成年人的SRH。
方法:波多黎各-CEAL的横截面分析。成年人(>18岁;n=582)完成了一项在线调查(2021年12月30日至2022年2月8日)。在过去30天内测量和分析每个攻击的存在,单独和组合(0、1、>2)。在大流行之前和大流行时测量了SRH(从差-优分级)。计算SRH的变化。具有稳健方差误差的调整后泊松模型估计患病率比(PR)。
结果:体验食物,水,药物,和医疗保健挑战(vs.不)与大流行不良SRH相关(PR=1.44,95CI=1.06-1.97;PR=1.59,95CI=1.15-2.18;PR=1.38,95CI=1.05-1.81;PR=1.56,9.5CI=1.15-2.12)。经历2+挑战(vs.无)与大流行不良SRH相关(PR=1.77,95CI=1.22-2.55)。此外,体验食物,药物,和医疗保健挑战(vs.not)与SRH降低相关(PR=1.35,95CI=1.08-1.69;PR=1.24,95CI=1.01-1.51;PR=1.25,95CI=1.01-1.54),以及经历2+挑战(vs.无;PR=1.49,95CI=1.15-1.92)。
结论:获取食物的挑战,水,药物,大流行期间的医疗保健服务与波多黎各相当贫困的SRH和SRH减少有关。公共卫生政策应确保获得基本需求。
BACKGROUND: The COVID-19 pandemic created challenges in accessing food, water, medications, and healthcare services some of which are linked with lower self-rated health (SRH). These challenges have already been documented in the US, but it remains unknown how the pandemic affected access to food, water, medications and healthcare services, and how these challenges relate to SRH in this group, a population experiencing profound health disparities and limited resources prior to the pandemic.
OBJECTIVE: To assess associations between challenges accessing food, water, healthcare, and medications during the COVID-19 pandemic and SRH among adults in Puerto Rico.
METHODS: Cross-sectional analysis of Puerto Rico-CEAL. Adults (>18 years; n=582) completed an online survey (December 30, 2021-February 8, 2022). Presence of each challenge during the past 30 days was measured and analyzed individually and combined (0, 1, >2). SRH (rated from poor-excellent) was measured before and at pandemic. Change in SRH was calculated. Adjusted Poisson models with robust variance errors estimated prevalence ratios (PR).
RESULTS: Experiencing food, water, medication, and healthcare challenges (vs. not) were associated with pandemic fair-poor SRH (PR=1.44, 95%CI=1.06-1.97; PR=1.59, 95%CI=1.15-2.18; PR=1.38, 95%CI=1.05-1.81; and PR=1.56,9 5%CI=1.15-2.12, respectively). Experiencing 2+ challenges (vs. none) was associated with pandemic fair-poor SRH (PR=1.77, 95%CI=1.22-2.55). Additionally, experiencing food, medication, and healthcare challenges (vs. not) was associated with decreased SRH (PR=1.35, 95%CI=1.08-1.69; PR=1.24, 95%CI=1.01-1.51; and PR=1.25, 95%CI=1.01-1.54, respectively), as well as experiencing 2+ challenges (vs. none; PR =1.49, 95%CI=1.15-1.92).
CONCLUSIONS: Challenges accessing food, water, medications, and healthcare services during the pandemic were associated with fair-poor SRH and decreased SRH in Puerto Rico. Public health policy should ensure access to basic needs.