Provider-Perceived Impacts of Social Vulnerability on Patients’ Access to Care During the COVID-19 Pandemic
Main Article Content
Abstract
Objective: To study the provider-perceived impacts of social vulnerability on patients’ access to care during the COVID-19 Pandemic.
Data Sources and Study Settings: Survey data was collected from healthcare providers in a medium-sized county within a south-eastern state in the U.S. during the COVID-19 pandemic.
Study Design: A cross-sectional mixed-method survey design was utilized to collect qualitative and quantitative data from study participants.
Data Collection: Healthcare providers were recruited from all major healthcare-related state licensure boards, including nurses, physicians, psychologists, social workers, and mental health counselors. The final study sample consisted of 141 licensed healthcare providers.
Principal Findings: Healthcare providers in our study indicated that the social vulnerability factors impacted patients’ access to care. This study provides recommendations for improving access to care among socially vulnerable populations during pandemics as a means to reduce health disparities. The study also identifies areas for future research.
Keywords:
Health Care Disparities, Health Equity, Nursing, Qualitative Research, Determinants of Health/Population Health/Socioeconomic Causes of Health
Article Details
How to Cite
NYUTU, Pius; WALL, Whitney; RUSS, Valeria A..
Provider-Perceived Impacts of Social Vulnerability on Patients’ Access to Care During the COVID-19 Pandemic.
Medical Research Archives, [S.l.], v. 12, n. 6, june 2024.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/5474>. Date accessed: 02 july 2024.
doi: https://doi.org/10.18103/mra.v12i6.5474.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
1. Holmes L, Deepika K, Williams J, et al. Medical Research Archives 2022. 10(6) Black/African Americans (AA) and Disproportionate Burden of SARS-COV-2 (COVID-19) Mortality in the United States. Doi:10.18103/mra.v10i6.2786
2. Lima NNR, de Souza RI, Feitosa PWG, et al. People experiencing homelessness: their potential exposure to COVID-19. Psychiatry Res. 2020;288:112945. Doi: 10.1016/j.psychres.2020.112945.
3. Shadmi E, Chen Y, Dourado I, et al. Health equity and COVID-19: global perspectives. Int J Equity Health. 2020;19(1):1-16. https://doi.org/10.1186/s12939-020-01218-z.
4. Crawshaw AF, Deal A, Rustage K, et al. What must be done to tackle vaccine hesitancy and barriers to COVID-19 vaccination in migrants? Journal of Travel Medicine, 2021; 28(4). https://doi.org/10.1093/jtm/taab048.
5. Willis, DE, Andersen JA, Bryant‐Moore K, et al., COVID‐19 vaccine hesitancy: Race/ethnicity, trust, and fear. Clinical and translational science. 2021;14(6): 2200-2207. https://doi.org/10.1111/cts.13077.
6. Peters DJ. Community susceptibility and resiliency to COVID-19 across the rural-urban continuum in the United States. J Rural Health. 2020;36(3):446-456. Doi: 10.1111/jrh.12477.
7. Dorn AV, Cooney RE, Sabin ML. COVID-19 exacerbating inequalities in the US. Lancet. 2020;395(10232):1243–1244. https://doi.org/10.1016/S0140-6736(20)30893-X.
8. Tai DBG, Shah A, Doubeni CA, et al. The disproportionate impact of COVID-19 on racial and ethnic minorities in the United States. Clin Infect Dis. 2021;72(4):703-706. Doi: 10.1093/cid/ciaa815.
9. Wilder JM. The disproportionate impact of COVID-19 on racial and ethnic minorities in the United States. Clin Infect Dis. 2021;72(4):707-709. Doi: 10.1093/cid/ciaa959.
10. Substance Abuse and Mental Health Services Administration (SAMHSA). Considerations for the care and treatment of mental and substance use disorders in the COVID-19 epidemic. Published May 7, 2020. Accessed October 18, 2023. https://www.samhsa.gov/sites/default/files/considerations-care-treatment-mental-substance-use-disorders-covid19.pdf
11. Yancy CW. COVID-19 and African Americans. JAMA. 2020;323(19):1891–1892. Doi:10.1001/jama.2020.6548
12. Johnston CD, Ruoxi C. The COVID-19 pandemic and its impact on the southern United States. Journal of Comparative Family Studies. 2020;51(3/4):314–323. https://doi.org/10.3138/jcfs.51.3-4.007
13. Wright AL, Sonin K, Driscoll J, et al. Poverty and economic dislocation reduce compliance with covid-19 shelter-in-place protocols. University of Chicago, Becker Friedman Institute for Economics Working Paper #40. Published April 15, 2020. Accessed on September 4, 2020. https://dx.doi.org/10.2139/ssrn.3573637
14. Agency for Toxic Substances and Disease Registry. CDC/ATSDR social vulnerability index. ATSDR Place and Health. U.S. Department of Health and Human Services, Last revised on October 26, 2022. Accessed on July 12, 2023. https://www.atsdr.cdc.gov/placeandhealth/svi/index.html
15. Flanagan BE, Hallisey EJ, Adams E, Lavery A. Measuring community vulnerability to natural and anthropogenic hazards: the Centers for Disease Control and Prevention's Social Vulnerability Index. J Environ Health. 2018;80(10):34-36.
16. Centers for Medicare and Medicaid Services. Physicians and other clinicians: CMS flexibilities to fight COVID-19. Fact sheet published on July 20, 2023. Accessed on October 4, 2023. https://www.cms.gov/files/document/physicians-and-other-clinicians-cms-flexibilities-fight-covid-19.pdf
17. Cancino RS, Su Z, Mesa R, Tomlinson GE, Wang J. The impact of COVID-19 on cancer screening: challenges and opportunities. JMIR Cancer. 2020;6(2):e21697. Doi: 10.2196/21697.
18. Occupational Safety and Health Administration. Protecting workers: guidance on mitigating and preventing the spread of COVID-19 in the workplace. Published June 10, 2021. Accessed on October 4, 2023. https://www.osha.gov/coronavirus/safework
19. Pujolar G, Oliver-Anglès A, Vargas I, Vázquez ML. Changes in access to health services during the COVID-19 pandemic: a scoping review. Int J Environ Res Public Health. 2022;19(3):1749. Doi: 10.3390/ijerph19031749.
20. Smith AC, Thomas E, Snoswell CL, et al. Telehealth for global emergencies: implications for coronavirus disease 2019 (COVID-19). J Telemed Telecare. 2020;26(5):309-313. Doi: 10.1177/1357633X20916567.
21. Azar KMJ, Shen Z, Romanelli RJ, et al. Disparities in outcomes among COVID-19 patients in a large health care system in California. Health Aff (Millwood). 2020;39(7):1253-1262. Doi: 10.1377/hlthaff.2020.00598.
22. Young CL. There are clear, race-based inequalities in health insurance and health outcomes (Commentary). USC-Brookings Schaeffer Center for Health Policy and Economics, Published on February 19, 2020. Accessed on October 4, 2023. https://www.brookings.edu/articles/there-are-clear-race-based-inequalities-in-health-insurance-and-health-outcomes/#:~:text=In%20the%20United%20States%2C%20there,states'%20refusal%20to%20expand%20Medicaid.
23. Cull WL, O'Connor KG, Sharp S, Tang SF. Response rates and response bias for 50 surveys of pediatricians. Health Serv Res. 2005;40(1):213-26. Doi: 10.1111/j.1475-6773.2005.00350.x.
24. Silverman TB, Schrimshaw EW, Franks J, et al. Response rates of medical providers to internet surveys regarding their adoption of preexposure prophylaxis for HIV: methodological implications. J Int Assoc Provid AIDS Care. 2018;17:2325958218798373. Doi: 10.1177/2325958218798373.
25. Cantuaria ML, Blanes-Vidal V. Self-reported data in environmental health studies: mail vs. web-based surveys. BMC Med Res Methodol. 2019;19(1):238. Doi: 10.1186/s12874-019-0882-x.
2. Lima NNR, de Souza RI, Feitosa PWG, et al. People experiencing homelessness: their potential exposure to COVID-19. Psychiatry Res. 2020;288:112945. Doi: 10.1016/j.psychres.2020.112945.
3. Shadmi E, Chen Y, Dourado I, et al. Health equity and COVID-19: global perspectives. Int J Equity Health. 2020;19(1):1-16. https://doi.org/10.1186/s12939-020-01218-z.
4. Crawshaw AF, Deal A, Rustage K, et al. What must be done to tackle vaccine hesitancy and barriers to COVID-19 vaccination in migrants? Journal of Travel Medicine, 2021; 28(4). https://doi.org/10.1093/jtm/taab048.
5. Willis, DE, Andersen JA, Bryant‐Moore K, et al., COVID‐19 vaccine hesitancy: Race/ethnicity, trust, and fear. Clinical and translational science. 2021;14(6): 2200-2207. https://doi.org/10.1111/cts.13077.
6. Peters DJ. Community susceptibility and resiliency to COVID-19 across the rural-urban continuum in the United States. J Rural Health. 2020;36(3):446-456. Doi: 10.1111/jrh.12477.
7. Dorn AV, Cooney RE, Sabin ML. COVID-19 exacerbating inequalities in the US. Lancet. 2020;395(10232):1243–1244. https://doi.org/10.1016/S0140-6736(20)30893-X.
8. Tai DBG, Shah A, Doubeni CA, et al. The disproportionate impact of COVID-19 on racial and ethnic minorities in the United States. Clin Infect Dis. 2021;72(4):703-706. Doi: 10.1093/cid/ciaa815.
9. Wilder JM. The disproportionate impact of COVID-19 on racial and ethnic minorities in the United States. Clin Infect Dis. 2021;72(4):707-709. Doi: 10.1093/cid/ciaa959.
10. Substance Abuse and Mental Health Services Administration (SAMHSA). Considerations for the care and treatment of mental and substance use disorders in the COVID-19 epidemic. Published May 7, 2020. Accessed October 18, 2023. https://www.samhsa.gov/sites/default/files/considerations-care-treatment-mental-substance-use-disorders-covid19.pdf
11. Yancy CW. COVID-19 and African Americans. JAMA. 2020;323(19):1891–1892. Doi:10.1001/jama.2020.6548
12. Johnston CD, Ruoxi C. The COVID-19 pandemic and its impact on the southern United States. Journal of Comparative Family Studies. 2020;51(3/4):314–323. https://doi.org/10.3138/jcfs.51.3-4.007
13. Wright AL, Sonin K, Driscoll J, et al. Poverty and economic dislocation reduce compliance with covid-19 shelter-in-place protocols. University of Chicago, Becker Friedman Institute for Economics Working Paper #40. Published April 15, 2020. Accessed on September 4, 2020. https://dx.doi.org/10.2139/ssrn.3573637
14. Agency for Toxic Substances and Disease Registry. CDC/ATSDR social vulnerability index. ATSDR Place and Health. U.S. Department of Health and Human Services, Last revised on October 26, 2022. Accessed on July 12, 2023. https://www.atsdr.cdc.gov/placeandhealth/svi/index.html
15. Flanagan BE, Hallisey EJ, Adams E, Lavery A. Measuring community vulnerability to natural and anthropogenic hazards: the Centers for Disease Control and Prevention's Social Vulnerability Index. J Environ Health. 2018;80(10):34-36.
16. Centers for Medicare and Medicaid Services. Physicians and other clinicians: CMS flexibilities to fight COVID-19. Fact sheet published on July 20, 2023. Accessed on October 4, 2023. https://www.cms.gov/files/document/physicians-and-other-clinicians-cms-flexibilities-fight-covid-19.pdf
17. Cancino RS, Su Z, Mesa R, Tomlinson GE, Wang J. The impact of COVID-19 on cancer screening: challenges and opportunities. JMIR Cancer. 2020;6(2):e21697. Doi: 10.2196/21697.
18. Occupational Safety and Health Administration. Protecting workers: guidance on mitigating and preventing the spread of COVID-19 in the workplace. Published June 10, 2021. Accessed on October 4, 2023. https://www.osha.gov/coronavirus/safework
19. Pujolar G, Oliver-Anglès A, Vargas I, Vázquez ML. Changes in access to health services during the COVID-19 pandemic: a scoping review. Int J Environ Res Public Health. 2022;19(3):1749. Doi: 10.3390/ijerph19031749.
20. Smith AC, Thomas E, Snoswell CL, et al. Telehealth for global emergencies: implications for coronavirus disease 2019 (COVID-19). J Telemed Telecare. 2020;26(5):309-313. Doi: 10.1177/1357633X20916567.
21. Azar KMJ, Shen Z, Romanelli RJ, et al. Disparities in outcomes among COVID-19 patients in a large health care system in California. Health Aff (Millwood). 2020;39(7):1253-1262. Doi: 10.1377/hlthaff.2020.00598.
22. Young CL. There are clear, race-based inequalities in health insurance and health outcomes (Commentary). USC-Brookings Schaeffer Center for Health Policy and Economics, Published on February 19, 2020. Accessed on October 4, 2023. https://www.brookings.edu/articles/there-are-clear-race-based-inequalities-in-health-insurance-and-health-outcomes/#:~:text=In%20the%20United%20States%2C%20there,states'%20refusal%20to%20expand%20Medicaid.
23. Cull WL, O'Connor KG, Sharp S, Tang SF. Response rates and response bias for 50 surveys of pediatricians. Health Serv Res. 2005;40(1):213-26. Doi: 10.1111/j.1475-6773.2005.00350.x.
24. Silverman TB, Schrimshaw EW, Franks J, et al. Response rates of medical providers to internet surveys regarding their adoption of preexposure prophylaxis for HIV: methodological implications. J Int Assoc Provid AIDS Care. 2018;17:2325958218798373. Doi: 10.1177/2325958218798373.
25. Cantuaria ML, Blanes-Vidal V. Self-reported data in environmental health studies: mail vs. web-based surveys. BMC Med Res Methodol. 2019;19(1):238. Doi: 10.1186/s12874-019-0882-x.