Changes in social lives and loneliness during COVID-19 among older adults: a closer look at the sociodemographic differences.

OBJECTIVES: The COVID-19 pandemic greatly impacted the social lives of older adults across several areas, leading to concern about an increase in loneliness. This study examines the associations of structural, functional, and quality aspects of social connection with increased loneliness during COVID-19 and how these associations vary by sociodemographic factors. DESIGN: Secondary data analyses on a nationally representative survey of older US adults. SETTING: The 2020 Health and Retirement Study (HRS) COVID-19 module. PARTICIPANTS: The study sample includes 3,804 adults aged 54 or older. MEASUREMENTS: Increased loneliness was based on respondents' self-report on whether they felt lonelier than before the COVID-19 outbreak. RESULTS: While 29% felt lonelier after COVID-19, middle-aged adults, women, non-Hispanic Whites, and the most educated were more likely to report increased loneliness. Not having enough in-person contact with people outside the household was associated with increased loneliness (OR = 10.07, p < .001). Receiving emotional support less frequently (OR = 2.28, p < .05) or more frequently (OR = 2.00, p < .001) than before was associated with increased loneliness. Worse quality of family relationships (OR = 1.85, p < .05) and worse friend/neighbor relationships (OR = 1.77, p < .01) were related to feeling lonelier. Significant interactions indicated stronger effects on loneliness of poor-quality family relationships for women and insufficient in-person contact with non-household people for the middle-aged group and non-Hispanic Whites. CONCLUSIONS: Our findings show an increase in loneliness during COVID-19 that was partly due to social mitigation efforts, and also uncover how sociodemographic groups were impacted differently, providing implications for recovery and support.

Sociodemographic and health status differences in delaying medical care during the COVID-19 pandemic among older adults: findings from the Health and Retirement Study.

BACKGROUND: During the COVID-19 Pandemic, adults in the United States reported delaying medical care, which may be tied risk of infection and local policies limiting appointment. Some populations may have been more likely to delay care than others, leading to other forms of health inequality during this period. To-date there is little research on delayed care among U.S. older adult. We determine the prevalence of delayed medical care among older adults and investigate sociodemographic and health status inequalities in delaying health care. METHOD: We used data from the first public release of the nationally representative Health and Retirement Study COVID-19 Subsample (N = 3006). Using logistic regression, we assessed whether differences in delaying health care varied by age, sex, race/ethnicity, education, self-rated health (SRH), and having any Activity of Daily Living (ADL) limitation. We also conducted additional analysis that evaluated differences in delaying care by two care subtypes: doctor and dental care visits. RESULTS: About 30% of U.S. older adults reported delaying care with the most common types of delayed care being dental or doctor visits. Adults ages 75 and older were less likely to delay care, while women, college educated, and those with poor SRH, and any ADL limitations were more likely to delay care. CONCLUSIONS: Nearly one-third of older adults delayed care during the COVID-19 pandemic. The increased likelihood of delayed care among people with worse health suggests that there may be longer-term impacts on the health care system and population health from the COVID-19 pandemic, and may contribute to health inequalities in the near future.

Long COVID and symptom trajectory in a representative sample of Americans in the first year of the pandemic.

People who have COVID-19 can experience symptoms for months. Studies on long COVID in the population lack representative samples and longitudinal data focusing on new-onset symptoms occurring with COVID while accounting for pre-infection symptoms. We use a sample representing the U.S. community population from the Understanding America Study COVID-19 Survey, which surveyed around 8000 respondents bi-weekly from March 2020 to March 2021. Our final sample includes 308 infected individuals who were interviewed one month before, around the time of, and 12 weeks after infection. About 23% of the sample experienced new-onset symptoms during infection which lasted for more than 12 weeks, and thus can be considered as having long COVID. The most common new-onset persistent symptoms among those included in the study were headache (22%), runny or stuffy nose (19%), abdominal discomfort (18%), fatigue (17%), and diarrhea (13%). Long COVID was more likely among obese individuals (OR = 5.44, 95% CI 2.12-13.96) and those who experienced hair loss (OR = 6.94, 95% CI 1.03-46.92), headache (OR = 3.37, 95% CI 1.18-9.60), and sore throat (OR = 3.56, 95% CI 1.21-10.46) during infection. There was a lack of evidence relating risk to age, gender, race/ethnicity, education, current smoking status, or comorbid chronic conditions. This work provides national estimates of long COVID in a representative sample after accounting for pre-infection symptoms.

Long COVID and Symptom Trajectory in a Representative Sample of Americans.

People who have COVID-19 can experience symptoms for months. Studies on long COVID in the population lack representative samples and longitudinal data focusing on new-onset symptoms occurring with COVID while accounting for pre-infection symptoms. We use a sample representing the U.S. community population from the Understanding America Study COVID-19 Survey, which surveyed around 8,000 respondents bi-weekly from March 2020 to March 2021. Our final sample includes 308 infected individuals who were interviewed one month before, around the time of, and 12 weeks after infection. About 23% of the sample experienced new-onset symptoms during infection which lasted for more than 12 weeks, and thus can be considered as having long COVID. The most common persistent new-onset symptoms among those included in the study were headache (22%), runny or stuffy nose (19%), abdominal discomfort (18%), fatigue (17%), and diarrhea (13%). Long COVID was more likely among obese individuals (OR = 5.44, p < 0.001) and those who experienced hair loss (OR = 6.94, p < 0.05), headache (OR = 3.37, p < 0.05), and sore throat (OR = 3.56, p < 0.05) during infection. Risk was unrelated to age, gender, race/ethnicity, education, current smoking status, or comorbid chronic conditions. This work provides national estimates of long COVID in a representative sample after accounting for pre-infection symptoms.

COVID-19 Social Distancing Measures and Loneliness Among Older Adults.

OBJECTIVES: In response to the coronavirus disease 2019 (COVID-19) pandemic, older adults are advised to follow social distancing measures to prevent infection. However, such measures may increase the risk of loneliness. The current study aimed to investigate (a) whether social distancing measures, particularly limiting close social interactions, are associated with loneliness among older adults, and (b) whether the association between social distancing measures and loneliness is moderated by sociodemographic characteristics. METHOD: Data were from the fourth wave (April 29 to May 26, 2020) of the nationally representative Understanding America Study COVID-19 Survey. We used data on adults 50 years or older (N = 3,253). Logistic regression models of loneliness were performed. Five indicators of social distancing measures were considered: (a) avoiding public spaces, gatherings, or crowds; (b) canceling or postponing social activities; (c) social visits; (d) no close contact (within 6 feet) with people living together; and (e) with people not living together. RESULTS: Cancelling or postponing social activities and avoiding close contact with people living together were associated with 33% (odds ratio [OR] = 1.33, confidence interval [CI] = 1.06-1.68, p < .05) and 47% (OR = 1.47, CI = 1.09-1.99, p < .05) greater odds of loneliness, respectively. Furthermore, limiting close contact with coresidents increased the probability of loneliness more for males, non-Hispanic Whites, and those with higher levels of education and income. DISCUSSION: Efforts should be made to help older adults maintain social connectedness with close others by virtual communication methods. Our findings also call special attention to vulnerable groups at elevated risks of loneliness, emphasizing the need for tailored interventions.

Media trust and infection mitigating behaviours during the COVID-19 pandemic in the USA.

INTRODUCTION: The COVID-19 pandemic is an unprecedented public health crisis. It is becoming increasingly clear that people's behavioural responses in the USA during this fast-changing pandemic are associated with their preferred media sources. The polarisation of US media has been reflected in politically motivated messaging around the coronavirus by some media outlets, such as Fox News. This resulted in different messaging around the risks of infection and behavioural changes necessary to mitigate that risk. This study determined if COVID-related behaviours differed according to trust in left-leaning or right-leaning media and how differences changed over the first several months of the pandemic. METHODS: Using the nationally representative Understanding America Study COVID-19 panel, we examine preventive and risky behaviours related to infection from COVID-19 over the period from 10 March to 9 June for people with trust in different media sources: one left-leaning, CNN and another right-leaning, Fox News. People's media preferences are categorised into three groups: (1) those who trust CNN more than Fox News; (2) those who have equal or no preferences and (3) those who trust Fox News more than CNN. RESULTS: Results showed that compared with those who trust CNN more than Fox news, people who trust Fox News more than CNN engaged in fewer preventive behaviours and more risky behaviours related to COVID-19. Out of five preventive and five risky behaviours examined, people who trust Fox News more than CNN practised an average of 3.41 preventive behaviours and 1.25 risky behaviours, while those who trust CNN more than Fox News engaged in an average of 3.85 preventive and 0.94 risky behaviours, from late March to June. The difference between these two groups widened in the month of May (p≤0.01), even after controlling for access to professional information and overall diversity of information sources. CONCLUSIONS: Our findings indicate that behavioural responses were divided along media bias lines. In such a highly partisan environment, false information can be easily disseminated, and health messaging, which is one of the few effective ways to slowdown the spread of the virus in the absence of a vaccine, is being damaged by politically biased and economically focused narratives. During a public health crisis, media should reduce their partisan stance on health information, and the health messaging from neutral and professional sources based on scientific findings should be better promoted.