Aging through the time of COVID-19: a survey of self-reported healthcare access.

BACKGROUND: Chronic conditions are common and require ongoing continuous management and preventive measures. The COVID-19 pandemic may have affected the management of chronic conditions by delaying care. We sought to understand the impact of personal characteristics (i.e., age) and healthcare factors (i.e., access to a provider) on healthcare access in a sample of Americans 50 years of age or older during COVID-19. METHOD: Participants completed an online survey at the start of the COVID-19 pandemic - the Aging in the Time of COVID Survey. Questions focused on health status, health care access, COVID-19 fear, and social connectedness. Participants were recruited through social media advertisements, list serves, and snowball sampling. Data collection started in early April 2020 and concluded in late May 2020. Logistic regression models examined the results of two key access points: healthcare provider/doctor (n = 481) and medication (n = 765), with 56 and 93% of participants reporting access to a provider and medications, respectively. RESULTS: Individuals with an established primary care provider were much more likely to obtain access to a healthcare provider, OR = 3.81 (95% CI: 1.69, 8.77), and to receive medication, OR = 4.48 (95% CI: 1.61, 11.48), during the time of COVID-19. In addition, access to medication was (a) higher for those who were older, OR = 1.05 (95% CI: 1.01, 1.09), had a higher income (greater than 100 k compared to less than 50 k, OR = 3.04 (95% CI: 1.11, 8.98), and (b) lower for those having caregiving responsibilities, OR = 0.41 (95% CI: 0.21, 0.78), or greater social isolation, OR = 0.93 (95% CI: 0.87, 0.98). CONCLUSIONS: Although most participants had access to medication, just over half had access to a healthcare provider when needed. Notably, health-seeking behaviors for individuals who do not have an established primary care providers as well as those who provide unpaid care, are socially isolated, and younger may require more proactive approaches to care monitoring, management, and maintenance.

Age-Based Healthcare Stereotype Threat during the COVID-19 Pandemic.

Older adults have been identified as a high-risk population for COVID-19 by the United States Centers for Disease Control and Prevention (CDC). Though well-intentioned, this nonspecific designation highlights stereotypes of older adults as frail and in need of protection, exacerbating negative age-based stereotypes that can have adverse effects on older adults' well-being. Healthcare stereotype threat (HCST) is concern about being judged by providers and receiving biased medical treatment based on stereotypes about one's identity - in this case age. Given the attention to older adults' physical vulnerabilities during the COVID-19 pandemic, older adults may be especially worried about age-based judgments from medical providers and sensitive to ageist attitudes about COVID-19. Online data collection (April 13 to May 15, 2020) with adults aged 50 and older (N = 2325, M = 63.11, SD = 7.53) examined age-based HCST. Respondents who worried that healthcare providers judged them based on age (n = 584) also reported more negative COVID-19 reactions, including perceived indifference toward older adults, young adults' lack of concern about health, and unfavorable media coverage of older adults. The results highlight the intersection of two pandemics: COVID-19 and ageism. We close with consideration of the clinical implications of the results.

COVID-19 worry, mental health indicators, and preparedness for future care needs across the adult lifespan.

OBJECTIVE: The COVID-19 pandemic has been a source of worry for many, but older adults have been identified as more vulnerable to serious cases and may therefore feel more concerned about the virus. We assessed whether COVID-19 worry was related to indicators of mental health and preparedness for future care, in an adult lifespan sample. METHOD: An online study (n = 485; age 18-82, M = 49.31, SD = 15.39) included measures of COVID-19 worry, depression, general anxiety, health anxiety, hostile and benevolent ageism, preparedness for future care, and demographic information. RESULTS: Age and living alone were positively associated with greater COVID-19 worry, as were health anxiety, general anxiety, benevolent ageism, and preparedness for future care needs via gathering information. A significant interaction indicated that among individuals reporting lower health anxiety, greater preference for gathering information was positively associated with greater COVID-19 worry; however, for individuals having high health anxiety, gathering information about future care was not related to COVID-19 worry, as their COVID-19 worry levels were moderately high. CONCLUSION: Older age was associated with greater COVID-19 worry, perhaps in response to the much publicized greater risk for negative outcomes in this population. In spite of this specific concern, indicators of older adults' continued mental health emerged. Preparedness for future care is also highlighted, as well as clinical implications.