Needs For Food, Medicine, and Mental Health Services Among Vulnerable Older Adults During Covid-19 Pandemic

ABSTRACT

Background: The COVID-19 pandemic has exacerbated multiple barriers to healthcare for vulnerable seniors. They may experience more difficulties in meeting their basic needs for food, medicine, and social support. The objective of the project was to connect with seniors to show our care, to assess food security, medication possession, mental health, and to refer those needing services to appropriate providers. Methods: Using a computer-assisted telephone interview (CATI) approach, we called patients served by our primary care providers from April to December 2020. The CATI assessed their mental health by Personal Health Questionnaire-2 (PHQ2) and General Anxiety Disorder-2 (GAD2). The California Health Place Index (HPI) was used to measure social determinants of health associated with community resources. Descriptive analyses examined the proportion of patients needing follow-up services and being referred to services to address food insecurity (if had <3 days of food), medication needs (if had <30 days of medicine), and mental health services (PHQ2>2 or GAD2>2). Multivariable logistic regression analyses examined demographic and health factors associated with the odds for needing and being referred for follow-up services. Results: Of 1921 respondents, their average age was 76 years (SD11). 52% female and 48% non-female (including male, transgender, and other);74% White, 7% Asian, 7% Hispanic, 3% Black, and 8% other. Medication needs existed among 595 (31%) patients, 196 (10%) faced food insecurity, and 292 (15%) needed mental health services. Regression results suggest, Blacks (OR1.86, p<0.05) had higher odds of being at risk of medication shortage than Whites;Blacks (OR2.30, p<0.05) and Hispanics (OR 2.30, p<0.05) had significantly higher odds of food insecurity than Whites. Higher odds for food insecurity referral were found among non-females (OR7.56, p<0.05) and Blacks (OR10.33, p<0.05). Blacks (OR13.34, p<0.05) and those living in 2nd quartile of HPI (OR2.57, p<0.05) had higher odds for mental health referrals. Conclusions: Significant disparities existed across gender, race, and community resource groups in need for food, medications, and mental health services. Findings underscore the imperatives for health and social services organizations to systematize outreach and follow-up services for vulnerable seniors.