Self-perceived disaster preparedness in minority older adults: A cross-sectional study.

OBJECTIVE: Evidence suggests that people of color, especially African Americans and non-White Hispanics, residing in low-income communities are the most vulnerable to natural disasters. This study assessed individual level of self-perceived disaster preparedness, disaster response actions, and sociodemographic predictors of disaster preparedness among older minority adults in Houston, Texas. METHOD: Working with Houston-area community-based organizations and senior-living centers, a cross-sectional survey, available in English and Spanish, was disseminated between November 2020 and January 2021. PARTICIPANTS: Five hundred and twenty-two older minority adults aged 55+ completed the electronic survey. MAIN OUTCOME MEASURE(S): The main outcome measure was the level of self-perceived preparedness regarding emergencies and disastersie, prepared vs not prepared-among the study participants. RESULTS: Overall, about 58 percent of older minority adults did not perceive themselves to be prepared. Compared to individuals reporting annual incomes below $25,000, individuals reporting annual incomes between $25,000 and $74,999 were more likely to report being prepared [odds ratio (OR) = 2.28, 95 percent confidence interval (CI) = 1.29, 4.05]. Individuals who tested positive or had a close family member test positive for COVID-19 experienced 2.16 times higher odds of having self-perceived disaster preparedness than those who did not [OR = 2.16, 95 percent CI = 1.37, 3.42]. None of the other covariates were statistically significant. CONCLUSIONS: While we observed no differences in self-perceived disaster preparedness between African American and Hispanic older adults, our findings suggest the importance of prior experience/exposure to previous disasters and the role of socioeconomic status in self-perceived disaster preparedness in minority older adults.

Associations between Patient- and Provider Level Factors, and Telemedicine Use in Family Medicine Clinics.

INTRODUCTION: Increased telemedicine implementation may promote primary care access. However, gaps in telemedicine uptake may perpetuate existing disparities in primary care access. This study assessed provider- and patient-level factors associated with telemedicine use in community-based family practice clinics. METHODS: This retrospective study used electronic medical records data from a large Federally Qualified Health Center. A 3-level mixed-effects logistic regression model explored predictors of telemedicine use, with provider and patient as random effects. RESULTS: The analytic sample included 37,428 unique patients with 106,567 primary care encounters with 42 family medicine providers. Fifty-seven percent of the sample identified as Hispanic, 28% non-Hispanic White, and 11% non-Hispanic Black. Compared to Hispanics, non-Hispanic White patients had 61% higher odds of a telemedicine visit, and non-Hispanic Black patients had 32% higher odds of a telemedicine visit. The odds of telemedicine use were lower for those who were uninsured. Those residing in metropolitan areas or medically underserved areas had greater odds of a telemedicine appointment. Commute time exhibited a dose-response relationship with telemedicine use. Provider characteristics were not significantly associated with telemedicine use. DISCUSSION: While provider characteristics were not associated with telemedicine use, greater focus on patient characteristics specific to the population served is necessary.