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Predictors and consequences of not seeking healthcare during the COVID-19 pandemic: findings from the HEAF cohort

Predictors and consequences of not seeking healthcare during the COVID-19 pandemic: findings from the HEAF cohort
Predictors and consequences of not seeking healthcare during the COVID-19 pandemic: findings from the HEAF cohort

The COVID-19 pandemic resulted in a dramatic reduction of routine healthcare availability in many European countries. Among a cohort of English middle-aged adults, we explored pre-pandemic and pandemic factors associated with not seeking healthcare during lockdown, and their effect on subsequent self-reported health measures. Longitudinal data from the Health and Employment After Fifty (HEAF) cohort were used. Pre-pandemic data came from the 5th annual follow-up (2019), when participants were aged 56-71 years, and pandemic data were collected by e-survey in February 2021 and November 2021. Response rates of the two e-surveys were 53% and 79%, respectively. Pre-pandemic predictors of not seeking healthcare were: female gender, higher BMI, higher comorbidity, poorer self-rated health and depression; non-care seekers were also more likely to report that family or friends were affected by COVID-19 and to have been advised to shield. Not seeking healthcare during lockdown was associated with a higher risk of reporting worsening of physical, but not mental, health during the later phase of the pandemic. In this cohort, those with generally poorer health were disproportionately more likely to not seek healthcare during lockdown, which may potentially exacerbate pre-existing inequalities and lead to longer-term health consequences.

Adult, COVID-19/epidemiology, Communicable Disease Control, Employment, Female, Health Services Accessibility, Humans, Middle Aged, Pandemics
1660-4601
D'Angelo, Stefania
13375ecd-1117-4b6e-99c0-32239f52eed6
Bevilacqua, Gregorio
e93e3b18-7d1e-4da5-9fcd-e6b4637e1c2e
Bloom, Ilse
af2a38ab-3255-414d-afa1-e3089ee45e3f
Ntani, Georgia
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109
D'Angelo, Stefania
13375ecd-1117-4b6e-99c0-32239f52eed6
Bevilacqua, Gregorio
e93e3b18-7d1e-4da5-9fcd-e6b4637e1c2e
Bloom, Ilse
af2a38ab-3255-414d-afa1-e3089ee45e3f
Ntani, Georgia
9b009e0a-5ab2-4c6e-a9fd-15a601e92be5
Walker-Bone, Karen
ad7d1336-ed2c-4f39-ade5-da84eb412109

D'Angelo, Stefania, Bevilacqua, Gregorio, Bloom, Ilse, Ntani, Georgia and Walker-Bone, Karen (2022) Predictors and consequences of not seeking healthcare during the COVID-19 pandemic: findings from the HEAF cohort. International Journal of Environmental Research and Public Health, 19 (20), [13271]. (doi:10.3390/ijerph192013271).

Record type: Article

Abstract

The COVID-19 pandemic resulted in a dramatic reduction of routine healthcare availability in many European countries. Among a cohort of English middle-aged adults, we explored pre-pandemic and pandemic factors associated with not seeking healthcare during lockdown, and their effect on subsequent self-reported health measures. Longitudinal data from the Health and Employment After Fifty (HEAF) cohort were used. Pre-pandemic data came from the 5th annual follow-up (2019), when participants were aged 56-71 years, and pandemic data were collected by e-survey in February 2021 and November 2021. Response rates of the two e-surveys were 53% and 79%, respectively. Pre-pandemic predictors of not seeking healthcare were: female gender, higher BMI, higher comorbidity, poorer self-rated health and depression; non-care seekers were also more likely to report that family or friends were affected by COVID-19 and to have been advised to shield. Not seeking healthcare during lockdown was associated with a higher risk of reporting worsening of physical, but not mental, health during the later phase of the pandemic. In this cohort, those with generally poorer health were disproportionately more likely to not seek healthcare during lockdown, which may potentially exacerbate pre-existing inequalities and lead to longer-term health consequences.

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ijerph-19-13271-v2 - Version of Record
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More information

Accepted/In Press date: 13 October 2022
Published date: 14 October 2022
Additional Information: Funding Information: The HEAF study is funded by the Medical Research Council programme grant (MC_UU_12011/5), and by grant awards from Versus Arthritis (formerly Arthritis Research UK) (22090); and the Economic and Social Research Council and Medical Research Council jointly (ES/L002663/1). Publisher Copyright: © 2022 by the authors.
Keywords: Adult, COVID-19/epidemiology, Communicable Disease Control, Employment, Female, Health Services Accessibility, Humans, Middle Aged, Pandemics

Identifiers

Local EPrints ID: 472106
URI: http://eprints.soton.ac.uk/id/eprint/472106
ISSN: 1660-4601
PURE UUID: 0b194685-1c8c-4d49-b9f9-74418aedd4d3
ORCID for Stefania D'Angelo: ORCID iD orcid.org/0000-0002-7267-1837
ORCID for Gregorio Bevilacqua: ORCID iD orcid.org/0000-0001-7819-1482
ORCID for Ilse Bloom: ORCID iD orcid.org/0000-0002-4893-1790
ORCID for Karen Walker-Bone: ORCID iD orcid.org/0000-0002-5992-1459

Catalogue record

Date deposited: 25 Nov 2022 17:47
Last modified: 26 Nov 2022 02:47

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Contributors

Author: Stefania D'Angelo ORCID iD
Author: Gregorio Bevilacqua ORCID iD
Author: Ilse Bloom ORCID iD
Author: Georgia Ntani

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