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Healthcare utilisation and physical activities for older adults with comorbidities in the UK during COVID-19

Research output: Contribution to journalArticlepeer-review

Jiunn Wang, Anne Spencer, Claire Hulme, Anne Corbett, Zunera Khan, Miguel Vasconcelos Da Silva, Siobhan O’Dwyer, Natalie Wright, Ingelin Testad, Clive Ballard, Byron Creese, Richard Smith

Original languageEnglish
JournalHealth and Social Care in the Community
Early online date9 Dec 2021
DOIs
Accepted/In press2021
E-pub ahead of print9 Dec 2021

Bibliographical note

Funding Information: This paper does not receive funding. The construction of the PROTECT dataset is coordinated by the University of Exeter and King's College London and is funded in part by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London, Maudsley NHS Foundation Trust, King's College London and Stavanger University Hospital. It was also supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula and the National Institute for Health Research (NIHR) Exeter Clinical Research Facility. The views expressed in this paper are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health. Funding Information: The construction of the PROTECT dataset is coordinated by the University of Exeter and King's College London and is funded in part by the National Institute for Health Research (NIHR) Biomedical Research Centre at South London, Maudsley NHS Foundation Trust, King's College London and Stavanger University Hospital. It was also supported by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care South West Peninsula and the National Institute for Health Research (NIHR) Exeter Clinical Research Facility. The authors would like to thank Ellie Pickering, Adam Bloomfield and Ben Wood at the University of Exeter for project management and IT development related to the COVID‐19 mental health questionnaire. We also thank the HRA for expediting ethical review, the PROTECT study PPI group and all participants for taking the time to complete the questionnaire. Dr Siobhan O'Dwyer is supported by the National Institute for Health Research Applied Research Collaboration South West Peninsula. The views expressed in this paper are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health or Public Health England. Publisher Copyright: © 2021 John Wiley & Sons Ltd.

King's Authors

Abstract

A major concern with COVID-19 was the impact it would have on individual health, the routine use of healthcare services, and physical activities, especially for older adults with comorbidities. To address this, we studied the association between these variables for older adults during the pandemic. To explore what policy instruments might be effective in mitigating the negative impacts, we investigated the effects of a shielding notice for those identified as vulnerable by the government and social media given it has been an important source for disseminating information of COVID-19. We employed a UK sample with 3,807 participants aged ≥50 from an online survey administered during May and June 2020. Based on numbers of comorbidities, we separated the sample into a higher comorbidity group with those in the upper quartile of the sample (n = 829) and a lower comorbidity group with the remainder (n = 2,978). Statistical methods include chi-squared analyses and cross-sectional regressions. We found that individuals with higher comorbidities were more likely to have poorer self-reported health and mental health and to receive a shielding notice from the government compared to those without (p < 0.05). Decreases in physical activities were associated with poorer self-reported health and the increases were associated with better self-reported health; on the other hand, the decreases were associated with poorer mental health, but the increases did not link to better mental health. Examination of the effects of policy instruments shows that a shielding notice was positively associated with primary care use. The notice generated greater reliance on telephone/video consultations compared to in-person consultations, but the impacts were less strong for people with higher comorbidities. Frequent use of social media raised the probability of increasing physical activities and reduced that of decreasing physical activities, implying social media being an effective tool in promoting physical activities during the lockdown and subsequent restrictions.

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