Accepted for/Published in: JMIR Aging
Date Submitted: Jun 7, 2024
Open Peer Review Period: Jun 7, 2024 - Aug 2, 2024
Date Accepted: Aug 19, 2024
(closed for review but you can still tweet)
Exploring the Linkages Among Chronic Illness, Substance Use, and COVID-19 in Adults Aged 50 and Older: A Retrospective Cross-Sectional Analysis of National Representative Data
ABSTRACT
Background:
The co-occurrence of chronic illness and substance use problems presents complex challenges for healthcare systems. Understanding the interplay between these factors, compounded by the context of the COVID-19 pandemic, is essential for effective intervention strategies.
Objective:
To investigate the relationships between chronic illness, substance use, and COVID-19 in adults aged 50 and older.
Methods:
Participants were 1,196 adults aged 50 and older. Descriptive statistics were used to describe demographic information. Logistic regressions and Multiple regression analyses were used to determine associations between chronic illness, substance use, and COVID-19. Mediation analysis was utilized to determine the effect of chronic illness mediators in the association between COVID-19 concern and substance use.
Results:
The mean age was 68 years (SD = 10.3 years), with 58.6% being women. Adjusted analysis revealed that age and sex (women) significantly predicted a lower level of substance use (p < 0.05). However, marital status (separated or widowed) and chronic illness significantly predicted a higher level of substance use (p < 0.05). Furthermore, having dementia, arthritis, and high cholesterol significantly predicted a higher level of concern about the COVID-19 pandemic (p < 0.05). Logistic regression analysis indicated that individuals with hypertension (OR = 1.91; 95% CI = 1.37-2.66; p < 0.001), lung disease (OR = 2.42; 95% CI = 1.23-4.75; p = 0.01), heart condition (OR = 1.99; 95% CI = 1.28-3.10; p = 0.002), stroke (OR = 2.35; 95% CI = 1.07-5.16; p = 0.03), and arthritis (OR = 1.72; 95% CI = 1.25-2.37; p = 0.001) were more likely to have their work affected by the COVID-19 pandemic. The mediation analysis showed a significant effect of COVID-19 concern on Substance Use through the mediation of Chronic Illness, with a 95% confidence interval of -0.02 to -0.01 and an indirect effect of -0.01.
Conclusions:
Our study reveals complex associations between chronic illness, substance use, and COVID-19 among adults aged 50 and older. It underscores the impact of demographics and specific chronic conditions on substance use behaviors and COVID-19 concerns. Additionally, certain chronic illnesses were linked to heightened vulnerability in employment status during the pandemic. These findings emphasize the need for targeted interventions addressing physical health and substance use in this population during COVID-19.
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Copyright
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