Trends and disparities in health status and health care in the United States during COVID-19 pandemic
Abstract Background Concerns exist over a possible worsening of disparities in health status and health care access across racial/ethnic and income groups during the COVID-19 pandemic. We aimed to characterize trends in racial/ethnic and income differences in self-reported measures of health status...
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BMC
2025-08-01
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| Online Access: | https://doi.org/10.1186/s12916-025-04315-4 |
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| author | Zhiyuan Wu Frank Qian Siyu Zou Xinye Zou Ruolin Zhang Xiuhua Guo Haibin Li |
| author_facet | Zhiyuan Wu Frank Qian Siyu Zou Xinye Zou Ruolin Zhang Xiuhua Guo Haibin Li |
| author_sort | Zhiyuan Wu |
| collection | DOAJ |
| description | Abstract Background Concerns exist over a possible worsening of disparities in health status and health care access across racial/ethnic and income groups during the COVID-19 pandemic. We aimed to characterize trends in racial/ethnic and income differences in self-reported measures of health status and health care access among US adults. Methods This serial cross-sectional nationally representative study included adults (age ≥ 18 years) participating in the National Health Interview Survey (NHIS) from 2019 to 2022. Self-reported health status (poor or fair health status, functional limitation, clinician-diagnosed depression or anxiety disorders) and health care access and affordability were collected. Results Our analysis included 107,230 adults (mean [SE] age, 48.1 [0.1] years, 51.6% women), of whom 6.1% were Asian, 12.1% were Black, 17.3% were Latino/Hispanic, and 64.5% were White. Black individuals with low income had the highest prevalence of poor or fair health status (30.9% [95% CI, 27.8%–34.3%] in 2019 and 28.4% [95% CI, 25.1% to 32.0%] in 2022), and these racial/ethnic gaps did not change significantly, irrespective of income levels. The prevalence of clinician-diagnosed depression or anxiety disorders increased from 2019 to 2022 for all racial/ethnic groups, especially for Whites (from 32.6% [95% CI, 30.8%–34.4%] to 38.2% [95% CI, 36.4% to 40.1%], P < 0.001). There was no significant change in functional limitations during the pandemic. Latino/Hispanic individuals with low income had the highest estimated prevalence of limited health care access from 2019 to 2022. Health insurance access and affordability significantly improved for White individuals with low income from 2019 to 2022 (P < 0.001), but not for other racial/ethnic groups. Racial/ethnic gaps in health care access and affordability did not change significantly, irrespective of income levels. Conclusions In a serial cross-sectional survey study of US adults during the COVID-19 pandemic, prevalence of clinician-diagnosed depression or anxiety disorders significantly increased. Racial and ethnic differences in health status and health care access either persisted or widened over time. |
| format | Article |
| id | doaj-art-8696a4badea945fbb0c06b6a3a0c3ded |
| institution | Kabale University |
| issn | 1741-7015 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | BMC |
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| series | BMC Medicine |
| spelling | doaj-art-8696a4badea945fbb0c06b6a3a0c3ded2025-08-20T04:02:55ZengBMCBMC Medicine1741-70152025-08-0123111410.1186/s12916-025-04315-4Trends and disparities in health status and health care in the United States during COVID-19 pandemicZhiyuan Wu0Frank Qian1Siyu Zou2Xinye Zou3Ruolin Zhang4Xiuhua Guo5Haibin Li6Department of Nutrition, Harvard T.H. Chan School of Public HealthSection of Cardiovascular Medicine, Boston Medical Center and Boston University Chobanian & Avedisian School of MedicineDepartment of Epidemiology, Johns Hopkins Bloomberg School of Public HealthCambridge Institute of Public Health, Department of Public Health and Primary Care, University of CambridgeHarvard T.H. Chan School of Public Health, Harvard UniversityDepartment of Epidemiology and Health Statistics, School of Public Health, Capital Medical UniversityDepartment of Cardiology, Beijing Chaoyang Hospital, Capital Medical UniversityAbstract Background Concerns exist over a possible worsening of disparities in health status and health care access across racial/ethnic and income groups during the COVID-19 pandemic. We aimed to characterize trends in racial/ethnic and income differences in self-reported measures of health status and health care access among US adults. Methods This serial cross-sectional nationally representative study included adults (age ≥ 18 years) participating in the National Health Interview Survey (NHIS) from 2019 to 2022. Self-reported health status (poor or fair health status, functional limitation, clinician-diagnosed depression or anxiety disorders) and health care access and affordability were collected. Results Our analysis included 107,230 adults (mean [SE] age, 48.1 [0.1] years, 51.6% women), of whom 6.1% were Asian, 12.1% were Black, 17.3% were Latino/Hispanic, and 64.5% were White. Black individuals with low income had the highest prevalence of poor or fair health status (30.9% [95% CI, 27.8%–34.3%] in 2019 and 28.4% [95% CI, 25.1% to 32.0%] in 2022), and these racial/ethnic gaps did not change significantly, irrespective of income levels. The prevalence of clinician-diagnosed depression or anxiety disorders increased from 2019 to 2022 for all racial/ethnic groups, especially for Whites (from 32.6% [95% CI, 30.8%–34.4%] to 38.2% [95% CI, 36.4% to 40.1%], P < 0.001). There was no significant change in functional limitations during the pandemic. Latino/Hispanic individuals with low income had the highest estimated prevalence of limited health care access from 2019 to 2022. Health insurance access and affordability significantly improved for White individuals with low income from 2019 to 2022 (P < 0.001), but not for other racial/ethnic groups. Racial/ethnic gaps in health care access and affordability did not change significantly, irrespective of income levels. Conclusions In a serial cross-sectional survey study of US adults during the COVID-19 pandemic, prevalence of clinician-diagnosed depression or anxiety disorders significantly increased. Racial and ethnic differences in health status and health care access either persisted or widened over time.https://doi.org/10.1186/s12916-025-04315-4Health statusHealth care accessHealth inequalityDepression/anxiety disordersCOVID-19 |
| spellingShingle | Zhiyuan Wu Frank Qian Siyu Zou Xinye Zou Ruolin Zhang Xiuhua Guo Haibin Li Trends and disparities in health status and health care in the United States during COVID-19 pandemic BMC Medicine Health status Health care access Health inequality Depression/anxiety disorders COVID-19 |
| title | Trends and disparities in health status and health care in the United States during COVID-19 pandemic |
| title_full | Trends and disparities in health status and health care in the United States during COVID-19 pandemic |
| title_fullStr | Trends and disparities in health status and health care in the United States during COVID-19 pandemic |
| title_full_unstemmed | Trends and disparities in health status and health care in the United States during COVID-19 pandemic |
| title_short | Trends and disparities in health status and health care in the United States during COVID-19 pandemic |
| title_sort | trends and disparities in health status and health care in the united states during covid 19 pandemic |
| topic | Health status Health care access Health inequality Depression/anxiety disorders COVID-19 |
| url | https://doi.org/10.1186/s12916-025-04315-4 |
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