Facemasks: Perceptions and use in an ED population during COVID-19

Area of Science:

• Public Health
• Epidemiology
• Health Disparities

Background:

• Facemask use is a key intervention for reducing SARS-CoV-2 transmission.
• Existing research often overlooks vulnerable populations, who disproportionately bear the pandemic's burden.
• Understanding mask perceptions and practices in these groups is crucial for equitable public health strategies.

Purpose of the Study:

• To assess beliefs, access, and practices of mask wearing among diverse urban emergency department (ED) patient populations.
• To identify disparities in mask use and barriers to access among socio-economic and racial/ethnic groups.

Main Methods:

• Secondary analysis of a cross-sectional study involving 2,292 patients from 15 US safety-net EDs (December 2020 - March 2021).
• Primary outcome: frequency of mask use outside the home.
• Secondary outcomes: mask availability and acquisition difficulties.

Main Results:

• High overall mask usage reported: 79% "all of the time," 96% "over half the time."
• Patients without primary care physicians (PCPs) and individuals experiencing homelessness reported lower mask usage (92% and 81%, respectively) compared to those with PCPs (97%) and housed individuals (96%).
• Homeless individuals and those without PCPs were more likely to face barriers in obtaining masks.

Conclusions:

• Despite high reported mask use, disparities exist, particularly for homeless individuals and those lacking PCPs.
• Barriers to mask access and consistent use are more prevalent in vulnerable populations.
• Emergency departments present an opportunity for targeted mask education and distribution to underserved communities.