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Chronic Conditions and Adherence to COVID-19 Preventive Measures in Pitt County, North Carolina
London B Grantham1,2, Aaron M Kipp1, C Suzanne Lea1
1Department of Public Health, Brody School of Medicine, East Carolina University, Greenville, North Carolina.
Introduction:
Individuals with chronic conditions have increased risk of severe COVID-19 infection. Few studies have been conducted in the U.S. regarding their engagement in recommended preventive behaviors. This study examines the associations between chronic conditions and adherence to COVID-19 preventive measures and vaccination intent in a community-based study conducted during the COVID-19 pandemic.
Methods:
A cross-sectional study was conducted in July-December 2020 among residents in Pitt County, North Carolina. Online surveys collected information on demographics; physical health and health behaviors; and COVID-19 preventive behaviors, including vaccination intent. Logistic regression estimated the associations between any chronic condition (versus none) and adherence to each preventive measure (always/most of the time versus half the time or less), adjusting for age, race, biologic sex, smoking, and alcohol. Analyses were repeated with an increasing number of chronic conditions.
Results:
Among 671 participants, adherence to preventive measures was often >90%. Intent to vaccinate showed evidence of a statistically significant dose-response relationship with each additional number of chronic conditions (AOR=1.19; 95% CI=1.03, 1.37). An increased odds of wearing a facemask in public was also found for any chronic condition, although this did not reach statistical significance (AOR=1.69; 95% CI=0.97, 2.95). The authors did not find significant associations between having a chronic condition and adherence to other preventive measures such as avoiding large crowds or distancing 6 feet apart.
Conclusion:
Adoption of preventive measures is an essential public health tool during epidemics/pandemics, particularly in the absence of vaccines. The study findings have implications for future public health messaging during a large-scale epidemic based on whether someone is likely engaged with and more trusting of the healthcare system (those with chronic conditions) versus those who are not.
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