Healthcare Utilization and Preventive Cardiovascular Health Screening Among Adults With Disabilities Amid COVID-19 Phases.

Abstract

This study examines healthcare utilization and preventive cardiovascular health screening among U.S. adults in 2021-2023 compared with those in prepandemic Year 2019 by disability status. This repeated cross-sectional analysis conducted in 2024 used data from National Health Interview Survey for years 2019-2023, including 150,198 adults. Disabilities were categorized as sensory, cognitive, physical, multiple, or none. Healthcare utilization measures (usual care source, wellness visits, and delayed/unmet care due to cost) and preventive screenings (blood pressure, cholesterol, glucose, flu-shot) were analyzed using descriptive methods and Poisson regression, reporting adjusted rate ratios with 95% CIs. During the COVID-19 pandemic, cardiovascular health screening rates decreased across all disability types except for sensory disability. Blood pressure screening for adults with cognitive disabilities dropped from 89% in 2019 to 83% in 2021, whereas blood glucose screening for those with multiple disabilities declined from 83.9% to 78.4%. Cholesterol screenings decreased across all disability types in 2021 but increased among adults with sensory disabilities in 2023 (adjusted rate ratio=1.07, 95% CI=1.03, 1.09). Notably, adults with cognitive (adjusted rate ratio=1.23, 95% CI=1.03, 1.43) and physical (adjusted rate ratio=1.13, 95% CI=1.01, 1.27) disabilities reported higher unmet medical needs due to cost than those without disabilities. Such differences persisted even after adjusting for pandemic-related socioeconomic changes (income, citizenship, employment, insurance). U.S. adults with disabilities experienced increased delays in medical care and declines in cardiovascular screenings during the COVID-19 pandemic, highlighting ongoing disparities in healthcare utilization. These findings underscore the urgent need for public health initiatives to enhance preventive health screening uptake among adults with disabilities.