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Health, Psychosocial, and Economic Impacts of the Covid-19 Pandemic on People with Chronic Conditions in India: A Mixed Methods Study

32 Pages Posted: 17 Dec 2020

See all articles by Kavita Singh

Kavita Singh

Centre for Chronic Conditions and Injuries (CCCI), Public Health Foundation of India (PHFI), and Centre for Chronic Disease Control (CCDC)

Dimple Kondal

All India Institute of Medical Sciences (AIIMS)

Sailesh Mohan

Centre for Chronic Disease Control

Suganthi Jaganathan

Centre for Chronic Disease Control

Deepa Mohan

Independent

Nikhil Srinivasapura Venkateshmurthy

Centre for Chronic Conditions and Injuries, Public Health Foundation of India

Prashant Jarhyan

Centre for Chronic Conditions and Injuries, Public Health Foundation of India

Anjana Ranjit Mohan

Madras Diabetes Research Foundation

Viswanathan Mohan

Madras Diabetes Research Foundation

K.M. Venkat Narayan

Emory University - Rollins School of Public Health

Dorairaj Prabhakaran

Public Health Foundation of India

Mohammed K. Ali

Emory University, Rollins School of Public Health, Hubert Department of Global Health

Nikhil Tandon

All India Institute of Medical Sciences (AIIMS)

Karen Eggleston

Stanford University - Walter H. Shorenstein Asia-Pacific Research Center (APARC)

More...

Abstract

Background: People with chronic conditions are disproportionately prone to be affected by the COVID-19 pandemic but there are limited data documenting this. We aimed to assess the health, psychosocial and economic impacts of the COVID-19 pandemic on people with chronic conditions in India.

Methods: Between July 29, to September 12, 2020, we telephonically surveyed adults (n=2335) with chronic conditions across four sites in India. Data on participants’ demographic, socio-economic status, comorbidities, access to health care, treatment satisfaction, self-care behaviors, employment, and income were collected using pre-tested questionnaires. We performed multivariable logistic regression analysis to examine the correlates of difficulty in accessing medicines and worsening of diabetes or hypertension symptoms. Further, a diverse sample of 40 participants completed qualitative interviews that focused on eliciting patient’s experiences during the COVID-19 lockdowns and data analysed using thematic analysis.

Findings: 1,734 individuals completed the survey (response rate=74%). The mean (SD) age of respondents was 57·8 years (11·3) and 50% were men. During the COVID-19 lockdowns in India, 83% of participants reported difficulty in accessing healthcare, 17% faced difficulties in accessing medicines, 59% reported loss of income, 38% lost jobs, and 28% reduced fruit and vegetable consumption. In the final-adjusted regression model, rural residence (OR, 95%CI: 4·01,2·90-5·53), having diabetes (2·42, 1·81-3·25) and hypertension (1·70,1·27-2·27), and loss of income (2·30,1·62-3·26) were significantly associated with difficulty in accessing medicines. Further, difficulties in accessing medicines (3·67,2·52-5·35), and job loss (1·90,1·25-2·89) were associated with worsening of diabetes or hypertension symptoms. Qualitative data suggest most participants experienced psychosocial distress due to loss of job or income and had difficulties in accessing in-patient services.

Interpretation: People with chronic conditions, particularly among poor, rural, and marginalized populations, have experienced difficulties in accessing healthcare and been severely affected both socially and financially by the COVID-19 pandemic.

Funding: None.

Declaration of Interests: No conflict of interest to declare.

Ethics Approval Statement: This study was approved by the Institutional Ethics Committees of the Centre for Chronic Disease Control, New Delhi, India, and the Madras Diabetes Research Foundation, Chennai, India. All participants provided verbal consent to this study over the phone.

Keywords: SARS coronavirus, COVID-19 pandemic, chronic conditions, India

Suggested Citation

Singh, Kavita and Kondal, Dimple and Mohan, Sailesh and Jaganathan, Suganthi and Mohan, Deepa and Venkateshmurthy, Nikhil Srinivasapura and Jarhyan, Prashant and Mohan, Anjana Ranjit and Mohan, Viswanathan and Narayan, K.M. Venkat and Prabhakaran, Dorairaj and Ali, Mohammed K. and Tandon, Nikhil and Eggleston, Karen, Health, Psychosocial, and Economic Impacts of the Covid-19 Pandemic on People with Chronic Conditions in India: A Mixed Methods Study. Available at SSRN: https://ssrn.com/abstract=3738624 or http://dx.doi.org/10.2139/ssrn.3738624

Kavita Singh (Contact Author)

Centre for Chronic Conditions and Injuries (CCCI), Public Health Foundation of India (PHFI), and Centre for Chronic Disease Control (CCDC)

Dimple Kondal

All India Institute of Medical Sciences (AIIMS) ( email )

Aurobindo Marg
Ansari Nagar East
New Delhi, New Delhi 110029
India

Sailesh Mohan

Centre for Chronic Disease Control ( email )

New Delhi
India

Suganthi Jaganathan

Centre for Chronic Disease Control ( email )

Deepa Mohan

Independent ( email )

Nikhil Srinivasapura Venkateshmurthy

Centre for Chronic Conditions and Injuries, Public Health Foundation of India ( email )

Prashant Jarhyan

Centre for Chronic Conditions and Injuries, Public Health Foundation of India ( email )

Anjana Ranjit Mohan

Madras Diabetes Research Foundation ( email )

Viswanathan Mohan

Madras Diabetes Research Foundation

Chennai
India

K.M. Venkat Narayan

Emory University - Rollins School of Public Health ( email )

Atlanta, GA 30322
United States

Dorairaj Prabhakaran

Public Health Foundation of India ( email )

4 Institutional Area
Vasant Kunj
New Delhi, Delhi 110070
India

Mohammed K. Ali

Emory University, Rollins School of Public Health, Hubert Department of Global Health ( email )

United States

Nikhil Tandon

All India Institute of Medical Sciences (AIIMS) ( email )

Aurobindo Marg
Ansari Nagar East
New Delhi, New Delhi 110029
India

Karen Eggleston

Stanford University - Walter H. Shorenstein Asia-Pacific Research Center (APARC) ( email )

Stanford, CA 94305
United States

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