Associations Between Chronic Health Conditions and COVID-19 Preventive Behaviors Among a Nationally Representative Sample of U.S. Adults: An Analysis of the COVID Impact Survey

Purpose: In the United States, over 2 million cases of COVID-19 cases have been identified and more than 100,000 lives have been lost. While COVID-19 related disparities among those with chronic conditions have been observed, research regarding the uptake of COVID-related preventive behaviors is scarce. Methods: We utilized data from a sample of 2190 U.S. adults from the COVID-19 Impact Survey to examine associations between the presence of underlying chronic health conditions and COVID-19-related preventive behaviors (e.g., use of face masks, hand washing, social distancing, etc.). We used multivariable logistic regression models to model associations between COVID-19 preventive behaviors across demographic and health characteristics. Results: Adults with cardiometabolic disease were more likely to report staying home because they felt unwell, compared with individuals without cardiometabolic disease. Individuals with underlying respiratory conditions were more likely to work from home, compared with individuals without a respiratory condition. Adults with immune conditions were twice more likely to report wearing a face mask when compared with individuals without immune conditions. Conclusion: This study provides U.S. national prevalence estimates and differences in adherence to COVID-19 preventive behaviors among those with and without the presence of underlying chronic health conditions. The prevalence of key preventive measures was high in the overall sample. Yet, engagement in COVID-19-related preventive behaviors varied significantly across chronic disease conditions. Messages around continued maintenance of the behaviors should be reinforced. Study implications suggest a need for more targeted messaging and resources available for individuals with certain underlying chronic conditions.