1410-P: Impacts of COVID-19 on Underserved Communities with Diabetes

People with diabetes have higher COVID-19 morbidity and mortality. These risks are amplified for racial minorities and people living in rural areas or with low income, who are more likely to experience severe COVID-19 illness, vaccine hesitancy, and unemployment. A survey of adults with type 1, type 2, and other forms of diabetes (n=450, µ age= 52.7 years) receiving care at 41 federally qualified and community health centers in FL and CA examined COVID-19 illness, prevention, and financial and healthcare impacts. Surveys were completed from fall 2021 to summer 2022; all outcomes were self-reported. Descriptive statistics were computed for key outcomes (n, %). Logistic regression assessed independent associations of COVID-19 vaccine receipt. Between-group comparisons were evaluated via Chi-Squared, Fisher’s Exact, and Cochran-Mantel-Haenszel tests. Overall, 29.7% of participants contracted COVID-19; of those, 45.3% sought medical care or were hospitalized. Most (81.3%) received at least 1 COVID-19 vaccine; of those, 97.5% were fully vaccinated. Hispanics had the highest vaccination rate while Non-Hispanic Blacks (NHB) had the lowest (91.1%, 73.9%, p=.0281). Hispanics had 4.63x greater odds of vaccination than Non-Hispanic Whites (NHW) [95% CI=(1.81, 11.89)]. A majority “always” or “very often” wore masks (53.2%). Participants reported income loss (64.9%), more frequently in FL (76.1%, CA: 52.2%, p<.001). NHB had the highest rate of severe income loss (26.4%, p=.0124). Loss of health insurance was greater among NHB (13.3%) than other races (<8%, p=.0422) and in FL (9.7%, CA: 4.5%, p=.039). Participants reported healthcare access changes (62%) and higher diabetes medication costs (41%). These findings demonstrate underserved communities with diabetes suffered significant health and financial challenges from COVID-19, which were especially disparate for NHB and FL residents. Further research, interventions, and policy changes are needed to promote health equity for underserved communities with diabetes.