Exploring the Linkages Among Chronic Illness, Substance Use, and COVID-19 Infection in Adults Aged 50 Years and Older: Retrospective Cross-Sectional Analysis of National Representative Data

Abstract

Background: The co-occurrence of chronic illnesses and substance use presents complex challenges for health care systems. Understanding the interplay between these factors, compounded by the context of the COVID-19 pandemic, is essential for effective intervention strategies. Objective: This study aims to investigate the relationships among chronic illness, substance use, and COVID-19 infection in adults aged 50 years and older. Methods: Participants were 1196 adults aged 50 years and older. Descriptive statistics were used to describe demographic information. Logistic regressions and multiple regression analyses were used to determine associations between chronic illnesses, substance use, and COVID-19 infection. Mediation analysis was used to determine the effect of chronic illness mediators in the association between COVID-19 concerns and substance use. Results: The mean age was 68 (SD 10.3) years, with 58.6% (701/1196) being women. Adjusted analysis revealed that age and sex (women) significantly predicted a lower level of substance use (P