# COVID-19 shutdown: impact of healthcare disruptions on cardiovascular health disparities among people with multiple chronic conditions in New York City.

> **NIH NIH R01** · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · 2024 · $665,975

## Abstract

PROJECT SUMMARY
In the first half of 2020, the SARS-CoV-2 (COVID-19) pandemic infected nearly 4 million persons in the U.S. and
caused over 150,000 deaths. In the midst of the early phase of this pandemic, people with multiple chronic
conditions (MCC) including diabetes, hypertension, obesity, and dyslipidemia, which are increasingly common
with age, were left extremely vulnerable to disruptions in healthcare delivery; in New York City (NYC), the first
U.S. epicenter of the COVID-19 outbreak, traditional ambulatory care ceased entirely for several months and
then reopened at only limited capacity. Implementation of telemedicine and modified in-person visits to bridge
this gap was attempted but adopted unevenly, and differential uptake may have worsened existing health
disparities. In this context, the unprecedented pandemic-disruption in ambulatory care in NYC provides a singular
opportunity to study the long-term effects of disasters on health care systems serving health disparity
populations. Our institution, NYU Grossman School of Medicine (NYUGSOM), is uniquely positioned to answer
these questions, having been at the center of the COVID-19 pandemic in NYC. We have robust existing data
partnerships with the INSIGHT Clinical Research Network, which includes a standardized electronic health
record (EHR) network of 5 NYC academic medical centers, and with the NYC Health and Hospitals Corporation
(NYC-H+H), the largest public hospital system in the U.S. We will leverage these 2 sources to determine, among
people age ≥50 with MCCs (≥2 chronic medical conditions), whether patterns of health system engagement
during the acute pandemic disruption phase (3/7/20-7/9/2020) influenced trajectories of 2 chronic diseases
(hypertension and diabetes) at 2 years, risk of cardiovascular events at 4 years, and whether disparities in
engagement exacerbated health inequities. In Aim 1 we will characterize ambulatory healthcare utilization and
quantify disruptions in healthcare services (total disruption vs. delayed care vs. sufficient care) during the acute
pandemic phase, overall and by subgroup (e.g. racial/ethnic minority, economically disadvantaged). In Aim 2 we
will then assess the impact of total disruption and delayed care in healthcare on 2-year trajectories of chronic
disease measures (mean systolic blood pressure, hemoglobin A1c), and in Aim 3 we will measure the impact of
healthcare disruptions on major adverse cardiovascular outcomes in the 4 years after the acute pandemic period,
and identify their impacts on disparities in CVD outcomes using causal mediation analysis methods. Our findings
will guide future disaster preparedness planning and allow health care systems to develop optimal care models
to mitigate CVD risk and avoid worsening disparities among socioeconomically disadvantaged and/or minority
populations. The MPIs for this project (Dr. Dodson and Dr. Thorpe) combine research experience in
cardiovascular medicine, gerontology, epidemiology, a...

## Key facts

- **NIH application ID:** 10914048
- **Project number:** 5R01AG073321-03
- **Recipient organization:** NEW YORK UNIVERSITY SCHOOL OF MEDICINE
- **Principal Investigator:** John A Dodson
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $665,975
- **Award type:** 5
- **Project period:** 2022-09-30 → 2027-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10914048

## Citation

> US National Institutes of Health, RePORTER application 10914048, COVID-19 shutdown: impact of healthcare disruptions on cardiovascular health disparities among people with multiple chronic conditions in New York City. (5R01AG073321-03). Retrieved via AI Analytics 2026-05-27 from https://api.ai-analytics.org/grant/nih/10914048. Licensed CC0.

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