The COVID-19 pandemic has had negative impacts on vulnerable populations worldwide. This study aimed to examine the association between the health worries of urban older people in Thailand and covariates related to income and non-income poverty, noncommunicable diseases (NCDs), and metabolic risk factors (MRFs). The study utilized the 2021 Survey on Housing and Support Services for Poor Older Adults, which sampled lower-income urban adults aged at least 55 years from five national regions. Bivariate analyses were performed to determine the relationships of NCDs and MRFs with the covariates. Then, binary logistic regression was used to analyze outcomes of perceived health risks including becoming infected with COVID-19, declining health status, and being unable to access health care. Higher educational attainment and income levels were observed to be negatively correlated with worse health status and the inability to access health care. Subjective household crowding consistently had a positive association with the three health concerns. Having MRFs was related only to concerns about health status and access to health care during the pandemic. Welfare and health policies need to improve their responsiveness to the needs of the older population, especially for protection from socioeconomic shocks such as those seen with the current pandemic.