By Carli Friedman, CQL Director of Research
One important measure of health care access and quality is how frequently people delay or forgo medical care. In addition, when people delay or forgo medical care, their health worsens and they are more likely to have more complex medical needs in the future, as well as higher medical costs. They even have higher rates of mortality and morbidity.
The COVID-19 pandemic made it more difficult for all people to access medical care. While people with disabilities faced many barriers and inequities accessing medical care prior to the pandemic, less is known about their ability to access medical care during the pandemic. For these reasons, the aim of this study was to examine people with disabilities’ access to medical care during the COVID-19 pandemic. To do so, we analyzed data from 334,772 people across the United States. Data were weighted to be representative of the United States population.
We found, during the second year of the pandemic (2021), 31% of people with disabilities delayed medical care and 29% forwent the care they needed altogether because of the pandemic. In fact, even when their other sociodemographics were controlled, people with disabilities were 2.3 times more likely to delay medical care than people without disabilities, and 2.7 times more likely to forgo the medical care they needed.
Delaying and Forgoing Medical Care During the Pandemic
There were also differences in delaying and forgoing medical care within the disability community itself. For example, the type of impairments people with disabilities had resulted in different rates of delaying and forgoing medical care, with people with cognitive disabilities being the most likely to delay and forgo medical care. In addition, the following people with disabilities were more likely to delay and forgo medical care: females; Hispanic people; widowed people; people with household incomes of less than $100,000; and people with Medicaid or who received health care from the Indian Health Service.
Differences in Delaying Medical Care Among People with Disabilities by Impairment Type
“As COVID-19 had a deadly cost for the disability community, many people with disabilities had to choose between getting the medical care they needed, or risking illness or death as a result of doing so. People with disabilities’ access to health care is impacted by socioeconomic disadvantages, a lack of integrated and consistent approaches to care, systemic inequalities and inequities, and ableism. To promote health equity as the pandemic continues and in the wake of recovery from the pandemic, people with disabilities must be consulted about their unmet needs, and their barriers to medical care need to be removed. The health and lives of people with disabilities are at stake” (Friedman & VanPuymbrouck, 2023, p. 10).
This article is a summary of the following journal manuscript: Friedman, C. & VanPuymbrouck, L. (2023). People with disabilities’ access to medical care during the COVID-19 pandemic. Social Work in Public Health. https://doi.org/10.1080/19371918.2023.2288352