Factors Associated With Health Care Delays Among Adults Over 50 During the COVID-19 Pandemic

Abstract

Background: Adults over 50 have high health care needs but also face high coronavirus disease 2019 (COVID-19)-related vulnerability. This may result in a reluctance to enter public spaces, including health care settings. Here, we examined factors associated with health care delays among adults over 50 early in the COVID-19 pandemic.

Methods: Using data from the 2020 wave of the Health and Retirement Study (N = 7 615), we evaluated how race/ethnicity, age, geographic region, and pandemic-related factors were associated with health care delays.

Results: In our sample, 3 in 10 participants who were interviewed from March 2020 to June 2021 reported delays in medical or dental care in the early stages of the COVID-19 pandemic. Non-Hispanic Whites (odds ratio [OR]: 1.37; 95% confidence interval [CI]: 1.19-1.58) and those of other racial/ethnic backgrounds (OR: 1.31; 95% CI: 1.02-1.67) delayed care more than Non-Hispanic Blacks. Other factors associated with delayed care included younger age, living in the Midwest or West, knowing someone diagnosed with or who died from COVID-19, and having high COVID-19-related concerns. There were no differences in care delays among adults aged > 70; however, among those ≤ 70, those who knew someone diagnosed with COVID-19 were more likely to delay care than those who did not. Additionally, among those ≤ 70, Non-Hispanic Whites and those of other racial/ethnic backgrounds delayed care more than Non-Hispanic Blacks and Hispanics.

Conclusions: There is considerable heterogeneity in care delays among older adults based on age, race/ethnicity, and pandemic-related factors. As the pandemic continues, future studies should examine whether these patterns persist.

Keywords: Age; Coronavirus; Geographical region; Health and Retirement Study; Health care delay; Race/Ethnicity.