Investigating Health Care Hesitancy During the COVID-19 Public Health Emergency

Throughout the coronavirus pandemic, rates for routine preventive care and chronic condition monitoring have dropped as efforts have increased to limit exposure and spread of the COVID-19 virus. After a period of closure, medical and dental care facilities are now open for visits, with protocols in place to limit transmission risk.

Although telemedicine use has increased, healthcare providers cannot adequately use it to monitor patients with chronic conditions; in addition, telemedicine cannot replace routine screening, immunizations, and other care provided in person. Without diagnostic tests, procedures, and in-person visits, it is likely that there will be a delay in diagnosis of cardiac events, cancerous polyps and tumors, and other medical issues. Furthermore, adults and children could miss routine or preventive care, such as vaccines, mammograms, and well child visits. Patients with chronic conditions who defer a visit may experience a flare-up of their illness.

The negative impact of deferred care will most greatly impact populations that are already underserved by the U.S. health care system: Blacks, Hispanics, individuals in rural areas, and lower income/uninsured individuals. This reduction in the use of primary care may exacerbate profound inequities.

The Study

Through administration of a national survey, researchers at AIR seek to understand and assess changes in individuals’ usage of medical and dental services before and after the public health emergency. We will explore factors that influence individuals’ willingness to seek routine monitoring or preventive care and closely examine underserved populations’ willingness to seek health care. In addition to collecting information about the individuals who complete the survey, we will collect information on the pandemic’s impact on seeking health care for children and adults under these individuals’ care. We will analyze the survey data with a focus on various subgroups such as race/ethnicity, individuals with elevated risk of suffering severe illness due to COVID-19, individuals who have lost their jobs during the public health emergency, and individuals who care for children and adults. 

In the longer term, we aim to understand the implications of hesitancy to seek routine care and will use these implications to inform the efforts of healthcare providers and dentists to reassure and encourage patients to seek in-person care.