I was curious about how COVID-19 may have impacted everyone's health care-seeking behavior, and used my STATA data analysis course to explore that question. My paper was ~15 pages and had some analytic weaknesses, but I think the points about race and pandemic narrative hold up. Below are excerpts from the paper. Please comment with your thoughts and if you think this is worth writing more about! Thank you!
Abstract
Shortly after it was announced as a global pandemic, healthcare facilities began to turn patients away, delaying elective procedures and reducing capacity to protect healthy people from exposure. Patients responded by reducing their interactions with health care facilities of all kinds. This discouraging effect on health-seeking behavior may affect different racial groups at variable rates. I used a sample of data from the Census Household Pulse Survey from July-August, 2020, to test the question if there are significant differences in how patients of different races seek health care services, and what other factors impact those decisions.
I expect that mediating variables- health insurance status and economic hardship- are significant contributors to all. Results showed significant relationship between economic hardship during the pandemic and its impact on care-seeking behavior for all race groups, and very minor impact from health insurance type on how people seek and find health care. These results could help providers, institutions and health educators understand the complex decision-making that patients are managing. This study could potentially add perspective to COVID relief policy and health communications campaigns to make a case for the ongoing evolution of our health care services, past the pandemic.
Background and Overview
All U.S. adults have been affected, in some manner, by the coronavirus pandemic. The demographic variable of interest is race and ethnicity. Race and ethnicity are usually predictors in the potential mediating variables, health insurance status and economic hardship. White people are significantly more likely to be enrolled in private insurance, to be more financially secure and food secure than non-White people (before and during the pandemic). The increase in job loss, and potential insurance loss in 2020 impact peoples’ access to needed health care services.
Data for this study comes from the Census Household Pulse Survey. The Census Household Pulse Survey is a publicly available, nationally representative survey of the United States non-institutionalized adult population. The Household Pulse Survey was designed in collaboration with the USDA Economic Research Service (ERS); the Bureau of Labor Statistics (BLS); the National Center for Health Statistics (NCHS); the National Center for Education Statistics (NCES); the Department of Housing and Urban Development (HUD); the Social Security Administration (SSA); and the Bureau of Transportation Statistics (BTS). It was created to collect data on the American public’s desires for, uses of, and access to health-related information and to inform officials and policymakers about communities and individuals across the United States impacted by the pandemic.
The Household Pulse Survey measures household experiences during the coronavirus pandemic. It is a nationally representative survey created in collaboration with multiple federal agencies to disseminate near real-time information contributing to federal and state response to recovery planning.
Conclusion
The impact of the COVID-19 pandemic is becoming more clear with time. I was initially curious about the impact of the pandemic influenced closures of many healthcare facilities across the country. Some shut their doors temporarily to all, but the majority of them tempered outpatient and non-urgent appointments to reduce the potential viral load and manage risk of their staff and authorized visitors. Interruptions in care could cause a negative downstream effect on general healthcare utilization. As patients received notice of canceled appointments, I thought that some may face so many barriers in the pandemic that they may not reschedule.
This data suggests that peoples’ engagement with their healthcare providers was significantly suppressed by economic hardship. Black, Other & Mixed, and Hispanic-Latinx populations already experienced inequitable access to quality care before the pandemic. The serious life changes that we have experienced- job loss, inability to pay bills and eat- has caused some depression of healthcare-seeking behavior. The data collection and policymaking within the pandemic is a rich ground for natural experiments (Miguel et al., 2014). Understanding this critical health-economic link may be helpful in building the necessary responses to concurrent healthcare and economic crisis. Federal aid in the form of regular income replacement, the extension of food assistance programs, and housing assistance can lift the burden on people so they can invest their attention on positive healthcare-seeking behavior and decision-making.
Comments