The responses show a concerning portion of adults, particularly young adults, have put off getting necessary health care due to social risk factors.
An “alarmingly high” number of adults are delaying their needed medical care due to barriers related to social determinants of health (SDoH), according to new research from Engagys, a health care consumer engagement consulting and research firm.
For the 2023 SDoH Consumer Survey, Engagys surveyed 570 adults ages 18 and older in May on topics including the ability to access care, behavioral health (in terms of isolation), transportation challenges, and discrimination.
“Older adults are doing far better than younger adults,” said Kathleen Ellmore, cofounder and managing partner at Engagys, in a statement. “Young people don’t have as much experience as health care consumers, and because they often lack health care knowledge, they may also lack confidence in navigating the health care system.”
Key survey findings include:
A significant number of consumers are delaying care
- More than a third of survey participants (43 percent) agreed or strongly agreed that they delayed care or did not receive needed medical care in the last 12 months.
- Adults ages 30-44 were most likely to report delaying or not receiving medical care.
- Engagys attributes the high rates of delayed care among this age demographic to two factors:
- U.S. families are having children later in life into their early 30s and 40s
- Families are busy raising children, and it is expensive
- Thirty-five percent of older adults ages 60 and older said they delayed care or did not receive medical care.
Social isolation is a persistent barrier
- More than a third of Americans (37.7 percent) said they feel lonely or isolated.
- Adults ages 30-44 (42 percent) were most likely to report loneliness or isolation, compared to those ages 60 and older (32 percent).
- Rates of loneliness and isolation were also very common among adults with a disability, with almost half (46 percent) reporting loneliness.
A lack of reliable transportation is a main factor
- Over 20 percent of survey participants lack reliable transportation.
- Adults with household incomes under $25,000 (28 percent) are nearly twice as likely to report issues with transportation compared to adults with incomes greater than $75,000 (15 percent).
- Hispanic adults (37 percent) are twice as likely to report a lack of transportation compared to non-Hispanic adults (16 percent).
- Older adults are three to four times less likely to report issues with transportation compared to other age groups, regardless of income.
Ethnicity and education impact discrimination
- Asian adults (21.1 percent) and Black or African American adults (20.5 percent) were twice as likely to agree that they experienced discrimination compared to white adults (10.7 percent).
- Adults without any college education (28 percent) were more likely to report feeling discriminated against compared to those with college or graduate degrees (18 percent).
Health confidence varies by age
- Most participants (69.1 percent) said they agree or strongly agree that they were able to ask their health care providers questions about their health.
- Adults over age 45 were 29 percent more likely to feel they were able to get their questions answered.
- When it comes to managing their care among different providers and services, 60 percent of participants ages 18-29 said they were able to get the help they needed to manage the different services from their personal doctor’s office; however, the rate of confidence significantly increased among adults ages 60 and older (83 percent).
- As for their confidence in their ability to take care of themselves, more adults aged 60 and older (89 percent) had confidence in their ability than adults aged 18-29 (64 percent).
“It appears that as consumers age through the health care system, they gain knowledge, expertise, and confidence within that system,” wrote researchers. The Engagys team recommended health plans work harder to engage their members and encourage them to seek preventive care. “Patients who understand their options earlier and have more convenient access to health care have a better chance of paying their bills and getting the care they need sooner.”