COVID-19 taking a heavier toll on low-income individuals in U.S. than other countries
Half of U.S. adults with lower income skip needed care because of costs.
COVID-19 is having a greater health and economic impact on low-income Americans than on their counterparts in other wealthy nations.
The 2020 Commonwealth Fund International Health Policy Survey compared the health experiences of adults with lower income and income-related disparities across 11 countries: Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, the United Kingdom and the United States. Among the key findings:
Adults with lower income in the United States are sicker and most likely to struggle to make ends meet. Across every measure the study looked at, people with lower income in the United States suffered more than in other countries:
- More than one-third of U.S. adults with lower income have two or more chronic conditions, significantly more than in other countries.
- Approximately one-third of adults with lower income in the United States, Australia and Canada reported having anxiety or depression, the highest rates in the survey. Their counterparts in Germany and Switzerland were the least likely to report these conditions.
- More than one-quarter of U.S. adults with lower income said that, in the past year, they worried about being able to afford basic necessities such as food or housing, a significantly greater proportion than seen in other countries, where 6% to 22% reported this.
Half of U.S. adults with lower income skip needed care because of costs. Fifty percent reported skipping doctor visits, recommended tests, treatments, follow-up care or prescription medications in the past year because of the cost. In contrast, just 12% to 15% of adults with lower income in Germany, the U.K., Norway and France reported this. Difficulty with paying medical bills is mostly a U.S. phenomenon: 36% of U.S. adults with low incomes reported this problem. That is significantly more than in all other countries, where rates ranged from 7% to 16%.
Adults with lower income in the United States have worse access to primary care. A regular source of care is crucial to long-term health. It also is central to COVID-19 recovery, because people who become ill will need reliable access to treatment. Access to primary care also facilitates access to vaccines when they are available. In most countries, nearly all adults with lower income reported having a regular doctor or place of care. However, rates in the United States, Canada and Sweden ranged from 85% to 89%.
“What’s clear from this study is that we cannot continue on the path of deepening inequality,” said David Blumenthal, M.D., president of the Commonwealth Fund. “As we progress through the darkest days of COVID-19 in the United States, people need access to affordable health care now more than ever. The new administration and Congress have an opportunity to apply the stark lessons learned from COVID-19 and over the last decade so that our health system works for everyone, no matter who they are or where they get care.”
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