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Women's Health USA 2013 An illustrated collection of current and historical data, published annually.

Barriers to Care and Unmet Need for Care

Narrative

Barriers to receiving needed health care can include cost, language or knowledge barriers, and structural or logistical factors, such as long waiting times and not having transportation.1 Barriers to care contribute to socioeconomic, racial/ethnic, and geographic differences in health care utilization and health status.

In 2011, 11.4 percent or 26.4 million adults reported that they delayed getting medical care in the past year due to various logistical or structural factors, such as not being able to get an appointment soon enough and inconvenient office hours (data not shown in graph images or in data tables on this site). Women were more likely than men to report having delayed care due to logistical barriers in the past year (13.5 versus 9.3 percent, respectively). For both men and women, those with lower household incomes were more likely to report having delayed care as a result of logistical factors. For example, nearly 1 in 5 women (18.6 percent) living in households with income below 100 percent of poverty reported having delayed care, compared to about 12 percent of women in households with incomes of 200 percent or more of poverty. Hispanic and non-Hispanic American Indian/Alaskan Native women were more likely than non-Hispanic White, non-Hispanic Black, and non-Hispanic Asian women to report having delayed care due to logistical barriers (17.9 and 23.7 percent versus 12.4, 14.0, and 12.4 percent, respectively; data not shown in graph images or in data tables on this site).

Women were also slightly more likely than men to have forgone needed health care due to cost (8.7 versus 7.4 percent, respectively). For both women and men, the proportion who did not get needed care due to cost varied by insurance status. Among women, more than 1 in 4 (28.2 percent) of those without health insurance experienced an unmet need for health care due to cost compared to 3.9 percent of women with private insurance and 8.8 percent with public insurance. The Affordable Care Act helps to remove financial barriers to care by expanding Medicaid eligibility for more low-income people, establishing health insurance marketplaces where many individuals and small businesses will qualify for financial assistance with health insurance, and requiring private plans to cover preventive services without copays.2

1 Carrillo JE, Carrillo VA, Perez HR, Salas-Lopez D, Natale-Pereira A, Byron AT. Defining and targeting health care access barriers. Journal of Health Care for the Poor and Underserved. 2011;22(2):562-75.

2 Kaiser Family Foundation link leaves hrsa.gov site. Health Reform: Implications for Women’s Access to Coverage and Care. August 29, 2013.  Accessed 09/04/13.

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Graphs

Data

Adults Aged 18 and Older Who Delayed Care Due to Logistical Barriers* in Past Year, by Poverty Level** and Sex, 2011
Poverty Level Percent of Women, Female Percent of Women, Male
*Reported that they delayed getting medical care in the past year due to any of five reasons: couldn’t get through on phone, couldn’t get appointment soon enough, office room wait too long, inconvenient office hours, no transportation; all estimates are age-adjusted.
**Poverty level, defined by the U.S. Census Bureau, was $23,021 for a family of four in 2011. Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 2011. Analysis conducted by the Maternal and Child Health Bureau.
Less than 100% of Poverty 18.6 13.7
100-199% of Poverty 14.8 11.7
200-399% of Poverty 12.4 8.5
400% of Poverty or More 11.6 7.6
Total 13.5 9.3
Adults Aged 18 and Older with Unmet Need for Health Care* Due to Cost, by Health Insurance Coverage and Sex, 2011
Health Insurance Coverage Percent of Adults, Female Percent of Adults, Male
*Reported that they needed but did not get medical care because they could not afford it; excludes dental care; all estimates are age-adjusted.
Source: Centers for Disease Control and Prevention, National Center for Health Statistics, National Health Interview Survey, 2011. Analysis conducted by the Maternal and Child Health Bureau.
Private Insurance 3.9 2.7
Public Insurance 8.8 7.8
Uninsured 28.2 23.3
Total 8.7 7.4