Around a fifth of Americans said they had difficulty accessing care for serious illnesses during the pandemic, according to a new poll from NPR, the Robert Wood Johnson Foundation, and the Harvard T.H. Chan School of Public Health.

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Many Americans struggled to get care during the pandemic

For the poll, researchers surveyed 4,192 U.S. adults ages 18 and older between May 16 and June 13 to determine the impact of several problems, including access to care, during the pandemic.

Overall, researchers found that roughly a fifth of respondents who had a serious illness in their household in the past year said they had trouble accessing care during the pandemic. Similarly, 17% of respondents reported having difficulties affording medical care or prescriptions drugs.

According to Mary Findling, assistant director of the Harvard Opinion Research Program, this suggests that a "staggering" number of people could not access necessary care and "[f]rom a health and good care standpoint, that's just too high."

Although a lack of health insurance has historically been a significant barrier to accessing care, it was not the primary reason for delayed care among the poll's respondents. In fact, among those who were unable to access care for serious illnesses, over 80% reported having health insurance.

"One thing it tells us is that just the provision of more health care insurance is not going to plug some of these gaps and holes that we're seeing in terms of individuals getting more care," said Loren Saulsberry, a health policy researcher at the University of Chicago.

"There are broader issues at play here," Findling added.

In addition, these disruptions in care had a larger impact on some racial and ethnic groups than others. For example, 35% of Native American households and 24% of Black households had trouble accessing care for serious illness compared to 18% of white households. Black, Latino, and Native American patients were also more likely than white patients to report unfair treatment, disrespect, being turned away, or poor treatment.

"What's really sad is the racial gaps in health care between Black and White Americans has remained," Findling said. "And looking across a broad range of measures, it's better to be a White patient than a Black patient in America today. And when you just stop and think about that, that's horrible."

Health systems are struggling to get routine care back on track

During the pandemic, routine care, including preventive services, early detection procedures, and elective procedures, became lower priorities for many hospitals as they focused on caring for Covid-19 patients. Overall, this led to significant delays and disruptions in care for many people.

"Over the last two years we estimate about 6 million women, for example, have missed routine cancer screening," said Arif Kamal, chief patient officer at the American Cancer Society. These missed screenings included mammograms for breast cancer and Pap smears for cervical cancer.

According to Kamal, these missed screenings may cause providers to detect cancers at later stages, which will make them harder to treat or cure.

In addition, many hospitals are still struggling to treat patients with serious illnesses who require lengthy stays or may be unable to transfer patients to other facilities due to Covid-19 outbreaks. "We can't get people out of the hospitals right now," said Cassie Sauer, CEO of the Washington State Hospital Association. "There's no back door, but the front door is wide open to the emergency room."

Because many hospitals are still overwhelmed with patients, many people have been unable to schedule regular procedures, including knee and heart valve replacements and cancer treatments. According to Sauer, these procedures are typically considered "elective," but postponing them can significantly impact a patient's health and quality of life.

"You have a chance of falling, you are probably going to gain weight," Sauer said. "You're going to lose flexibility. You know, all those things contribute to a potential decline, cardiac issues, respiratory issues."

"I think that the toll of this delayed care is tremendous," she added. (Chatterjee, "Shots," NPR, 8/8; NPR-RWJF-Harvard poll, accessed 8/9)