Welcome to Survey Spotlights a new feature of the Bridge to Health Survey, providing a focused summary of the survey results from a new perspective.
Kicking off the series is a focus on access to care, the ability to utilize quality health care services at the time care is needed. Even though the number of uninsured Americans is at an historic low, recent data suggests that a growing number of individuals are unable to access needed health care due to limitations of their insurance coverage.
In addition to coverage constraints, access to care disparities are recognized to a growing extent across a range of societal dimensions including race, sexual identity, and socioeconomic status, among others. New data underscores difficulties accessing care for people of color, compounded by the current challenges of continuing pandemic concerns, high inflation, and political unrest.
To understand how these issues are impacting people in our region, we took a closer look at the 2020 Bridge to Health Survey responses (adults 18+ years of age) to questions that captured frequency and reasons for delaying or not seeking medical, mental health, and dental care. Because there was little change in frequency of delayed care from 2015 to 2020, we stratified the 2020 responses by insurance type and race group to provide another perspective.
There are clear differences by both insurance type and race group. Black, indigenous, and people of color (BIPOC) and individuals enrolled in low income health insurance programs had higher frequencies of delayed care seeking for medical, mental health, and dental care.
The COVID-19 pandemic universally ranked as the top reason for delaying care, but other top reasons differed by both insurance type and race group in most cases. The survey was administered nine months into the pandemic's identification in the U.S.
Please read on for a graphical summary of the data. All content is based on the 2020 Bridge to Health Survey regional responses to questions regarding delaying or not seeking health care in the past 12 months. More than one choice could be selected for reason for delaying care. Category definitions are provided at the end. Click on graphics for an enlarged version.
INSURANCE TYPE
Respondents enrolled in Medical Assistance or Other Public programs were more likely to delay medical care.
Top reasons varied by insurance type. Cost was selected more frequently by respondents with private coverage, and anxiety and disrespect were selected more frequently by those on Medical Assistance and Other Public programs.
RACE
Respondents identifying as BIPOC or multi-race were more likely to delay medical care.
Cost was a top reason for delay for respondents in both race groups. Anxiety, disrespect, and the pandemic were selected more frequently by BIPOC or multi-race respondents.
INSURANCE TYPE
Respondents enrolled in Medical Assistance were more likely to delay mental health care.
Top reasons were similar across insurance types. However, cost was selected somewhat more frequently by those with private coverage, and trouble getting an appointment was selected more frequently by respondents on Medical Assistance and Other Public programs. Not knowing where to go was selected more frequently overall for mental health compared to medical or dental care.
RACE
Respondents identifying as BIPOC or multi-race were more likely to delay mental health care.
Top reasons were similar across race groups. However, anxiety, not knowing where to go, and the pandemic were selected more frequently by BIPOC or multi-race respondents.
INSURANCE TYPE
Respondents enrolled in Medical Assistance or Other Public programs were more likely to delay dental
care.
Cost and lack of insurance coverage were top reasons for all insurance type holders. Denial of insurance type by dentist, issues finding service in the area, and transportation barriers were selected much more frequently by respondents on Medical Assistance and Other Public programs.
RACE
Respondents identifying as BIPOC or multi-race were more likely to delay dental care.
Cost and lack of insurance coverage were top reasons for both race groups. Denial of insurance type by dentist and issues finding service in the area were selected more frequently by BIPOC or multi-race respondents.
DEFINITIONS
The 2020 Bridge to Health Survey was designed to gather population-based health data on adult residents in eight counties of Northeastern Minnesota (Aitkin, Cook, Carlton, Itasca, Koochiching, Lake, Pine, and St. Louis) and Douglas County, Wisconsin.
Insurance type is based on current health coverage type selected by respondents, with more than one choice allowed. "Private" includes employer-sponsored plans and coverage outside of the workplace purchased on the private health insurance market. "Medical Assistance" includes government-sponsored low income programs: Medicaid, Minnesota Medical Assistance, and Prepaid Medical Assistance Program. "Other Public" includes other government-sponsored programs such as Indian or Tribal Health Service, MinnesotaCare, BadgerCare, and CHAMPUS/TRICARE/Veteran's benefits.
For race groups, "White" includes respondents who selected "White" only, and "BIPOC or Multi-race" includes respondents who selected a race category other than or in addition to "White".
