The Impact of Health Coverage, Race and Ethnicity on Utilization of Preventive Medical Care during the First Year of the Covid-19 Pandemic: Findings from the National Health Interview Survey 2019-2020.

Objectives: This study examined COVID-19's impact in the 2020 compared to 2019 survey years on preventive medical care utilization.

Research Design: Using a cross-sectional sample of adults aged 18 years and over (2019; n = 31,997; 2020; n = 31,568), from the National Health Interview Survey, multivariable models compared 2020 to 2019 survey years for receiving diabetes screening blood tests, well-care visits, and physical therapy. An additional multivariable model predicted not having medical care due to the COVID-19 pandemic in the 2020 2020 survey year.

Results: In the 2020 versus 2019 survey years, the likelihood lowered for receiving a blood test for diabetes screening (aOR .83 CI = .76, .90). There was a lowered likelihood for a well care visits (aOR = .98 CI = .84, 1.1) and physical therapy (aOR = .97 CI = .89, 1.0). Black (aOR = .62 CI = .51, .75), Hispanic (aOR = .62 CI = .51, .75) and Asian (aOR .67 CI = .53, .86) adults had a lowered likelihood of having physical therapy compared to White adults. Having no insurance coverage lowered the likelihood of getting all three indicators of preventive medical care. There was a higher likelihood of not getting medical care due to COVID-19 in the 2020 survey year (aOR = 1.7 CI = 1.3, 2.1) with Medicaid compared to private coverage.

Conclusions: Use of preventive medical care lowered in the pandemic. Race and ethnicity and not having any coverage contributed to not receiving preventive care. Medicaid appeared to increase utilization of preventive medical care but not acute medical care.