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. 2020 Sep 11;69(36):1250–1257. doi: 10.15585/mmwr.mm6936a4

TABLE 1. Estimated prevalence of delay or avoidance of medical care because of concerns related to COVID-19, by type of care and respondent characteristics — United States, June 30, 2020.

Characteristic No. (%) Type of medical care delayed or avoided*
Urgent or emergency
Routine
Any
% P-value§ % P-value§ % P-value§
All respondents
4,975 (100)
12.0

31.5

40.9

Gender
Female
2,528 (50.8)
11.7
0.598
35.8
<0.001
44.9
<0.001
Male
2,447 (49.2)
12.3
27.0
36.7
Age group, yrs
18–24
650 (13.1)
30.9
<0.001
29.6
0.072
57.2
<0.001
25–44
1,740 (35.0)
14.9
34.2
44.8
45–64
1,727 (34.7)
5.7
30.0
34.5
≥65
858 (17.3)
4.4
30.3
33.5
Race/Ethnicity
White, non-Hispanic
3,168 (63.7)
6.7
<0.001
30.9
0.020
36.2
<0.001
Black, non-Hispanic
607 (12.2)
23.3
29.7
48.1
Asian, non-Hispanic
238 (4.8)
8.6
31.3
37.7
Other race or multiple races, non-Hispanic
150 (3.0)
15.5
23.9
37.3
Hispanic, any race or races
813 (16.3)
24.6
36.4
55.5
Disability**
Yes
1,108 (22.3)
22.8
<0.001
42.9
<0.001
60.3
<0.001
No
3,867 (77.7)
8.9
28.2
35.3
Underlying medical condition††
No
2,537 (51.0)
8.2
<0.001
27.9
<0.001
34.7
<0.001
One
1,328 (26.7)
10.4
33.0
41.2
Two or more
1,110 (22.3)
22.7
37.7
54.7
2019 household income, USD
<25,000
665 (13.4)
13.9
0.416
31.2
0.554
42.8
0.454
25,000–49,999
1,038 (20.9)
11.1
30.9
38.6
50,000–99,999
1,720 (34.6)
12.5
30.5
41.1
≥100,000
1,552 (31.2)
11.2
33.0
41.4
Education
Less than high school diploma
65 (1.3)
15.6
0.442
24.7
0.019
37.9
0.170
High school diploma
833 (16.7)
12.3
28.1
38.1
Some college
1,302 (26.2)
13.6
29.7
40.3
Bachelor's degree
1,755 (35.3)
11.2
34.8
43.6
Professional degree
1,020 (20.5)
10.9
31.2
39.5
Employment status
Employed
3,049 (61.3)
14.6
<0.001
31.5
0.407
43.3
<0.001
Unemployed
630 (12.7)
8.7
34.4
39.5
Retired
1,129 (22.7)
5.3
29.9
33.8
Student
166 (3.3)
22.7
30.5
50.3
Essential worker status§§
Essential worker
1,707 (34.3)
19.5
<0.001
32.4
0.293
48.0
<0.001
Nonessential worker
1,342 (27.0)
8.4
30.3
37.3
Unpaid caregiver status¶¶
Unpaid caregiver for adults
1,344 (27.0)
29.8
<0.001
41.0
<0.001
64.3
<0.001
Not unpaid caregiver for adults
3,631 (73.0)
5.4
27.9
32.2
U.S. Census region***
Northeast
1,122 (22.6)
11.0
0.008
33.9
0.203
42.5
0.460
Midwest
936 (18.8)
8.5
32.0
38.7
South
1,736 (34.9)
13.9
29.6
40.7
West
1,181 (23.7)
13.0
31.5
41.5
Rural/Urban classification†††
Urban
4,411 (88.7)
12.3
0.103
31.5
0.763
41.2
0.216
Rural
564 (11.3)
9.4
30.9
38.2
Health insurance status
Yes
4,577 (92.0)
12.4
0.036
32.6
<0.001
42.3
<0.001
No
398 (8.0)
7.8
18.4
24.8
Know someone with positive test results for SARS-CoV-2§§§
Yes
989 (19.9)
8.8
0.004
40.7
<0.001
46.6
<0.001
No
3,986 (80.1)
12.8
29.2
39.5
Knew someone who died from COVID-19
Yes
364 (7.3)
10.1
0.348
41.4
<0.001
46.3
0.048
No
4,611 (92.7)
12.2
30.7
40.5
Believed to be in group at high risk for severe COVID-19
Yes
981 (19.7)
10.0
0.050 42.5
<0.001 49.4
<0.001
No 3,994 (80.3) 12.5 28.8 38.8

Abbreviations: CI = confidence interval; COVID-19 = coronavirus disease 2019; USD = U.S. dollars.

* The types of medical care avoidance are not mutually exclusive; respondents had the option to indicate that they had delayed or avoided more than one type of medical care (i.e., routine medical care and urgent/emergency medical care).

Statistical raking and weight trimming were employed to improve the cross-sectional June cohort representativeness of the U.S. population by gender, age, and race/ethnicity according to the 2010 U.S. Census.

§ The Rao-Scott adjusted Pearson chi-squared test was used to test for differences in observed and expected frequencies among groups by characteristic for avoidance of each type of medical care (e.g., whether avoidance of routine medical care differs significantly by gender). Statistical significance was evaluated at a threshold of α = 0.05.

“Other” race includes American Indian or Alaska Native, Native Hawaiian or Pacific Islander, or Other.

** Persons who had a disability were defined as such based on a qualifying response to either one of two questions: “Are you limited in any way in any activities because of physical, mental, or emotional condition?” and “Do you have any health conditions that require you to use special equipment, such as a cane, wheelchair, special bed, or special telephone?” https://www.cdc.gov/brfss/questionnaires/pdf-ques/2015-brfss-questionnaire-12-29-14.pdf.

†† Selected underlying medical conditions known to increase the risk for severe COVID-19 included in this analysis were obesity, diabetes, high blood pressure, cardiovascular disease, and any type of cancer. Obesity is defined as body mass index ≥30 kg/m2 and was calculated from self-reported height and weight (https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html). The remaining conditions were assessed using the question “Have you ever been diagnosed with any of the following conditions?” with response options of 1) “Never”; 2) “Yes, I have in the past, but don’t have it now”; 3) “Yes I have, but I do not regularly take medications or receive treatment”; and 4) “Yes I have, and I am regularly taking medications or receiving treatment.” Respondents who answered that they have been diagnosed and chose either response 3 or 4 were considered as having the specified medical condition.

§§ Essential worker status was self-reported.

¶¶ Unpaid caregiver status was self-reported. Unpaid caregivers for adults were defined as having provided unpaid care to a relative or friend aged ≥18 years at any time in the last 3 months. Examples provided to survey respondents included helping with personal needs, household chores, health care tasks, managing a person’s finances, taking them to a doctor’s appointment, arranging for outside services, and visiting regularly to see how they are doing.

*** Region classification was determined by using the U.S. Census Bureau’s Census Regions and Divisions. https://www2.census.gov/geo/pdfs/maps-data/maps/reference/us_regdiv.pdf.

††† Rural-urban classification was determined by using self-reported ZIP codes according to the Federal Office of Rural Health Policy definition of rurality. https://www.hrsa.gov/rural-health/about-us/definition/datafiles.html.

§§§ For this question, respondents were asked to select the following statement, if applicable: “I know someone who has tested positive for COVID-19.”