Impact of the First Year of the COVID-19 on Unmet Healthcare Need among New York City Adults: a Universal Healthcare Experiment

Abstract

We examined the impact of the rst year of the COVID-19 pandemic on unmet healthcare need among New Yorkers and potential differences by race/ethnicity and health insurance. Data from the Community Health Survey, collected in 2018, 2019, and 2020, were merged to compare unmet healthcare need within the past 12 months during the pandemic versus the two years before the pandemic. Simple and multivariable logistic regression models evaluated change in unmet healthcare need overall. We assessed whether race/ethnicity or health insurance status modi ed the association. Overall, 12% of New Yorkers (N = 27,660) experienced unmet healthcare during the three-year period. In univariate and multivariate models, the rst year of the pandemic was not associated with change in unmet healthcare need (OR = 1.04, p = 0.548; OR = 1.03, p = 0.699, respectively). No interaction between the rst year of the pandemic and race/ethnicity (p-values range: 0.081-0.893) but there was signi cant interaction with health insurance status (interaction P = 0.009). Stratifying on health insurance status, those uninsured had borderline signi cant lower odds of unmet healthcare need during 2020 compared to the two years prior (OR = 0.72, p = 0.051) while those with insurance had a slight increase that was not signi cant (OR = 1.12, p = 0.143). Unmet healthcare need among New Yorkers during the rst year of the pandemic did not differ signi cantly from the two years prior. Federal pandemic relief funding, which offered no-cost COVID-19 testing and care to all, irrespective of health insurance or legal status, may have helped equalized access to healthcare.