CONCLUSION Over the course of the pandemic, high-need New Yorkers’ needs for healthcare changed, as did their ability to receive it. Despite their similar or even greater need throughout the pandemic, economically disadvan- taged New Yorkers were much less likely to receive the healthcare that they needed than their more-ad- vantaged counterparts. Specifically, economically disadvantaged New Yorkers were almost three times as likely to delay or forgo physical healthcare than more-advantaged New Yorkers in 2022—a wider gap in delayed or forgone care than in 2021. They were also more likely to delay or forgo mental healthcare than the more-advantaged in both 2021 and 2022. Although both groups saw modest growth in receipt of mental healthcare services over the course of the pandemic, mental healthcare remained generally less accessible than physical healthcare services for many high-need New Yorkers. Reasons for delaying care varied. The pandemic was a primary reason that high-need New Yorkers delayed healthcare and it became less of a barrier over time. However, the persisting economic disparities in delayed or forgone care point to the severity of other barriers to accessing healthcare that go beyond the temporary shock of the pandemic. Namely, affordability concerns—such as the high cost of care—contributed to high levels of delayed and forgone care, especially among the economically disadvantaged. Insurance coverage also appears to have declined among economically disadvantaged New Yorkers as the pandemic started receding, further exacerbating inequalities in the City among those struggling with healthcare needs. New York City, in many ways, remains a city divided between those with economic security and those struggling to get by. As the pandemic has waned, our results suggest that structural inequalities in access to and utili- zation of healthcare have unfortunately begun to re-emerge.
PATTERNS OF DELAYED HEALTHCARE AMONG NEW YORKERS WITH HIGH HEALTHCARE NEED 16
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