INTRODUCTION
At the onset of the COVID-19 pandemic, Columbia University, with support from Robin Hood and The Leona M. and Harry B. Helmsley Charitable Trust, began collecting data on healthcare access and utilization across New York City via the Poverty Tracker (see text box). The objective was to better understand the healthcare needs of New Yorkers and the difficulties they faced in meeting those needs. As the pandemic strained healthcare systems nationwide, Poverty Track- er data offered a unique opportunity to understand changes in access and utilization at the lo- cal level. The data revealed two patterns: first, New Yorkers experiencing poverty or material hardship had a greater need for healthcare due to chronic or work-limiting health conditions. Second, those who had a greater need for care were more likely to delay (and in many cases, entirely forgo) such care, and this was especially true of New Yorkers facing poverty or material hardship. 1 As the pandemic has waned in intensity over time, questions about its lingering effects on access to health- care continue to be raised, especially among vulnerable populations. Since 2020, the Poverty Tracker has collected data on healthcare use and access that allow us to explore how disparities in healthcare outcomes have evolved over the course of the pandemic. This pair of briefs follow up on the healthcare experiences of New Yorkers with high healthcare needs since the onset of the COVID-19 pandemic. We explore changes in core measures of healthcare access during the pandemic and how these measures have varied among New Yorkers with different economic backgrounds. In this brief, we focus specifically on changes in delayed and forgone care among New Yorkers with high healthcare needs, their reasons for doing so, and the role affordability plays in shaping their access to care. Instances of delayed care are just one example of the disruptions the pandemic imposed on healthcare ac- cess and utilization. 2 Understanding changes in the experience and drivers of delaying or forgoing care over the course of the pandemic, is critical to improving healthcare access for New Yorkers of various economic backgrounds, especially those with high healthcare needs.
1 Maury et al., “Health and healthcare in New York City: second report.” 2 Czeisler et al., “Delay or avoidance of medical care because of COVID-19–related concerns — United States, June 2020.”
PATTERNS OF DELAYED HEALTHCARE AMONG NEW YORKERS WITH HIGH HEALTHCARE NEED 2
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