Marianne Goodland, Colorado Politics

The biennial Colorado Health Access Survey, released Wednesday by the Colorado Health Institute, indicated that COVID-19 caused “historic shifts in health, access to care, and social and economic conditions.”

More Coloradans than ever reported mental health challenges, and that was especially true of young adults.

“Fewer people went to the doctor,” the report accompanying the survey continued. “Many Coloradans lost their job-based insurance, and more than a million had their incomes reduced. People of color were especially hard hit.”

There was, however, some bright spots. According to the survey, quick shifts in policy at the state and federal level, as well as cash assistance, may have helped people who lost health insurance remain insured and helped others avoid eviction.

Pollsters said Medicaid stepped in to cover people who lost their jobs.

“Statewide rates of hunger and housing insecurity did not increase. Fewer people used health care, but providers and regulators created telemedicine systems almost overnight to compensate for a substantial portion of missed care,” according to the report, “Navigating Uncharted Waters: The Pandemic, Health Coverage, and Care in Colorado.”

The National Opinion Research Center (NORC) at the University of Chicago conducted the online survey of more than 10,000 households between Feb. 1 and June 7.

According to the report, NORC oversampled rural regions, people of Hispanic/Latino ethnicity, people of Black or African American race, adults ages 18 to 29, people without insurance and households with children. To obtain respondents, NORC sent letters to randomly selected households throughout Colorado asking them to participate in the survey and directing them to a website or toll-free number to call. All responses to the survey are self-reported and anonymous; the survey was conducted in both English and Spanish.

The margin of error for the survey varies by question, because the answer to a question may trigger a new question. The confidence interval is described as being at 95%.

New in this year’s biennial survey: questions on economic and social impacts of the pandemic and experiences with telemedicine.

Michele Lueck, president and CEO of the Colorado Health Institute, said, “Colorado’s existing social safety net, along with some quick policy choices and grassroots work, helped catch many respondents when they fell. The pandemic also worsened existing inequities and created a mental health crisis that our communities will need to be diligent in addressing.”

One of the catches by the safety net Lueck described: Coloradans who lost jobs, and the health insurance that went with it, turned to public programs such as Medicaid. That kept the state’s uninsured rate at 6.6%, the same rate since 2015.

Policy interventions have included cash assistance, such as individual stimulus payments, more unemployment benefits from the state and federal government, as well as rent assistance provided by the state.

Gov. Jared Polis banned evictions then extended it several times. Those supplemented community efforts to ensure statewide rates of housing insecurity and hunger did not increase, despite the recession, according to CHI.

The survey indicated 5.6% of the state’s residents face housing insecurity, and the survey cites 8.1% with food insecurity. Communities of color had rates of food and housing insecurity higher than those for white Coloradans.

“While the results of the survey show that the state has much to be proud of, the fact that the pandemic was harder on communities already facing inequities demonstrates that we still have much more work to do to ensure the health of all Coloradans,” said Jeff Bontrager, a director at CHI and principal investigator for the survey.

Other findings include:

  • Mental health: More than 1 in 3 respondents ages 16 and older said their mental health was negatively affected by COVID-19, including more than half of young adults. Nearly 1 in 4 respondents ages 5 and older (23.7%) had eight or more days of poor mental health in the past month. The CHI said the percentage of respondents claiming their mental health was poor set a record in the 12-year history of the survey.
  • Coronavirus impacts: The pandemic’s impact extended well beyond infection rates, touching on employment, finances and child care. Almost 3 in 10 people ages 16 and older (29.3%) told survey-takers that losing hours or income, as 17.2% struggled to afford basic necessities. These issues were even more pronounced among Hispanic/Latino and Black or African American respondents, who were also hit especially hard by the virus.
  • Telehealth: More than a third of respondents (35.9%) said they used telemedicine at some point in the prior year, including nearly half (48.7%) of people enrolled in Medicare, a group that includes mostly older adults. Most respondents who used telemedicine had a positive experience: 79.5% said it was as good or better than being seen in person. Telemedicine also may have helped address the mental health issues raised by the survey, which indicated that use of mental health care services actually increased, “likely due to growing demand during isolation and the relative ease of delivering many mental health services via telemedicine.”
  • Missed care: Reductions in nonessential procedures and concerns about exposure to the coronavirus led to an overall decrease in health care use between 2019 and 2021. Just 16.3% of those surveyed reported they used the emergency room, the lowest rate in the survey’s history.
  • Dental issues: Two-thirds of respondents (67.1%) reported seeing a dentist or dental hygienist in the past year, down from 73.6% in 2019.

The survey also was broken down into regional findings.

For El Paso County: more than a third of respondents said they experienced declines in mental health and had either reduced work hours or income during the pandemic. The survey reported 38.8% of respondents were categorized as essential workers. The percentage of uninsured respondents dropped from 5.6%  in 2019 to 5.2%, the survey reported.

More than 49% of Denver respondents reported a decline in mental health during the pandemic, with one-third classified as essential workers. About one-third of respondents said they lost hours or income during the pandemic. The percentage of uninsured respondents increased, from 6.1% in 2019 to 7.5%, according to the survey.

The Colorado Consumer Health Initiative’s Adam Fox, in a statement Wednesday, said, “While the Colorado Health Access Survey shows the many negative effects of the pandemic on the health of Coloradans, especially for people of color and young adults, there is also some good news. Colorado’s overall number of uninsured stayed almost stable despite the pandemic, and the state is seeing a decrease in surprise medical bills because of legislation the Colorado Consumer Health Initiative and other consumer advocates helped to pass.”

Fox called on state and federal officials to address the inequities cited in the survey.

“Our elected officials in D.C. need to listen to the voters and address ballooning prescription drug prices, and the state’s implementation of the Colorado Option must move forward to bring more affordable and equitable health insurance plans to Colorado families and small businesses starting in 2023,” Fox said. “If we are going to achieve health equity, we also need to invest more to ensure Coloradans don’t go hungry, have affordable housing and child care access, and ensure Coloradans can take care of their mental and oral health needs in addition to physical health.”

See the original article here.

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