More Than One in Four Non-elderly Women Delay or Forgo Medical Care Due to Costs

Large Percentages of Women Say Their Doctors Haven’t Talked About Diet, Exercise, Smoking, STDs, or HIV

Washington, D.C. – A new national survey of women on their health finds that a substantial percentage of women cannot afford to go to the doctor or get prescriptions filled. Although a majority of women are in good health and satisfied with their health care, many have health problems and do not get adequate levels of preventive care. For those who are sick, poor, or uninsured, the challenges are magnified. The Kaiser Family Foundation report, Women and Health Care: A National Profile, is based on a national survey of 2,766 women age 18 and older.

As health care costs grow, more than one-quarter of non-elderly women (27%) and two-thirds of uninsured women (67%) report they delayed or went without care they believed they needed in the past year because they could not afford it, compared to 24% and 59% respectively in 2001. Among women with private coverage, nearly one in five (17%) delayed or went without care. In addition, 20% of women ages 18 and older say they did not fill a prescription in the past year because of the cost.

“The growth in health care costs has become a central women’s health issue,” said Alina Salganicoff, Vice President and Director of Women’s Health Policy at the Kaiser Family Foundation. “A sizable share of women are falling through the cracks, either because they don’t have insurance or even with insurance can’t afford to pay for medical care or prescription drugs.”

Fewer than half of all women say they have talked to a health care professional in the past three years about smoking (33%), alcohol use (20%), and calcium intake (43%), while just over half have talked about diet, exercise, and nutrition (55%). Among women of reproductive age (18-44), fewer than one in three (31%) say that they have talked with their doctor about their sexual history and specific issues, such as STDs (28%) and HIV/AIDS (31%) in the past three years.

Mammography rates reported by women ages 40 to 64 have not improved, falling slightly from 73% in 2001 to 69% in 2004. Only 40% of uninsured women over 40 had a mammogram in the past year, compared to three-quarters of women with private coverage (74%) or Medicare (73%). Pap testing rates reported among women ages 18 to 64 also fell from 81% in 2001 to 76%. Only 38% of women 50 and older say they have had a colon cancer screening test in the past two years and 37% of women 45 and older say they received a test for osteoporosis in the past two years.

Additional key findings:

Prescription Drug Costs

• Women (56%) are more likely than men (42%) to use a prescription medicine on a regular basis, and are also more likely to report difficulties affording their medications.
• 41% of uninsured women say they did not fill a prescription due to costs, as do one in six women (17%) with private coverage and nearly one in five women with Medicaid (19%).
• One in seven (14%) women also report that they skipped or took smaller doses of their medicines in the past year to make them last longer.

Chronic Health Conditions and Mental Health 

• Nearly four in 10 women (38%), have a chronic condition, such as diabetes, asthma or hypertension that requires ongoing medical attention, compared to 30% of men. 
• One in four women (23%) reported they have been diagnosed with depression or anxiety, over twice the rate for men (11%).

Access and Quality of Care Among Women in Fair or Poor Health

• Over one-third (37%) of women in fair or poor health say that they delayed or went without medical care in the past year due to costs, and one-third (34%) did not fill a prescription because they couldn’t afford it.
• Nearly one-third (31%) of women in fair/poor health report concerns about the quality of care they received in the past year, compared to 18% of women in better health.

Women as Caregivers and Family Decision Makers

• One in 10 women (12%) care for a sick or aging relative. Among this group, forty percent are low-income, 46% have a chronic health condition of their own, and 29% provide more than 40 hours of care per week. One in five (20%) non-elderly caregivers are uninsured.
• Eight in 10 mothers/guardians say they have lead responsibility for choosing their children’s doctors (79%), taking them to appointments (84%), and ensuring they receive follow-up care (78%).

The report will be released at a briefing today in Washington, D.C. that includes a panel discussion among Alina Salganicoff, Ph.D. Vice President and Director of Women’s Health Policy at Kaiser and report co-author; Carolyn M. Clancy, MD, Director, Agency for Healthcare Research and Quality; Paula A. Johnson, MD, MPH, Executive Director, Connors Center for Women’s Health and Gender Biology, Brigham and Women’s Hospital, and, Susan Starr Sered, PhD, Co-author of Uninsured in America, Life and Death in the Land of Opportunity and Research Director, Religion and Health Initiative, Suffolk University, Boston, MA.

The Kaiser Family Foundation is a non-profit, private operating foundation dedicated to providing information and analysis on health care issues to policymakers, the media, the health care community, and the general public. The Foundation is not associated with Kaiser Permanente or Kaiser Industries.

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