As the fourth year of the COVID-19 pandemic looms, a new study led by McMaster University researchers has found that one in four adults over age 50 experienced challenges accessing health-care services during the first year of the pandemic.

The study, published February 14 in CMAJ Open, analyzed data collected from nearly 24,000 middle-age and older adults participating in the Canadian Longitudinal Study of Aging (CLSA) to identify factors associated with unmet health care needs during the pandemic.

“Our study found that 25 per cent of adults in the CLSA faced challenges accessing health-care services during the first year of the pandemic and this differed by age, education, immigration status and region of the country,” said Laura Anderson, the study lead and an associate professor in the Department of Health Research Methods, Evidence, and Impact at McMaster.

“Even more concerning is that there were eight per cent of participants who reported that they did not go to the hospital or see a doctor even though they needed to.”

The study found the main reasons reported for not seeking health care were that services were redirected to priority groups, and fear of COVID-19. The redirection of health-care services to priority groups was of greater concern to adults aged 50 to 54 than to those aged 85 to 96 years. The researchers theorized this could be related to older adults experiencing a relatively smaller interruption to health care.

Immigrants and people living with chronic conditions were also more likely to indicate challenges accessing health-care services and not visiting a hospital or doctor, which is consistent with previous research that shows these groups have unique barriers to accessing care that predate the pandemic.

Women were also more likely than men to report not visiting a hospital or doctor when needed, as were racialized participants compared to those who are white.

"Substantial unmet health-care needs were reported by Canadian adults during the first year of the pandemic," the researchers wrote. "The results of this study have important implications for health equity."

Participants with higher education levels had greater odds of facing challenges when accessing care, which may be due to a perceived greater disruption to care as this group typically had higher rates of health-care utilization prior to the pandemic, the researchers found.

There were also regional differences in unmet health-care needs. Quebec residents had higher odds of not visiting a hospital or doctor, and Ontario residents had higher odds of facing challenges to accessing health care and barriers to SARS-CoV-2 testing.

The research team concluded that “unmet health care needs during the COVID-19 pandemic may have serious implications on patient care and potentially enduring consequences.”

“We plan to next evaluate how interruptions in health care during the pandemic impacted the incidence and severity of chronic diseases, including obesity, diabetes and cardiovascular disease,” Anderson said.