US Seniors' Pandemic Care Worst Among Wealthy Nations: Survey

Marcia Frellick

September 15, 2021

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Older adults in the United States — particularly among Black and Latino/Hispanic populations — experienced worse access to healthcare for chronic conditions during the pandemic than older adults in 10 other wealthy countries, according to findings from The Commonwealth Fund's 2021 International Health Policy Survey of Older Adults released today.

David Blumenthal, MD, president of The Commonwealth Fund, said during a press briefing Tuesday that surveying the senior population in the United States is particularly insightful because it is the only group with the universal coverage of Medicare, which offers a more direct comparison with other countries' universal healthcare coverage.

More than one third (37%) of older US adults with multiple chronic conditions reported pandemic-related disruptions in their care — higher than rates in Canada, the Netherlands, and UK. In Germany, only 11% had canceled or postponed appointments.

The survey was conducted between March and June 2021 and included responses from 18,477 adults age 65 and older in Australia, Canada, France, Germany, the Netherlands, New Zealand, Norway, Sweden, Switzerland, and UK, and US adults age 60 and older.

Among older adults who need help with daily activities, those in the United States, Canada, UK, and Australia were the most likely to say they did not receive needed services from professionals or family members.

In the United States, 23% of people who said they needed help with activities such as housework, meal preparation, and medication management experienced a disruption in care because services were canceled or very limited during the pandemic. For comparison, only 8% of seniors in Germany and 11% of seniors in the Netherlands did not receive help with basic daily activities.

Many US Seniors Used Up Savings

"Nearly one in five older adults report that they used up their savings or lost their main source of income because of the pandemic. We see much lower rates in other countries like Germany, Switzerland, the Netherlands, and Sweden," Reginald D. Williams, vice president for international health policy and practice innovations at The Commonwealth Fund, said during Tuesday's briefing.

Older US adults reported economic difficulties related to the pandemic at a rate of up to six times that of other countries, he said.

The differences by race were stark. While 19% of US seniors overall experienced financial hardships related to the pandemic, 32% of Black seniors and 39% of Latino/Hispanic seniors in the United States experienced hardships. Germany had the lowest rate, at 3% overall.

"As the COVID-19 pandemic in the United States continues to evolve," Williams said, "finding ways to reduce care barriers — affordability and connecting adults to usual sources of primary care, enhancing access to economic supports and social services — can help narrow the gaps."

Blumenthal said that even though "Medicare is a critical lifeline," it has flaws.

"Medicare plans have significant gaps that leave beneficiaries vulnerable to sizable out-of-pocket expenses," he said.

Placing caps on out-of-pocket costs and covering more health services, such as dental, vision, and hearing care, could help make the population less vulnerable, Blumenthal said. "The chronic lack of security facing US seniors, especially those who are Black or Hispanic, is exacerbating the pandemic's devastating toll," he added.

Blumenthal and Williams have reported no relevant financial relationships.

Marcia Frellick is a freelance journalist based in Chicago. She has previously written for the Chicago Tribune, Science News, and, and was an editor at the Chicago Sun-Times, the Cincinnati Enquirer, and the St. Cloud (Minnesota) Times. Follow her on Twitter at @mfrellick

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