‘Amazing’ number couldn’t care less during pandemic, poll results: gunshots


Tomeka Kimbrough-Hilson was diagnosed with uterine fibroids in 2006 and underwent surgery to remove a benign mass. When she had symptoms again in 2020, she was unable to get an appointment with a gynecologist. Her experience was not unusual, according to a new poll by NPR, the Robert Wood Johnson Foundation and the Harvard TH Chan School of Public Health.

Nicole Buchanan for NPR


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Nicole Buchanan for NPR


Tomeka Kimbrough-Hilson was diagnosed with uterine fibroids in 2006 and underwent surgery to remove a benign mass. When she had symptoms again in 2020, she was unable to get an appointment with a gynecologist. Her experience was not unusual, according to a new poll by NPR, the Robert Wood Johnson Foundation and the Harvard TH Chan School of Public Health.

Nicole Buchanan for NPR

When the pandemic started, Tomeka Kimbrough-Hilson knew she had a small growth in her uterus. She was first diagnosed with uterine fibroids in 2006 and the non-cancerous mass was removed with outpatient laser surgery. Over the years, she has also been able to manage her symptoms with medication and lifestyle changes.

But when those symptoms — a bloated stomach, irregular periods, nausea — returned in 2020, Kimbrough-Hilson couldn’t get an appointment with a specialist.

“March 27 came and everything shut down,” says Kimbrough-Hilson, 47, of Stone Mountain, Georgia. “I wasn’t at the required level of care [immediate attention]because of all the precautions that had to be taken.”

But even after lockdown was lifted in spring 2020, Kimbrough-Hilson, a mother of five who works in the health insurance industry, was unable to see a gynecologist.

She left message after message with the providers. But their calls went unanswered, or providers were fully booked for months. “I couldn’t get the appointments,” she says. “I couldn’t go on.”

Her stomach is now swollen, she often feels tired and nauseous, she says: “I often throw up.”

She also struggled to get dates for other members of her family. Her 14-year-old daughter underwent brain surgery before the pandemic, but was then unable to get follow-up appointments until recently.

Kimbrough-Hilson’s family’s experience is not unusual, according to a new poll by NPR, the Robert Wood Johnson Foundation and the Harvard TH Chan School of Public Health.

Among households that have had a serious illness in the past year, one in five respondents said they have had difficulty accessing medical care during the pandemic.

That’s a “staggering” number of people who don’t have access to care, says Mary Findling, associate director of the Harvard Opinion Research Program. “From a health and nursing perspective, that’s just too high.”

Other recent studies have found significant delays in cancer screening and disruptions in routine diabetes, child, and mental health care. While it’s early to know the long-term impact on people’s health, researchers and doctors are concerned, especially as the disruptions continue and the country’s healthcare system is struggling to recover from the pandemic.

The new survey also found that some racial and ethnic groups are hit harder by disruptions in care. Among households with someone who had a critical illness in the past year, 35% of Alaskan Indian and Native American households and 24% of black households experienced difficulty accessing medical care for a critical illness, compared with just 18% of white households .

Among black respondents who had visited a provider in the past year, 15% said they were disrespected, rejected, unfairly treated or treated poorly because of their race or ethnicity, compared to just 3% of white respondents who did the same said.

“What’s really sad is that the racial disparities in healthcare between black Americans and white Americans have persisted,” says Findling. “And if you look at a wide range of measures, in America today, it’s better to be a white patient than a black patient. And if you just stop and think about it, it’s awful.”

Health insurance was not a barrier to access

The vast majority of people — regardless of race or ethnicity — who experienced delays in care reported having health insurance.

“One thing tells us that providing more health insurance isn’t going to fill some of these gaps and holes that we’re seeing in relation to individuals receiving more care,” says Loren Saulsberry, a health policy researcher at the University of Chicago who helped with the survey worked closely with Findling.

“There are broader issues at play here,” says Findling, such as the historic shortage of workers in healthcare systems. “The pandemic continues and is wreaking havoc on everyone.”

Saulsberry, who studies health disparities in vulnerable populations, says the pandemic has exacerbated those disparities because of a number of barriers, including a person’s zip code.

For example, the state of Georgia, where Kimbrough-Hilson lives, has had one of the lowest numbers of gynecologists in the country for years. Now she’s having a harder time than ever getting an appointment with one.

“I was able to have my teeth done, my eyes checked,” she says. “But I’m not getting into women’s health.”

She has a referral from her GP, she says, but it’s “30 to 40 miles away for a practice.”

Healthcare systems are too overwhelmed to provide routine care

While the pandemic exacerbated inequalities in care, it also overwhelmed the healthcare system, causing delays and disruptions across the board, says Cassie Sauer, CEO of the Washington State Hospital Association.

And it’s taken a huge financial toll, too, says Dr. Arif Kamal, chief patient officer at the American Cancer Society. “Part of that has to do with actually caring for patients who are very complex and have very serious illnesses due to COVID-19,” he says. “But even during this time there was a loss of income because other activities had to be stopped, such as elective surgeries.”

As a result, prevention services and early detection activities – not the “highest margin activities” for health systems – have taken a back seat, he adds.

“We estimate that in the past two years, for example, about 6 million women missed routine cancer screening,” says Kamal. These include missed mammograms to detect breast cancer and Pap smears to check for cervical cancer.

Kamal worries that in a year or two, providers will detect cancers at later stages due to missed screenings, making them more difficult to treat or cure.

Meanwhile, healthcare systems continue to feel the effects of the pandemic, causing continued delays in what was once routine care.

Sauer has experienced this at work and in her personal life.

“In my own family, we fought to get access to medical care for my children and my parents,” says Sauer.

Her 80-year-old father, who has Parkinson’s disease, had a fall over the winter holidays and was hospitalized. “I was with him and cared for him in the hospital. My mom had COVID at the time, so she couldn’t be there,” she says. “And I couldn’t figure out how to get him out of the hospital.”

He had to go to a qualified nursing facility, but she couldn’t get him there. “I found two nursing homes that go well together,” says Sauer. “And both have closed because they had COVID outbreaks on the same day.”

This is still one of the biggest problems the country’s hospitals are currently facing, she adds. “We can’t get people out of the hospitals at the moment. There is no back door, but the front door to the ER is wide open.”

There are patients who spend up to 90 days in a hospital, she says, when the average hospital stay is three days. “So you’ve taken the place of 30 patients who needed care.”

Because of this, after more than two years of the pandemic, people are still unable to schedule regular procedures, from knee and heart valve replacements to cancer treatments.

These procedures can be considered “elective,” but postponing them can have a significant impact on a patient’s health and quality of life, she adds.

“You can fall, you will probably gain weight,” says Sauer. “You will lose flexibility. You know, all of these things are contributing to a possible decline, heart problems, breathing problems.” Which in turn can also increase your risk of serious illness from COVID.

“I think the toll of this delayed treatment is enormous,” she says.

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