Survey Finds Many Women Go Without Preventive Care
AAFP Resources Can Help Patients, Clinicians Overcome Barriers
Feb. 8, 2023, News Staff — During the past 12 months, nearly half of all American women skipped a preventive health service such as an annual checkup, a vaccine or a recommended test or treatment, with the inability to afford out-of-pocket costs and difficulty getting an appointment among the most common reasons.
These findings in an Ipsos survey of more than 3,200 women illustrate the barriers that many women encounter in obtaining care that could help maintain their physical and mental well-being and reduce their risk of serious illness. The findings come as a federal requirement that most private insurance plans cover certain preventive services free of charge is at risk.
Methods and Results
The survey asked women 18 and older about their general experiences with health care. More than 89% said they had some type of health insurance coverage, and 77% said it was easy for them to access the health care they need. In addition, 78% reported they had a primary care physician, such as a family physician, who they saw routinely; 74% said they usually went to their PCP when they needed preventive care.
Family physicians rated better than others in providing certain types of preventive services. Participants said they received recommendations about getting a vaccine from FPs far more often than from any other source. Family physicians were also listed as the source women trusted most (54%) when deciding whether to get a vaccine; the next highest rated source was the CDC, at 12%.
Story Highlights
Despite the high rate of people with insurance coverage, 45% of women surveyed said they had foregone at least one kind of preventive care service in the past 12 months. Among the services missed,
- 25% couldn’t get an appointment with a PCP, an OB/Gyn or other specialist,
- 22% skipped an annual checkup or routine test,
- 22% did not get a vaccine recommended by a health care professional,
- 14% skipped a recommended medical test or treatment and
- 4% couldn’t get an appointment for a health screening or diagnostic test.
When asked for the single most important reason why they may have not received preventive care,
- 25% said they couldn’t afford the out-of-pocket costs;
- 23% said they had limited time to make an appointment;
- 11% faced difficulties in scheduling an appointment, such as challenges with online scheduling or health care professional availability; and
- 9% were limited in their choices by their insurance.
While the survey did not offer direct solutions to reducing costs or increasing accessibility, large majorities of women said they want any preventive care guidelines developed by the federal government or other national organizations to emphasize that services be affordable, flexible and equitable:
- 91% said it’s important that guidelines prioritize ensuring comprehensive preventive care and screening is affordable;
- 90% said it’s important that guidelines encourage conversations between patients and health care professionals and shared decision-making;
- 89% said it’s important to prioritize removing barriers to care, not making it more difficult for women to get screenings, and ensuring that equitable standards of care are available to all women; and
- 87% said it’s important to prioritize ensuring that guidelines don’t have a negative impact on health equity.
The survey was conducted by Ipsos for the Alliance for Women’s Health and Prevention.
AAFP and Partners Help Provide Optimal Care
The Academy has been a longstanding advocate of promoting women’s health. In 2022 alone, the AAFP wrote or signed more than 20 letters to Congress to support maternal health, postpartum Medicaid coverage, expanded protections for pregnant employees and related topics. Many of these issues were favorably addressed with the passage of the Consolidated Appropriations Act of 2023.
The AAFP has also developed several clinical recommendations and guidelines for women’s health in general and maternity care in particular.
AFP by Topic collections, meanwhile, give members access to the latest review articles from American Family Physician on labor, delivery and postpartum issues; menopause; menstrual disorders; neonatology and newborn issues and prenatal care, and several Academy-produced learning activities and products help members provide high-quality care while earning CME credit.
A longstanding AAFP partner organization, the Women’s Preventive Services Initiative, also has developed a number of valuable resources for family physicians and other health care professionals. These include an ever-expanding series of recommendations for women’s preventive health care services; a well-woman chart and set of clinical summary tables (available in English and Spanish); and various toolkits, patient education pamphlets and guidance documents.
Additionally, the Academy is a core partner with the Alliance for Innovation on Maternal Health, an initiative designed to reduce severe maternal morbidity and mortality and make giving birth safer through promoting consistent maternity care practices. These practices are outlined in the Alliance’s patient safety bundles, which address specific maternal health conditions and follow evidence-based structures that have been proven to improve patient outcomes.
Finally, another resource of note is the Hear Her campaign, a project supported through a partnership with the CDC Foundation and funding from the Merck for Mothers program. Hear Her aims to raise awareness of serious pregnancy-related complications and their warning signs, and to provide education and encouragement to pregnant and postpartum patients with resources in English and Spanish.