A study found that over the course of about 20 years, barriers to health care unrelated to insurance coverage have increased for all populations but particularly for racial and ethnic minorities.

Utilizing data from the National Health Interview Survey from 1999 to 2018, Yale researchers analyzed 590,603 adults and found that the proportion of people reporting barriers to care nearly doubled. These barriers to care are lack of transportation, inability to reach providers by phone, no appointment availability, inconvenient office hours and long wait times.

During the 20-year period, the proportion of participants who reported these barriers jumped from 7.1% to 13.5%. Black and Latino individuals experienced “significantly higher” barrier prevalence regarding long wait times and lack of transportation compared with white adults, according to the study. 

Researchers noted that simply expanding health insurance may not solve this problem.

“Although increasing insurance coverage may address unmet medical needs by reducing cost, it is less clear that it removes barriers to timely medical care that are not directly related to cost,” the study’s authors wrote.

They went on to explain that social determinants often add to these barriers. Segregation, for example, continues to affect Black and Latino individuals who live in communities that lack proper medical facilities, resulting in an overreliance on emergency departments, which can be more costly to patients.

According to the study’s authors, strategies for addressing these disparities “could include addressing differences in distribution of healthcare facilities, increasing flexibility of care (eg, implementing urgent clinics that do not result in discontinuity of care), including insurance coverage for nonemergency transportation to medical care, and leveraging digital health technologies for high-quality telehealth consultations that are available and accessible.”