Just as women have borne the brunt of economic damage from the pandemic, a new report makes clear that Covid-19 has also disproportionately taken a toll on women’s health and access to care.  

According to a national survey, conducted late in 2020 by the Kaiser Family Foundation (KFF), more than one-third (38%) of women had skipped preventive services, such as checkups or routine tests, during the pandemic. Nearly one-quarter (23%) had forgone a recommended test or treatment. In comparison, only 26% and 15% of men had missed preventive or recommended care, respectively.

“The fact that women are more likely than men to delay their healthcare services is not surprising, as women have been disproportionately burdened with child and household care, home schooling and, in many cases, an inability to maintain employment due to the many obligations placed upon them,” said Dr. Sonia S. Hassan, professor of obstetrics and gynecology and associate vice president in the Office of Women’s Health at Wayne State University. 

The KFF survey showed that women who need care the most were more likely to skip it. Nearly half of women who reported being in poor or fair health had skipped preventive (46%) or recommended care (32%) compared with women in better health (36% and 21%, respectively).

Perhaps surprisingly, higher income women were more likely to have skipped preventive care than lower income women. Forty percent of women with incomes above 200% of the federal poverty level—or just under $26,000 per year—reported skipping preventive care. Only 33% of women with lower incomes had done so. 

Women with private insurance (39%) or Medicaid (38%) were also more likely to go without preventive care than uninsured women (30%).

Lower income women may have been less likely to skip healthcare services, but they were more likely to report not filling a prescription or not taking the recommended dose. Fourteen percent of women earning less than 200% FPL hadn’t filled or fully taken their prescriptions compared with 8% of women earning more.  

Even if women wanted to get recommended healthcare services, the pandemic created barriers for many. Thirty percent of women reported not being able to get an appointment due to the pandemic compared with 20% of men. 

Barriers getting appointments were greater for some women than others. Women in poor or fair health (40%) were more likely to report problems getting appointments compared with women in good or excellent health (29%). Thirty-six percent of Hispanic women reported difficulties making appointments during the pandemic, compared with 32% of Black women and 28% of white and Asian women.

There may be one silver lining in the KFF survey related to women’s access to care: increased use of telemedicine. By late 2020, 38% of women surveyed had used telemedicine compared with just 13% before the pandemic. 

Mental health was one of the most common reasons for telehealth visits. Of women who had used telemedicine during the pandemic, 17% had used it for mental health care. 

But that may not be nearly enough to meet growing mental health needs, especially among women. 

Half (51%) of women surveyed reported that pandemic-related stress or worry impacted their mental health compared to one-third (34%) of men. Among those affected, 21% of women categorized the impact on their mental health as major compared with 17% of men. 

Despite widespread mental health needs, only 15% of women had sought mental health care. Women without health insurance were even less likely (10%) to seek mental health care. 

Hassan has observed the pandemic’s mental health impact on patients. “In our high-risk pregnant population, over 50% experienced anxiety and/or depression during the pandemic,” she said. 

Though the direct effects of this elevated stress on pregnancy outcomes are still being studied, according to Hassan, they could cause women more health problems down the road.

“Because most human disease is related to stress and inflammation, high rates of stress in women will result in an increase in the incidence of chronic disease and morbidity,” Hassan said. “A deliberate effort must be made to design and implement effective interventions that will mitigate the mental effects of the situations and challenges created by the pandemic.”