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Millions of Americans With Chronic Ills Put Off Health Care

Survey shows they suffer consequences of delaying doctor visits, filling prescriptions

WEDNESDAY, March 18 (HealthDay News) -- Millions of Americans suffering from at least one chronic health problem are putting off care, not taking needed medications, and resigning themselves to feelings of isolation and depression.

So reveals a new poll commissioned by the National Council on Aging, with support from The Atlantic Philanthropies and the California HealthCare Foundation.

"This report presents a distressing picture of the barriers facing those most in need of ongoing care and support, whether or not they have insurance," said Carol Pryor, policy director of the Access Project in Boston. "As we look toward reforming our health care system, we need to ensure that these barriers are reduced or eliminated. In some countries, for example, co-pays are waived for people with chronic conditions to ensure that they can get timely care without having to worry about the cost. This can reduce barriers to care and also lower costs in the long run."

The findings strongly echo those from a Harris Interactive/HealthDay poll released last week, which found that more than three-quarters of adult Americans who have health insurance say they still worry about paying more for their medical care, and almost 50 percent say they're "very" or "extremely" worried about the issue.

Again, many in this demographic are not filling prescriptions, missing doctors' visits, not taking recommended treatments or cutting back on medication and foregoing dental care.

Experts expressed concern that, with the economy in recession and many Americans losing their employer-based health insurance, the problem may only get worse.

According to the National Council on Aging, 30 million Americans aged 65 and over have at least one chronic health condition. Such conditions eat up the lion's share of the nation's health care costs.

"Nearly 133 million people in the U.S. have chronic conditions such as arthritis, high blood pressure and high cholesterol. The medical care costs of people with chronic diseases account for more than 75 percent of the nation's $2 trillion in medical costs," said James Firman, president and CEO of the National Council on Aging at a Wednesday teleconference. "Despite all we're spending, the quality of chronic care is not particularly good. Forty-four percent of patients do not receive recommended care.

"If you think it's bad today, as the nation ages dramatically, so will our chronic needs," Firman added. "Often missing is the voice of those suffering from chronic conditions."

Here are the high points of the new poll, which surveyed 1,109 Americans aged 44 and over, each of whom suffered from at least one chronic health problem, such as heart disease, diabetes, arthritis, asthma or depression:

  • Sixty-eight percent of respondents had at least two chronic conditions, while 20 percent had four or more.
  • Not surprisingly, those with one chronic condition reported being healthier and having more resources, both financial and social, than those with more health problems.
  • One-quarter of respondents said they had delayed getting health care or neglected filling a prescription because of financial concerns. This problem seemed to be more pronounced among Latinos (43 percent) and Baby Boomer women (39 percent).
  • Low-income individuals were more likely to delay care, but also 22 percent of individuals with household incomes of $50,000 or more having made such a decision.
  • Those who have put off care suffer the consequences: 45 percent are "always" or "frequently" in pain (vs. 28 percent of those who sought prompt care), while 49 percent were always or frequently tired (vs. 28 percent of their counterparts) and 40 percent were stressed (vs. 17 percent of those getting care).
  • In general, about one-third of respondents were "always" or "frequently" in physical pain. Those with multiple chronic conditions were more likely to report being in pain.
  • Half felt depressed and angry as a result of their health conditions.
  • Thirteen percent said health care providers "rarely" refer them to supportive services, while 32 percent said providers "never" do so. Among individuals aged 75 and older, 56 percent said their providers "rarely" or "never" refer them to support services.
  • Being chronically ill also left many Americans feeling isolated: 39 percent reported not getting the help and support they need to cope; many have had to cut back on social activities and also experience stress in their family relationships.
  • One-quarter of those with jobs reported having had to miss work due to health concerns.

"Many Americans with chronic conditions are struggling, especially those delaying care, Latinos, those with low income. We know this is more difficult for them, and our non-system of care probably is the least responsive to these people," said Nancy Whitelaw, senior vice president of the National Council on Aging and director of the Center for Healthy Aging. "They are in pain, stressed, a lot of things are going on in their life that makes it difficult to cope. They look to healthcare providers but don't feel they are getting the support they need. They lack confidence about their ability to do these things on their own. They want help in tailoring [interventions] to their own life. They would like to get this help from providers, from their community, from online resources."

More information

Visit the U.S. National Council on Aging for more about this poll.

SOURCES: March 18, 2009, teleconference with James P. Firman, Ed.D. president and CEO, National Council on Aging (NCOA); Veenu Aulakh, California HealthCare Foundation; Nancy Whitelaw, Ph.D., director, Center for Healthy Aging, and senior vice president, NCOA; Delores Palmer, R.N., Harvest Health Program, and director, Center in the Park; Carol Pryor, policy director, Access Project, Boston; March 18, 2009, poll, National Council on Aging

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