# Sociodemographic Drivers of Delays in Seeking Medical Care in the All of Us Cohort

## TL;DR

This study explores why people delay seeking medical care, finding that costs, anxiety, and work issues are common reasons, with differences based on gender and race.

## Contribution

The study identifies sociodemographic factors associated with delays in medical care using a large, diverse cohort and proposes targeted interventions.

## Key findings

- Out-of-pocket expenses were the most common reason for delayed medical care (16.68%).
- Females had higher odds of delaying care due to costs compared to males.
- Married individuals were more likely to delay care due to childcare responsibilities.

## Abstract

Background/Objectives: This study examined the reasons and sociodemographic drivers behind delays in seeking medical care among participants in the All of Us Research Program. Methods: A cross-sectional study was conducted using data collected between 2018 and 2024. The primary outcome was the prevalence of reasons for delayed medical care (DMC). Descriptive statistics were used to calculate the prevalence of the various reported reasons for delayed medical care. Binary logistic regression was applied to examine the association between sociodemographic characteristics and each reported reason for delayed medical care. Results: Out of a total of 633,000 All of Us participants, 300,820 participants had complete data on the healthcare utilization and access survey and were eligible for final analysis. The most common reported reasons for DMC were out-of-pocket expenses (16.68%), nervousness about seeing a provider (14.18%), and inability to get time off work (11.04%). Females had significantly higher odds of DMC due to out-of-pocket costs (OR = 1.31, 95% CI: 1.28–1.33). Black (OR = 0.81, 95% CI: 0.78–0.84) and Asian (OR = 0.94, 95% CI: 0.89–0.99) individuals had lower odds of DMC due to out-of-pocket costs. Married individuals had more than twice the odds of DMC due to childcare responsibilities (OR = 2.45, 95% CI: 2.33–2.56). Conclusions: A significant proportion of participants reported DMC due to various reasons, with financial, medical visit anxiety, and work-related reasons being the most common. These findings highlight actionable intervention targets, including nurse-led cost navigation and financial counseling, flexible scheduling/telehealth to reduce work-related delays, and patient-centered communication and outreach strategies to reduce visit-related anxiety and support caregiving and transportation needs.