Experiences of Forgone Care During the COVID-19 Pandemic and Older Adults’ Mental Health: Variations by Race and Ethnicity

TL;DR

This study explores how missing medical care during the pandemic affected older adults' mental health, with differences seen across racial and ethnic groups.

Contribution

The study reveals how forgone care during the pandemic disproportionately impacted mental health outcomes among Black older adults compared to others.

Findings

Forgone care was common and linked to higher psychological distress and worse sleep quality across racial and ethnic groups.

Black older adults who missed chronic care had significantly worse sleep than White counterparts.

Missing chronic, mental, and preventative care was associated with greater distress and sleep issues for all groups.

Abstract

The COVID-19 pandemic led to substantial forgone care. However, relatively few studies have investigated the mental health consequences of forgone care experiences on older adults and how these associations vary by race and ethnicity during this period. This study analyzed US older adults aged 55 or older from the Health, Ethnicity, and Pandemic Survey (N = 883; average age = 65), a nationally representative survey conducted in late 2020. Weighted OLS regression was used to examine the association between measures of forgone care and mental health outcomes. Results showed that experiences of forgone care were prevalent and similar across racial and ethnic groups, with some variations across types of missed care. Furthermore, forgone care and missing various types of care during the COVID-19 pandemic were associated with higher psychological distress and poorer sleep quality, with some variations by race and ethnicity. Black older adults who had forgone care and missed more types of care showed even poorer sleep than their White counterparts. Additionally, missing chronic care, mental care, and preventative care, but not other types of care, was associated with greater psychological distress and poorer sleep for all racial and ethnic groups. However, Black older adults who missed chronic care had even poorer sleep than Whites. Findings emphasize the need to support all older adults’ healthcare access of various types during the pandemic and the importance of focusing on specific racial and ethnic groups such as Black older adults who were more affected by forgone care.

The online version contains supplementary material available at 10.1007/s40615-025-02304-0.