Delay of Routine Health Care During the COVID-19 Pandemic: A Theoretical Model of Individuals’ Risk Assessment and Decision Making

Delaying routine health care can have major negative impacts at the individual and population level. Macro-level data reveals that U.S. patients under-utilized routine health care services (e.g., primary care visits, routine preventative tests and screenings, routine optometry and dental appointments, and routine visits for chronic disease management) during the COVID-19 pandemic, indicating that patients broadly chose to delay health care services. Yet, there is a large gap in research on how and why patients understand risks associated with seeking or delaying routing health care during an infectious disease pandemic. Our research addresses this gap using qualitative methods (semi-structured interviews) with 40 participants living in regions across the U.S. Our analysis builds upon Unger-Saldaña and Infante-Castañeda’s model describing delayed health care, extending this model to describe health care delays during an infectious disease pandemic. Specifically, we show how perceptions of uncertainty and subjective risk assessments operating at two levels (internal and external to one’s social bubble) interact to produce decisions about delaying routine health care.

* Myeong Lee is the corresponding author. 


[In Press] Social Science & Medicine
Prakriti Shukla
Myeong Lee
Kathleen H. Pine
Samantha Whitman