Reduced Access to Care

Household Pulse Survey

census experimental data

To rapidly monitor recent changes in health care access, the National Center for Health Statistics (NCHS) partnered with the U.S. Census Bureau on an experimental data system called the Household Pulse Survey. This 20-minute online survey was designed to complement the ability of the federal statistical system to rapidly respond and provide relevant information about the scope of the impact of the coronavirus pandemic in the U.S. Data collection began on April 23, 2020 and is anticipated to continue for 90 days.

NCHS included questions about the impact of the coronavirus pandemic on unmet needs for care. Unmet needs for health care are often the result of cost-related barriers. The National Health Interview Survey (NHIS), conducted by NCHS, is the source for high-quality data to monitor cost-related health care access problems in the U.S. For example, in 2018, 7.3% of persons of all ages delayed needed medical care due to cost and 4.8% needed medical care but did not get it due to cost. However, cost is not the only reason someone might delay or not receive needed medical care. As a result of the coronavirus pandemic, people also may not get needed medical care due to cancelled appointments, cutbacks in transportation options, fear of going to the emergency room, or an altruistic desire to not be a burden on the health care system, among other reasons.

Estimates on this page are derived from the Household Pulse Survey and show the percentage of U.S. adults who delayed getting medical care in the last four weeks or who needed medical care at any time in the last four weeks for something other than coronavirus but did not get it because of the coronavirus pandemic.

Pulse Survey Topics

Use the drop-down menus to show data for selected indicators or categories. Select the buttons at the bottom of the dashboard to view national and state estimates. The data table may be scrolled horizontally and vertically to view additional estimates.


Technical Notes

 

Survey Questions

At any time in the last 4 weeks, did you DELAY getting medical care because of the coronavirus pandemic?

At any time in the last 4 weeks, did you need medical care for something other than coronavirus, but DID NOT GET IT because of the coronavirus pandemic?

 

Estimation

Estimates on this page are based on responses from adults aged 18 years and over. Persons with missing responses for the characteristics of interest are not shown separately in the tables and are not included in the calculation of percentages.  Therefore, percentages reported here may differ from those available from the Census Bureau website: https://www.census.gov/householdpulsedataexternal icon.

 

Data Source

The U.S. Census Bureau, in collaboration with five federal agencies, launched the Household Pulse Survey to produce data on the social and economic impacts of Covid-19 on American households.  The Household Pulse Survey was designed to gauge the impact of the pandemic on employment status, consumer spending, food security, housing, education disruptions, and dimensions of physical and mental wellness.

The survey was designed to meet the goal of accurate and timely weekly estimates. It was conducted by an internet questionnaire, with invitations to participate sent by email and text message. The sample frame is the Census Bureau Master Address File Data. Housing units linked to one or more email addresses or cell phone numbers were randomly selected to participate, and one respondent from each housing unit was selected to respond for him or herself. Estimates are weighted to adjust for nonresponse and to match Census Bureau estimates of the population by age, gender, race and ethnicity, and educational attainment. All estimates shown meet the NCHS Data Presentation Standards for Proportionspdf icon.

 

 

Weighted Response Rate and Sample Size
Week Weighted Response Rate Sample Size
April 23-May 5 3.8% 68,703
May 7-12 1.3% 39,187
May 14-19 2.3% 118,429
May 21-26 3.1% 89,659
May 28-June 2 3.5% 93,116
June 4-9 3.1% 74,316
June 11-16 2.3% 67,452
June 18-23 2.9% 98,617
June 25-30 3.3% 90,093
July 2-7 3.2% 82,904
July 9-14 3.1% 83,366
July 16-21 2.9% 78,689

 

Limitations

The Household Pulse Survey is different from other surveys. NCHS, the Census Bureau, and other federal statistical agencies are considered the preeminent source of the nation’s most important benchmark surveys.  Many of these surveys have been in production for decades and provide valuable insight on health, social, and economic trends. However, the production of benchmark data requires a relatively long lead time, and personal interviews (face-to-face or telephone) require additional time.  While efforts are underway to introduce COVID-19 questions into these surveys, that process can take months, sometimes years, before data are made available.

The Household Pulse Survey is different:  It was designed to go into the field quickly, to be administered via the web, and to disseminate data in near real-time, providing data users with information they can use now to help ease the burden on American households and expedite post-pandemic recovery.  The Census Bureau is fielding the Household Pulse Survey as a demonstration project, with data released as part of its Experimental Statistical Products Series.

Confidence intervals included in the tables on this page only reflect the potential for sampling error.  Nonsampling errors can also occur and are more likely for surveys that are implemented quickly, achieve low response rates, and rely on online response.  Nonsampling errors for the Household Pulse Survey may include:

  • Measurement error: The respondent provides incorrect information, or an unclear survey question is misunderstood by the respondent. The Household Pulse Survey schedule offered only limited time for testing questions.
  • Coverage error: Individuals who otherwise would have been included in the survey frame were missed. The Household Pulse Survey only recruited households for which an email address or cell phone number could be identified.
  • Nonresponse error: Responses are not collected from all those in the sample or the respondent is unwilling to provide information. The response rate for the Household Pulse Survey was substantially lower than most federally sponsored surveys.
  • Processing error: Forms may be lost, data may be incorrectly keyed, coded, or recoded. The real-time dissemination of the Household Pulse Survey provided limited time to identify and fix processing errors.

The Census Bureau employs quality control procedures to minimize these errors.  However, the potential bias due to nonsampling errors has not yet been evaluated.

 

For more information on the Household Pulse Survey, please visit https://www.census.gov/householdpulsedataexternal icon.

Page last reviewed: July 29, 2020