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Pennsylvania Value:
Percentage of adults who reported a time in the past 12 months when they needed to see a doctor but could not because of cost
Pennsylvania Rank:
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Percentage of adults who reported a time in the past 12 months when they needed to see a doctor but could not because of cost
US Value: 10.1%
Top State(s): Hawaii: 5.7%
Bottom State(s): Texas: 16.8%
Definition: Percentage of adults who reported a time in the past 12 months when they needed to see a doctor but could not because of cost
Data Source and Years(s): CDC, Behavioral Risk Factor Surveillance System, 2022
Suggested Citation: America's Health Rankings analysis of CDC, Behavioral Risk Factor Surveillance System, United Health Foundation, AmericasHealthRankings.org, accessed 2024.
The United States spends more on health care than any other country in the Organization for Economic Co-operation and Development (OECD), yet provides fewer resources to its citizens.
The high cost of health care in the U.S. is one of the major factors in avoiding needed care. Other barriers include inadequate or nonexistent insurance coverage, transportation issues, negative interactions with providers and care teams, delayed access and issues with childcare or work schedules.
Avoiding or delaying needed health care has been associated with increased preventable hospitalizations and missed opportunities to prevent disease and manage chronic conditions, all of which can lead to worse and more expensive health outcomes. Meanwhile, the cost of health care in the United States is projected to continue increasing through 2031. In 2021, the average American spent nearly $13,000 on health care.
According to America’s Health Rankings data, the prevalence of avoiding care due to cost is higher among:
Additionally, adults ages 18-64 who are uninsured are more likely to have problems paying medical bills compared with adults who have health insurance. Even among those with health insurance, many adults are underinsured, meaning their coverage doesn’t allow affordable access to health care.
Multidisciplinary interventions that increase the affordability of health care by preventing disease and reducing out-of-pocket costs may help reduce the proportion of adults who avoid care due to the cost. Examples include:
The American Medical Association recommends several strategies to improve access to health care, including expanding Medicaid in more states and addressing physician shortages.
Healthy People 2030 has multiple objectives related to health care access, including:
“2021 National Healthcare Quality and Disparities Report.” Rockville, MD: Agency for Healthcare Research and Quality, December 2021. https://www.ahrq.gov/sites/default/files/wysiwyg/research/findings/nhqrdr/2021qdr.pdf.
Anderson, Gerard F., Peter Hussey, and Varduhi Petrosyan. “It’s Still The Prices, Stupid: Why The US Spends So Much On Health Care, And A Tribute To Uwe Reinhardt.” Health Affairs 38, no. 1 (January 2019): 87–95. https://doi.org/10.1377/hlthaff.2018.05144.
Bazemore, Andrew, Stephen Petterson, Lars E. Peterson, Richard Bruno, Yoonkyung Chung, and Robert L. Phillips. “Higher Primary Care Physician Continuity Is Associated With Lower Costs and Hospitalizations.” The Annals of Family Medicine 16, no. 6 (November 2018): 492–97. https://doi.org/10.1370/afm.2308.
Bertakis, Klea D., and Raham Azari. “Patient-Centered Care Is Associated with Decreased Health Care Utilization.” The Journal of the American Board of Family Medicine 24, no. 3 (May 1, 2011): 229–39. https://doi.org/10.3122/jabfm.2011.03.100170.
Cha, Amy E., and Robin A. Cohen. “Problems Paying Medical Bills, 2018.” NCHS Data Brief No. 357. Hyattsville, MD: National Center for Health Statistics, February 2020. https://www.cdc.gov/nchs/data/databriefs/db357-h.pdf.
Cosgrove, Delos M., Michael Fisher, Patricia Gabow, Gary Gottlieb, George C. Halvorson, Brent C. James, Gary S. Kaplan, et al. “Ten Strategies To Lower Costs, Improve Quality, And Engage Patients: The View From Leading Health System CEOs.” Health Affairs 32, no. 2 (February 2013): 321–27. https://doi.org/10.1377/hlthaff.2012.1074.
Pezzin, Liliana E., Hillary R. Bogner, Jibby E. Kurichi, Pui L. Kwong, Joel E. Streim, Dawei Xie, Ling Na, and Sean Hennessy. “Preventable Hospitalizations, Barriers to Care, and Disability.” Medicine 97, no. 19 (2018). https://doi.org/10.1097/MD.0000000000010691.
Yong, Pierre L., Robert S. Saunders, and LeighAnne Olsen, eds. The Healthcare Imperative: Lowering Costs and Improving Outcomes: Workshop Series Summary. Institute of Medicine Roundtable on Evidence-Based Medicine. Washington, D.C.: National Academies Press, 2010. https://doi.org/10.17226/12750.
America’s Health Rankings builds on the work of the United Health Foundation to draw attention to public health and better understand the health of various populations. Our platform provides relevant information that policymakers, public health officials, advocates and leaders can use to effect change in their communities.
We have developed detailed analyses on the health of key populations in the country, including women and children, seniors and those who have served in the U.S. Armed Forces, in addition to a deep dive into health disparities across the country.