Involuntary and patient-initiated delays in medical care during the COVID-19 pandemic.

This paper uses data from a new, nationally representative survey to study delays in non-COVID-related medical care among US adults during the COVID-19 pandemic. We expand on prior research by taking a comprehensive look at the many reasons patients may have experienced delays in medical care and by studying the longer-run implications of these delays for patients' self-reported health, use of telemedicine, feelings of regret, and likelihood of delaying care again in the future. Classifying delays in care broadly as involuntary (those due to availability or "supply-side" constraints) or patient-initiated (those due to patient concerns or "demand-side" constraints), we document important differences across demographic groups in the propensity to delay care for these reasons. In contrast to most prior work on this topic, our analyses can disentangle differences in the likelihood of delaying care from differences in pre-pandemic care-seeking behavior. We also demonstrate that the types of medical care that were delayed during the pandemic differed based on whether the delay was involuntary or patient-initiated, as did the duration of the delays and their associations with self-reported health, telemedicine use, and feelings of regret.

Local food prices, SNAP purchasing power, and child health.

The Supplemental Nutrition Assistance Program (SNAP, formerly food stamps) is one of the most important elements of the social safety net. Unlike most other safety net programs, SNAP varies little across states and over time, which creates challenges for quasi-experimental evaluation. Notably, SNAP benefits are fixed across 48 states; but local food prices vary, leading to geographic variation in the real value - or purchasing power - of SNAP benefits. In this study, we provide the first estimates that leverage variation in SNAP purchasing power across markets to examine effects of SNAP on child health. We link panel data on regional food prices to National Health Interview Survey data and use a fixed effects framework to estimate the relationship between local purchasing power of SNAP and children's health and health care utilization. We find that lower SNAP purchasing power leads to lower utilization of preventive health care and more days of school missed due to illness. We estimate no effect on parent-reported health status.