Association between Poverty and Refraining from Seeking Medical Care during the COVID-19 Pandemic in Japan: A Prospective Cohort Study

Erika Obikane (), Daisuke Nishi, Akihiko Ozaki, Tomohiro Shinozaki, Norito Kawakami and Takahiro Tabuchi
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Erika Obikane: Department of Social Medicine, National Center for Child Health and Development, Tokyo 157-0074, Japan
Daisuke Nishi: Department of Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-0033, Japan
Akihiko Ozaki: Department of Breast and Thyroid Surgery, Jyoban Hospital of Tokiwa Foundation, Iwaki 972-8322, Japan
Tomohiro Shinozaki: Department of Information and Computer Technology, Faculty of Engineering, Tokyo University of Science, Tokyo 162-8601, Japan
Norito Kawakami: Department of Digital Mental Health, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655, Japan
Takahiro Tabuchi: Department of Cancer Control Center, Osaka International Cancer Institute, Osaka 541-8567, Japan

IJERPH, 2023, vol. 20, issue 3, 1-14

Abstract: This limited study examined how low household income affected avoidant behaviors to seek medical care during the pandemic. We investigated an association between household income below the relative poverty line and refraining from seeking medical care (RSMC) in a longitudinal study during the COVID-19 pandemic. We conducted an analysis of a population-based internet cohort in Japan. Individuals aged 20 to 79 years old living in Japan participated in the internet surveys between 2020 and 2021. The primary outcome was the RSMC of regular visits and new symptoms in 2021. A total of 19,672 individuals were included in the analysis. Household income below the relative poverty line in 2020 was significantly associated with refraining from seeking regular medical visits for men and women (for men, odds ratio: 1.28; confidence interval: 1.19, 1.83; for women, odds ratio: 1.42; confidence interval: 1.14, 1.82) in 2021, after accounting for RSMC in 2020. Relative poverty in 2020 was also associated with the RSMC of new symptoms among men (for males, odds ratio: 1.32; confidence interval: 1.05, 1.66) in 2021 after adjusting for covariates. The study suggested the need to alleviate the financial burden of vulnerable people seeking medical care and advocate for making necessary medical visits, even in a pandemic.

Keywords: low household income; relative poverty; inequality; access to medical care; COVID-19 (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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