Census: Doctor visits on the decline

By Sabrina Tavernise, New York Times

WASHINGTON — Americans of working age are going to the doctor less frequently than they were 10 years ago, according to a report by the Census Bureau.

In 2010, people age 18 to 64 made an average of 3.9 visits to doctors, nurses and other medical professionals, down from 4.8 visits in 2001, said the report, which was released on Monday.

The precise reasons for the decline were unclear, said Brett O’Hara, an official at the Census Bureau and a co-author of the report. But the changing demographics of the American population most likely had something to do with it.

As baby boomers retire, for example, they leave a working-age population that is on average younger and that tends to use less health care. Still, that is likely to be only a small part of the explanation, as the baby boomers began to move into retirement only at the end of the report’s period, about two years ago.

Another possible reason for the decline in doctor visits, Mr. O’Hara said, is that the share of uninsured working-age people has expanded over the past decade. People without insurance are less likely to visit a doctor, said the report, which was based on the Survey of Income and Program Participation, a long-running survey of more than 80,000 households. The share of working-age Americans without health insurance was 21.8 percent in 2010, according to the Census Bureau, up from 17 percent in 2001.

The report measures the years before 2010, when a provision in the Affordable Care Act began allowing young adults to stay on their parents insurance policies until age 26. That change has helped stem the rise in the uninsured.

People lacking insurance were far less likely to go to doctors. Just 24 percent of the uninsured went to a doctor at least once in 2010, compared with 72 percent of the general population of working age adults, the report found.

The share of doctors visits by uninsured adults was low, O’Hara said, despite the safety net that is supposed to help them get medical care, like as federally financed community health centers and hospitals with charity care.

But even for those with insurance, costs have increased, with deductibles and premiums rising far faster than inflation, and many have cut back on doctor visits, said Kathleen Stoll, director of health policy at Families USA, a nonprofit health care research and advocacy group.

“Many are thinking twice before going to a physician,” she said.

Still, about two-thirds of Americans reported being in good or excellent health, the report said, compared with about one-third that reported being in fair or poor health. The report also showed the sharp difference in medical usage by income. Nearly 40 percent of people in poverty did not visit a doctor in 2010, compared with 19 percent of people from higher income levels.

Hispanics were the least likely to seek medical care, with 42 percent reporting not having visited a doctor at all in 2010. Among whites, the share was 23 percent and among blacks it was 30 percent.