State of the Facts
While there is no perfect measure of how the healthcare system is equipped to deal with an influx of novel coronavirus patients, it’s important to consider how many hospital beds are in the US. As of 2018, the US had approximately 924,000 hospital beds, or 2.8 beds per 1,000 people. This is less than half the number of hospital beds per person that there was in 1980.
At the last count in 2015, approximately 65.5% of all hospital beds are already occupied at any one time.
According to the Centers for Disease Control and Prevention (CDC), those who are over 60 or have chronic medical conditions are at heightened risk for developing COVID-19. According to the Census, 72.7 million Americans, or 22% of the population, were 60 or older as of 2018.
There are a host of medical conditions that might cause individuals to be at heightened risk of contracting COVID-19. According to the CDC, while smoking rates in the US have fallen in recent years, 16% of the US population still smokes. One in three adults has hypertension (high blood pressure), a known risk factor for developing severe COVID-19 symptoms. One in ten adults have been told by a medical professional that they have asthma. Additionally, those with conditions causing immunodeficiencies, such as cancer or HIV, are at heightened risk due to their weakened immune systems. For more information on at-risk populations, see our recent piece on health conditions and coronavirus risk.
As the coronavirus continues to spread, healthcare access will be critical for affected individuals. However, multiple barriers might prevent access to care.
For some, lack of health insurance may be a barrier. According to the Census, 27.5 million Americans, or 8.5% of the population, were uninsured as of 2018, an increase from the 2017 low of 7.9%. The uninsured population skews young, Hispanic, and foreign-born. However, most Americans—67%—are covered by private health insurance, whether they purchased it on their own or received it through their employer. The majority of full-time private-sector workers—85%—received health care benefits from their employer, while only 23% of part-time employees did, according to 2019 data from the Bureau of Labor Statistics (BLS). If economic conditions continue to worsen and employers are forced to begin layoffs, the number of uninsured individuals may rise, as workers may no longer be able to access benefits through their employer.
The affordability of healthcare may also be an issue. According to a 2018 survey conducted by the CDC, 12.2% of Americans said that there was a time in the past 12 months when they have needed to see a doctor but could not because of cost.
Others still might not have access to a healthcare facility. At last count, 13.7 million Americans, or 4% of the population, live in medically underserved areas, defined as areas with a shortage of health care services for residents. A shortage is defined by a score based on the area’s provider to population ratio, poverty rate, infant mortality rate, and the percent of the population that is elderly.
Accessing healthcare or taking time to rest often requires paid sick leave. As of 2019, 73% of private industry workers in the United States had paid sick leave benefits available from their employers. Both access to paid sick leave and the number of days available vary significantly by occupation and work-status (part-time vs. full-time), implying that those in lower-paying professions or working part-time may face more difficulty taking time off sick. For example, 94% of those in management and business occupations have access to paid sick leave, whereas only 58% of those in service occupations do.
The CDC has suggested that older people may be at twice the risk of younger people of contracting serious symptoms from COVID-19. In many regions, those 60 and older may be the first asked to stay home from due to their heightened risk. As of 2019, 14% of the US workforce was 60 or older, and 24% was 55 or older, according to data from the Bureau of Labor Statistics.
Another concern is that as schools close, students who depend on school meals will be left to find alternative sources of nutrition. As of 2018, 74.3% of students at schools participating in the National School Lunch Program, or 22 million children, receive free or reduced-price school lunches. As of 2016, there were 56.4 million children enrolled in public and private elementary and secondary education across the country. As of the 2016-17 school year, 52.3% of public school students were eligible for free or reduced lunch.
Participants in the free and reduced lunch program are children whose families are in poverty and may not be able to provide adequate meals at home. Schools may not charge children more than 40 cents for a reduced-price lunch.
Chart One: CDC
Chart Two: Census Single Year of Age Estimates
Chart Three: Census Current Population Survey
Chart Four: Bureau of Labor Statistics
Chart Five: Bureau of Labor Statistics
Chart Six: US Department of Agriculture
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