Half of women skip or delay care due to 'triple threat' of factors, report finds

Half of women in the U.S. skip or delay medical care due to the “triple threat” of affordability, access challenges and past negative experiences, a new Deloitte report finds.

The report is based on a 2024 survey that reached more than 2,000 U.S. consumers, which found that 50% of women report skipping or delaying medical care. They are 35% more likely to skip care than men. This can be attributed to long wait times, transportation issues and a lack of convenient appointments.

Cost is also a factor, per the report. The survey found women are 31% more likely than men to skip care, including mental health services, specifically due to cost. Women are less financially prepared for unforeseen medical expenses, with nearly half reporting they are unprepared or only slightly prepared to pay $500 for an emergency. That is up 37% from two years ago. By contrast, only a quarter of men report being unprepared for such emergencies.

“You can’t achieve your full potential in your health and wellbeing without having the financial health as well,” Kulleni Gebreyes, M.D., U.S. chief health equity officer and managing principal of life sciences and healthcare at Deloitte, told Fierce Healthcare.

A previous Deloitte analysis of claims data found that women pay $15.4 billion more in out-of-pocket costs per year than men. It also found that women, even when excluding maternity-related care, require on average nearly 10% more healthcare services than men. This difference, according to Deloitte, could be due to biological differences or disease prevalence.

A focus group from a past Deloitte study revealed that 40% of women reported skipping or avoiding care because of how a provider or staff member treated them in the past. And women’s healthcare issues are often misdiagnosed or overlooked, the latest report highlighted. For example, middle-aged women with symptoms of heart disease are twice as likely as men to be misdiagnosed. These experiences can cause distrust and lead women to avoid needed care.

This is partly because of a biased system that “has been designed on a one-size-fits-all model,” per Gebreyes. When she was training in medical school, she explained, the average patient was described as a 70-kilogram white male. As a result, men have been and largely remain the default standard for many things in healthcare, despite data showing that women make up nearly 60% of the paid workforce and 65% of the unpaid workforce in the U.S.

Among the top types of care women forego due to cost are acute illness (38%), preventive care (35%) and women’s health issues (34%). Avoiding or delaying routine care can result in worsening health conditions, which could ultimately lead to higher associated costs of treatment, per the report.

“The more we delay care, the more likely we’re going to be sicker when it’s diagnosed and the more likely it’s going to cost us more,” Gebreyes said.

The good news, Gebreyes said, is that healthcare stakeholders can each do something today to make a meaningful change for the better for women. “There are ways we can all figure out how to make the system have fewer obstacles for women accessing care,” she said.

Employers can improve workforce health by promoting health literacy, prioritizing well-being and increasing access to preventive screenings. They can consider benefits to enhance coverage for women beyond fertility and childbirth. And they can consider flexible work schedules, onsite healthcare services, subsidized child care and paid sick leave.

Payers can help bridge equity gaps by examining their plan designs for gender biases and introducing products to equally benefit genders. For instance, adjusting cost-sharing mechanisms in proportion to healthcare utilization could be a tactic. Payers could also help employers find plans that achieve equity goals while negotiating affordable rates with network providers. And they could incorporate gender-specific cost estimates into cost-transparency tools.

Hospitals and health systems could enhance care for women by investing in alternative sites of care and other low-cost settings like telehealth or retail care to improve access to care, according to the report authors. Other recommendations outlined in the report include customizing care and treatment plans through personalization and improving the patient experience based on feedback mechanisms. Health systems should encourage clinicians to listen actively and educate women about their health to help drive informed choices about their care. Prioritizing workforce diversity by supporting gender-diverse care teams is also crucial, as well as designing digital tools equitably and with privacy in mind, the report authors wrote.

Finally, investors can play a role by continuing to fund products and services dedicated to women’s health, the report noted. Adopting a women-centered design approach and involving women, community voices and diverse teams in that process can spur more innovative and inclusive solutions. Life science stakeholders can direct more R&D efforts toward health conditions specific to women. And boards of directors can play an important role by overseeing organizations’ efforts to remain accountable, manage budgets, measure progress and evaluate initiatives around research and innovations.