The healthcare system in the United States has been characterized by a hospital-based and specialty-driven approach, and is plagued by low performance despite high healthcare spending. This situation is compounded by the lack of a strong preventative healthcare system, leading to a shortage of primary care physicians and worsening health disparities (Sawin and O’Conner, 2019). The COVID-19 pandemic has had an immense impact on healthcare systems in the United States and across the globe, especially preventative care. While people were in lockdown, healthcare resources were diverted to address COVID-19, often taking away support from preventative and primary care (Czeisler, et al., 2020). In the United States 6 in 10 adults have a chronic disease, and 4 in 10 have 2 or more chronic diseases (Chronic Diseases in America, 2022). The pandemic has highlighted the urgent need for greater investment into strong preventative care.  

As clinics have tried to catch up with the backlog of patients they did not see for preventative, elective, or broadly less urgent care during pandemic lockdowns, further delays in healthcare access have occurred, compounding pressure on the healthcare system. This has exposed the population to an increase in morbidity and mortality resulting from untreated chronic health conditions. (Horn, et al., 2020). As of June 30, 2022, 41% of US adults had delayed or avoided medical care during the pandemic due to COVID-19 concerns. 12% of these were people who avoided urgent or emergency care. Caregivers for adults, people with two or more underlying chronic diseases, and people with disabilities were more likely to avoid medical care. While the reasons behind these patterns are not completely understood, they may include adherence to public health recommendations, closure of health care facilities and fear of exposure to SARS-CoV-2 (Czeisler, 2020).  

The pandemic has also brought to light various criticisms of the way preventative care in the US operates. Annual exams tend to have limited clinical value and for many providers are a way to check off regulatory boxes rather than engage in preventative care (Horn and Haas, 2020). The current model of preventative services in the U.S. exacerbates existing health disparities as the use of annual exams is more common in White populations but not in populations of color (Horn and Haas, 2020). Rather than simply focusing on annual well visits, there must be a model of healthcare that focuses on population health and real-time preventative care. (Horn and Haas, 2020).  

Another proposed method to improve preventative care, especially in marginalized populations, is the employment of community-based patient navigators. These navigators offer a culturally sensitive route to close gaps preventative care such as cancer screening rates and bring healthcare to communities that have previously lacked access to care (Horn and Haas, 2020).  

Preventative care must also utilize technology to improve access and information sharing among healthcare workers and patients. Sophisticated patient portal systems provide immediate access to testing results. Electronic medical records can be used to identify disease trends and inform public health population measures to improve health in communities (Sawin and O’Conner, 2019).  

The COVID-19 pandemic has highlighted the pressing need for preventative care in the United States healthcare system. This shift requires innovative, patient-focused solutions that can help address health disparities. It is essential for the healthcare system to prioritize preventative care to provide equitable access and improve health outcomes (Sawin and O’Conner, 2019).  

References 

Chronic diseases in America. Centers for Disease Control and Prevention. December 13, 2022. https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm.  

Czeisler MÉ, Marynak K, Clarke KEN, et al. Delay or Avoidance of Medical Care Because of COVID-19-Related Concerns – United States, June 2020. MMWR Morb Mortal Wkly Rep. 2020;69(36):1250-1257. Published 2020 Sep 11. doi:10.15585/mmwr.mm6936a4 

Horn DM, Haas JS. Covid-19 and the Mandate to Redefine Preventive Care. N Engl J Med. 2020;383(16):1505-1507. doi:10.1056/NEJMp2018749 

Lim J, Broughan J, Crowley D, et al. COVID-19’s impact on primary care and related mitigation strategies: A scoping review. Eur J Gen Pract. 2021;27(1):166-175. doi:10.1080/13814788.2021.1946681 

Sawin G, O’Connor N. Primary Care Transformation. Prim Care. 2019;46(4):549-560. doi:10.1016/j.pop.2019.07.006