Colorado Health Access Survey Captures a Moment of Truth

Press Release

Coloradans are having an increasingly hard time finding mental health care. Meanwhile, housing instability and hunger rose in 2023 after the end of pandemic policies that provided social assistance, new data show.

Results of the Colorado Health Access Survey (CHAS), released by the Colorado Health Institute, reveal substantial changes in health, health access, and social stressors stemming from the COVID-19 pandemic and the government’s response. The survey of nearly 10,000 Colorado households, which was fielded from March to September 2023, captures a historical moment with important lessons for health policy.

"We see the 2023 CHAS findings as a moment of truth. The data show the impacts of policy on Coloradans’ abilities to access to care, maintain insurance coverage, pay their rent or mortgage, and put food on the table for their families. And now we’re seeing some of those gains slip away as pandemic policies have been lifted," said Sara Schmitt, President and CEO of the Colorado Health Institute.

New questions added to the 2023 survey focused on long COVID, access to reproductive health care, climate change, and more. The Colorado Health Institute will continue to roll out additional survey analyses throughout the year. However, all the results are available today through a public use file or topic-specific spreadsheets. Visit the Colorado Health Institute’s website to find deeper analysis of each topic, regional profiles, workbooks, and interactive graphics.

"The Colorado Health Access Survey provides insights for policymakers, grassroots organizations, researchers, and others in the community to assess needs and improve health," Schmitt said. "Because the survey has been fielded since 2009, it also allows us to measure progress and track long-term changes."

Key Findings

Insurance

More than 19 in 20 Coloradans had health insurance in 2023 — driving the uninsured rate down to its lowest point ever, 4.6% — thanks to emergency rules that kept people enrolled in Medicaid during the pandemic. But the emergency rules have expired, and it’s likely the uninsured rate has risen again.
People on the Western Slope continued to lack health coverage at a higher rate than those elsewhere in Colorado.

Mental Health

The public health emergency may have ended, but Colorado remains in a mental health crisis. More than one in four people (26.2%) reported eight or more days of poor mental health in the past month. And 17% (about 880,000 people) said they could not get the mental health care they needed.
Adults under the age of 50 and LGBTQ+ Coloradans struggled the most, with more than half of Coloradans identifying as LGBTQ+ reporting poor mental health.

Climate and Health

Climate change has affected the health of nearly 2 million Colorado adults or their families. Of those who said climate change has affected their health, nearly seven in 10 said it made breathing problems worse (65.6%), one in three said it negatively affected their mental health (32.9%), one in 10 suffered heat illness, heat stress, or heat stroke (9.6%), and nearly one in 20 lost housing, property, or income (4.7%).
Coloradans also worry that their communities are not prepared for climate disasters, especially those in Denver and on the Eastern Plains.

Housing Stability

As with the insured rate, housing policy during the COVID-19 pandemic led to higher levels of housing security. But because housing protections ended earlier, the CHAS already shows instability levels returning to 2019 levels or higher. In 2023, 7.1% of all Coloradans (16.9% of renters and 2.4% of homeowners) worried they would not have stable housing in the next two months. That was up from 5.6% in 2021.
Many people of color were impacted by housing affordability issues in 2023. Hispanic or Latino and Black or African American Coloradans were more likely to have trouble with housing affordability compared with their white neighbors. Hispanic or Latino Coloradans experienced the most instability with 19.5% unable to pay rent or mortgage in the last year, and 12.7% worried they would not have stable housing in the next two months.
Statewide, people in northeast Colorado and Pueblo County had the most trouble paying the rent or mortgage in the past year.

Food Security

The rate of food insecurity also improved slightly during the pandemic (8.1% in 2021, down from 9.6% in 2019) but jumped more than three percentage points to 11.2% in 2023.
Food insecurity affected farming communities the most, with as many as a fifth of people in Weld County and counties in southeast and south-central Colorado reporting eating less than they thought they should because they could not afford food.
Men reported the lowest rates of food insecurity (9.1%), compared with women (12.2%). Nearly two in 10 (18.2%) nonbinary/other gender Coloradans reported eating less because they couldn’t afford food.

Affordability of Care

The cost of getting care — filling a prescription, getting a doctor’s care, seeing a specialist — was still a barrier for more than a million Coloradans (19.8%).
More than half the people without insurance skipped care because of cost (56.2%). Having insurance helps, and yet, nearly two in 10 Coloradans with employer-sponsored insurance (18.8%) and one in four with individual market coverage (25.5%) said they could not afford the care they needed.
American Indian or Alaska Native Coloradans more frequently reported being unable to afford care due to cost (35.0%) compared with the state’s other race and ethnic groups.

Disrespect in Health Care

Disrespectful treatment in the medical system is a growing problem. In 2023, nearly one in 13 adults (7.1%) reported being treated with less respect than others when seeking health care in the past year. This represented 296,065 adults who faced disrespectful treatment. That’s up from about one in 25 (3.8%) in 2021.
A patient’s age (38.4%) and income or financial situation (34.5%) were the most common reasons cited for disrespect, but race (31.0%), disability (28.8%), weight (25.4%), and gender (24.4%) were among the other reasons given.
Younger adults ages 18-25 (15.7%) were most likely to report feeling disrespected.

Long COVID

Nearly half of Coloradans 16 and older (48.8%) said they tested positive for COVID-19 at some point since the start of the pandemic. One in seven of those (about 300,000 Coloradans) said their symptoms lasted three months or longer — which is classified as long COVID.

Resources

The 2023 Colorado Health Access Survey website contains links to these data and additional resources:

Briefs for each topic area listed above that include interactive graphics
A pdf of our chart pack: A Moment of Truth, Well-Being in the Wake of the Pandemic
Regional Fact Sheets (by Health Statistics Region)
Workbook downloads (Excel Spreadsheets) with detailed topical information
Survey Materials (questionnaire, public use file, data dictionary, etc.)
Behind the Numbers: Stories that bring the CHAS data to life
Interactive Data Dashboard (coming soon)

The Colorado Health Foundation is the lead sponsor for the Colorado Health Access Survey. Other funders include the Colorado Springs Health Foundation, Colorado Department of Health Care Policy and Financing, Colorado Department of Human Services, Colorado Office of e-Health Innovation, Colorado Behavioral Health Administration, Colorado Department of Labor and Employment, Colorado Department of Public Health and Environment, Colorado Gives Foundation, Delta Dental Foundation of Colorado, and the Steadman Group.

About the Colorado Health Institute

The Colorado Health Institute is a nonprofit, mission-driven research and consulting group advancing equity and well-being in our communities through deep expertise and implementational know-how. We simplify the complex, provide context, and advance policies that make a difference.

Contact for the Colorado Health Institute

Joe Hanel, Communications Director, hanelj@coloradohealthinstitute.org or 720.382.7093