Colorado Health Access Survey Reveals How State Fared During Coronavirus Pandemic

Government Efforts and Social Safety Net Supported Many, But Mental Health Concerns Emerged as Major Challenge

Rapid policy changes paired with existing health and social supports protected many Coloradans from the cascading impacts of the COVID-19 pandemic, new data from the 2021 Colorado Health Access Survey suggests. But the pandemic worsened existing inequities and contributed to declining mental health and reduced use of health care.

These and other findings from the Colorado Health Access Survey provide the most comprehensive picture to date of how the state weathered the unprecedented health crisis. The survey, conducted every other year by the Colorado Health Institute (CHI), is the premier source of information on health coverage, access to health care, and the factors that influence health in Colorado. New questions added to the survey in 2021 captured both the economic and social impacts of the pandemic as well as experiences with telemedicine.

“Colorado’s existing social safety net, along with some quick policy choices and grassroots work, helped catch many Coloradans when they fell,” said Michele Lueck, President and CEO of CHI. “But the pandemic also worsened existing inequities and created a mental health crisis that our communities will need to be diligent in addressing.”

Many Coloradans lost jobs that provided them with health insurance coverage, but public programs, chiefly Medicaid, stepped in to fill the gap. As a result, the state’s uninsured rate remained at 6.6%, statistically unchanged since 2015.

Policy interventions such as cash assistance and a ban on evictions augmented community efforts to ensure statewide rates of housing insecurity and hunger did not increase despite the unprecedented recession: The Colorado Health Access Survey found 5.6% of the state’s residents reporting housing insecurity in 2021 and 8.1% reporting food insecurity. But some communities were hit harder than others: Rates of both food and housing insecurity for Black or African American, Hispanic/Latino, and American Indian and Alaska Native people were higher than they were for white Coloradans.

“While the results of the survey show that the state has much to be proud of, the fact that the pandemic was harder on communities already facing inequities demonstrates that we still have much more work to do to ensure the health of all Coloradans,” said Jeff Bontrager, a Director at CHI and Principal Investigator for the survey.

Other Key Findings:

Mental Health: More than one in three Coloradans ages 16 and up said their mental health was negatively affected by COVID-19, including more than half of young adults. Nearly one in four Coloradans ages 5 and older (23.7%) said they had eight or more days of poor mental health in the past month, a sharp increase from the previous high of 15.3% in 2019.

Coronavirus Impacts: The pandemic’s impact extended well beyond infection rates, touching on employment, finances, and child care. Almost a third of Coloradans ages 16 and up (29.3%) reported losing hours or income, and 17.2% struggled to afford basic necessities. These issues were even more pronounced among Hispanic/Latino and Black or African American Coloradans, who were also hit especially hard by the COVID-19 virus.

Telehealth: More than a third of Coloradans (35.9%) said they used telemedicine at some point in the prior year, including nearly half (48.7%) of people enrolled in Medicare, a group that includes mostly older adults. Most people who used telemedicine had a positive experience: 79.5% said it was as good or better than being seen in person.

Missed Care: Reductions in nonessential procedures and concerns over exposure to the coronavirus led to an overall decrease in health care use between 2019 and 2021. Just 16.3% of Coloradans used the emergency room, the lowest rate in the survey’s history.

Dental Issues: Only two-thirds of Coloradans (67.1%) reported seeing a dentist or dental hygienist in the past year, down from 73.6% in 2019. And while 82.9% of Coloradans reported that they had excellent, very good, or good oral health, some 400,000 Coloradans said they were unable to participate in regular daily activities like school or work due to dental pain.

The survey of more than 10,000 Coloradans was fielded between February and June 2021. Detailed results are available on the Colorado Health Institute's website.

The Colorado Health Foundation provides primary funding for the Colorado Health Access Survey. Other funders include Community First Foundation, Colorado Springs Health Foundation, Rocky Mountain Health Foundation, and Delta Dental of Colorado Foundation. The Latino Community Foundation of Colorado, Colorado Department of Human Services Office of Behavioral Health, Colorado Department of Health Care Policy & Financing, and UCLA Center for Health Policy Research sponsored specific questions on the survey.

About the Colorado Health Institute

The Colorado Health Institute is a nonprofit and independent health policy research organization. CHI believes that good health policy leads to a healthier Colorado. Every day we bring research, insight, and expertise to leaders across the state, because informed decisions lead to better health for all.

Contact for the Colorado Health Institute

Joe Hanel, communications director, hanelj@coloradohealthinstitute.org or 720.382.7093