Why do young adults forego healthcare?


Vargas, Gabriela; Charlton, Brittany; Stamoulis, Caterina; Milliren, Carly; & Richmond, Tracy (2018). Why do young adults forego healthcare?. Global Adolescent Health Equity. Seattle, WA: Journal of Adolescent Health.


Purpose There is limited research on why young adults (18–26 year olds) forego healthcare; even less is known on gender differences. This study sought to define the prevalence of foregone healthcare among young adult males and females using a nationally representative sample, and to assess associations of sociodemographic factors, health, healthcare use, and gender. Methods Data was used from wave 3 of the National Longitudinal Study of Adolescent Health, conducted in 2001–2002. Respondents were asked if within the last year they did not seek medical attention when they thought they should. A complete case analysis was performed of a sub-population of 13,347 (6,200 males and 7,147 females) of 15,150 respondents, who met inclusion criteria for the study. Frequencies were obtained for reported foregone visits, sociodemographic factors, health, healthcare use, as well as health concern(s) at and reason(s) for foregone visit. Multivariable logistic regression analyses were used to examine the effects of sociodemographic factors, health, and healthcare use on foregone healthcare by gender. Results Prevalence for foregone visits was similar among young adult males (24.0%) and females (23.3%). Both males and females were statistically significant more likely to forego care if they identified as Hispanic [males OR 1. 4, 95% confidence interval (CI): (1.2–1.7); females OR 1.2, (1.0–1.4)], reported very good versus excellent health [males OR 1.4 (1.2–1.6); females OR 1.8, (1.6–2.1)], chronic problem [(males OR 1.2, (1.2–1.6); females OR 1.4, (1.2–1.6)], prescription use [(males OR 1.2, (1.0–1.4); females OR 1.2, (1.2–1.6)], and if they were working [(males OR 1.5, (1.2–1.8); females OR 1.5, (1.2–1.8)]. Males also had a statistically higher likelihood to forego care with age [OR 1.1, (1.0–1.1)]. Factors associated with decreased likelihood of foregone care for both males and females were continuous insurance coverage versus no insurance [males OR .4 (.3–.5); females OR .5, (.4–.7)] and routine check-up within last 12 months [males OR .8, (.7–.9); females OR .8 (.7–1.0)]. The main health concern at time of foregone visit, for both males (43.3%) and females (58.1%), was feeling sick. The main reasons for foregone visit were similar among males and females, and included a) thought the problem would go away (males 33.6%, females 31.4%), b) couldn't pay (males 27.2%, females 35.7%), and c) didn't have time (males 29.5%, females 29.3%). Conclusions These findings suggest that young adult males and females are equally as likely to forego healthcare. Clinicians should be aware of the causes of foregone healthcare and re-examine public health and office systems as well as provide anticipatory guidance to address individual risk factors with the goal to improve young adult health.



Reference Type

Conference proceeding

Book Title

Global Adolescent Health Equity


Vargas, Gabriela
Charlton, Brittany
Stamoulis, Caterina
Milliren, Carly
Richmond, Tracy

Year Published


Volume Number





Journal of Adolescent Health

City of Publication

Seattle, WA





Reference ID