UHG Report Finds Encouraging Trends During The Coronavirus Pandemic

While the coronavirus pandemic has had a terrible impact on measures such as the national mortality rate and health equity, certain measures—such as the prevalence of multiple chronic conditions and overall very good or excellent health—witnessed encouraging improvements, according to the UnitedHealth Group’s America’s Health Rankings Report for 2021.

“In this year’s report—which provides a comprehensive look at our nation’s overall health—we begin to see how the COVID-19 pandemic has had both direct and indirect impacts on health and health trends,” said Rhonda Randall, DO, executive vice president and chief medical officer of UnitedHealthcare Employer and Individual, part of UnitedHealth Group. 

“The report also demonstrates an urgent and ongoing need to further examine and discuss these findings and how to best address Americans’ most pressing health needs.”

In 2019 and 2020, national mortality rates rose by 17 percent when compared to rates before the pandemic. And early data indicated that the mortality rate in 2021 rose 21 percent above pre-pandemic levels.

The coronavirus pandemic itself was largely responsible for raising these rates, becoming the third most prevalent cause of death in 2020 and claiming nearly 378,000 lives.

While mortality escalated, more Americans reported very good or excellent health. From 2012 through 2019, the number of Americans who said that they were in very good or excellent health dropped steadily from 52.7 percent to 49.7 percent. However, in 2020, this share of the population grew to 56.3 percent.

The population of individuals with multiple chronic diseases also decreased. From 2019 into 2020, four percent fewer patients reported having three or more of the eight chronic conditions that UnitedHealth Group tracked.

Cancer diagnoses dropped significantly, declining seven percent from 2019 to 2020. Prior to 2020, the rate of cancer diagnoses increased nine percent from 2016 to 2019.

“It is possible that a marked decline in routine cancer screenings due to the COVID-19 pandemic may have contributed to this decrease, with some cases of cancer and other chronic conditions going undiagnosed,” the researchers acknowledged.

“Further analysis will be necessary as additional data become available to understand the full impact of COVID-19 on chronic conditions in the US.”

Average time sleeping improved in 2020, the report found. The number of individuals who reported that they slept on average less than seven hours each day dropped by six percent.

Excessive drinking trends also seemed to have shifted. Reports of binge drinking and heavy drinking diminished by five percent to 17.6 percent of adults—a rate that has not been seen since 2014. 

The report noted that while binge drinking declined, heavy drinking increased from 6.5 percent to 6.7 percent. Still, the pandemic has underscored ways that payers can improve substance abuse care.

Flu vaccinations also increased by eight percent from 2019 to 2020. The 2020 flu vaccination rate set a record that had not been reached since America’s Health Ranking report began tracking flu vaccinations in 2012.

Additionally, the mental healthcare and primary care workforce grew by 30 percent from 2017 to 2021. However, the distribution of mental healthcare workers continued to present access to care barriers, with some states like Massachusetts receiving a huge influx of workers and other states like Alabama still lacking a strong workforce.

The prevalence of mental distress reportedly declined from 2019 to 2020, dropping four percent and reversing a climbing trend that had started in 2014. However, this trend was not ubiquitous across patient populations. Certain minority groups and individuals with lower education and income levels were more likely to experience mental distress.

Separate studies have also illuminated the impact that the coronavirus pandemic had on seniors’ mental health.

Despite these improvements, the report also underscored the detrimental impacts of the coronavirus pandemic.

In particular, lack of health equity, drug use, and e-cigarette usage all gained greater prevalence in 2020.

Care disparities were very evident in the presence of multiple chronic conditions among certain minority populations, with American Indian and Alaska Native adults experiencing 5.5 times higher rates of multiple chronic conditions than Asian adults. Separate studies have also indicated differences in mortality rates among seniors based on racial care disparities.

High health status was also much more prevalent among individuals who graduated from college, compared to high school graduates. And certain states achieved better health outcomes than others, with West Virginia residents experiencing multiple chronic conditions at a rate 2.9 times the prevalence in Hawaii.

“The pandemic has shown us how important it is to have a strong public health infrastructure to continue to address the challenges we face,” said Georges C. Benjamin, MD, executive director of the American Public Health Association. “It is my hope that we use this data to build a public health system that can work to protect all Americans and address health inequities.”