Poll: Half of Households in the Four Largest U.S. Cities Report Serious Financial Problems Including Depleted Savings, and Trouble Paying Bills or Affording Medical Care

Princeton, N.J.—An NPR/Harvard T.H. Chan School of Public Health/Robert Wood Johnson Foundation poll reveals at least half of households in the four largest U.S. cities—New York City (53%), Los Angeles (56%), Chicago (50%), and Houston (63%)—report facing serious financial problems during the coronavirus outbreak. Serious problems are reported across a wide range of areas during this time, including depleted household savings, serious problems paying credit card bills and other debt, and affording medical care.

Many of these problems are concentrated among Black and Latino households; households with annual incomes below $100,000; and households experiencing job or wage losses since the start of the outbreak. Serious financial problems during the coronavirus outbreak are reported by majorities of Black households in New York City (62%), Los Angeles (52%), Chicago (69%) and Houston (81%). Serious financial problems are also reported by majorities of Latino households in New York City (73%), Los Angeles (71%), Chicago (63%), and Houston (77%) during this time. In addition, majorities of households with annual incomes below $100,000 report facing serious financial problems in New York City (65%), Los Angeles (64%), Chicago (59%), and Houston (72%) during the coronavirus outbreak.

When it comes to employment problems, half or more households in these cities report any adult household members have lost their jobs, been furloughed, or had wages or hours reduced since the start of the outbreak (New York—50%, Los Angeles—61%, Chicago—51%, Houston—57%). And among these households with job or wage losses during the coronavirus outbreak, more than two-thirds report facing serious financial problems (New York—73%, Los Angeles—73%, Chicago—69%, Houston—81%).

In health care, significant shares of households in New York, Los Angeles, Chicago, and Houston report household members have been unable to get medical care for serious problems when they needed it during the coronavirus outbreak, and they have faced negative health consequences as a result. Since the start of the coronavirus outbreak, 19 percent of New York households, 20 percent of Los Angeles households, 23 percent of Chicago households, and 27 percent of Houston households report anyone in their household has been unable to get medical care for a serious problem when they needed it. A majority of these households with anyone who has been unable to get care when needed (New York City—59%, Los Angeles—63%, Chicago—55%, Houston—75%) report negative health consequences as a result.

"The Impact of Coronavirus on Households in Major U.S. Cities" was conducted July 1–August 3, 2020, among 3,454 U.S. adults, including 512 adults living in New York City, 507 adults living in Los Angeles, 529 adults living in Chicago, and 447 adults living in Houston. Adults in this survey were asked to report on serious problems facing both themselves and others living in their households, so measures are reported as a percentage of households for all household-related questions.

“This pandemic has revealed glaring problems in the nation’s health care system,” says RWJF President and CEO Richard Besser, MD. “At a time when a significant number of people need health care most, many cannot get it. We need to be able to provide safe, affordable care for people with COVID-19, as well as for the many with chronic medical conditions so rampant in America. It is unacceptable that in a wealthy nation like ours factors such as income or race play such a big role in health care access.”

When it comes to caring for children, majorities of households with children in New York (60%), Los Angeles (69%), Chicago (51%), and Houston (60%) report experiencing serious problems during this time. This includes sizable shares of households with serious problems keeping children’s education going, helping children adjust to major life changes, finding childcare while working, and finding space for children to get physical activity while maintaining a safe distance from others.

Households with children in major cities also face significant barriers with internet connectivity during the coronavirus outbreak. At least four in ten households with children report either having serious problems with their internet connection to do schoolwork or their jobs, or that they do not have a high-speed internet connection at home (New York—43%, Los Angeles—54%, Chicago—40%, Houston—45%).

“Before federal coronavirus support programs even expired, we find millions of people with very serious problems with their finances, health care, and with caring for children,” said Robert J. Blendon, co-director of the survey and Richard L. Menschel Professor Emeritus of Public Health and Professor of Health Policy and Political Analysis at Harvard T.H. Chan School of Public Health. “Though we want to believe we are all in this together, findings show problems concentrated in people who earn less than $100,000, people who have lost wages or jobs, and Black and Latino Americans.” 

Methodology

The poll in this study is part of an on-going series of surveys developed by researchers at the Harvard Opinion Research Program (HORP) at Harvard T.H. Chan School of Public Health in partnership with the Robert Wood Johnson Foundation and NPR. The research team consists of the following members at each institution. 

Interviews were conducted online and via telephone (cell phone and landline), July 1–August 3, 2020, among a nationally representative, probability-based sample of 3,454 adults age 18 or older in the United States. The survey included representative samples of adults living in each of the four largest U.S. cities: New York City, Los Angeles, Chicago, and Houston. Data collection was conducted in English and Spanish by SSRS (Glen Mills, Pa.), an independent research company.

The core of the sample was address-based, with respondents sampled from the United States Postal Service’s Computerized Delivery Sequence (CDS) file. Sampled households were sent an invitation letter including a link to complete the survey online and a toll-free number that respondents could call to complete the survey with a telephone interviewer. All respondents were sent a reminder postcard, which also included a QR code they could scan to be linked to the survey via a smart device. Households that could be matched to telephone numbers and that had not yet completed the survey were called to attempt to complete an interview. In order to represent the hardest-to-reach populations, the address-based sample (ABS) was supplemented by telephone interviews with respondents who had previously completed interviews on the weekly random-digit dialing (RDD) SSRS Omnibus poll and online using the SSRS Opinion Panel, a probability-based panel. 

A total of 2,992 respondents completed the questionnaire online, 127 by calling in to complete, and 335 were completed as outbound interviews. 

Possible sources of non-sampling error include non-response bias, as well as question wording and ordering effects. Non-response produces some known biases in survey-derived estimates because participation tends to vary for different subgroups of the population. To compensate for these known biases and for variations in probability of selection within and across households, the samples were weighted to match the distribution of the population based on data from the U.S. Census Bureau’s 2018 American Community Survey (ACS). Weighting parameters included: gender, age, education level, race/ethnicity, and for the national sample also region. 

Respondents who were the only person living in a household were asked about their own experiences. Respondents who had anyone else also living in their household were asked about the experiences of anyone living in the household. Together these responses represent the experience of the household.    

About Harvard T.H. Chan School of Public Health

Harvard T.H. Chan School of Public Health brings together dedicated experts from many disciplines to educate new generations of global health leaders and produce powerful ideas that improve the lives and health of people everywhere. As a community of leading scientists, educators, and students, we work together to take innovative ideas from the laboratory to people’s lives—not only making scientific breakthroughs, but also working to change individual behaviors, public policies, and health care practices. Each year, more than 400 faculty members at Harvard Chan teach 1,000-plus full-time students from around the world and train thousands more through online and executive education courses. Founded in 1913 as the Harvard-MIT School of Health Officers, the School is recognized as America’s oldest professional training program in public health.

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About the Robert Wood Johnson Foundation

For more than 45 years the Robert Wood Johnson Foundation has worked to improve health and health care. We are working alongside others to build a national Culture of Health that provides everyone in America a fair and just opportunity for health and well-being. For more information, visit www.rwjf.org. Follow the Foundation on Twitter at www.rwjf.org/twitter or on Facebook at www.rwjf.org/facebook.