LISTEN: People with lower incomes have longer wait times for services, study says
AYESHA RASCOE, HOST:
We all spend so much time waiting - in the line at the grocery store, at the dentist's office, for the bus. But a new study in Nature shows that low-income people wait even longer on an average day for services than those who are high-income. Katie Vinopal is an associate professor at The Ohio State University and one of the authors of the study. Welcome to the show.
KATIE VINOPAL: Thanks. Thanks for having me.
RASCOE: First, tell us about the difference between, like, low-income people versus high-income people when it comes to wait times in general.
VINOPAL: So we know that having enough time makes for a healthier and happier life, right? We need enough time to manage our stress, play with our kids, exercise, on and on. But this idea of time inequality is kind of broad, right? It's difficult to measure. So one way of getting at an aspect of this, at least, is by examining these differences in time spent waiting for necessary goods and services. So pretty much no one likes to wait. It's unproductive. It's unpleasant. So we find that on an average day, relative to high-income people, people with low income are one percentage point more likely to wait, three percentage points more likely to wait when using services and that they spend an additional minute waiting. So this means the annual waiting time for high-income people is about 7 1/2 hours, compared to about 13.6 hours for people with low income. So the waiting time is nearly double for low-income people.
RASCOE: And so six hours - that doesn't sound like a huge difference. Can you explain, like, what type of difference that makes?
VINOPAL: First, six hours - a six-hour gap - is nearly a workday, right? So if you have a low income, especially if you're an hourly worker, those six hours are important to your budget. Second, about 24% of U.S. adults fall into the income bracket that we're considering low income for this study - so less than $20,000 a year. So in the aggregate, this gap in waiting time represents a huge national cost, so somewhere between 3.6 and $9.3 billion per year.
RASCOE: So, I mean, your study says that this gap that we're seeing between the different income classes when it comes to waiting time, that it cannot be explained by differences in family obligations or demographics or education or work time, travel time. And if that's the case, then what is going on?
VINOPAL: You know, our data doesn't allow us to see exactly why this is happening. So some of this is speculation. But previous research points to a number of likely reasons for time inequality, generally. For example, higher-income people usually have more job flexibility that might allow them to schedule appointments during off-peak hours. They also don't have to worry about taking a whole day off work or losing pay to accommodate those kinds of appointments. We also know that people in more disadvantaged economic circumstances are more likely to do more waiting-intensive things, like interacting with the government more often and in more burdensome ways. We know Medicaid patients have longer doctor's waiting rooms compared to privately insured patients. And then finally - and this is a big one - I think neighborhoods play a huge role here. So people living in communities with less access to reliable, high-quality, efficient services - like fully staffed and efficient grocery stores, for example - are likely to spend more time waiting.
RASCOE: Now I want to talk about the racial aspect of this because I was struck by the fact that although there are income differences, this study found that even high-income Black people experience the same wait times as low-income Black people. So what is happening with that?
VINOPAL: Wealthier white people face an average wait time of 28 minutes, whereas wealthier Black people are facing an average wait time of 54 minutes. But again, previous research points to a number of likely explanations. So the first is discrimination in treatment - right? - so anti-Black racism. So, for example, one study found that when seeking mental health care, middle-class seekers were offered appointments more often than their working-class counterparts. But then even among middle-class patients, Black mental health care seekers were less likely than white mental health care seekers to be offered an appointment. And the second potential explanation, again, has to do with geography. So neighborhoods matter, and we have a history of redlining and systematic disinvestment from neighborhoods that are less white in this country, which means Black communities have received less financial supports and capital investments, leaving services overburdened and under-resourced.
RASCOE: I do want to ask, because it seems like one thing about - if you have to wait longer for services, does your studies show anything about people just giving up on getting the service altogether? I could see this happening with medical services and others where you just go, I just don't have time to do that.
VINOPAL: So we don't get at this in this study, but we hope future research picks this up because we might worry that wait times alter behavior in damaging ways. Like you say, with long wait times, lower-income households might put off seeking medical care until health problems become worse. People living in a neighborhood without great grocery options might choose to save time, purchase less healthy but faster food options. Long waits at polling locations mean people are less likely to vote, right? So I think that wait times, or just kind of the way people are forced to spend their time, is a hidden burden of poverty, right? People know that it exists, and anecdotally, if you talk to anyone, they'll tell you that being low-income or being poor is expensive and time-consuming.
RASCOE: That's Katie Vinopal. She is an associate professor at The Ohio State University. Thank you so much for joining us.
VINOPAL: Thank you. Transcript provided by NPR, Copyright NPR.