Barriers to healthcare and their relationship to well-being and social support for autistic adults during COVID-19

Abstract

Aim: The present study aimed to investigate barriers to healthcare and their relationships to social and emotional wellbeing and intersectional inequalities for autistic adults during Covid-19 restrictions in the UK.

Background: Autistic adults experience severe health inequalities and report more barriers to

accessing health services compared to other both disabled and non-disabled populations. The

Covid-19 pandemic has impacted many areas ofsociety that may have increased vulnerability

of autistic people to social and health inequalities, including delivery of healthcare from in-

person to remote methods.

Method: 128 autistic adults who lived in the UK took part in an online survey. Measures

included the Barriers to Healthcare Checklist (Short Form) and PROMIS outcome measure

bank to assess emotional wellbeing and social support. Participants rated their agreement

with items, retrospectively considering three different points of the trajectory of Covid-19

restrictions: before Covid-19, during the first lockdown in spring 2020, and in the month

prior to taking the survey during autumn 2020. They completed a follow-up survey six

months later to continue to assess change as restrictions in the UK were eased.

Findings: The average number of barriers to healthcare showed no significant change

between all four time points. However, the nature of barriers to healthcare changed at the

point of lockdown and persisted beyond the easing of Covid-19 restrictions. Barriers to

demographic groups including gender, education and presence oadditional disabilities. The

findings may help to identify areas to target to improve access to both remote and in-person

health systems for autistic people as modes of delivery continue to change over time.