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Informing Policy. Advancing Health.

Taking Care of Business: Work Demands Keep More Coloradans from Getting Needed Medical Care

The 9-to-5 grind. The night shift. The 40-hour work week that always seems to go beyond. Demanding work schedules are increasingly being cited by Coloradans as a reason they’re not getting the health care that they need.

The percentage of employed Colorado adults who say they were unable to make an appointment because they could not take time off work increased by nearly two percentage points to 12.2 percent in 2015 from 10.4 percent in 2013, according to the Colorado Health Access Survey (CHAS)

This means that 307,122 employees could not take time from work for a doctor’s appointment in 2015 compared with 259,422 in 2013, an increase of nearly 50,000.

But some workers face this problem more than others. 

Income Levels:

A greater percentage of lower-income workers find it difficult to get the time off for health care.

About one of six (16.5 percent) working Coloradans with annual household incomes just above the poverty line — between 101 and 200 percent of the federal poverty level (FPL) –– report that their work schedules are keeping them from accessing care. 

These low-income Coloradans are more likely to work hourly jobs, which may not offer benefits like paid time-off for medical needs. They may also be juggling multiple jobs and tight schedules.

On the other end of the scale, 10 percent of workers in the highest-income group – above 400 percent of the poverty level – said they could not miss work for an appointment. Coloradans in this bracket are more likely to be salaried employees with more flexible work schedules. They also may have benefits such as paid time-off or paid leave for medical reasons.

Insurance Types:

About 12 percent of workers with private insurance said they were unable to get health care because of work obligations compared with 11.1 percent of employees who are publicly insured through Medicaid or Medicare. But it’s uninsured workers who most often report missing an appointment because of work, with 15 percent saying their work schedules kept them from visiting the doctor.


Fewer parents are reporting that they didn’t take a child to the doctor because they couldn’t get time off work. Only 7.1 percent of parents said they couldn’t take time off work for their child’s medical appointment in 2015, down from 9.4 percent in 2013. During that time, the percentage of Hispanic parents who reported not being able to leave work to take their kids to medical appointments dropped by more than half, to 7.4 percent in 2015 from 14.8 percent in 2013. 

Policy Implications

Some cities and states across the nation are instituting paid leave policies.  California employees – including part-time and temporary workers – must accrue at least one hour of paid leave for every 30 hours worked as of July 2015. In San Francisco, the City Supervisors voted to require six weeks of fully paid parental leave for all employees. And on the East Coast, New York just joined New Jersey and Rhode Island in establishing a paid family leave policy. 

So far, no Colorado cities have added a paid leave policy. Colorado legislators postponed three bills related to paid leave during this session.

Meanwhile, some clinics and offices in Colorado are beginning to offer evening, weekend and drop-in appointments. And the increase in retail clinics may be a providing options for patients with unpredictable work schedules.