The number of child and adolescent health center patients fell by 14 percent from 2019 to 2020

Children represent more than one quarter of all health center patients, although, as discussed below, the proportion of health center patients who are children fell notably between 2019 and 2020, from 31 percent to 28 percent,[3] mirroring a nationwide trend of declining pediatric care during the pandemic as families tried to avoid exposure to possible infection by delaying or forgoing health care for children.[4]

Figure 2 illustrates the change in the volume of total patients and patients by age group between 2019 and 2020. The total number of patients served fell by over 1.2 million, or four percent. This was the first recorded drop in the number of health center patients since the UDS was established over 25 years ago.[5] The number of children served fell by over 1.3 million, or 14 percent, the largest decline among the age groups. This decline may be partially attributable to temporary closures of school-based sites—nearly 2,100 health center sites were temporarily closed as of April 2020[6] and school-based sites accounted for more than 3,000 (22 percent) of all 13,555 health center sites in 2020[7]—but it is difficult to say with certainty because HRSA’s Health Center COVID-19 Survey has tracked the number but not the type of temporarily closed sites.[8]

Figure 2

Total Patients 

Children Under 18

Non-Elderly Patients

Elderly Adults

In contrast to younger patients, the number of non-elderly adult patients remained stable from 2019 to 2020, while the number of elderly patients grew by two percent. The share of non-elderly adult patients age 18 to 64 grew from 60 percent to 62 percent during that same time period, while the share of elderly patients remained stable at ten percent. Over time, the percentage of adult health center patients ages 65 and older has slowly climbed, from seven percent in 2002 to 10 percent in 2020;[1] over that same time period, the share of children declined from 36 percent to 28 percent and non-elderly adult patients increased from 57 percent to 62 percent (Figure 3). The increasing percentage of health center patients who are elderly likely reflects a number of factors, including the growing number of poor elderly adults,[2]a general aging of the population and changes in health care seeking patterns,[3] and the importance of health centers as a source of ambulatory care for dual-eligible patients.[4]

Figure 3

2002

2020