From February 28th – March 13th, 2024, the Oregon Values and Beliefs Center conducted a statewide survey of Oregonians’ values and beliefs on the topic of health and healthcare. This memorandum summarizes key findings regarding questions related to preventative care, healthcare system change, healthcare actions, and sources of information. Another memo has been prepared for insurance, access, and quality.
The question numbers in this document correspond with the accompanying annotated questionnaire and tabs. Due to rounding, the percentages reported below may not add up to 100% or compare exactly to the percentages for the same question in the annotated questionnaire or tabs.
Included below for selected questions are some noteworthy subgroup variations for age, gender, area of the state, BIPOC/white, etc. The accompanying set of tabs notes subgroup variations for all the questions.
For survey full question wording, all statistically significant subgroup findings, and respondent quotes, readers are encouraged to refer to the accompanying documents located at the bottom of this post under “For More Information”: (1) annotated questionnaire, (2) crosstabulations, and (3) verbatim written responses spreadsheet (upon request).
Summation Quotes
Amaury Vogel, Executive Director:
Preventative Care
“About two thirds of Oregonians feel their healthcare coverage is not focused on prevention and about the same number feel their provider should be more focused on preventative healthcare.”
“When commenting about health practices and illness prevention, Oregonians want to see improvement and most often mention specific illnesses and conditions, like diabetes and hypertension, more focus on preventative care, and building trust in healthcare providers.”
“Oregonians most often associate exercise, diet and practicing good hygiene as key to maintaining health and for illness prevention.”
Healthcare System Change
“Oregonians give the state a passing grade for providing healthcare to Oregonians with around seven out of ten residents give either a B grade or a C grade.”
“A majority of Oregonians want major change to the healthcare system in Oregon and the sentiment is even stronger for the mental health system in the state with two-thirds want major change.”
“Oregonians want a more proactive approach to providing mental health services including quicker appointments, cost controls, and higher care standards for the Oregon Health Plan.”
“Oregonians believe that society treats physical health as more important than mental health when they personally feel they are equally important.”
Healthcare Actions/Initiatives
“Majorities of Oregonians rate four healthcare actions that could be taken by society as desirable, with the strongest desire being for rigorous evaluation and ethical considerations guiding the public distribution of health services and striving to replace illness treatment with healthy living as the primary goal of healthcare.”
“Oregonians rated six tax-or consumer funded health care actions as desirable, feeling strongest about ensuring equal access to quality healthcare and providing accessible and quality prenatal care. Though with less enthusiasm, a majority of Oregonians also rate as desirable incentivizing providers to serve rural areas or other underserved location, ensuring people can safely pursue active lifestyles, establishing a universal public-funded health delivery system, and supporting neighborhood gardens.”
Information Sources
“The most common ways Oregonians stay informed about health and healthcare are through consultations with their doctors, relevant news articles, and conversations with family and friends.”
Preventative Care
Healthcare Coverage
- 38% of Oregonians report that their healthcare coverage is only mildly focused on prevention (represented by the answer choice “3” on a five-point scale). Four in ten Oregonians lean toward the state being “focused” or “very focused” on prevention, and the remaining 23% say the state does not focus enough on prevention (giving either a “2” or a “1” on the 5-point scale) (Q10).
Providers Focus
- A majority of Oregonians (63%) feel that healthcare providers should place more focus on preventative healthcare (Q11).
Health Practices and Illness Prevention
- When considering actions for illness prevention, Oregonians think of several kay strategies: engaging in regular exercise or physical activity (56%), maintaining nutrition and a balanced diet (54%), and practicing good hygiene habits such as handwashing and covering coughs/sneezes (50%). Additionally, attending regular health check-ups (47%), ensuring adequate sleep (46%), and avoiding harmful substances (42%) are widely recognized as important illness preventive measures (Q7-Split Sample).
- Engaging in self-care and stress reduction activities (30%) and minimizing the spread of illnesses like wearing a mask, practicing sex, and staying in when sick (29%) are also mentioned with relatively high frequency. However, practices like regularly cleaning or disinfecting surfaces (18%), staying informed about new health guidelines (17%), connecting with nature (15%), going to therapy or a support groups (12%), cultivating social connections (9%), practicing holistic or naturopathic medicine like massages or acupuncture (8%), limiting screentime via phone, computer, tv, etc. (7%), and practicing sun safety (6%) are less frequently mentioned.
- Men are more inclined to list exercise and physical activity compared to women. Women, on the other hand, are more inclined to list attending regular health check-ups than men.
- Respondents ages 55+ are more likely to emphasize attending regular health checkups and avoiding harmful substances compared to younger respondents. Respondents younger than 54, on the other hand, are more likely than those older to focus on self-care and stress reduction, as well as going to therapy and regularly cleaning and disinfecting surfaces.
- Respondents with a college degree are more likely than those with some college education or a high school education to emphasize physical activity, nutrition, and regular health checkups. Respondents with a high school education or less or some college education, on the other hand, are more likely to emphasize regularly cleaning and disinfecting surfaces, as well as engaging in self-care or going to therapy or a support groups, than those with 4-year degrees.
- Oregonians report a similar prioritization of strategies when it comes to staying healthy as they do for illness prevention: exercising (63%), maintaining nutrition and a balanced diet (55%), getting adequate sleep (52%), practicing good hygiene habits, (47%), attending regular health check-ups (43%), and avoiding harmful substances are frequently mentioned (42%) (Q8-Split Sample).
- For staying healthy, men are more inclined to list physical activity and avoiding harmful substances compared to women. Women, however, are more likely to list engaging in self-care than men.
- Respondents ages 55+ are more likely to emphasize exercising, nutrition, adequate sleep, health checkups, and avoiding harmful substances compared to younger respondents. Respondents younger than 54, on the other hand, are more likely to focus on self-care and stress reduction, as well as going to therapy.
- Respondents with a college degree are more likely than those without (some college education or high school education or less) to list exercising and nutrition. On the other hand, respondents without 4-year degrees emphasize practicing good hygiene and regularly cleaning and disinfecting surfaces.
- Most Oregonians (58%) report they exercise (defined as getting at least “30 minutes of moderate physical activity”) at least three to four times a week. A third (33%) say 1-2 times a week, and 9% of Oregonians get no exercise in a typical week (Q9).
- When asked to comment freely about practices to stay healthy and prevent illness, Oregonians generally indicate their desire for self-improvement in both. Respondents also note the lack of accessible and affordable programs that cover illness prevention. Below are some representative quotes about health maintenance and illness prevention (Q12):
“Health promotion and prevention are important, but we also need to build trust in our institutions that do these. Access is a major barrier, but so is motivation to seek care or practice prevention.”
Woman, age 30-44, Deschutes County, White
“There isn’t much of it [preventative care] in Oregon.”
Man, age 30-44, Josephine County, White
“I think individual consumers would save so much time and money if there were more illness prevention practices available because you wouldn’t have to get medications as often.”
Woman, age 18-29, Columbia County, Native American, American Indian, or Alaska Native and White
“More focus on diabetes and hypertension prevention through diet and exercise should be incentivized.”
Woman, age 30-44, Multnomah County, White
“[There is] limited coverage or restrictive conditions to access mental therapy, physical therapy, fitness facilities, and acupuncture. Dental and hearing are not considered fundamental to health.”
Man, age 55-64, Marion County, White and another race or ethnicity
Healthcare System Change
State’s Job Performance
- Most Oregonians believe Oregon is passably, but not ideally, providing healthcare to its citizens. When Oregonians are asked to grade the state on its provision of healthcare on an A ~ F scale, only 10% of respondents give an A grade. Around seven out of ten respondents give either a B grade (31%) or a C grade (40%). Finally, 19% give healthcare in Oregon a D or an an F grade (Q1).
- Respondents aged 18 – 54 are generally more likely to give healthcare in Oregon an “A” than those aged 55 – 75+. Despite this, respondents aged 30 – 54 are also the most likely to give healthcare in Oregon an “F.”
- Respondents without college education are more likely to give healthcare in Oregon an “A” over those with some or four years of college education.
- BIPOC respondents are more likely to give healthcare in Oregon an “A” than white respondents, whereas white respondents are more likely to give Oregon a “C” than BIPOC respondents.
Need for Change
- Three in four Oregonians believe that the mental health system in Oregon needs major change. Around half of Oregonians also believe that the healthcare system in Oregon, in general, needs major change (Q2).
- Women are more likely to report that major change is needed for both the mental health system and the healthcare system, broadly, in Oregon compared to men.
- Respondents who are 54 and younger are more likely to report that major change is needed in Oregon’s healthcare system in general compared to respondents who are 55 and older.
- The 2002 Oregon Values and Beliefs Study asked a similar question about the healthcare system in Oregon needing major change (healthcare generally, not specifically mental health), to which 64% of Oregonians answered that major change was needed (Q25, 2002 OVB). The general sentiment that Oregon’s healthcare system needs major change seems to persist today.
Kind of Change
- Oregonians emphasize the need for a more proactive approach to addressing mental health, ensuring quicker appointments with healthcare professionals, controlling the high cost of healthcare, and implementing better care standards for the Oregon Health Plan (Q3).
“There are not enough mental hospitals to meet the population’s needs. Drug addicted individuals do not receive treatment to break their addictions and stop using because of psychological problems. There should be more efforts to reach out to people who avoid healthcare and get them to understand the necessity of preventive care.”
Woman, age 65-74, Washington County, Black or African American
“More local clinics needed: wait-lists too long for counseling, [especially] drug rehab.”
Woman, age 55-64, Jackson County, Asian
“Healthcare is ridiculously expensive, so much so that it typically feels cheaper to forgo your physicals and in general avoid visits to doctor or hospital unless it’s an extreme emergency. I can’t stand feeling like it’s too expensive to get preventative care.”
Woman, age 18-29, Polk County, White
“More care for people in OHP. Now I don’t mean doctors and hospitals, I mean care. It seems like everyone who has OHP never gets acknowledged or if they do it’s like a year later they can be seen and they constantly get put on the back burner or are dismissed.”
Man, age 30-44, Washington County, Native American, American Indian, or Alaska Native and White
“There are too many gaps that people can fall through. Sometimes you make too much to get OHP but only by a few bucks, which is not enough to cover a personal healthcare service. Plus a lot of time when you lose healthcare you also lose SNAP. It’s ridiculous. There needs to be help to cover the gap areas.”
Woman, age 45-54, Polk County, Black or African American, Native American, American Indian, or Alaska Native, and White
- Overwhelmingly, Oregonians feel that for individuals, physical health and mental health are equally important (81%, Q4).
- Q18 of the November 2021 OVBC Survey asked this same question, to which 79% of Oregonians responded, “equally important,” 12% responded “mental health,” and 7% responded “physical health.” Overall, Oregonians’ responses this time around reflect closely what they said in 2021.
- On the other hand, most Oregonians believe that society treats physical health as being more important than mental health (Q5).
- The November 2021 OVBC Survey asked this same question, to which 65% of Oregonians responded, “physical health,” 23% said, “equally important,” and 6% said “mental health” (Nov 2021 OVBC).
Healthcare Actions
Without Mention of Cost or Tax Implications
- Oregonians, when asked to indicate the desirability of healthcare actions society could take, express the strongest overall desire for rigorous evaluation and ethical considerations to guide decisions on publicly funded medical services for fair distribution (71%). Oregonians also express similar enthusiasm for striving to replace illness treatment with healthy living as the primary goal of healthcare (70%, Q16).
With Mention of Cost or Tax Implications
- When asked to identify the desirability of various tax- or consumer-funded healthcare initiatives, Oregonians overwhelmingly emphasize ensuring equal access to quality healthcare (74% of respondents express desire, with 53% expressing strong desire) and providing accessible and quality prenatal care (71% of respondents desire, with 46% strongly desiring) (Q17).
- Though with less overall enthusiasm, Oregonians also support the other initiatives listed, including incentivizing providers to serve rural and other underserved locations (67%), ensuring people can safely pursue active lifestyles (61%), establishing a universal publicly funded health delivery system (59%), and supporting neighborhood gardens (59%).
Sources of Information
- Oregonians rely most commonly on content that they access in print or online or through the general media (podcasts, TV, etc.) or social media. They also stay informed about health and healthcare through consultation with their medical care providers and conversations with family and friends. While less common, some Oregonians mention staying up to date with the help of insurance providers, allied health professionals, and alternative medicine providers. Also mentioned is learning about health and healthcare through advertising by pharmaceutical and healthcare companies (Q6).
“[I stay informed about healthcare] Based on what my doctor says and what is working- for other people that I am in consistent contact with.”
Man, age 18-29, Multnomah County, White
“[I stay informed about healthcare through] News programs, major newspapers and information from Harvard medical, John Hopkins, and NIH.”
Woman, age 65-74, Washington County, Black or African American
“I personally seek alternatives to supplement allopathic medicine because our medical system isn’t training our doctors to truly make efforts to treat and help each individual patient mainly due to time constraints and revenue.”
Woman, age 65-74, Lane County, Asian and White
“Talking to knowledgeable friends and professionals.”
Non-binary or gender non-conforming, age 18-29, Benton County, Another race or ethnicity
Methodology: The online survey consisted of 1,811 Oregon residents ages 18+ and took approximately 10 minutes to complete. This is a sufficient sample size to assess Oregonians’ general opinions and to review findings by multiple subgroups. Respondents were contacted by using professionally maintained online panels. A variety of quality control measures were employed to gather responses, including questionnaire pre-testing, validation, and real-time monitoring of responses. To ensure a representative sample, demographic quotas were set, and data was weighted by area of the state, gender, age, and education.
Statement of Limitations: Based on a 95% confidence interval, this survey’s margin of error for the full sample is ±2.30%. Due to rounding or multiple-answer questions, response percentages may not add up to 100%.
OVBC surveys currently use aggregated data to analyze the opinions of BIPOC residents in comparison to the opinions of residents who identify as white and not another race. BIPOC residents are not monoliths; the grouping represents a wide diversity of races and ethnicities. The findings included in this memo should not be construed such that all people of color are believed to share the same opinions. Disaggregated race data will be provided when sample sizes permit reliability.
For More Information:
Acknowledgments:
We are deeply grateful to the Northwest Health Foundation for their generous sponsorship of this project. Their support has been invaluable to our mission of conducting independent, nonpartisan research. With their help, we are able to better assist organizations throughout Oregon in utilizing data to strengthen their communities.
Oregon Values and Beliefs Center (OVBC): This research was completed by the Oregon Values and Beliefs Center as a community service. OVBC is an independent and non-partisan organization and an Oregon charitable nonprofit corporation. Representative OVBC projects include a series of in-depth business interviews for the Columbia County Economic Team, as well as an extensive opinion research study about Oregonian’s values and beliefs, in partnership with over 20 organizations (Learn more about the 2023 Typology Study).