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This summary of the literature on Access to Health Services as a social factor of health is a narrowly specified evaluation that is not planned to be exhaustive and may not attend to all measurements of the problem. Please note: The terminology used in each summary is constant with the particular references. For additional information on cross-cutting subjects, please see the Access to Medical care literature summary.

Related Objectives (4 )
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Here's a photo of the objectives related to topics covered in this literature summary. Browse all objectives.

Increase the proportion of teenagers who had a preventive health care see in the previous year - AH-01 Increase the proportion of people with medical insurance - AHS-01 Increase the proportion of people with dental insurance coverage - AHS-02 Increase the percentage of grownups who get advised evidence-based preventive healthcare - AHS-08

Related Evidence-Based Resources (5 )

Here's a snapshot of the evidence-based resources related to topics covered in this literature summary. Browse all evidence-based resources.

Breast Cancer: Screening Cervical Cancer: Screening Colorectal Cancer: Screening Improving Access to Oral Health Care for Vulnerable and Underserved Populations Oral Health in America: A Report of the Surgeon General

Healthy People 2030 organizes the social factors of health into 5 domains:

Economic Stability Education Access and Quality Health Care Access and Quality Neighborhood and Built Environment Social and Community Context Literature Summary

The National Academies of Sciences, Engineering, and Medicine (previously called the Institute of Medicine) specify access to health care as the "timely usage of personal health services to accomplish the finest possible health outcomes."1 Lots of people face barriers that avoid or limit access to required healthcare services, which may increase the threat of poor health results and health disparities.2 This summary will go over barriers to health care such as absence of health insurance, poor access to transport, and restricted health care resources, with a special concentrate on how these barriers impact under-resourced communities.

Unequal distribution of health care protection contributes to variations in health.2 Out-of-pocket healthcare costs may lead people to delay or give up (such as physician visits, dental care, and medications),3 and medical debt is typical amongst both guaranteed and uninsured people.3,4 People with lower earnings are typically uninsured,5,6,7,8 and minority groups account for over half of the uninsured population.9

Lack of health insurance coverage may negatively affect health.9,10 Uninsured grownups are less likely to receive preventive services for persistent conditions such as diabetes, cancer, and heart disease.10,11 Similarly, kids without health insurance coverage are less likely to get suitable treatment for conditions like asthma or vital preventive services such as oral care, immunizations, and well-child check outs that track developmental turning points.10

In contrast, research studies show that having medical insurance is related to enhanced access to health services and much better health tracking.12,13,14 One study showed that when formerly uninsured adults ages 60 to 64 years became eligible for Medicare at age 65 years, their usage of basic medical services increased.13 Similarly, providing Medicaid protection to previously uninsured grownups considerably increased their opportunities of receiving a diabetes diagnosis and using diabetic medications.15 Medicaid protection is also critical for making it possible for kids with special health needs or persistent illnesses to gain access to health services. The Children's Medical insurance Program (CHIP) provides sole coverage for 41 percent of children with special health care needs.16 Many healthcare resources are more widespread in neighborhoods where locals are well-insured,10 however the kind of insurance coverage individuals have might matter too. Medicaid patients, for instance, experience gain access to concerns when living in locations where couple of physicians accept Medicaid due to its lowered compensation rate.14,17,18

Medical insurance alone can not remove every barrier to care. Limited schedule of healthcare resources is another barrier that might minimize access to health services and increase the danger of bad health outcomes.19,20 For example, physician scarcities might suggest that clients experience longer wait times and delayed care.18

Inconvenient or undependable transportation can disrupt consistent access to healthcare, potentially adding to unfavorable health results.21 Research has revealed that individuals from racial/ethnic minority groups who had actually an increased danger for extreme health problem from COVID-19 were more likely to do not have transport to healthcare services.22 Transportation barriers and domestic segregation are also related to late-stage discussion of certain medical conditions (e.g., breast cancer).23,24,25

Expanding access to health services is a crucial step toward decreasing health disparities. Affordable health insurance becomes part of the solution, however factors like economic, social, cultural, and geographic barriers to health care need to also be considered,20 as need to brand-new strategies to increase the efficiency of health care delivery.18,26,27 Further research is needed to better understand barriers to healthcare, and this extra proof will assist in public health efforts to deal with access to health services as a social determinant of health.

Citations

Institute of Medicine (U.S.) Committee on Monitoring Access to Personal Healthcare Services. (1993 ). Access to healthcare in America (M. Millman, Ed.). National Academies Press.

Institute of Medicine (U.S.) Committee on Understanding and Eliminating Racial and Ethnic Disparities in Healthcare (2003 ). Unequal treatment: Confronting racial and ethnic disparities in healthcare (B. D. Smedley, A. Y. Stith, & A. R. Nelson, Eds.). National Academies Press.

Pryor, C., & Gurewich, D. (2004 ). Getting care but paying the rate: how medical financial obligation leaves many in Massachusetts facing hard choices. The Access Project.

Herman, P. M., Rissi, J. J., & Walsh, M. E. (2011 ). Health insurance coverage status, medical debt, and their effect on access to care in Arizona. American Journal of Public Health, 101( 8 ), 1437-1443.

Hadley, J. (2003 ). Sicker and poorer - the repercussions of being uninsured: A review of the research study on the relationship between medical insurance, healthcare use, health, work, and income. Medical-Car Research and Review, 60(2_suppl), 3S-75S.

Franks, P., Clancy, C. M., & Gold, M. R. (1993 ). Medical insurance and mortality: Evidence from a nationwide cohort. JAMA, 270( 6 ), 737-741.

Zhu, J., Brawarsky, P., Lipsitz, S., Huskamp, H., & Haas, J. S. (2010 ). Massachusetts health reform and disparities in protection, access and health status. Journal of General Internal Medicine, 25( 12 ), 1356-1362.

DeNavas-Walt, C. (2010 ). Income, hardship, and health insurance protection in the United States (2005 ). Diane Publishing.

Majerol, M., Newkirk, V., & Garfield, R. (2015 ). The uninsured: A guide. Kaiser Family Foundation Publication, 7451-10.

Institute of Medicine (U.S.) Committee on Medical Insurance Status and Its Consequences. (2009 ). America's uninsured crisis: Consequences for health and healthcare. National Academies Press.

Ayanian, J. Z., Weissman, J. S., Schneider, E. C., Ginsburg, J. A., & Zaslavsky, A. M. (2000 ). Unmet health requirements of uninsured grownups in the United States. JAMA, 284( 16 ), 2061-2069.

Baicker, K., Taubman, S. L., Allen, H. L., Bernstein, M., Gruber, J. H., Newhouse, J. P., ... & Finkelstein, A. N. (2013 ). The Oregon experiment - results of Medicaid on medical results. New England Journal of Medicine, 368( 18 ), 1713-1722.

McWilliams, J. M., Zaslavsky, A. M., Meara, E., & Ayanian, J. Z. (2003 ). Impact of Medicare coverage on basic scientific services for formerly uninsured adults. JAMA, 290( 6 ), 757-764.

Buchmueller, T. C., Grumbach, K., Kronick, R., & Kahn, J. G. (2005 ). Book review: The effect of health insurance on healthcare usage and ramifications for insurance expansion: An evaluation of the literature. Treatment Research and Review, 62( 1 ), 3-30.

Myerson, R., & Laiteerapong, N. (2016 ). The Affordable Care Act and diabetes diagnosis and care: Exploring the possible impacts. Current Diabetes Reports,16( 4 ), 1-8.

Musumeci, M. (2018 ). Medicaid's role for kids with special healthcare needs. Journal of Law, Medicine & Ethics, 46( 4 ), 897-905.

Decker, S. L. (2012 ). In 2011 almost one-third of physicians said they would not accept new Medicaid patients, but rising costs may help. Health Affairs, 31( 8 ), 1673-1679.

Bodenheimer, T., & Pham, H. H. (2010 ). Primary care: Current problems and proposed solutions. Health Affairs (Project Hope), 29( 5 ), 799-805. doi: 10.1377/ hlthaff.2010.0026.

National Association of Community Health Centers and the Robert Graham Center. (2007 ). Access denied: A look at America's clinically disenfranchised. National Association of Community Health Centers, Incorporated.

Douthit, N., Kiv, S., Dwolatzky, T., & Biswas, S. (2015 ). Exposing some essential barriers to health care access in the rural USA. Public Health, 129( 6 ), 611-620. doi: 10.1016/ j.puhe.2015.04.001.

Syed, S. T., Gerber, B. S., & Sharp, L. K. (2013 ). Traveling towards disease: Transportation barriers to health care gain access to. Journal of Community Health, 38( 5 ), 976-993. doi: 10.1007/ s10900-013-9681-1.

Clay, S. L., Woodson, M. J., Mazurek, K., & Antonio, B. (2021 ). Racial disparities and COVID-19: Exploring the relationship in between race/ethnicity, individual factors, health access/affordability, and conditions related to an increased seriousness of COVID-19. Race and Social Problems, 1-13. doi: 10.1007/ s12552-021-09320-9.

Dai, D. (2010 ). Black residential segregation, disparities in spatial access to healthcare centers, and late-stage breast cancer medical diagnosis in city Detroit. Health & Place, 16( 5 ), 1038-1052. doi: 10.1016/ j.healthplace.2010.06.012.

Tarlov, E., Zenk, S. N., Campbell, R. T., Warnecke, R. B., & Block, R. (2009 ). Characteristics of mammography center locations and stage of breast cancer at medical diagnosis in Chicago. Journal of Urban Health: Bulletin of the New York City Academy of Medicine, 86( 2 ),196 -213. doi: 10.1007/ s11524-008-9320-9.

Wang, F., McLafferty, S., Escamilla, V., & Luo, L. (2008 ). Late-stage breast cancer medical diagnosis and healthcare access in Illinois. Professional Geographer, 60( 1 ), 54-69. doi: 10.1080/ 00330120701724087.

Green, L. V., Savin, S., & Lu, Y. (2013 ). Primary care physician shortages might be removed through usage of groups, nonphysicians, and electronic communication. Health Affairs (Project Hope), 32( 1 ), 11-19. doi: 10.1377/ hlthaff.2012.1086.

Rieselbach, R. E., Crouse, B. J., & Frohna, J. G. (2010 ). Teaching main care in neighborhood health centers: Addressing the workforce crisis for the underserved. Annals of Internal Medicine, 152( 2 ), 118-122.