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

Related Objectives (4 )
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Here's a snapshot of the objectives related to topics covered in this literature summary. Browse all goals.
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Increase the percentage of adolescents who had a preventive healthcare see in the past year - AH-01 Increase the proportion of people with health insurance coverage - AHS-01 Increase the percentage of people with dental insurance coverage - AHS-02 Increase the proportion of grownups who get recommended evidence-based preventive health care - AHS-08

Related Evidence-Based Resources (5 )

Here's a snapshot of the evidence-based resources associated with 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 (formerly understood as the Institute of Medicine) define access to health care as the "timely usage of personal health services to attain the finest possible health results."1 Many people deal with barriers that prevent or restrict access to required healthcare services, which may increase the risk of poor health results and health variations.2 This summary will go over barriers to healthcare such as lack of medical insurance, bad access to transport, and limited healthcare resources, with an unique concentrate on how these barriers effect under-resourced neighborhoods.

Unequal distribution of healthcare protection adds to disparities in health.2 Out-of-pocket treatment costs may lead people to delay or forgo needed care (such as medical professional visits, oral care, and medications),3 and medical debt is typical amongst both insured and uninsured people.3,4 People with lower earnings are often uninsured,5,6,7,8 and minority groups represent over half of the uninsured population.9

Lack of health insurance coverage may negatively impact health.9,10 Uninsured grownups are less likely to get preventive services for chronic conditions such as diabetes, cancer, and heart disease.10,11 Similarly, kids without medical insurance coverage are less likely to get proper treatment for conditions like asthma or critical preventive services such as oral care, immunizations, and well-child gos to that track developmental turning points.10

On the other hand, studies reveal that having medical insurance is connected with enhanced access to health services and better health monitoring.12,13,14 One study showed that when previously ages 60 to 64 years ended up being eligible for Medicare at age 65 years, their usage of basic medical services increased.13 Similarly, offering Medicaid protection to previously uninsured grownups considerably increased their opportunities of getting a diabetes medical diagnosis and utilizing diabetic medications.15 Medicaid protection is also important for making it possible for kids with unique health requirements or persistent diseases to access health services. The Children's Health Insurance Program (CHIP) uses sole protection for 41 percent of kids with unique health care requires.16 Many healthcare resources are more common in communities where homeowners are well-insured,10 but the type of insurance individuals have might matter as well. Medicaid clients, for instance, experience access problems when residing in areas where couple of doctors accept Medicaid due to its reduced reimbursement rate.14,17,18

Health insurance coverage alone can not remove every barrier to care. Limited schedule of health care resources is another barrier that might lower access to health services and increase the danger of bad health results.19,20 For example, doctor lacks might suggest that patients experience longer wait times and postponed care.18

Inconvenient or unreliable transportation can interfere with constant access to health care, possibly contributing to unfavorable health results.21 Research has shown that individuals from racial/ethnic minority groups who had actually an increased danger for severe illness from COVID-19 were most likely to do not have transportation to health care services.22 Transportation barriers and property partition are also related to late-stage discussion of specific medical conditions (e.g., breast cancer).23,24,25

Expanding access to health services is an essential action toward reducing health variations. Affordable health insurance coverage belongs to the option, but aspects like economic, social, cultural, and geographical barriers to healthcare must also be thought about,20 as must new techniques to increase the effectiveness of healthcare shipment.18,26,27 Further research is required to much better understand barriers to health care, and this extra evidence will facilitate public health efforts to resolve access to health services as a social factor 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 health care (B. D. Smedley, A. Y. Stith, & A. R. Nelson, Eds.). National Academies Press.

Pryor, C., & Gurewich, D. (2004 ). Getting care however paying the price: how medical financial obligation leaves many in Massachusetts dealing with difficult choices. The Access Project.

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

Hadley, J. (2003 ). Sicker and poorer - the consequences of being uninsured: An evaluation of the research study on the relationship between medical insurance, healthcare usage, health, work, and earnings. Medical-Car Research and Review, 60(2_suppl), 3S-75S.

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

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

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

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

Institute of Medicine (U.S.) Committee on Health 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 needs of uninsured adults 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 - impacts of Medicaid on scientific outcomes. 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 clinical services for formerly uninsured grownups. JAMA, 290( 6 ), 757-764.

Buchmueller, T. C., Grumbach, K., Kronick, R., & Kahn, J. G. (2005 ). Book review: The result of medical insurance on treatment 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 potential effects. 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 decline brand-new Medicaid patients, however increasing fees might assist. Health Affairs, 31( 8 ), 1673-1679.

Bodenheimer, T., & Pham, H. H. (2010 ). Primary care: Current problems and proposed options. 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 rejected: An appearance at America's medically disenfranchised. National Association of Community Health Centers, Incorporated.

Douthit, N., Kiv, S., Dwolatzky, T., & Biswas, S. (2015 ). Exposing some crucial barriers to healthcare 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 healthcare access. 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, personal factors, health access/affordability, and conditions associated with an increased intensity of COVID-19. Race and Social Problems, 1-13. doi: 10.1007/ s12552-021-09320-9.

Dai, D. (2010 ). Black residential partition, disparities in spatial access to healthcare facilities, and late-stage breast cancer diagnosis in metropolitan 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 places and stage of breast cancer at diagnosis in Chicago. Journal of Urban Health: Bulletin of the New York 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 diagnosis and health care access in Illinois. Professional Geographer, 60( 1 ), 54-69. doi: 10.1080/ 00330120701724087.

Green, L. V., Savin, S., & Lu, Y. (2013 ). Medical care physician lacks could be removed through usage of teams, 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 primary care in community university hospital: Addressing the workforce crisis for the underserved. Annals of Internal Medicine, 152( 2 ), 118-122.