This summary of the literature on Access to Health Services as a social factor of health is a directly specified evaluation that is not planned to be exhaustive and might not address all dimensions of the issue. Please note: The terminology utilized in each summary is consistent with the particular recommendations. For extra details on cross-cutting subjects, please see the Access to Primary Care literature summary.

Related Objectives (4 )
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Increase the percentage of adolescents who had a preventive healthcare go to in the past year - AH-01 Increase the proportion of people with health insurance - AHS-01 Increase the proportion of people with oral insurance - AHS-02 Increase the proportion of adults who get suggested evidence-based preventive healthcare - AHS-08

Related Evidence-Based Resources (5 )

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

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

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

The National Academies of Sciences, Engineering, and Medicine (previously known as the Institute of Medicine) specify access to health care as the "prompt usage of individual health services to accomplish the best possible health results."1 Many individuals deal with barriers that prevent or limit access to needed health care services, which might increase the risk of poor health results and health disparities.2 This summary will talk about barriers to healthcare such as lack of health insurance, poor access to transport, and minimal healthcare resources, with an unique concentrate on how these barriers impact under-resourced neighborhoods.

Unequal distribution of health care protection adds to variations in health.2 Out-of-pocket medical care costs may lead people to delay or give up required care (such as physician visits, oral care, and medications),3 and medical debt prevails amongst both guaranteed and uninsured individuals.3,4 People with lower incomes are typically uninsured,5,6,7,8 and minority groups represent over half of the uninsured population.9

Lack of medical insurance coverage might adversely impact health.9,10 Uninsured adults are less likely to get preventive services for chronic conditions such as diabetes, cancer, and cardiovascular illness.10,11 Similarly, children without health insurance protection are less likely to receive appropriate treatment for conditions like asthma or vital preventive services such as oral care, immunizations, and well-child check outs that track developmental milestones.10

On the other hand, research studies show that having medical insurance is related to improved access to health services and much better health tracking.12,13,14 One study showed that when previously uninsured grownups ages 60 to 64 years became eligible for Medicare at age 65 years, their usage of basic clinical services increased.13 Similarly, supplying Medicaid coverage to previously uninsured adults substantially increased their opportunities of getting a diabetes diagnosis and using diabetic medications.15 Medicaid protection is also critical for allowing children with special health requirements or chronic illnesses to access health services. The Children's Health Insurance Program (CHIP) uses sole protection for 41 percent of kids with unique healthcare requires.16 Many healthcare resources are more common in communities where citizens are well-insured,10 however the type of insurance individuals have may matter as well. Medicaid clients, for example, experience access concerns when residing in areas where couple of doctors accept Medicaid due to its minimized reimbursement rate.14,17,18

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

Inconvenient or undependable transportation can disrupt consistent access to healthcare, possibly contributing to negative health outcomes.21 Research has revealed that people from racial/ethnic minority groups who had an increased threat for serious disease from COVID-19 were most likely to do not have transportation to health care services.22 Transportation barriers and domestic partition are also connected with late-stage discussion of certain medical conditions (e.g., breast cancer).23,24,25

Expanding access to health services is an important action toward minimizing health variations. Affordable health insurance becomes part of the solution, however aspects like economic, social, cultural, and geographical barriers to health care should likewise be thought about,20 as should brand-new techniques to increase the effectiveness of health care delivery.18,26,27 Further research study is needed to better comprehend barriers to healthcare, and this additional proof will help with public health efforts to deal with access to health services as a social factor of health.
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Citations

Institute of Medicine (U.S.) Committee on Monitoring Access to Personal Health Care Services. (1993 ). Access to health care 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 variations in health care (B. D. Smedley, A. Y. Stith, & A. R. Nelson, Eds.). National Academies Press.

Pryor, C., & Gurewich, D. (2004 ). Getting care but paying the price: how medical debt leaves many in Massachusetts facing hard options. The Access Project.

Herman, P. M., Rissi, J. J., & Walsh, M. E. (2011 ). Health insurance coverage status, medical financial obligation, 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 consequences of being uninsured: An evaluation of the research study on the relationship in between health insurance, healthcare use, health, work, and earnings. Medical-Car Research and Review, 60(2_suppl), 3S-75S.

Franks, P., Clancy, C. M., & Gold, M. R. (1993 ). Medical insurance and death: 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 disparities in coverage, 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 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 - effects of Medicaid on clinical 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 clinical services for formerly uninsured adults. JAMA, 290( 6 ), 757-764.

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

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

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

Decker, S. L. (2012 ). In 2011 nearly one-third of doctors said they would decline new Medicaid patients, however rising charges might help. Health Affairs, 31( 8 ), 1673-1679.

Bodenheimer, T., & Pham, H. H. (2010 ). Primary care: Current issues and proposed services. 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 crucial barriers to health care gain access to 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 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 variations and COVID-19: Exploring the relationship between race/ethnicity, personal aspects, 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 segregation, disparities in spatial access to health care centers, and late-stage breast cancer medical 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 facility areas and phase 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 medical 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 shortages could be gotten rid of through usage of groups, nonphysicians, and electronic interaction. 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 medical care in neighborhood university hospital: Addressing the workforce crisis for the underserved. Annals of Internal Medicine, 152( 2 ), 118-122.