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 extensive and might not deal with all dimensions of the problem. Please note: The terminology used in each summary follows the respective referrals. For additional info on cross-cutting subjects, please see the Access to Medical care literature summary.

Related Objectives (4 )

Here's a picture of the objectives associated with subjects covered in this literature summary. Browse all objectives.

Increase the proportion of teenagers who had a preventive health care check out in the past year - AH-01
Increase the percentage of individuals with health insurance - AHS-01
Increase the proportion of individuals with dental insurance coverage - AHS-02
Increase the percentage 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 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 Healthcare for Vulnerable and Underserved Populations
Oral Health in America: A Report of the Surgeon General

Healthy People 2030 arranges the social determinants 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 referred to as the Institute of Medicine) specify access to healthcare as the "prompt usage of personal health services to attain the very best possible health results."1 Many individuals face barriers that prevent or limit access to required healthcare services, which may increase the danger of bad health outcomes and health disparities.2 This summary will talk about barriers to healthcare such as absence of health insurance, bad access to transport, and minimal health care resources, with a special focus on how these barriers impact under-resourced neighborhoods.

Unequal circulation of health care protection contributes to disparities in health.2 Out-of-pocket healthcare costs may lead people to postpone or give up required care (such as medical professional check outs, dental care, and medications),3 and medical debt is typical amongst both insured and uninsured individuals.3,4 People with lower earnings are frequently uninsured,5,6,7,8 and minority groups represent over half of the uninsured population.9

Lack of medical insurance coverage might negatively impact 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, children without medical insurance protection are less likely to get suitable treatment for conditions like asthma or critical preventive services such as dental care, immunizations, and well-child visits that track developmental turning points.10

On the other hand, studies reveal that having health insurance coverage is connected with improved access to health services and better health monitoring.12,13,14 One study showed that when formerly uninsured grownups ages 60 to 64 years became qualified for Medicare at age 65 years, their use of standard clinical services increased.13 Similarly, providing Medicaid coverage to formerly uninsured grownups significantly increased their opportunities of receiving a diabetes medical diagnosis and utilizing diabetic medications.15 Medicaid protection is likewise crucial for enabling kids with special health needs or chronic health problems to gain access to health services. The Children's Medical insurance Program (CHIP) offers sole protection for 41 percent of children with unique health care needs.16 Many healthcare resources are more common in communities where residents are well-insured,10 but the kind of insurance people have may matter too. Medicaid patients, for example, experience access problems when residing in locations where few physicians accept Medicaid due to its reduced compensation rate.14,17,18

Health insurance coverage alone can not eliminate every barrier to care. Limited availability of health care resources is another barrier that may lower access to health services and increase the danger of poor health results.19,20 For example, doctor lacks may imply that patients experience longer wait times and delayed care.18

Inconvenient or unreliable transportation can hinder consistent access to health care, potentially adding to negative health results.21 Research has revealed that people from racial/ethnic minority groups who had an increased risk for severe illness from COVID-19 were most likely to do not have transport to health care services.22 Transportation barriers and property partition are likewise related to late-stage discussion of particular medical conditions (e.g., breast cancer).23,24,25

Expanding access to health services is a crucial step towards minimizing health disparities. Affordable health insurance coverage is part of the solution, but elements like financial, social, cultural, and geographical barriers to health care should also be considered,20 as should new strategies to increase the performance of health care shipment.18,26,27 Further research study is needed to better understand barriers to health care, and this extra proof will help with public health efforts to address 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 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 healthcare (B. D. Smedley, A. Y. Stith, & A. R. Nelson, Eds.). National Academies Press.

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

Herman, P. M., Rissi, J. J., & Walsh, M. E. (2011 ). Medical insurance status, medical financial obligation, and their influence 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 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 nationwide friend. 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, poverty, 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 Medical Insurance Status and Its Consequences. (2009 ). America's uninsured crisis: Consequences for health and health care. 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 - impacts of Medicaid on scientific 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 previously uninsured adults. JAMA, 290( 6 ), 757-764.

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

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

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

Decker, S. L. (2012 ). In 2011 nearly one-third of doctors stated they would decline brand-new Medicaid clients, however increasing costs might help. Health Affairs, 31( 8 ), 1673-1679.

Bodenheimer, T., & Pham, H. H. (2010 ). Medical care: Current issues 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 rejected: A look at America's medically 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 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 between race/ethnicity, individual aspects, health access/affordability, and conditions connected with an increased seriousness of COVID-19. Race and Social Problems, 1-13. doi: 10.1007/ s12552-021-09320-9.

Dai, D. (2010 ). Black domestic partition, disparities in spatial access to health care centers, 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 locations and phase 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 gain access to in Illinois. Professional Geographer, 60( 1 ), 54-69. doi: 10.1080/ 00330120701724087.

Green, L. V., Savin, S., & Lu, Y. (2013 ). Primary care physician scarcities could be eliminated 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 health centers: Addressing the labor force crisis for the underserved. Annals of Internal Medicine, 152( 2 ), 118-122.