Health care is vital for society. Access to healthcare is also a fundamental human right. So why is healthcare not received equally across the world? What are some of the barriers that prevent people from receiving good quality health care? There is a lack of medical professionals worldwide; however, this is not the only reason that healthcare disparities exist worldwide. Let's take a look at the obstacles many people face when trying to access good quality health care.
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Health care is vital for society. Access to healthcare is also a fundamental human right. So why is healthcare not received equally across the world? What are some of the barriers that prevent people from receiving good quality health care? There is a lack of medical professionals worldwide; however, this is not the only reason that healthcare disparities exist worldwide. Let's take a look at the obstacles many people face when trying to access good quality health care.
Access to Healthcare Definition
Health care is a service that aims to support, maintain, and improve human health in all aspects. This is done by medically trained professionals. It is a highly important service within society; it impacts all aspects of a person, from physical, social, and mental well-being to overall quality of life. Ultimately, health and health care affect the entire population of the planet.
In addition to this, healthcare plays a significant role in understanding the economic stability of a country. Countries that have no healthcare systems are usually Low-Income Countries (LICs). Countries with strong and stable healthcare systems are typically located in High-Income Countries (HICs). These are also considered more economically stable countries.
It is important that people across the world have access to health care because it promotes health, prevents disease, reduces illness and death, and encourages health equity. But what do we mean by this?
Access to health care is the ability to easily attain healthcare, and therefore ensure healthy living for education and work to continue.
Health equity is equal access and opportunity to remain healthy.
The World Health Organisation (WHO) is a United Nations agency that aims to encourage good health and health care across the world. The WHO states that around half of the world’s population does not have access to health care.
Health Care Access and Quality Index
The Healthcare Access and Quality (HAQ) Index is a measure of the access and quality of medical care. The scale used for this ranges from 0 to 100. Where 0 is the poorest health care access and health care quality, 100 is the best health care access and quality. The HAQ Index is based on amenable mortality.
Amenable mortality refers to the deaths caused by a range of diseases that are known to be prevented with the correct and effective health care. The diseases include appendicitis and diabetes.
Fig. 1 - Health care Access and Quality Index, 2015.
Barriers to Access to Healthcare
Access to health care has many barriers, and these barriers prevent people from maintaining their health and reaching their full potential.
Poverty
Poverty not only affects access to health care; it is also a cause of ill health. Poverty often affects the financial aspects of people’s lives. This means that it is difficult for people in poverty to afford things that can improve health, from healthy foods and sufficient nutrition to medicines, or even information regarding healthcare.Other costs may include the cost of health care consultations, as well as the cost of travel to the consultation and even loss of income that may occur from calling in sick to work.
Education
Education is critical for people to gain knowledge and an understanding of health care. If people are unaware of how to remain healthy or how to access health care, their ability to receive health care becomes severely limited.
Cost of Health Insurance
Health insurance is a monthly or yearly payment that goes towards unexpected costs and helps people to receive healthcare at an affordable rate. Without health insurance, healthcare fees are usually extremely high. However, health insurance is another element that prevents access to health care. This is because health insurance enforces monthly payments to gain access to health care. If people cannot afford to meet these payments, this consequently limits their access to healthcare. This may mean they have to pay high prices to receive health care.
Income and Jobs
To be able to afford health care and health insurance, an income is required. Therefore, a lack of income can become a barrier to accessing health care. Many employers offer insurance packages to their employees at a discounted rate. Sometimes, healthcare is even free through employers.
Linguistic and Cultural Proficiency
Language barriers can impact access to health care. This is because misunderstandings and miscommunications can lead to the incorrect treatment of care, understanding of the patient’s condition, or even a misdiagnosis if the patient and caregiver do not speak the same language. In extreme cases, this can be life-threatening. This does not necessarily mean that everyone must speak the same language, however, this is an important factor for accessing healthcare. Translators are crucial tools in health care situations.
Cultural competence is also key in health care. This allows medical professionals to be more aware of how cultures may affect the health care of a patient.
Cultural competence in health care is understanding that your cultural values and experiences may be different to other people's. It also involves respecting, honouring, and valuing different cultures or ways of living, identities and beliefs. For example, health care workers should consider dietary or religious needs, such as not offering pork to a Muslim patient.
Therefore, if a health care professional is unaware or judgemental of various cultures, there may be impacts on the treatment and health care, ultimately impacting the patient's access to health care. Being culturally competent means providing the same standard of care to everybody, regardless of who they are or what they believe.
Transportation
If people who require health care have no way of getting to the location of health care treatment, then their access to health care will be consequently affected. Without transportation, people could miss appointments, may be unable to pick up prescriptions, or may not even be able to reach a hospital in an emergency. Whether this is not owning a personal car, not being able to afford public transport, or living rurally, transportation is a key factor when thinking about people's access to healthcare.
Fig. 2 - This bus is heading to Ealing Hospital in London. But what if you couldn't afford the bus fare?
Health Care Access Disparities
Disparities in health care access can often be a result of discrimination or prejudice. Discrimination is when a person is mistreated because of their identity. Discrimination based on ethnicity, gender, sexuality, and income can impact whether a person may receive proper health care.
Racial discrimination is a typical example; many cancers or skin disorders are studied from a white perspective and therefore are missed in people of colour.
People of colour (and also women) are also often not used in studies, skewing data towards white men. In some cases, discrimination can often prevent minority groups from seeking health care in the first place, perhaps due to unfair treatment in the past.
Did you know that heart attacks affect men and women differently, but the most common signs are how men experience them?
One in Four Older Adults of Colour Say Health Care Professionals Have Treated Them Unfairly or Ignored Their Health Concerns Because of Race or Ethnicity.1
- The Commonwealth Fund, 2022.
Access to Health Care in the US
Many developing countries struggle with access to health care. Despite this, countries that have high-quality healthcare systems also have issues with health care access. This can be due to demand, which impacts waiting times for health care, or the very expensive cost of health care.
The US has poor health compared to many countries. This is due to issues with access to health care, such as the cost of US health care, poverty and income inequality, as well as a lack of physical activity and unhealthy actions, such as a poor diet.
Did you know that South Korea ranks in first place for healthcare quality?
Effect of the Affordable Care Act on Health Care Access
In the US, the Affordable Health Care Act (ACA) was signed into law in 2010. This act aimed to make health insurance more affordable for more people. This enabled better access to health care in the US. The ACA offers rights and protections that ensure health coverage is fair and easy to understand. It also reduces geographic, racial, and economic inequalities in healthcare due to better access to a range of healthcare insurance policies.
What impact has the Affordable Care Act had on healthcare access?
More people now have health insurance, and this allows people to have access to health care. Further to this, studies show that socioeconomic differences decreased regarding health care, as well as the number of deaths, due to the ACA. Ultimately, the ACA has improved access to health care for those that have been able to purchase health insurance under the ACA, although there are still many US citizens who are not covered by health insurance. Therefore, their access to health care is still limited.
Health Care Access - Key takeaways
Access to health care is crucial for human life. It is the ability to receive high-quality healthcare from medical professionals.
The Health Access and Quality (HAQ) Index is a measure of the access to high-standard medical care using a scale of 0 (lowest access and quality) to 100 (highest access and quality).
Barriers to accessing health care include poverty, education, cost of health insurance, income and jobs, discrimination, linguistics and cultural proficiency, as well as transportation.
The US has poor access to health care due to unhealthy lifestyles, expensive medical costs, and issues of poverty and income inequalities.
The Affordable Care Act (ACA) is a law that was enforced in 2010 that allows more people to be able to afford medical insurance in the US, therefore improving access to health care.
References
The Commonwealth Fund, NEW REPORT: How Older Adults View Racial and Ethnic Discrimination in the U.S. Health Care System, News Release, 2022.
Fig. 1: Healthcare Access and Quality Index, 2015. (https://commons.wikimedia.org/wiki/File:Healthcare_Access_and_Quality_Index,_OWID.svg), by Our World in Data (https://ourworldindata.org/grapher/healthcare-access-and-quality-index), licensed by CC BY-SA 3.0 (https://creativecommons.org/licenses/by/3.0/deed.en).
Fig. 2: bus heading to Ealing hospital in London (https://commons.wikimedia.org/wiki/File:Off_To_Ealing_Hospital_-_geograph.org.uk_-_2687259.jpg), by Martin Addison (https://www.geograph.org.uk/profile/4942), Licensed by CC BY-SA 2.0 (https://creativecommons.org/licenses/by-sa/2.0/).
Frequently Asked Questions about Health Care Access
Poverty affects access to healthcare because it can lead to ill health; it can often be difficult to afford healthy foods when in poverty. Healthcare is also difficult to afford when impoverished.
A lack of healthcare causes poverty because people may become ill without healthcare, and then they cannot earn an income. This leads to poverty.
The Patient Protection and Affordable Care Act increased access to health insurance because it offers more affordable health insurance, as well as rights and protections and reductions in inequalities.
Poverty may increase the risk of health problems, by limiting access to sufficient nutrition.
The country that ranks first in access to healthcare is South Korea.
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