Question

In your reading, [Steinbach, R., & Eni-Olotu, M. (2016) Inequalities in health (e.g. by region, ethnicity, soci-economic position or gender) and in access to health care, including their causes], inequality in the Access to health services is described. Based on this information, look up a current and relevant barrier to equality in access of health care (e.g. travel times, transportation or communication, access to new information and treatments, wait times, and/or cost) either in your own country, or any other, and discuss the potential causes and effects of this barrier to access. [e.g. inequalities in access due to urban/rural residence in Canada]

REFERENCE

Steinbach, R., & Eni-Olotu, M. (2016). Inequalities in health (e.g. by region, ethnicity, soci-economic position or gender) and in access to health care, including their causes. Equality, Equity and Policy. Access at: http://www.healthknowledge.org.uk/public-health-textbook/medical-sociology-policy-economics/4c-equality-equity-policy/inequalities-distribution

Answer 1

Equality of access requires the distribution of health to determine a wide variety of individual, community, and national factors. Access to health care is a supply side issue indicating the level of service which the health care system offers the individual. Many studies investigating access to health care use treatment received (i.e. utilisation) as a proxy for access. However, utilisation of health services may vary for many several reasons (such as perceptions of benefits or availability, availability of alternative therapies or services) and is an imperfect measure of access such as;

• Travel distance to facilities is equal.
• Transport and communication services are equal.
• Waiting times are equal.
• Patients are equally informed about the availability and effectiveness of treatments.
• Charges are equal (with equal ability to pay).

Inequalities in health have been measured using many different outcomes including infant deaths, mortality rates, morbidity, disability, and life expectancy. Health outcomes generally worsened with greater socioeconomic disadvantage. There are four major models used to explain social class inequalities in health;

1. Behavioural model: Dietary choices, consumption of drugs, alcohol and tobacco, active leisure time pursuits, and use of immunisation, contraception and antenatal services.
2. Materialist model: Poverty exposes people are more likely to live in areas where they are exposed to harm such as air-pollution and damp housing. Inequalities in health tend to follow a steady gradient, rather than there being poor outcomes for the most disadvantaged and equally good outcomes for the rest of society.
3. Psycho-social model: Stressful social circumstances produce emotional responses which bring about biological changes that increase risk of heart disease. Psycho-social risk factors include social support, control and autonomy at work, the balance between home and work, and the balance between efforts and rewards.
4. Life-course model: Individuals who experienced poor home conditions in childhood are more likely to experience occupational disadvantage.