Global Health and Disparity in Healthcare
22.01.2017
Access to comprehensive healthcare is fundamental to health and affects the overall physical, social, and mental health status. It is the ability of individuals or groups to obtain the services they seek, and is widely regarded as an important health determinant. Disparity in healthcare can be defined as differences or inequalities in accessing or receiving health care and services that help to achieve the best health outcomes. These differences and inequalities can be reflected in coverage, services, workforce, timeliness and quality of services received. Accessing healthcare requires 3 distinct steps which are: entry into the health care system, access to a health care location where needed services are provided and availability of health care provider with whom the patient can communicate and trust.
Research has shown inequalities in the distribution of health by race, income, education, neighborhood location, social class, gender and ethnicity. Health outcomes used to measure these include infant deaths and other preventable diseases and deaths, mortality rates, morbidity, disability, quality of life and life expectancy. Many individuals and families face barriers to health care and services including physical inaccessibility, socio-cultural issues or the cost of non-insured health services (e.g. eye and dental care, mental health services and prescription drugs). Other barriers include racism; language difficulties experienced by immigrants who cannot communicate in French or English; inadequacy of service providers available; lack of insurance; lack of cultural sensitivity, humility and understanding from health-care providers; location and the cost of transportation; extensive wait times; services not covered by benefits, a shortage of doctors/nurses in the area; low income and inability to create time from work and family responsibilities. To illustrate this, a study in Canada on immigrant women’s health showed that while immigrant women viewed health and prevention similarly to Canadian-born women, their ability to access the resources needed to stay healthy were different. At the same time, access to health care is also a challenge for Canadians in remote communities’ and Aboriginal populations who live off-reserve mostly due to location and the cost of transportation. Despite the fact that this population is more likely to report having unmet health care needs (20% compared to 13%), they are less likely than the overall population to regularly visit a physician.(77% compared to 70%). Barriers and challenges in accessing health care can lead to a deterioration of health, emotional distress and feelings of exclusion and isolation.
Few programs attempt to close the gaps in accessing health services by the undeserved population and reduce disparities in healthcare. They include West Prince TeleHomeCare, which provides another option for people deciding to live in their own homes while dealing with health issues and Toronto’s Mobile Health Unit which provides sexual health services onsite to the many immigrant women working in garment factories in Toronto’s downtown core.
The World Health Organization’s recommendation to address inequities and disparities in healthcare is that countries must address the systemic and structural stratification of their societies as a national priority. This means reducing the gap and inequalities in healthcare between those at the highest and lowest income levels through actions that will eradicate poverty and increase opportunities for employment, education and early child development among the entire population.