Barriers to healthcare access in a non-elderly urban poor American population

Abstract

An understanding of perceived barriers to health-care is critical to improving healthcare access for all Americans. To determine perceived barriers to health-care in an urban poor population in Dayton, Ohio, a face-to-face door-to-door survey of individuals identified through targeted, stratified, area probability sampling was done. A sample of 413 non-elderly poor adults, including 19% without telephones, reported personal relevance of various barriers to healthcare access. Most frequently endorsed barriers were lack of information about free or reduced-cost health-care, anticipated cost, and difficulty accessing child-care. Seventy-four per cent of respondents reported more than one barrier. Individuals without telephones and those without health insurance reported more barriers to health-care. Reported barriers were similar for working and non-working poor, except for transportation problems, more frequently reported by non-working respondents. This study provides important data on what poor people in a medically underserved community perceive to be barriers to accessing health-care and underscores the importance of including people without telephones in the study design. Respondents who did not have telephones were more likely to report multiple barriers, particularly problems with lack of information about free or discounted medical care, child-care, and transportation. These findings suggest the importance of door-to-door surveys rather than telephone surveys for getting accurate data on the poor.

Structural Reinterpretation of Poverty by Examining Working Poverty: Implications for Community and Policy Practice

“…They are twice as likely as other workers to become unemployed, and consequently experience economic hardships (Corcoran & Hill, 1980). Poor workers and their families receive lower health care benefits due to access barriers (Ahmed, Lemkau, Nealeigh, & Mann, 2001;Guendelman, Wyn, & Tsai, 2002;Wolfe, 1994) and lower social security benefits upon retirement (Ozawa, 1982).…”

Does General, Physical and Mental Health Differ by Healthcare Coverage or Healthcare Cost for Middle-Aged Females?

“…This cross-sectional analysis used 2015 data from the Behavioral Risk Factor Surveillance System (BRFSS) conducted by the Center for Disease Control [18]. BRFSS collects data in the United States and U.S territories by conducting telephone surveys with Random Digit Dialing (RDD) techniques for landline and mobile phones concerning chronic health conditions, health-related risk behaviors, and use of preventive services for participants 18 years and older.…”

“…These states were chosen for their higher proportions of individuals who reported (a) fair or poor general health, (b) having no healthcare coverage, (c) difficulty with cost and paying for healthcare, and (d) being middle-aged females based on the BRFSS 2015 prevalence survey data maps [18].…”

Using the USA Framework to Meet the Needs of the Poor in our Communities

“…Although lack of education and insurance benefits may play a small part in these statistics, the working poor report more barriers to accessing preventative care and are less likely to receive care than those living above the poverty line [3,4]. Sadly, Bloch et al [5] also found that primary care providers "lack…understanding of the lived reality of poverty" and have "prejudicial attitudes" which lead to "a failure to collect adequate data about patients' social circumstances and to the development of inappropriate plans of care" (p. 1).…”