Despite myriad efforts made by government agencies and health organizations to improve access to healthcare, it remains a challenge across the United States. One article in the Journal of Health Care for the Poor and Underserved found that barriers to care contribute to poor health outcomes and health disparities. On the flip side, expanding access to care empowers individuals to build relationships with providers and therefore prevent, manage, and overcome illness and injury—creating stronger, more prosperous communities in the process.
Current Barriers to Care
Access to healthcare is a multifaceted issue. To start, the high cost of healthcare can be a tremendous hurdle; in 2021, nearly 10 percent of adults reported being unable to get medical care, or having their care delayed, because of cost. Relatedly, lack of insurance represents another hurdle to accessing care. As of 2020, 27.5 million people in the U.S. were uninsured, while people of color and those in poverty are more likely to be uninsured. Geography is another barrier; people living in rural or remote areas may have fewer providers and facilities available to them. A lack of reliable transportation can compound this problem; each year, 3.6 million Americans miss or delay medical care because they lack vehicle access or face long travel times.
Language barriers can also make it difficult for patients to know what health services are available and communicate effectively with providers. According to the Agency for Healthcare Research and Quality, patients with limited English proficiency experience more medical errors, longer hospital stays, and higher rates of readmission. Finally, stigma around mental health, substance use, and reproductive health can prevent individuals from disclosing their issues to providers.
What Governments Can Do
Understanding common barriers to care is the first step to remedying them. To address gaps in insurance, for instance, governments can increase funding for programs like Medicaid and the Children’s Health Insurance Program (CHIP), which provide healthcare coverage to low-income individuals and families. Additionally, governments can increase reimbursement rates and reduce the administrative burden related to such programs, making it easier for healthcare providers to accept them.
Geographic hurdles to care can be minimized in two main ways: by increasing public transportation options in underserved areas and expanding access to telehealth services. Language barriers, meanwhile, can be mitigated via online translation services for non-English speakers and increased cultural competency training for healthcare providers. Regarding stigma, the integration of mental healthcare into primary care settings can serve to improve access, as can providing incentives for mental health providers to work in underserved areas, such as rural towns and inner cities.
The Role of Data
Because access to healthcare is a multifaceted issue, improving it requires the work of both government agencies and healthcare organizations. But to target hurdles to care more granularly, governments also need the ability to compile and analyze data about everything from service providers to insurance coverage. Virginia’s Framework for Addiction Analysis and Community Transformation (FAACT), for example, brings together information from multiple federal, state, local and private organizations. This data allows stakeholders to identify and prioritize areas lacking in substance use treatment but high in overdoses. In some areas, the state even piloted Narcan vending machines to increase its Naloxone distribution footprint.
The same data has also helped localities apply for federal grants. One locality was awarded $1 million in SAMSHA funding to deliver care directly in high schools. The care, which targeted young people struggling with substance use, completely eliminated barriers such as transportation and stigma for students in need.
In Montana, for instance, the Department of Health recently launched a web-based data and analytics platform that makes it easier for public health employees to access informative survey results on health insurance coverage, preventive health screenings, mental health, and chronic condition diagnoses, as well as health-linked behaviors such as exercise and substance use. When it comes to access to healthcare, data is power. Without a detailed understanding of where care is lacking and why, it’s much more difficult for government agencies to successfully implement solutions.
The Bottom Line
Ensuring residents have access to quality healthcare is extremely important. And yet, barriers persist. By understanding barriers to care and taking steps to remedy them, government agencies can better support their residents and build stronger communities. While access to care is a complicated issue, having data on care deserts, uninsurance trends, and the prevalence of other barriers is crucial to ensuring responses are properly targeted and sufficiently effective.
The author Lydia Paull-Flores, is Senior Director, GCOM and co-author, Mehret Girmay, is an Epidemiologist, GCOM.