Access to health services affects the well-being of millions of consumers. Although the topic of health-related access is regularly featured in popular and academic conversations, these conversations primarily concentrate on objective or situational access factors. This research focuses instead on consumers’ subjective perception of access to better appreciate how personally experienced service availability and ease of access jointly determine consumers’ access perceptions. The authors find that perceived access to health services (PAHS) offers insight into the relationships between access, perceived health vulnerability, and overall health. Through scale development and a series of three theory-testing studies, this work demonstrates the close link between PAHS and perceived vulnerability (Study 1), connects this relationship to overall health (Studies 1–3), and establishes behavioral changes associated with access-vulnerability concerns (Study 2). Moreover, Study 3 finds evidence for a “muting” effect of health system distrust on the relationship between PAHS and perceived vulnerability as well as an “amplifying” effect of health motivation on the relationship between perceived vulnerability and overall health. Together, these studies illustrate PAHS’s relevance for explaining consumer vulnerability and overall health.
The Coronavirus (COVID-19) pandemic reduced real and perceived access to healthcare services, exacerbating pandemic fear, and thus influencing consumers' adoption of preventative health behaviors. Extending the EHBM, results from two studies show that perceived access to health services and pandemic fear impact an individual's general and COVID-preventative health behaviors. High perceived access reduces pandemic fear through its buffering effects on perceived health vulnerability and pandemic-related health system concern, especially with telehealth usage during the pandemic. While pandemic fear motivates COVID-19 vaccination, pandemic fear reduces personal preventative health behavior (e.g., healthy eating, exercising) and has little effect on personal COVID-preventative behaviors (e.g., wearing a mask, social distancing) when individuals perceive high pandemic-related control. Moreover, the fear-behavior link does not hold for preventative health visits; instead, perceived access directly promotes preventative visits and screening. This research informs public health stakeholders' communication, education, and resource allocation during health crises like the COVID-19 pandemic.
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