Health inequity and social determinants of healthcare utilization in the disadvantaged community of Hong Kong

Tan, Joelle Hwee Inn; Goh, Amelia Xin Chun; Yi, Hana

doi:10.1093/heapro/daab195

Cited by 6 publications

(5 citation statements)

References 39 publications

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“…Such an act depicts an unequal power relationship in health communication when healthcare practitioners make patients surrender autonomy and independent thinking by taking up the sick role and obeying their verdicts. Our findings echo Tan et al's (2021) argument that healthcare providers' ‘inattentive communication skills and paternalistic attitudes' discourage patients from involving in care‐related decision‐making.…”

Section: Discussionsupporting

confidence: 86%

Health‐seeking, intercultural health communication, and health outcomes: An intersectional study of ethnic minorities' lived experiences

Leung

2023

Journal of Advanced Nursing

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Aims:To explore ethnic minorities' lived experiences of health-seeking and healthcare utilization in Hong Kong, and to examine the impact of intersectionality of sociocultural identities on intercultural health communication.Design: Qualitative exploratory design.Methods: Data collection methods were semi-structured interviews, unstructured observations, and unstructured informal group discussions. Twenty-five informants, including eight Pakistanis, seven Nepalese, five Indians, four Bangladeshis and one Sri Lankan, were recruited using the snowball sampling method and individually interviewed between 25th June and 23rd September 2019.Results: Sixteen females and nine males, aged 21-76 years, were in the study. Twothirds could communicate in English, but eight required interpreters. Thematic analysis reveals four factors affecting intercultural health communication: healthcare professionals' cultural insensitivity, red-tapism and ethnic minorities' language improficiency and/or deficiency in medical knowledge. Health professionals' workplace stress and cultural insensitivity prompt ineffective intercultural communication, making ethnic minority patients feel disrespected despite having adopted the Hong Kong culture.The intersectionality of sociocultural identities plus health professionals' blocking behaviours results in health inequalities. Conclusion:The unequal power relationship between health professionals and ethnic minority patients may lead to dehumanizing and depersonalized experiences for patients, as humanity is the heart and soul of medicine. Therefore, the government should raise healthcare providers' cultural sensitivity and diversity awareness, and offer ethno-specific care and more interpretation services. Impact:The study addresses health inequalities among Hong Kong ethnic minority patients with different sociocultural identities. About the impact of ineffective intercultural health communication on health inclusion and health outcomes, policies and practices should ameliorate health professionals' cultural sensitivity, awareness of the unequal power relationship and respect for diversity. Patient or Public Contribution:Referred by organizations serving ethnic minorities, the minority patients shared their lived experiences in health-seeking.

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Section: Discussionsupporting

confidence: 86%

Health‐seeking, intercultural health communication, and health outcomes: An intersectional study of ethnic minorities' lived experiences

Leung

2023

Journal of Advanced Nursing

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“…A more cost-effective approach could also include programs that focus on promoting health in these groups and investing in community empowerment and engagement [46]. More focused health literacy programs should target those who are in need of health literacy, and healthcare providers should invest more time and efforts into culturally and linguistically diverse groups [46][47][48] to enhance their engagement and adherence to post-treatment plans.…”

Section: Recommendations and Future Directionsmentioning

confidence: 99%

Barriers to Cardiac Rehabilitation among Patients Diagnosed with Cardiovascular Diseases—A Scoping Review

Iyngkaran,

Appuhamilage,

Patabandige

et al. 2024

IJERPH

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Background: Cardiovascular diseases (CVDs) are a rising global burden. Preventative strategies such as cardiac rehabilitation (CR) have shown a marked reduction in disease burden. Despite this, CR is underutilized worldwide. This study aims to identify the barriers to CR among patients diagnosed with CVD. Methods: A scoping review of the literature was conducted following the Joanna Briggs Institute (JBI) guidelines. Four major databases, including CINAHL, PubMed, EBSCOhost, and Scopus, were used to obtain studies published between 2010 and 2023. Search terms such as “Cardiac rehab*”, “Barrier*”, “Cardiovascular”, “Disease”, and “diagnosis*” were utilized in order to obtain subject-specific studies relevant to the research question. Results: From the initial 2098 studies, only 14 were included in the final analysis, consisting of both qualitative and quantitative designs. The thematic analysis included “healthcare system-related factors”, “Socioeconomic factors”, and “individual characteristics”. Healthcare system-related factors were mostly related to the poor availability of CR programs, lack of proper referral strategies, inadequate knowledge of CR provider and inter-provider communication issues, and lack of alternative methods of CR delivery. The socioeconomic barriers were lack of education, longer distance to CR facilities, high cost of care, unemployment, and poor income status. The identified individual characteristics were female gender, older age, and comorbidities. Conclusions: Lack of resources, poor access, educational attainment, and high cost of care were some of the barriers to CR, particularly in low- and middle-income countries (LMICs). Health policymakers and healthcare providers should implement strategies incorporating the issues identified in this scoping review. Systematic reviews may be required to confirm these findings.

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Section: Recommendations and Future Directionsmentioning

confidence: 99%

Barriers to Cardiac Rehabilitation among Patients Diagnosed with Cardiovascular Diseases- A Scoping Review

Iyngkaran,

Appuhamilage,

Patabandige

et al. 2024

Preprint

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Background: Cardiovascular diseases (CVDs) are a rising global burden. Preventative strategies such as Cardiac Rehabilitation (CR) have shown a marked reduction of disease burden. Despite this, CR is underutilized worldwide. This study aims to identify the barriers to CR among patients diagnosed with CVD. Methods: A scoping review of the literature was conducted following the Joanna Briggs Institute (JBI) guidelines. Three major databases including CINAHL, PubMed, EBSCOhost and Scopus were used to obtain studies published between 2010 and 2023. Search terms such as “Cardiac rehab*”, “Barrier*”, “Cardiovascular”, “Disease” And “diagnosis*” Were utilized in order to obtain subject-specific studies relevant to the research question. Results: From the initial 2098 studies only 14 were included in the final analysis, consisting of both qualitative and quantitative designs. The thematic analysis included “healthcare system-related factors”, “Socioeconomic factors”, and “individual characteristics”. Healthcare system-related factors were mostly related to poor availability of CR programs, lack of proper referral strategies, inadequate knowledge of CR provider and inter-provider communication issues, and lack of alternative methods of CR delivery. Socioeconomic barriers were lack of education, longer distance to CR facilities, high cost of care, unemployment, and poor income status. Identified individual characteristics were female gender, older age, and comorbidities. Conclusion: Lack of resources, poor access, educational attainment, and high cost of care were some of the barriers to CR, particularly in low and middle-income countries (LMICs). Health policymakers and healthcare providers should implement strategies incorporating issues identified in this scoping review. Systematic reviews may be required to confirm these findings.

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Health inequity and social determinants of healthcare utilization in the disadvantaged community of Hong Kong

Cited by 6 publications

References 39 publications

Health‐seeking, intercultural health communication, and health outcomes: An intersectional study of ethnic minorities' lived experiences

Health‐seeking, intercultural health communication, and health outcomes: An intersectional study of ethnic minorities' lived experiences

Barriers to Cardiac Rehabilitation among Patients Diagnosed with Cardiovascular Diseases—A Scoping Review

Barriers to Cardiac Rehabilitation among Patients Diagnosed with Cardiovascular Diseases- A Scoping Review

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