Predictors of Access to Healthcare: What Matters to Rural Appalachians?

Abstract

Objective:Lack of access to healthcare is frequently cited as a primary reason for health disparities globally, especially in poor, rural areas such as Appalachia in the U.S. This study examined predictors of perceived access to healthcare among residents in a poor, medically underserved, rural Appalachian community.Methods:The study was guided by the revised behavioral model of healthcare services utilization. Self-reported survey data were obtained from a convenience sample of 921 residents in rural Tennessee.Results:The majority of respondents in this study did not perceive access to healthcare to be a problem in their community. Financial factors, health status, and associated social factors negatively affected only a small number respondents’ perceptions of access to healthcare.Conclusions:Despite the presence of multiple factors previously shown to affect access to healthcare, the majority of respondents in this study did not perceive access to healthcare to be a problem in their community. Results of this study suggest that to understand an individual’s passage through the healthcare system, the contextual aspects of healthcare utilization, should be added to coverage, services, timeliness, and workforce as a fifth component of access to healthcare. Assessing perceived need and associated cultural factors that affect individuals’ concepts of health and wellness represent important areas for future exploration to explain observed health disparities. Additionally, findings showed that having sufficient quality and quantity of healthcare professionals and services in a community or region may be necessary, but not sufficient to explain health disparities and the underlying reasons why individuals choose or choose not to seek health services.

Policy Literacy, Barriers, and Gender Impact on Accessibility to Healthcare Services under Compulsory Migrant Health Insurance among Myanmar Migrant Workers in Thailand

“…According to Aday and Andersen (1998), gender is one of the predisposing factors in accessing healthcare [ 31 ]. In this study, female migrants achieved a higher accessibility to healthcare services than their male counterparts, a result that is consistent with two previous studies [ 32 , 33 ]. As in other Asian countries, males are considered as the leader of the family in Myanmar culture.…”

Assessing health disparities in breast cancer incidence burden in Tennessee: geospatial analysis

“…Specifically, in the city of Detroit, being unmarried, being Black, and residing in an area of extreme poverty were all significant [ 57 ]. Health insurance is also identified as a predictor of access and use of healthcare services [ 54 , 58 – 60 ]. In our study, we found marital status and type of health insurance coverage played a significant role in the diagnosis of breast cancer.…”

Sociodemographic Factors and Health Insurance Coverage Are Associated with Invasive Breast Cancer in Tennessee: Appalachian and Non-Appalachian County Comparison

“…Equitable access to quality health care is one of the major necessities to promoting health and well-being in minority and underserved populations, especially in poor and rural areas. 40 Evidence indicates that inequalities in health care access are primarily due to high numbers of not insured or underinsured low-income individuals. 31 , 41–45 For instance, several past studies 31 , 42–45 have found that uninsured patients and patients on Medicaid were more likely to receive a later stage BC diagnosis than women with private insurance.…”