Predictors of young people's healthcare access in the digital age

Abstract

Objective: To quantify barriers to healthcare for young people (12-24 years) and identify sociodemographic correlates and predictors. Methods:This cross-sectional survey targeted young people living in New South Wales, Australia, with oversampling of marginalised groups. Principles Component Analysis (PCA) identified clusters of barriers. Ordinal regression identified predictors of each barrier cluster. Results:A total of 1,416 young people completed surveys. Participants with chronic conditions and increasing psychological distress reported a greater number of barriers. Of 11 potential barriers to visiting a health service, cost was most common (45.8%). The PCA identified three clusters: structural barriers (61.3%), attitudinal barriers (44.1%) and barriers relating to emerging autonomy (33.8%).Conclusions: Barriers to healthcare reported by young people are multi-dimensional and have changed over time. Structural barriers, especially cost, are the most prominent among young people. Approaches to overcome structural barriers need to be addressed to better support marginalised young people's healthcare access.Implications for public health: Understanding predictors of different barrier types can inform more targeted approaches to improving access. Equitable access to healthcare is a priority for early diagnosis and treatment in young people, especially reducing out of pocket costs.

Intersectionality: Social Marginalisation and Self-Reported Health Status in Young People

“…In a linked Access 3 study we found that increasing marginalisation was inversely associated with reporting of the number of healthcare access barriers [11]. This could be a good news story that highly marginalised young people are reaching the healthcare required.…”

“…To directly inform new policy in the state of New South Wales (NSW), Australia, this cross-sectional study, the NSW Youth Health Access survey [11], was part of a larger project ("Access 3") which was designed to explore barriers to access to healthcare, health system navigation, and the role of technology. The methods have been fully described in the study protocol [12], and a summary is provided below.…”

“…Appropriate attention by health professionals, policymakers, and researchers would be helpful to more adequately support the needs of marginalised young people. In a systematic review of marginalised young people's healthcare access, "other" gender status was frequently not collected [11]. Thus, when considering health inequalities and gender, if gender is conceptualized only as a binary concept, this vulnerable group will be overlooked [40].…”

Artspace: Enabling young women’s recovery through visual arts: A qualitative study

“…Many young people express uncertainty about how and where to seek help with these issues . Accessing health care is particularly difficult for young people who are marginalised as a result of low incomes, lack of family support, or structural violence, experiencing discrimination due to disability, homophobia or racism …”

Digital Mental Health Intervention Uptake Among Distressed New Zealand High School Students in a Comprehensive Survey: Implications for Digital Help Provision

“…Alongside individual and social barriers, larger structural systems such as the cost, accessibility and structure of the healthcare system can create barriers to mental healthcare (Barker et al, 2005). Children and adolescents have cited a plethora of structural barriers to accessing mental healthcare, including lack of time, money, help options, and transport options, long waiting lists, inconvenient opening hours, and staff attitudes (Radez et al, 2020;Robards et al, 2019). Acknowledging adolescents' current barriers to mental health services is required to ensure that existing services and new approaches are developed to provide effective, accessible and equitable mental healthcare options (Patton et al, 2016;Robards et al, 2019).…”