Summary
A public health issue common in Canada is the difficulty of receiving access to treatment for patients. The problem of not getting access to treatments is relevant to understand because individuals have a right to basic health care. People are denied health care for reasons involving their socioeconomic status, geographical residence, and costs of healthcare. Every person deserves reasonable health care without financial, economic, social or other types of barriers (Hajizadeh, 2017).
Explanations of the Context and Importance
Socioeconomic Status (SES)
Lots of individuals face many difficulties in situations because of one’s socioeconomic status. A combined measure of one’s resources and stature in a society is an individual’s socioeconomic status (Brady & Matthews, 2002). Socioeconomic status includes resources regarding financial security and assets, the income people make, or housing quality. The status one may have in a society revolves around their education (i.e., if they have attained a high school degree or university degree). An individual's occupation and profession, to the amount of social support around them, also determine a person's socioeconomic status. A person's socioeconomic status can be a burden to getting fair access to treatments.
High and low socioeconomic status are two widely, different ranges. High SES deals with having a higher level of education attained, increasing income, lots of social support and security. Someone with high SES is in a position of a better advantage to better access to health care, easier access to treatments. (Malat, van Ryn, & Purcell, 2006). While a person with low SES will have a decreasing chance of health and treatment access because they have a low income, didn’t attain much education, poor housing quality, or decreased social support and security.
One concern about the access to treatments is the waiting time for receiving access to health care services. For instance, if a patient is feeling very ill, travelling to a doctor’s office can be difficult. Having nearby social support from family members or friends can be easier to get to immediate care. Being sick and going to check into a physician’s office alone can be challenging to do so on someone’s own, and it might take longer to do so by yourself. This can affect a person’s time to receive instant primary care. About 4.6% of adult Canadians deal with long wait times, with the highest percentage from Quebec (Hajizadeh, 2017). From 2000 to 2010, Figure 1 demonstrates the rest of the percentages of long wait times and that it was a barrier to access to health care in Canada.
Figure 1
Percentages of Lengthy Wait Times Across the Provinces of Canada: 2000-2010.
Hajizadeh, M. (2018).
Following this, another example for long wait times is the delay for an appointment with a specialist. A general practitioner (within primary care) can recommend patients to a consultant when more dedicated care is needed. However, there may be extended wait times for receiving that secondary care. Secondary care is the specialist in a particular field, such as a cardiologist, an allergy specialist, an ENT (ear, nose, throat) specialists, etc. Patients struggled with long delays from primary to secondary care (Berendsen, Jong, Jong, Dekker & Schuling, 2009). These long delays can be waiting many hours in a waiting room, or a patient could be waiting three months before seeing a specialist. Long delays can affect one's physical health as they are waiting to get treated quickly. To understand the actors involved in primary and secondary care, refer to Figure 2 (Berendsen, Jong, Jong, Dekker & Schuling, 2009).
Figure 2
Roles of the General Practitioner and Specialist
Berendsen, A.J., Jong, G., Jong, B., Dekker, J.H., & Schuling, J. (2009).
Location/ Place of Residence
The geographical location that someone may reside in can affect their ability in receiving primary care. For instance, depending on living in a rural or urban community, some health facilities are nearby to homes or distant. Not having the transportation to go to a healthcare facility, or public transportation not being available are barriers for someone trying to get access to treatments and health care. A study analyzed people’s illnesses and their travel time to a specialized health care facility. With increasing travel time for patients, it contributed to missing a few kidney dialysis sessions (Kelly, Hulme, Farragher, & Clarke, 2016). Even in other countries, people are experiencing difficulty getting quick care because of the distance of locations.
Another difficulty people may face for immediate care is pregnancy. If a pregnant woman suddenly has pain and contractions, and a hospital is very far in distance, it’s clearly difficult for a woman to get the proper care and needs to help her. The far distance between patients and the health facility are shown to be a barrier in seeking health care (Thaddeus & Maine, 1994). Many decades ago, especially for women living in a rural community, it was very common that there was not enough time to immediately get to a doctor. It tends to be a home-birth and other women are nearby to help the mother give birth.
Thaddeus and Maine (1994) discovered a few phases of delays that pregnant woman encounter. One phase is the delay of being able to reach an adequate health facility. This is based on issues of travel from home to the hospital, the availability and cost of transportation, and road conditions. The other phase is the delay of acceptable care at their health care facility. This deals with the shortages of nurses or doctors, supplies, equipment, medications or unavailability of rooms. Relating back to waiting times, many of these delays can be a contributor to a maternal or child death.
It is clear that they can depend on a few people nearby, but it is not as satisfying as getting the essential health care treatments that are needed. There must be a difference made if anything, having smaller health facilities near undeveloped communities for their safety, and their right to standard health care.
Insurance Coverage/Cost of Health Care
Receiving health care and treatment costs have continued to rise over the years. Expenses can range from health check-ups to surgeries, and medications and necessities to help support a physical or mental health issue. To pay for these necessities, having a low income can be struggling for them. In Canada, health check-ups, surgeries, and treatments are covered by public health insurance. However, other international countries do not hold the same benefits as Canada. In Nigeria, the costs and distance to a health care facility affect a person to seek traditional medical care (Thaddeus & Maine, 1994). An individual being unemployed, or one's financial status should not hinder them from treatments. All health care needs are not covered by public insurance. Consequently, individuals remain struggling to pay for other recommended essentials (Mkhitaryan & Krikorian, 2009). Financial burdens are another obstruction for patients trying to take care of their health.
Policy Implications and Recommendations
Several people are struggling to get access to treatments, and to get to a health care facility, and take care of their health. People in rural areas seem to be at a disadvantage than those living in urban areas. Solutions must include by building many more nearby health care facilities in the smaller communities or having nearby doctors and nurses, or other health care practitioners around. Additional support is suggested for underprivileged patients. More financial support is in need for extra necessities if insurance coverage is not available, and patients are in need of more social support despite socioeconomic status. A lot of improvement can be made based on better health policies, government policies, and individuals willing to help others in need of good healthcare.
Conclusion
Getting access to treatments is a standard policy for individuals in Canada. Facing financial, economic or social challenges with an illness, disability, or any health issue can be overwhelming for individuals. To summarize, someone coming from a high SES will have increased chances towards health or treatment access, and would not have many barriers. However, someone with a low SES might experience challenges and have decreasing chances at treatment access. There will always be a great difficulty for people living far in proximity to a health care facility, and if transportation is not available, it makes it more difficult to receive access to treatment and care. Costs of health care are usually covered in Canada, but if people still do not have an income that can provide the other remaining necessities, people are struggling to take care of themselves afterwards. People have the right to health care and access to treatments. Everyone’s physical or mental health should always be a priority as well. Patients should not have to struggle because of obstacles that are not under their control.