Even a free access to health care services does not eliminate inequalities of access to health care services. Two studies attempt to address this paradox and understand the role of health care services with regard to health inequalities.
Researchers have formulated various hypotheses to explain this phenomenon, ranging from health determinants (eg nutrition, exercice, sedentarity), to risk behaviour and socio-economic conditions. However, the role played by health care systems has rarely been evaluated, although differences in access to health care can reinforce existing inequalities.
The IRDES (Institute of research in health economics based in France), has recently published a twofold study based on a literature review and on an overview of three leading action plans in Europe where health care systems were incorporated in a comprehensive strategy to tackle health inequalities: the UK, the Netherlands and Sweden.
At the same time, Eurohealthnet and EHMA - (the European Health Management Association) have published a report on “The role of the Health Care sector in Tackling Poverty and Social Exclusion in Europe”, that analyses, amongst other things, the barriers to accessing health care and health care financing in relation to poverty.
Health equality Vs health equity
Both studies highlight the beneficial role of health care services in addressing health inequalities with regard to equity of access, affordability and responsiveness.
Horizontal and vertical inequities are a persistent feature across EU health systems: individuals in equal need are not always treated equally and the relative financial burden of health systems is not always fairly distributed.
There are many barriers that hinder health service access and service affordability. Some such as distance and transport, voice and health beliefs affect mainly people from lower social-economic groups.
Social inequalities in access to medical services do exist, particularly for people on lower incomes and for older people. Better educated people tend to have access to medical specialists and dentists more easily and more frequently, while people with less income tend to use more GPs and emergency services only when they are seriously ill, even when their access to health services is free. This fact affects their perspective for receiving adequate services, their prognosis for recovery and consequently their overall health.
While the two studies conclude that the health sector can contribute signicantly to achieving objectives aimed at reducing poverty and social exclusion, the sector may not be aware of its specific role.
IRDES study - Part 1 (in French): “What role for health care system in health inequalities reduction policies? - Health inequalities determinants and the health care system role”
IRDES study - part 2 (in French): “What role for health care system in health inequalities reduction policies? - Three European experiences”
The role of the Health Care sector in Tackling Poverty and Social Exclusion in Europe
