Abstract
The interplay between socioeconomic status and access to public healthcare is a complex and multifaceted concern that requires an interdisciplinary methodology. By integrating perspectives from economics, sociology, public health, and policy analysis, this paper aims to establish a holistic framework for examining the impact of Socioeconomic Status (SES) on healthcare accessibility and proposing specific policy measures that could effectively reduce disparities in healthcare. This study examines the influence of socioeconomic status on healthcare access, highlighting the exacerbation of social inequalities and economic disparities in social sciences, public health, and economics. It employs a mixed-method approach, including household survey data, medical records, case studies, and interviews, to examine the socio-economic features of children's acute illness care facilities (FHCs). Beneficiaries are those who access these services, and data is collected daily from those approaching FHCs for any services on the day of the researcher's visit. Results indicate that financial barriers, geographic isolation, and lack of health insurance are the main hurdles faced by lower socioeconomic status (SES) groups in accessing care. In addition to these inherent differences, structural factors such as lack of access to health infrastructure, as well as legal and administrative barriers, further compound the widening equity gap. The paper recommends policy measures aimed at improving health insurance, suggesting that access is a key driver of this shift in utilization patterns. Lower-SES populations face knowledge, financial, and geographic barriers, whereas higher-SES populations generally have more resources, greater awareness, and better access.
References
Andersen, R. M., & Davidson, P. L. (2007). Improving access to care in America: Individual and contextual indicators. In R. M. Andersen, T. H. Rice, & G. F. Kominski (Eds.), Changing the U.S. health care system: Key issues in health services policy and management (3rd ed., pp. 3–31). Jossey-Bass.
Adler, N. E., & Stewart, J. (2010). Health disparities across the lifespan: Meaning, methods, and mechanisms. Annals of the New York Academy of Sciences, 1186(1), 5–23. https://doi.org/10.1111/j.1749-6632.2009.05337.x
Andrulis, D. P. (1998). Access to care is the centerpiece in the elimination of socioeconomic disparities in health. Annals of Internal Medicine, 129(5), 412. https://doi.org/10.7326/0003-4819-129-5-199809010-00012
Ataguba, J. E., & Kabaniha, G. A. (2022). Characterizing key misconceptions of equity in health financing for universal health coverage. Health Policy and Planning, 37(7), 928–931. https://doi.org/10.1093/heapol/czac041
Bambra, C., Smith, K. E., Garthwaite, K., Joyce, K. E., & Hunter, D. J. (2010). A labour of Sisyphus? Public policy and health inequalities research from the Black and Acheson Reports to the Marmot Review. Journal of Epidemiology & Community Health, 65(5), 399–406. https://doi.org/10.1136/jech.2010.111195
Barnes, L., Hall, P. A., & Taylor, R. C. R. (2023). The structural sources of socioeconomic inequalities in health: A cross-national perspective. Socius Sociological Research for a Dynamic World, 9, 237802312311748. https://doi.org/10.1177/23780231231174832
Becker, G., & Newsom, E. (2003). Socioeconomic status and dissatisfaction with health care among chronically ill African Americans. American Journal of Public Health, 93(5), 742–748. https://doi.org/10.2105/AJPH.93.5.742
Blumenthal, D., & Collins, S. R. (2014). Health care coverage under the Affordable Care Act - A progress report. New England Journal of Medicine, 371(3), 275–281. https://doi.org/10.1056/NEJMhpr1405667
Braveman, P., Egerter, S., & Williams, D. R. (2011). The social determinants of health: Coming of age. Annual Review of Public Health, 32(1), 381–398. https://doi.org/10.1146/annurev-publhealth-031210-101218
Daniels, N. (2013). Healthcare resources, distribution of. The International Encyclopedia of Ethics. https://doi.org/10.1002/9781444367072.wbiee494
Debnath, T., Barman, B., Barman, K., & Roy, R. (2023). Accessibility and availability of reproductive health care services at primary health centre level and association with health outcome in Aspirational Districts of India. Clinical Epidemiology and Global Health, 23, 101385. https://doi.org/10.1016/j.cegh.2023.101385
Farmer, P., Kleinman, A., Kim, J., & Basilico, M. (2013). Reimagining global health: An introduction. University of California Press.
Frean, M., Gruber, J., & Sommers, B. D. (2017). Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act. Journal of Health Economics, 53, 72–86. https://doi.org/10.1016/j.jhealeco.2017.02.004
Galobardes, B., Lynch, J., & Smith, G. D. (2007). Measuring socioeconomic position in health research. British Medical Bulletin, 81–82(1), 21–37. https://doi.org/10.1093/bmb/ldm001
Guagliardo, M. F. (2004). Spatial accessibility of primary care: Concepts, methods and challenges. International Journal of Health Geographics, 3(1), 3. https://doi.org/10.1186/1476-072X-3-3
Krieger, N. (2001). Theories for social epidemiology in the 21st century: An ecosocial perspective. International Journal of Epidemiology, 30(4), 668–677. https://doi.org/10.1093/ije/30.4.668
Little, C., Alsen, M., Barlow, J., Naymagon, L., Tremblay, D., Genden, E., Trosman, S., Iavicoli, L., & Van Gerwen, M. (2021). The impact of socioeconomic status on the clinical outcomes of COVID-19: A retrospective cohort study. Journal of Community Health, 46(4), 794–802. https://doi.org/10.1007/s10900-020-00944-3
Marmot, M. (2005). Social determinants of health inequalities. The Lancet, 365(9464), 1099–1104. https://doi.org/10.1016/S0140-6736(05)71146-6
Marmot, M. (2015). The health gap: The challenge of an unequal world. Bloomsbury Publishing USA.
Nandi, A., Hajizadeh, M., Harper, S., Koski, A., Strumpf, E. C., & Heymann, J. (2016). Increased duration of paid maternity leave lowers infant mortality in low- and middle-income countries: A quasi-experimental study. PLoS Medicine, 13(3), e1001985. https://doi.org/10.1371/journal.pmed.1001985
Organization, W. H. (2010). Equity, social determinants and public health programmes. World Health Organization.
Pampel, F. C., Krueger, P. M., & Denney, J. T. (2010). Socioeconomic disparities in health behaviors. Annual Review of Sociology, 36(1), 349–370. https://doi.org/10.1146/annurev.soc.012809.102529
Peters, D. H., Garg, A., Bloom, G., Walker, D. G., Brieger, W. R., & Rahman, M. H. (2008). Poverty and access to health care in developing countries. Annals of the New York Academy of Sciences, 1136(1), 161–171. https://doi.org/10.1196/annals.1425.011
Phelan, J. C., Link, B. G., & Tehranifar, P. (2010). Social conditions as fundamental causes of health inequalities: Theory, evidence, and policy implications. Journal of Health and Social Behavior, 51(1_suppl), S28–S40. https://doi.org/10.1177/0022146510383498
Wagstaff, A., & Neelsen, S. (2019). A comprehensive assessment of universal health coverage in 111 countries: A retrospective observational study. The Lancet Global Health, 8(1), e39–e49. https://doi.org/10.1016/S2214-109X(19)30463-2
Williams, D. R., Lawrence, J. A., & Davis, B. A. (2019). Racism and health: Evidence and needed research. Annual Review of Public Health, 40(1), 105–125. https://doi.org/10.1146/annurev-publhealth-040218-043750

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