User:EnricoRescigno/sandbox

Inequality in Healthcare Access for Immigrants
The most prevalent barriers faced by immigrants with regard to accessing primary care services are related to geography and geographic distribution, language, and culture. Moreover, the distribution of physicians has a direct impact on the utilization of primary care services by immigrants. Immigrants tend to settle in suburbs, and long term immigrants tend to migrate toward suburban areas. These areas offer the most affordable housing options for immigrants, however this creates a “spatial mismatch” between patients and physicians since physicians and medical services are primarily concentrated in urban areas.

Language is another strong barrier faced by immigrant populations due to the poor distribution of same-language physicians. Immigrants often face challenges in terms of understanding English medical terms. These linguistic differences are yet another contributing factor to the discordance and miscommunication between immigrants and English-speaking physicians.

Since healthcare services in Canada are paid in-part by the federal and provincial governments and by health insurance systems,  economic and financial barriers are generally not considered to be a severe issue dealt with by the immigrant community. However, local availability (i.e., spatial accessibility ) of physicians and individual patient preferences such as ethnicity and language spoken by physicians are both impactful factors contributing to the precipitous decrease in primary healthcare access by immigrants.

LGBT Access to Healthcare
The healthcare needs of the LGBT community are affected by a number of social, behavioural, and structural factors. Various bodies of literature have identified the health disparities associated with the LGBT community, and how these individuals receive disproportionate healthcare services. For example, mental health disorders such as depression and anxiety, eating disorders, obesity, and cardiovascular diseases are all of higher prevalence and a major concern amongst LGBT persons. These health issues are not sufficiently addressed either, as healthcare professionals (such as physicians) may be unaware of these individuals’ sexual orientation. In 2008, Analysis of Canadian Community Health Service data showed that: LGB persons were more likely to seek out mental health services than heterosexuals ; lesbians have lower reported rates of using family physicians ; bisexuals report higher levels of unmet healthcare needs compared to heterosexuals(2); and LGB persons perceive they have less equitable access to healthcare services compared to heterosexual persons.

Another barrier that exists with regard to the healthcare disparities experienced by LGBT persons is the stigma that continues to persist in society. Moreover, LGBT populations may fear that their health needs are not considered in primary health since healthcare has been historically been constituted through a cisnormative and heteronormative framework. As a result, LGBT populations are less likely to access primary healthcare services due to the fear of discrimination. In addition, recent data shows that healthcare professionals lack adequate knowledge and cultural competence when it comes to addressing health issues predominantly affecting the LGBT community. Cultural competence is an important consideration in assessing the quality of care received by the LGBT community, as a lack of cultural competency in healthcare professionals and systems leads to a reduced life expectancy, a lower quality of life, and an increased risk of acute and chronic illness amongst LGBT persons. Research has also highlighted that higher rates of chronic illness seen in LGBT persons is associated with discrimination, minority stress, avoidance of healthcare providers, and irregular access to healthcare services.

Another important consideration in addressing the quality of care received by the LGBT community is patient-physician communication. Many health risks LGBT persons face come as a result of avoidance and/or dissatisfaction of healthcare services; this is in-part due to the fact that there are a number of assumptions made by the patient’s healthcare providers, such as assuming the sexuality of the patient and predicting their sexual behaviours. In these scenarios, it can be very difficult for LGBT persons to feel comfortable in a clinical setting because they may experience a decline in self-confidence and trust in their healthcare providers.

The underlying message in terms of providing equitable care, and access to care, for patients in the LGBT community is that healthcare providers and systems must be aware of the appropriate methods through which to administer care. The specific needs of LGBT persons must be appreciated in order to enhance the quality of care and provide it in a non-judgemental, gender-neutral manner.

Health Disparities Amongst Women
With regard to disparities in healthcare associated with gender and sex, there are significant inequities among women related to socioeconomic status, geographical location, and ethnicity. It has been hypothesized that women experience a higher rate of health-related issues because of their reduced access to the material and social conditions of life that foster good health, as well as a heightened level of stress associated with their gender and marital roles. Moreover, extensive research evidence has shown that women with low income and who work full-time outside of the house have poorer health status in comparison to their male counterparts. The added responsibilities women hold as primary caregivers in households not only creates additional stress, but also indirectly increases the difficulty of the scheduling and meeting of medical appointments; these implications explain women’s poorer self-rated health status in comparison to men, as well as their report of their unmet healthcare needs. These findings demonstrate the implications gender has on the receival of care, but more specifically, women’s ability, or the lack thereof, to address their own healthcare needs. Further investigating ways in which women face disparities in Canada’s healthcare system is crucial to ensuring optimal health outcomes.