We’d like to believe that everyone will have a positive experience when they need to shop for health insurance, see a doctor, or simply maintain a healthy lifestyle. Unfortunately, this just isn’t the case in the United States. Social factors affect us in every area of life, including health, wellness, and how we’re treated by healthcare professionals.

It’s impossible to escape the realities of society and the history of oppression in our cultures, even when it comes to something as basic as talking with a doctor or trying to pay for a routine procedure. There are so many factors dictating our experience with the healthcare system. It’s important to be aware of these differences and inequalities so we can work toward a better, more equal society that prioritizes health for all.

What Are the Social Issues We’re Facing in Healthcare?

Also known as the “social determinants of health,” social issues in healthcare describe the factors that make it easier or harder for someone to get access to quality care and wellness opportunities.

Typically, people with more resources and power have a much easier time getting the treatment and advice they need to stay healthy. They are able to afford comprehensive insurance that allows them to pay for medical treatment when needed. They are also more likely to get the respect and trust of healthcare professionals, leading to a higher level of care.

Systemic health disparities generally affect people who already belong to vulnerable communities. They may face barriers in other areas of their lives and additionally have trouble accessing healthcare, which often leads to chronic health problems or environmental health risks from poor living conditions.

Many people are unable to access proper preventative care due to a lack of health insurance or education. Language barriers can also lead to poorer access and quality of care.

The Six Social Factors in Systemic Health Inequities

 There are six social factors that affect an individual person’s likelihood of receiving quality healthcare. Everyone has a unique situation and many people have several social factors impacting their ability to access health services. These factors are:

• Class/income
• Legal status
• Race and ethnicity
• Gender identity and sexual orientation
• Disability
• Region

Some people are completely unaffected by these factors, while others might face barriers from all six. Understanding how they affect access can help us come up with solutions.

Class/Income and Healthcare 

Health insurance is expensive in the United States, and it is often dependent on employment status. Many lower- and middle-class jobs do not offer health benefits and don’t pay their employees enough to purchase insurance independently.

Even for people who have insurance, costs can be prohibitive. High deductibles and out-of-pocket costs cause many people to avoid going to the doctor except in emergencies. This reduces overall health and well-being or leads to life-threatening conditions. Medical debt is a common cause of bankruptcy.

Region and Healthcare Scarcities

Many areas of the country are facing shortages in healthcare personnel. Both rural and urban areas are experiencing these shortages, causing long waiting periods and forcing people to see any provider that may be available. Sometimes, this means people must travel long distances or work with a provider who doesn’t make them feel comfortable.

Legal Status as a Deterrent for Seeking Care

Noncitizens often struggle to obtain healthcare, especially those who are undocumented. They are almost never eligible for public health insurance and typically struggle to pay for their care out of pocket. Additionally, many undocumented immigrants avoid preventative or routine care for fear of deportation.

Systemic Racism in Healthcare 

Even if people can manage to see a doctor and pay for their care, systemic racism in healthcare affects people all over the country. Many Black, Latino, and Native Americans struggle with getting white doctors to take their symptoms seriously, leading to alarming disparities in care.

Other systemic issues compound the problem as well. Poverty, housing discrimination, and other factors all influence healthcare disparities. Barriers to entry affect the number of medical students of color, reducing the chance of people being able to see a doctor of their own race.

Gender Issues in Healthcare  

Women’s health issues have been politicized, making it difficult for many women to access family planning assistance, abortion, and preventative care. Transgender individuals face widespread discrimination and may have trouble accessing both routine care and gender confirmation surgery. Protections regarding gender and sexual orientation have been threatened or rolled back in many regions, leading to a lack of access and poorer health within these various groups.

Disability and Medical Coverage 

Many people with disabilities need access to quality healthcare the most. While the Americans with Disabilities Act has provided some protections, many lawmakers have tried to cut funding for programs assisting those with disabilities, such as Medicaid. Additionally, many people with one or more disabilities have trouble accessing reliable transportation to get to and from their medical appointments.

Remedying Structural Inequalities in Healthcare

These social barriers to equality in healthcare are complex and overwhelming. With that said, we must be focused on finding solutions, and quickly. Every American deserves to live healthy lives, without fear of discrimination. Changing the entire structure of the systems of power will be essential to realizing true equality. That task starts with education and demands for change across the nation.