Whole-person Wellness Blog: The importance of access

For this month’s whole-person wellness blog, Dr. Lisa Tshuma, a project director at The Wright Center, will provide valuable and vital information on access to health care services. She is a passionate and fierce advocate about improving access to care for all as demonstrated by her work on the Language and Disability Access HRSA grant, awarded to The Wright Center for Graduate Medical Education in September 2023. – Allison

Access to health care services is an important component of overall health and well-being. It impacts our quality of life and can enable us to live healthier lives. When we are healthy, we are better able to participate in society and contribute to our communities.

Many people with limited English proficiency and/or disabilities still face barriers to accessing health care, despite federal laws to ensure equal access. Identifying these barriers is the first step in improving access to care for everyone in our community. Let’s briefly explore some common barriers to accessing health care.

Communication Barriers:
People with hearing, vision, or speech impairments, as well as people with limited English proficiency, may face difficulty communicating with health care providers, leading to misunderstandings and suboptimal care.

Physical Barriers:
Some health care facilities are not designed to be accessible to people with mobility, sensory, or cognitive impairments. This can include inaccessible entrances, ramps, elevators, restrooms, and examination rooms. For people with sensory issues, physical barriers can also include loud waiting rooms or bright lights.

Lack of Accessible Equipment:
Health care facilities may not have the necessary equipment to reasonably accommodate people with disabilities, such as accessible scales, examination tables, chairs, wheelchairs, and supportive tools such as dressing sticks.

Attitudinal Barriers:
Some health care workers may have inappropriate attitudes or lack the necessary training to provide satisfactory care for people with disabilities or limited English proficiency (LEP). Ableism stigmatizes human variations in bodies, abilities, and behaviors that are different from preconceived ideas of normalcy. People can exhibit ableism without even realizing it; you don’t have to be disabled to experience ableism.

Transportation Challenges:
People with disabilities or limited English proficiency may have difficulty accessing health care facilities due to limited transportation options or the inability to navigate public transportation.

Financial Barriers:
High costs of health care in the United States, including medical supplies, prescription medications, and therapies can be a significant barrier for people with disabilities, especially those with low incomes.

Lack of Awareness:
Many people with disabilities and LEP may not be aware of their rights to accessible health care or the services available to them.

In Pennsylvania, about one in four adults, or about 28%, have a disability. Centers for Disease Control and Prevention research reports that people with disabilities are more likely to have serious medical conditions than non-disabled adults. These conditions include diabetes, heart disease, and depression. Many people in our community can benefit from each of us adopting an access to care mindset in our daily work and lives.

Here are five things we can do individually and collectively to improve and sustain access to care:

– Ask our patients about their needs and preferences.
– Document our patient’s needs and preferences.
– Incorporate the question, “How is access to care impacted by _?” in our daily work.
– Designate sufficient financial resources for accessibility.
– Connect to the expertise of the community. Recruit and work with people who have lived experience with access to care barriers.

A multi-faceted approach is required to ensure everyone in our community has access to care. Each of us has an important role to play in building accessible health care systems and making our patients feel like valued members of our community. Please join me in making access to care a priority in our daily work. We are the solution to ensuring access to care for everyone in our community.

Yours in community health,

Lisa Tshuma, DBH, MPAS, MPA, DipACLM, PA-C
Project Director, The Wright Center for Community Health