Access to general practitioner services amongst underserved Australians: a microsimulation study

<p>Abstract</p> <p>Background</p> <p>One group often identified as having low socioeconomic status, those living in remote or rural areas, are often recognised as bearing an unequal burden of illness in society. This paper aims to examine equity of utilisation of general practitioner services in Australia.</p> <p>Methods</p> <p>Using the 2005 National Health Survey undertaken by the Australian Bureau of Statistics, a microsimulation model was developed to determine the distribution of GP services that would occur if all Australians had equal utilisation of health services relative to need.</p> <p>Results</p> <p>It was estimated that those who are unemployed would experience a 19% increase in GP services. Persons residing in regional areas would receive about 5.7 million additional GP visits per year if they had the same access to care as Australians residing in major cities. This would be a 18% increase. There would be a 20% increase for inner regional residents and a 14% increase for residents of more remote regional areas. Overall there would be a 5% increase in GP visits nationally if those in regional areas had the same access to care as those in major cities.</p> <p>Conclusion</p> <p>Parity is an insufficient goal and disadvantaged persons and underserved areas require greater access to health services than the well served metropolitan areas due to their greater poverty and poorer health status. Currently underserved Australians suffer a double disadvantage: poorer health and poorer access to health services.</p

Barriers to health and social services for street-involved youth in a Canadian setting

Although street-involved youth contend with many health and social problems, the extent to which vulnerable youth engage with supportive services has not been well described. This study sought to examine the prevalence and correlates associated with having difficulty accessing health and social services among a prospective cohort of street-involved youth in Vancouver, Canada. Among 1019 street-involved youth, 650 (64%) reported having difficulty accessing services during the study period. In a multivariate analysis, youth who reported having difficulty accessing services were significantly more likely to be socially and economically vulnerable. Specifically, they were more likely to report severe housing instability, high-intensity drug use, recent interactions with law enforcement, drug dealing, and histories of violence and physical abuse. Study findings point to opportunities to improve access to services among vulnerable youth through removal of blanket age restrictions for youth services, establishing youth-centric social housing, and supporting peer-driven, low-threshold services

Association between cultural distance and migrant self-rated health

We study whether migrants' health in Europe is associated with the cultural distance between their host country and country of origin. To this end, we run multilevel regression models on data merging (i) self-rated health and social background of more than 3,800 migrants from the European Social Survey with (ii) an index of cultural distance based on country differences in values, norms and attitudes measured in the World Values Survey. We find that higher levels of cultural distance are associated with worse health of migrants. This association is comparable in size to the negative association between health and female gender (compared to male gender) but less important than the association between health and education level. In addition, this association is less significant among second-generation migrants than among first-generation migrants