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Geography and Healthcare Equity in the U.S.
The insurance coverage, accessibility to treatment, functional capacity, standards of healthcare, and care costs in the U.S. health system vary widely by geographical location. Geographical location plays a vital role in healthcare accessibility and equality concerns. Uneven geographic access to health care is a result of areas with greater income disparity and social inequality along demographical lines, which may deter or avoid investing in facilities that benefit the entire public (Tsui et al., 2020). Governmental authority is divided between the federal and state governments under the constitutional system of the United States. This framework is reflected in the Affordable Care Act (ACA), which among other reforms to the healthcare system, broadened Americans options for healthcare. States are free to decide how to carry out the legislation, even though the government offers the majority of funding for subsidized coverage and establishes a federal minimum for insurance regulatory requirements.
Even within one state, geographic diversity in health markers may be found at the subregional level. Because of these regional differences, certain areas of the United States are less developed economically than average rates would indicate. The Affordable Care Act (ACA) initiative, for instance, aims to lower the countrys uninsured rate and eliminate the regional disparity in coverage for health insurance (Collins & Lambrew, 2019). However, policies can be insufficient to provide complete population coverage of primary care services, according to studies that demonstrate geographic obstacles to exist still even after user fees have been eliminated (Nguyen et al., 2018). Community health workers (CHWs), who are laypeople with training in treating a specific subset of clinical situations, are the main policy option for overcoming geographic obstacles (Garchitorena et al., 2021). The federal requirements, funding, and the freedom given to localities in implementing the legislation have all resulted in improvements in access. This is significant for those who reside in underperforming areas as well as for the overall U.S. economy and political decision-making.
References
Collins, S., & Lambrew, J. (2019). Federalism, the Affordable Care Act, and Health Reform in the 2020 Election. Commonwealth Fund. Web.
Garchitorena, A., Ihantamalala, F. A., Révillion, C., Cordier, L. F., Randriamihaja, M., Razafinjato, B., Rafenoarivamalala, F. H., Finnegan, K. E., Andrianirinarison, J. C., Rakotonirina, J., Herbreteau, V., & Bonds, M. H. (2021). Geographic barriers to achieving universal health coverage: evidence from rural Madagascar. Health Policy and Planning, 36(10), 16591670. Web.
Nguyen, H. T., Zombré, D., Ridde, V., & de Allegri, M. (2018). The impact of reducing and eliminating user fees on facility-based delivery: a controlled interrupted time series in Burkina Faso. Health Policy and Planning, 33(8), 948956. Web.
Tsui, J., Hirsch, J. A., Bayer, F. J., Quinn, J. W., Cahill, J., Siscovick, D., & Lovasi, G. S. (2020). Patterns in Geographic Access to Health Care Facilities Across Neighborhoods in the United States Based on Data From the National Establishment Time-Series Between 2000 and 2014. JAMA Network Open, 3(5), e205105. Web.
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