Determinants of health-service use by low-income people.
Poverty influences health status, life expectancy, health behaviours, and use of health services. This study examined factors influencing the use of health-related services by people living in poverty. In the first phase, 199 impoverished users of health-related services in 2 large Canadian cities were interviewed by their peers. In the second phase, group interviews with people living in poverty (n = 52) were conducted. Data were analyzed using thematic content analysis. Diverse health-related services were used to meet basic and health needs, to maintain human contact, and to cope with life's challenges. Use of services depended on proximity, affordability, convenience, information, and providers' attitudes and behaviours. Use was impeded by inequities based on income status. To promote the health of people living in poverty, nurses and other health professionals can enhance the accessibility and quality of services, improve their interactions with people living in poverty, provide information about available programs, offer coordinated community-based services, collaborate with other sectors, and advocate for more equitable services and policies.
Stewart
Miriam
M
Faculty of Nursing, University of Alberta, Edmonton, Canada. miriam.stewart@ualberta.ca
Reutter
Linda
L
Makwarimba
Edward
E
Rootman
Irving
I
Williamson
Deanna
D
Raine
Kim
K
Wilson
Doug
D
Fast
Janet
J
Love
Rhonda
R
McFall
Sharon
S
Shorten
Deana
D
Letourneau
Nicole
N
Hayward
Karen
K
Masuda
Jeff
J
Rutakumwa
William
W
D000416:Alberta; D006077:Government Agencies / Q000191:economics*; D006296:Health Services / Q000706:statistics & numerical data; D006801:Humans; D015401:Nursing Administration Research; D009864:Ontario; D011203:Poverty