What role does social class play in the quality of healthcare you receive?

Social class significantly influences the quality of healthcare individuals receive. Research indicates that social class affects access to treatment for major morbidity conditions, with Indigenous communities and older widows being less likely to access treatment compared to other social groups. Additionally, disparities in healthcare access based on social class are evident in the presence of health insurance coverage and the availability of primary healthcare facilities. While the presence of a functional primary healthcare center increased the likelihood of treatment for most social groups, it did not have the same effect for Indigenous communities.

Comparto recomendaciones prácticas: 1. Investiga los programas de asistencia médica gratuitos o de bajo costo en tu área. 2. Aprende sobre los requisitos de elegibilidad para acceso a coberturas de seguros subsidiados para población menos favorecida. 3. Consulta con clínicas comunitarias o centros de salud que ofrecen servicios con tarifas ajustadas según los ingresos. 4. Explora opciones de telemedicina o consultas virtuales para evitar largos tiempos de espera. 5. Mantén un estilo de vida saludable para prevenir problemas mayores de salud. 6. Aboga por una reforma en el sistema de salud que brinde acceso equitativo a todos. 7. Edúcate sobre tus derechos y opciones como paciente, independientemente de tu situación económica.

Social class determines access to healthcare in cases where there are long waiting lists as poorer people cannot afford private care.

Social class definitely influences the care a person receives in current healthcare systems. Social stratification is a reality in every aspect of society not just healthcare. There are markers that seemingly justify these realities. For example, less affluent persons tend to be less educated and less compliant . Other noticeable dynamics include the realities of diminished family support systems in lower social classes. More affluent and educated persons tend to research not only laws that affect their care, but also lifestyle changes that impact their wellbeing and treatment outcomes.

Additionally, in a health system, Physicians and Providers should not be made aware of the type of insurance or income that their patients are using, and instead leave that information only being available to applicable prior authorization and billing staff. This helps reduce under-treatment for patients with certain insurances such as Medicaid, which has lower reimbursement rates.

Implicit bias is the “subconscious” prejudices and attitudes that a person develops through the course of their life- even if an individual does not consciously or outwardly show these biases. These biases can affect the way providers treat patient conditions and can be invisible but dangerous. Healthcare systems should require providers to go through routine implicit bias training.

De allí que son indispensables reformas de los sistemas de salud para que el acceso, la cobertura y calidad sean óptimas para todas las poblaciones sin importar condiciones económicas, clase social, lugar de residencia, idioma, género, entre otras. Existen países y experiencias que demuestran que es posible introducir mejoras en el financiamiento solidario de los sistemas de salud, capacidades regulatorias para la protección social, medidas de eficiencia y mejor organización de los servicios. Explore estás experiencias que están disponibles en observatorios regionales de los sistemas de salud, sitios web especializados y de organismos de cooperación multilateral.

Agree with Paul - health literacy is an important factor to understanding what services are available to help detect, treat and manage health conditions. There are well intended health screening programs such as asthma action plans and heart health checks which are not reaching intended cohorts besides the worried well. Access to GPs to deliver these programs in lower socioeconomic areas and available wrap around health and social support means that many miss out.

Health literacy needs to be delivered within our educational system. Let’s look at the primary system, where the concept of health is introduced. Nutrition, hygiene, physical fitness, social interaction, safe behaviours, yes, but do we introduce health literacy? How does our complex health system work? How do you access its services and what are your rights/entitlements? We have universal healthcare in Australia, but what does that mean to someone who lives in a remote area, has economic challenges, or requires specific engagement with health providers due to cultural or social circumstances? Start in primary schools, establish a universal curriculum across state and private schools, and the social class gap disappears. Thoughts?

We have universal health care in Australia, but access to health care is not aways equitable. I think there are a number of factors at play here, and health literacy is one of the biggest ones. While health literacy is a completely different concept to the social class (and isn’t Australia supposed to be a classless society?) the social determinants of health - particularly around education - are very closely tied to health literacy and in my view this is where the gap lies.

Inequality in New Zealand (NZ) rose sharply (when the mean "household equivalent disposable income" for the lowest Social Economic Status (SES) group decreased by 17% and rose for the top income group by 36%. Indicators included a downward, spiralling economic trend in literacy & mental health, increased anti-social behaviour, full prisons, & risky sexual behaviours, i.e., STI outbreaks (MSD, 2016). This is significant for NZ because 10% of citizens own 52% of NZ's total net worth & 50% own 5% of NZ's total net worth (Boston, Bradstock, Eng, 2010). Literacy, Economic, & Social can each become dominant in various parts of our lives, and therefore, they all are signi?cant to understanding causes.

Higher social class access more preventive care because there is better understanding of what preventive care can do, hence an innate drive to seek that out. It should result in earlier detection of conditions and less cost in treatment downstream. With certain innovations and advances in preventive care and a consumer mindset in this realm, the cost of accessing of preventive care can also go up if not managed well.

Particularly in the case of demanding therapies that require consistent adherence, it can certainly play a role what level of education you have or to which educational class you belong. This level of education is used as justification, as in some healthcare systems it is associated with an expected level of adherence. This then serves as a justification for payers when deciding whether to admit a person to a cost-intensive therapy based on lifelong adherence.