It’s easy to think that if a healthcare or community service exists, people who need it will use it. A clinic opens nearby, a food assistance program has available spots, transportation assistance is offered, a nonprofit launches free screenings, and a health plan provides preventive benefits.
The resource is there, so access is resolved, right? Not necessarily.
There is an important difference between a service being available and a service being truly accessible. For many people, the hardest part isn’t whether help exists, but whether they can find, understand, trust, reach, and afford the time required to use it, and successfully navigate the process.
Availability Is Only the First Step
Healthcare researchers increasingly find that access is more than a program or provider being in the community. Access also involves the availability of appointments, cost, transportation, language, trust, digital usability, and how easy or difficult the system is to navigate.
That distinction matters. A clinic may be available five miles away, but for someone without reliable transportation, paid time off, childcare, or an appointment that fits their work schedule, that clinic may as well be a million miles away since they have no practical way to get there and use it.
In other words, proximity doesn’t always equal access.
Everyday Life Gets in the Way
The social determinants of health are the nonmedical conditions that influence health outcomes, including factors related to economic stability, education, neighborhoods, transportation, food access, and social environments. These factors help explain why someone might know a service exists and still not use it.
Imagine a parent who has access to a free health screening but works an hourly job, has two children, and shares one vehicle with another family member. The screening itself may cost nothing.
Getting there could still mean lost wages, arranging childcare, coordinating transportation, and finding several hours in an already packed day. The service is “free,” but using it isn’t necessarily free.
Transportation Remains a Real Barrier
Transportation is one of the best examples of the gap between availability and accessibility. A peer-reviewed analysis of National Health Interview Survey data estimated that 5.8 million people in the United States delayed medical care in 2017 due to lack of transportation.
Researchers also found transportation barriers disproportionately affected people experiencing poverty and those with chronic conditions. More recent data find that 5.7% of U.S. adults lack reliable transportation for daily living in 2022, with the problem more common among people with lower incomes.
A program can have open appointments all week, but those openings mean little to someone who cannot reliably reach them.
People May Not Understand How to Use the Help
Another barrier is health literacy. Research involving adults age 50 and older found that people with lower health literacy were more likely to delay or forgo needed care and report difficulty finding a healthcare provider, even after researchers accounted for factors such as insurance coverage and poverty.
Think about what that means for community organizations. Simply publishing information about a program may not be enough.
Many people need straightforward answers to the questions, “Do I qualify? What will this cost, and what documents do I need? Who do I call? Is this available in my language? What happens after I apply?”
These basic questions need answers for us to move forward, and when those answers are difficult to find, complicated forms and unfamiliar terminology become barriers in themselves.
Trust Matters, Too
People also have to trust the organization providing the service. Research associates greater mistrust of healthcare organizations with behaviors including postponing needed care, missing follow-up appointments, not filling prescriptions, and not following medical advice.
Trust is built by present organizations that use their relationships to foster consistent, respectful communication and transparency, where people already feel at ease. That is why community partnerships are so valuable.
Schools, churches, neighborhood organizations, local nonprofit groups, community health workers, and other dependable sources turn awareness into action.
The Goal Should Be Usable Access
We therefore need to ask a different question; rather than just asking ‘Is this service available? ‘ we should also ask ‘Can the people who need it use it realistically?’
What this involves is looking past the number of clinics, programs, appointments, or resources provided. It means taking into account transportation, scheduling, language, health literacy, trust, technology, childcare, cost, awareness, and the ordinary realities of the communities in question.
For organizations like The Access to Health Foundation, community-centered outreach makes a meaningful difference. Connecting people with resources is important, but helping remove the obstacles between people and those resources is what turns availability into genuine access.
Because a resource that exists but remains out of reach isn’t fulfilling its full purpose, do you want to help us make a difference? Every day, we work to improve health equality and invite you to help bring better care to more communities.
Take a look at our four ways to support us and pick the one that fits you best. We appreciate having you with us.
Follow “Health Equality in Action – Turning Access Into Outcomes” each week and join us as we learn together what healthcare equality can be.