(Universitat Autònoma de Barcelona. Institut de Ciència i Tecnologia Ambientals)
(James J. Peters VA Medical Center (Nova York, Estats Units d'Amèrica))
| Date: |
2022 |
| Abstract: |
Background: Access to health care has traditionally been conceptualized as a function of patient socio-demographic characteristics (i. e. , age, race/ethnicity, education, health insurance status, etc. ) and/or the system itself (i. e. , payment structures, facility locations, etc. ). However, these frameworks typically do not take into account the broader,dynamic context in which individuals live and in which health care systems function. Purpose: The growth in market-driven health care in the U. S. alongside policies aimed at improving health care delivery and quality have spurred health system mergers and consolidations, a shift toward outpatient care, an increase in for-proft care, and the closure of less proftable facilities. These shifts in the type, location and delivery of health care services may provide increased access for some urban residents while excluding others, a phenomenon we term "health care gentrifcation. " In this commentary, we frame access to health care in the United States in the context of neighborhood gentrifcation and a concurrent process of changes to the health care system itself. Conclusions: We describe the concept of health care gentrifcation, and the complex ways in which both neighborhood gentrifcation and health care gentrifcation may lead to inequitable access to health care. We then present a framework for understanding health care gentrifcation as a function of dynamic and multi-level systems, and propose ways to build on existing models of health care access and social determinants of health to more efectively measure and address this phenomenon. Finally, we describe potential strategies applied researchers might investigate that could prevent or remediate the efects of health care gentrifcation in the United States. |
| Grants: |
Ministerio de Ciencia e Innovación CEX2019-000940-M
European Commission 678034
|
| Note: |
Altres ajuts: Juan de la Cierva (JC-2018- 035322-I) |
| Note: |
Unidad de excelencia María de Maeztu CEX2019-000940-M |
| Rights: |
Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.  |
| Language: |
Anglès |
| Document: |
Article ; recerca ; Versió publicada |
| Subject: |
Health care access ;
Gentrifcation ;
Health equity ;
Urban health |
| Published in: |
International Journal for Equity in Health, Vol. 21, (May 2022) , art. 66, ISSN 1475-9276 |
| Related work: |
Cole, Helen;Franzosa, Emily. «Correction : Advancing urban health equity in the United States in an age of health care gentrifcation : a framework and research agenda». International Journal for Equity in Health, Vol. 21, (June 2022), art. 84 https://doi.org/10.1186/s12939-022-01686-5 |
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(Universitat Autònoma de Barcelona. Institut de Ciència i Tecnologia Ambientals)
