POVERTY, UNEMPLOYMENT, AND ACCESS TO HEALTH CARE AMONG PATIENTS WITH CHRONIC DISEASES

Abstract

Poverty and unemployment affect health care access and outcomes for chronic illness patients because they are key social determinants of health. The author of this manuscript illustrates the complex relationship between chronic illness and poverty. It is shown that how poverty impacts the likelihood of chronic disease and further, how chronic disease may itself deepen poverty via loss of income, job loss, out-of-pocket expenditure, cost of medication, and diminished capacity to work, etc. Unemployment worsens disease management by creating financial stress, disrupting insurance coverage, limiting access to medication and reducing continuity of care. Patients with chronic conditions who are low-income face several barriers including lack of insurance, transport problems, geographic distance, low health literacy, stigma, inadequate social support, and low availability of affordable primary care. Financial impediments can cause treatment to be delayed, patients to bypass taking their medications, and other complications. The paper asserts that efficacious management of chronic diseases goes beyond clinical care; instead it requires universal health coverage, subsidized care, patient-centered medical homes, community health workers, integrated care model, health-literacy support and policies that shield patients at risk of catastrophic heath expenditure and more. For chronic disease and health equity outcomes, tackling poverty and unemployment is particularly important.