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Access Denied: Taking Action for Medically Underserved Children

Redlener, Irwin E.

Advocacy centered on access to health care for children is a straightforward business. The goal is clear: children need readily available, comprehensive, continuity-based, family-friendly, and child-friendly health services to meet a range of well-accepted objectives, including preventing, screening, acute care as needed, management of chronic conditions, and anticipatory guidance. Pediatricians refer to such a health care environment as a "medical home." Children who, for any reason, are unable to access such care are considered medicalIy underserved. Although wide-ranging barriers interfere with access to medical homes for millions of children, particular populations remain at high risk for chronically poor access. These are precisely the groups that require focused and sustained attention from advocates and policymakers. The fact is that serving vulnerable populations, such as homeless children, involves more than designing good programs, important as this may be. Often, the greater challenge is to understand and manage the barriers that keep such families from being able to utilize whatever services might be available. This paper proposes a strategic approach for programs dealing with health care services for severely medically underserved children. Accordingly, it is important to begin by attempting to understand the functional or operational definition of "health care access" and to derive therefrom a clear sense of the specific barriers that impede access.

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Published In
Journal of Urban Health: Bulletin of the New York Academy of Medicine
Volume
75
Issue
4
Pages
724 - 731
Academic Units
National Center for Disaster Preparedness
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