Those served by our five — soon to be six — medical centers often have difficulty accessing urgent and non-urgent gynecological and reproductive medical care. 

We know all too well the challenges our low-income, rural, often isolated, patients face. As part of our work promoting access to care, we advocate for policies that:

  • Alleviate social determinants of health barriers;
  • Expand care to the under and uninsured; 
  • Reduce language and cultural barriers; and
  • Increase investment in comprehensive, evidence-based, medically accurate, and age-appropriate sexual health education.

Today, on Giving Tuesday, we kick off a series of blog posts on the importance of health care advocacy by focusing on the first bullet point above: Alleviate social determinant of health barriers.

Social Determinants of Health are the conditions in people’s lives that can affect their health outcomes and risks. Typically, these barriers to care are found within five separate areas: neighborhood and physical environment, health care access and quality, economic stability, education access and quality, and social and community context.


NEIGHBORHOOD AND PHYSICAL ENVIRONMENT: Low-income individuals and racial/ethnic minorities are more likely to live in unsafe housing, and in neighborhoods without green spaces and healthy food options. Neighborhood differences can create and reinforce disadvantages, given disproportionate access to resources and exposures to conditions that are harmful to health. Policies that bring retail food stores to disadvantaged communities, increase community revitalization, increase environmental safety measures, and enforce fair housing can create healthier neighborhoods for everyone.


HEALTH CARE ACCESS AND QUALITY: In our region of upstate New York, some 5% — or nearly 20,000 people — don’t have health insurance, making them less likely to have a primary care provider and unable to afford the health care services and medications they need. Strategies to increase insurance coverage are critical for making sure more people get important health care services, like preventive care and treatment for chronic illnesses. Sometimes, people don’t get recommended health care services because they don’t have a primary care provider. Their community may lack enough providers or they may lack the transportation necessary to get to one. Sometimes, the provider may lack the linguistic and cultural competency needed to serve diverse populations. Interventions to increase access to health care professionals and improve communication can help more people get the care they need.


ECONOMIC STABILITY: In our region, 15% of residents — that’s nearly 60,000 people — are living in poverty. In addition, many are what we call ALICE: Asset Limited, Income Constrained, Employed. These are people that earn above the federal poverty level, but not enough to afford a bare-bones household budget. They are often left making decisions between basic necessities, such as whether to fill a prescription or fix their car, or between quality child care and paying rent. A disproportionate number of families, while they do not meet the federal poverty level, may still choose to delay health care because they cannot afford it. Interventions to increase gainful employment and provide access to high-quality child care can help more people find and keep jobs. In addition, policies to help people pay for food, housing, health care, and education can reduce poverty, and improve health and well-being.


EDUCATION ACCESS AND QUALITY: People with higher levels of education are more likely to be healthier and live longer. Education can increase people’s knowledge, problem-solving, and coping skills, enabling them to make better-informed choices. In addition, education provides the knowledge and skills necessary for employment, meaning a greater likelihood of being employed at all, and of having a job with healthier working conditions, better benefits, and higher wages. Interventions to help people stay in and do well in school — as well as those that help families pay for college — can have crucial, long-term health benefits.


SOCIAL AND COMMUNITY CONTEXT: People’s relationships and interactions with family, friends, co-workers, and community members can have a major impact on their health and well-being. Many people face challenges and dangers that are outside of their control but that have a negative impact on their health and safety. Interventions for people to get the social and community support they need, as well as those to reduce racism and discrimination, are critical to support health.