Practical Barriers to Health Equity: Challenges, Opportunities, and Solutions

Abstract

Purpose: The purpose of this systematic review is to outline the barriers to health equity with the goal of identifying strategies which have the potential to bridge disparities for disadvantaged and underserved populations in the future. Methods and Materials: This study was designed based on the preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) statement. A literature search of peer-reviewed publications was undertaken to identify studies pertaining to healthcare access. Articles published from January 2013 to January 2023 were included. An interpretive synthesis was then presented and the practical implications discussed. Results: A total of 531 original studies were identified and differed significantly in their clinical design, methods, and endpoints. The core themes could broadly be categorized into those related to insurance coverage, (N = 90), out-of-pocket costs (N = 81), social determinants (N = 77), infrastructural deficits including appointment, and/or provider availability (N = 70), communication gaps (N = 60), technical literacy, (N = 59), racism and bias (N = 55), and information sharing (N = 39). Conclusions: Barriers to achieving health equity are complex, multifaceted, and deeply rooted. Successfully making progress will require thoughtful, evidence-based innovation with sustained engagement from a myriad of stakeholders so that high-quality care can be prioritized for all members of society.