Experiences, perceptions and expectations of health services amongst marginalized populations in urban Australia: A meta‐ethnographic review of the literature
Abstract Background Poor health outcomes amongst marginalized groups result in part from health inequities related to social and structural determinants of health. Marginalized people report higher incidences of comorbidities, chronic disease and adverse health behaviours than their nondisadvantaged...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-10-01
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| Series: | Health Expectations |
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| Online Access: | https://doi.org/10.1111/hex.13386 |
| _version_ | 1797989708131729408 |
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| author | Kirsten Baker Professor Jon Adams Dr. Amie Steel |
| author_facet | Kirsten Baker Professor Jon Adams Dr. Amie Steel |
| author_sort | Kirsten Baker |
| collection | DOAJ |
| description | Abstract Background Poor health outcomes amongst marginalized groups result in part from health inequities related to social and structural determinants of health. Marginalized people report higher incidences of comorbidities, chronic disease and adverse health behaviours than their nondisadvantaged peers. The objective of this review is to examine marginalized Australians' experiences of and access to community‐based primary health services in urban locations. Methods A systematic search incorporating related MeSH terms and synonyms pertaining to marginalized Australian populations and their health‐seeking was conducted across seven databases. We included qualitative studies that reported experiences of health‐seeking within community‐based primary health care in metropolitan Australia. Participant populations experiencing marginalization due to social stigma and isolation, early‐life disadvantage, poor health and/or financial hardship were included. A meta‐ethnographic framework was used to synthesize themes across selected studies and researcher triangulation was employed to develop higher‐order themes. Results Search results revealed 26 studies included for critical appraisal and synthesis. Seven higher‐order themes were developed describing experiences of health service engagement amongst marginalized groups: (1) Understanding the patient within the context of family and community, (2) Health and cultural beliefs influence health‐seeking, (3) Lack of information and poor cultural competence limit utilization of services, (4) Motivation for treatment influences health service engagement, (5) Accessing services, a spectrum of experience—from discrimination to validation, (6) Navigating a complex system in a complex society, (7) Preferences for health care and expectations for systemic change. Conclusion Marginalized Australians experience health disadvantage across micro, meso and macro levels of health system navigation and commonalities in health‐seeking were identified across each of the distinct marginalized groups in our analysis. This review outlines important areas of consideration for health care provision and policy development essential to helping address health inequities for a diversity of marginalized populations. Patient or Public Contribution Whilst patient voices were reported across all studies included within this review, no further patient or public contribution applies to this study. |
| first_indexed | 2024-04-11T08:24:46Z |
| format | Article |
| id | doaj.art-7ac21b7d7bcd47618443078c6df85991 |
| institution | Directory Open Access Journal |
| issn | 1369-6513 1369-7625 |
| language | English |
| last_indexed | 2024-04-11T08:24:46Z |
| publishDate | 2022-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Expectations |
| spelling | doaj.art-7ac21b7d7bcd47618443078c6df859912022-12-22T04:34:49ZengWileyHealth Expectations1369-65131369-76252022-10-012552166218710.1111/hex.13386Experiences, perceptions and expectations of health services amongst marginalized populations in urban Australia: A meta‐ethnographic review of the literatureKirsten Baker0Professor Jon Adams1Dr. Amie Steel2Faculty of Health, School of Public Health Sydney University of Technology Sydney AustraliaFaculty of Health, School of Public Health Sydney University of Technology Sydney AustraliaFaculty of Health, School of Public Health Sydney University of Technology Sydney AustraliaAbstract Background Poor health outcomes amongst marginalized groups result in part from health inequities related to social and structural determinants of health. Marginalized people report higher incidences of comorbidities, chronic disease and adverse health behaviours than their nondisadvantaged peers. The objective of this review is to examine marginalized Australians' experiences of and access to community‐based primary health services in urban locations. Methods A systematic search incorporating related MeSH terms and synonyms pertaining to marginalized Australian populations and their health‐seeking was conducted across seven databases. We included qualitative studies that reported experiences of health‐seeking within community‐based primary health care in metropolitan Australia. Participant populations experiencing marginalization due to social stigma and isolation, early‐life disadvantage, poor health and/or financial hardship were included. A meta‐ethnographic framework was used to synthesize themes across selected studies and researcher triangulation was employed to develop higher‐order themes. Results Search results revealed 26 studies included for critical appraisal and synthesis. Seven higher‐order themes were developed describing experiences of health service engagement amongst marginalized groups: (1) Understanding the patient within the context of family and community, (2) Health and cultural beliefs influence health‐seeking, (3) Lack of information and poor cultural competence limit utilization of services, (4) Motivation for treatment influences health service engagement, (5) Accessing services, a spectrum of experience—from discrimination to validation, (6) Navigating a complex system in a complex society, (7) Preferences for health care and expectations for systemic change. Conclusion Marginalized Australians experience health disadvantage across micro, meso and macro levels of health system navigation and commonalities in health‐seeking were identified across each of the distinct marginalized groups in our analysis. This review outlines important areas of consideration for health care provision and policy development essential to helping address health inequities for a diversity of marginalized populations. Patient or Public Contribution Whilst patient voices were reported across all studies included within this review, no further patient or public contribution applies to this study.https://doi.org/10.1111/hex.13386delivery of health carehealth equityhealth servicespublic healthsocial determinants of healthvulnerable populations |
| spellingShingle | Kirsten Baker Professor Jon Adams Dr. Amie Steel Experiences, perceptions and expectations of health services amongst marginalized populations in urban Australia: A meta‐ethnographic review of the literature Health Expectations delivery of health care health equity health services public health social determinants of health vulnerable populations |
| title | Experiences, perceptions and expectations of health services amongst marginalized populations in urban Australia: A meta‐ethnographic review of the literature |
| title_full | Experiences, perceptions and expectations of health services amongst marginalized populations in urban Australia: A meta‐ethnographic review of the literature |
| title_fullStr | Experiences, perceptions and expectations of health services amongst marginalized populations in urban Australia: A meta‐ethnographic review of the literature |
| title_full_unstemmed | Experiences, perceptions and expectations of health services amongst marginalized populations in urban Australia: A meta‐ethnographic review of the literature |
| title_short | Experiences, perceptions and expectations of health services amongst marginalized populations in urban Australia: A meta‐ethnographic review of the literature |
| title_sort | experiences perceptions and expectations of health services amongst marginalized populations in urban australia a meta ethnographic review of the literature |
| topic | delivery of health care health equity health services public health social determinants of health vulnerable populations |
| url | https://doi.org/10.1111/hex.13386 |
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