1. Barriers to Care Laurie A. Belknap, D.O., FAAFP Assistant Professor of Family Medicine Laurie.belknap@osumc.edu

2. Learning Objectives  Identify barriers for a child or adult in gaining access to health care. (2546-10584)  Identify issues of health determinants and health disparities in patients and recognize their potential influences on patients’ health. (10667-10670)  Describe differences in how medical care is provided in a variety of settings.(2546-2548)  Identify examples of community resources that can assist in patient care. (2546-2549)

3. Learning Resources  Health Disparities Overview, http://www.ncsl.org/research/health/health-disparities- overview.aspx#2 http://www.ncsl.org/research/health/health-disparities- overview.aspx#2  Adolescent and School Health, Health Disparities, http://www.cdc.gov/healthyyouth/disparities/ http://www.cdc.gov/healthyyouth/disparities/  Community Resource Guide, Columbus and Greater Central Ohio, http://www.cscc.edu/campus- life/cares/pdf/CARES%20Ohio%20ResourceGuide.pdfhttp://www.cscc.edu/campus- life/cares/pdf/CARES%20Ohio%20ResourceGuide.pdf  Franklin County Children Services 2014 Resource Guide http://wwwfranklincountyohio.gov/children_services/asse ts/pdf/resource-guide.pdf http://wwwfranklincountyohio.gov/children_services/asse ts/pdf/resource-guide.pdf  National CLAS Standards, http://minorityhealth.hhs.gov/templates/browse.aspx?lvl= 2&lvlID=15 http://minorityhealth.hhs.gov/templates/browse.aspx?lvl= 2&lvlID=15  www.aafp.org/pcmhresources and transformed.com www.aafp.org/pcmhresources

4. Barriers to Access Personal Unemployment Lack of education Lack of transportation Language and cultural barriers Disadvantaged minority Lack of family support Personal beliefs on health Personal time commitments, work or caring for others Community Low socioeconomic status Geographic barriers, rural or intercity urban Low educational status Lack of providers Lack of social services Lack of referral resources Increased ethnic diversity Perceived cultural bias, race or religion Health System High cost of care Insufficient mental health providers Lack of primary care providers Lack of coordination of care Lack of chronic disease management Lack of flexible hours Increasing numbers of uninsured or underinsured.

5. Health Determinants Financial barriers Resources unavailable Access Self Destiny Spiritual beliefs Personal beliefs Language barriers Limited cognition Physical impairment with hearing, vision, or speech Comprehension barriers, reading and writing Lack of computer or technological skills Literacy Issues Cultural communication Cultural Norms

6. Health Care Disparities Racial Minorities Ethnic Groups Lower Income, Poverty LGBT Populations Linguistic Minorities Vulnerable Populations, Elderly and Children Geographic, Rural Locations

7. Medical Care Settings Rural Hospital Private Practice Suburban Urgent Care Emergency Department Urban GeneralistSpecialist

8. Community Resources Social ServicesChildren ServicesCounty AgenciesCommunity ProgramsCharity OrganizationsReligious Organizations

9. Summary Personal barriers Community barriers System barriers

10. Thank you for completing this module Questions? Contact me at: Laurie.belknap@osumc.edu