Defining and targeting health care access barriers

J Health Care Poor Underserved. 2011 May;22(2):562-75. doi: 10.1353/hpu.2011.0037.


The impact of social and economic determinants of health status and the existence of racial and ethnic health care access disparities have been well-documented. This paper describes a model, the Health Care Access Barriers Model (HCAB), which provides a taxonomy and practical framework for the classification, analysis and reporting of those modifiable health care access barriers that are associated with health care disparities. The model describes three categories of modifiable health care access barriers: financial, structural, and cognitive. The three types of barriers are reciprocally reinforcing and affect health care access individually or in concert. These barriers are associated with screening, late presentation to care, and lack of treatment, which in turn result in poor health outcomes and health disparities. By targeting those barriers that are measurable and modifiable the model facilitates root-cause analysis and intervention design.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Community Health Services / organization & administration*
  • Evidence-Based Practice
  • Health Services Accessibility / organization & administration*
  • Health Status Disparities
  • Healthcare Disparities / ethnology*
  • Humans
  • Mass Screening
  • Models, Organizational*
  • Patient Acceptance of Health Care / ethnology
  • Socioeconomic Factors