Experiences, perceptions and expectations of health services amongst marginalized populations in urban Australia: A meta-ethnographic review of the literature

Kirsten Baker; Jon Adams; Amie Steel

doi:10.1111/hex.13386

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Experiences, perceptions and expectations of health services amongst marginalized populations in urban Australia: A meta-ethnographic review of the literature

Journal article

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Experiences, perceptions and expectations of health services amongst marginalized populations in urban Australia: A meta-ethnographic review of the literature

Kirsten Baker, Jon Adams and Amie Steel

Health expectations : an international journal of public participation in health care and health policy, Vol.25(5), pp.2166-2187

10/2022

DOI: https://doi.org/10.1111/hex.13386

PMID: 34904344

Appears in Recent National Centre for Naturopathic Medicine Publications

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Abstract

Health Care Sciences & Services

Health Policy & Services

Life Sciences & Biomedicine

Public, Environmental & Occupational Health

Science & Technology

delivery of health care

health equity

health services

public health

social determinants of health

vulnerable populations

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.

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Title: Experiences, perceptions and expectations of health services amongst marginalized populations in urban Australia: A meta-ethnographic review of the literature
Creators: Kirsten Baker - University of Technology Sydney
Jon Adams - University of Technology Sydney
Amie Steel - University of Technology Sydney
Publication Details: Health expectations : an international journal of public participation in health care and health policy, Vol.25(5), pp.2166-2187
Publisher: Wiley
Number of pages: 22
Identifiers: 991013035759602368
Copyright: © 2021 The Authors. Health Expectations published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Academic Unit: National Centre for Naturopathic Medicine
Language: English
Resource Type: Journal article

Experiences, perceptions and expectations of health services amongst marginalized populations in urban Australia: A meta-ethnographic review of the literature

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