Читать книгу Handbook of Clinical Gender Medicine - Группа авторов - Страница 17

Across the healthcare landscape we see different utilization rates, as well as different barriers and enablers to healthcare access. For example, women in high-income countries are more likely to engage in preventative health activities than are men. They are also more likely to seek treatment for most diseases and to do so early in the course of an illness [1]. In contrast, women within emerging economies, such as those of Ghana and India, have been shown to utilize health systems less than men during their lifespan due to restrictive barriers such as childcare duties and care giving obligations, as well as service cost [2, 3]. Irrespective of country of origin, women in general are less likely to perceive their overall cardiac risk level and therefore are less likely to attribute their symptoms to a possible cardiac related health issue [4].

Men’s lower healthcare utilization rates in high-income countries are linked to the trend that they are fulltime workers, work longer hours, and have less flexible schedules than women do [1, 5]. Additionally, the presence of long wait times (more than 1 week) for a routine care appointment is a strong negative predictor of men accessing the health system within the USA [1]. Although variation may exist across countries, a study conducted in Denmark shows that working-age men have higher rates of hospitalization and mortality than their female counterparts [6]. This is attributed to lower rates of healthcare practitioner contact [6].

Available information from both the USA and Canada provides insights with respect to the LGBT population’s utilization of healthcare systems. Lesbians and gay men are less likely to seek preventive care, such as cancer-screening services, and to have poorer health maintenance behaviors than the general population [1, 7, 8]. This disparity is thought to be attributable to stigma, healthcare professionals’ perceived biases, lack of clinical and cultural knowledge, and lack of gender-sensitive care [1, 7, 8].

Lesbians are also less likely to have health insurance, to see a healthcare practitioner, or to have a consistent source of care [1, 7, 8]. This population is believed to underutilize health systems and delay health seeking [1, 7, 8]. In contrast, gay men living with a partner are as likely as a male living with a female partner to have a consistent source of care and to have significantly elevated chances of having seen a clinician within the last year [1, 7].

Transgender, bisexual, and intersex people are less likely to utilize the healthcare system than is the population as a whole [7, 8], while research demonstrates that trans-gender people are less likely to be insured than the general population. The underutilization of the healthcare system by bisexuals and intersex people is reported as being due to their perception that healthcare professionals lack the requisite knowledge to support their unique needs [7, 8].