Similarities and intersections – A comprehensive view in three studies

Abstract

Abstract Background Various groups face difficulties in access to, and usage of health care. Research on marginalization in health care, and programs aiming to reduce inequalities usually focus on one single group at a time. Regarding the heterogeneity of groups defined by a few social characteristics, our aim was to question the specificity of barriers, and similarities between different groups. Methods The results of a mixed methods study focusing on elderly people with Turkish migration background were compared to the interim results of a qualitative study focusing on transgender persons, and the interim results of a qualitative study focusing persons with trauma related psychiatric diagnoses. Results 1) While relevant barriers in access to, and usage of health care seem to be group-specific at the first view, their underlying mechanisms of emergence are analogous. 2) Beside more obvious similarities, 3) further barriers arise by the combination of more than the mainly addressed characteristics of the different groups. Conclusions Barriers analogous or similar among different groups lead to underlying structural or professionality-related issues. If different dimensions of marginalization intersect, they may be disguised by a concentration on single characteristics. To target health inequalities on the long term, a closer look on similarities between groups facing health inequalities could improve the development of programs for a broader range of persons. Key messages The comparison of different marginalized groups is useful to identify and target systematic inequalities in health care. Researchers and stakeholders should consider mechanisms of multiple marginalization.