The Law and Poor People's Access to Health Care

Abstract

Studies of health care delivery system and patterns of utilization ineluctably point to same basic conclusions-that the poor are sicker than nonpoor, and yet they use fewer health services.' The statistics on sickness and need for services among poverty populations are staggering. Comparing families with annual incomes of less than $2,000 to those with incomes of $7,000 or more, former suffer from heart conditions at a rate four times as high as latter, they incur rheumatism and arthritis six times as often, and they suffer eight times as many visual impairments.2 And while such figures on chronic illness are partially attributable to large numbers of elderly poor, extraordinary amounts of illness plague all segments of poverty population.3 The data on usage of health services is no less conclusive in supporting proposition that poor persons receive health care far less frequently than more affluent persons. For example, one study has indicated that children in families with incomes under $2,000 average 1.6 physician visits per year compared with 5.7 visits for children in families with incomes over $7,ooo.4 Thus, illness is not adequately treated and preventive services are seldom provided among poor. Although facts on usage of services may be clear, explanation is more difficult to pinpoint, for a multitude of factors probably account for ultimate fact that poor persons do not receive sufficient services. There may be inadequate information or knowledge about need for and availability of services, cultural attitudes influencing utilization, problems of alienation, language barriers, or simply physical distance barring usage of facilities. All of these elements may contribute to some degree, or in some instances.5 But thesis of this article is that existence