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剖析印度班加罗尔老年人在获得医疗保健方面交通不平等的作用。

Unpacking the role of transport inequalities among older adults for accessing healthcare in Bengaluru, India.

机构信息

Transdisciplinary Centre for Qualitative Methods, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, India.

Department of Human Geography and Spatial Planning, Faculty of Geosciences, Utrecht University, Utrecht, The Netherlands.

出版信息

Glob Public Health. 2023 Jan;18(1):2274438. doi: 10.1080/17441692.2023.2274438. Epub 2023 Oct 30.

Abstract

Mobility, access to transport and healthcare play a crucial part in healthy ageing. However, these often posechallenges for older adults in the global South. This study applies the three concepts of 'motility' (access, competence and appropriation), to explore transport inequalities and barriers to access healthcare services for older adults in Bengaluru, India. The paper draws on interviews with sixty adults, aged 50 years and over, residing in urban Bengaluru. A semi-structured in-depth interview guide was employed to explore the transport inequalities. Applying thematic analysis, we present the mobility and transport barriers to access healthcare. Restricted access to healthcare services due to unavailable and unaffordable transportation resulted in missed appointments, delayed care and deterioration of health conditions. To cope with the barriers, older adults often visited less specialised clinics for regular check-ups and those with financial constraints resorted to self-medication. These actions further deteriorated health and led to adverse health outcomes. Our findings suggest that integrated health and transport policies must be designed to ensure equitable access to transportation services. Enabling older adults to have more independent lives and improve access to preventive healthcare is essential for better health outcomes.

摘要

流动、交通出行和医疗保健在老年人的健康老龄化中起着至关重要的作用。然而,在全球南方,这些对于老年人来说往往是挑战。本研究运用“流动性”(出行、能力和利用)的三个概念,探讨了印度班加罗尔老年人的交通不平等和获取医疗保健服务的障碍。本文通过对居住在班加罗尔市区的 60 名 50 岁及以上成年人的访谈,汲取了相关数据。研究采用半结构化深度访谈指南来探索交通不平等问题。通过主题分析,我们提出了获取医疗保健服务的流动性和交通障碍。由于缺乏可用且负担得起的交通出行,导致老年人难以获得医疗服务,从而导致错失预约、延误治疗和健康状况恶化。为了应对这些障碍,老年人往往会去不太专业的诊所进行常规检查,而那些经济拮据的人则会选择自行用药。这些做法进一步恶化了他们的健康状况,并导致了不良的健康后果。研究结果表明,必须制定综合的卫生和交通政策,以确保公平获得交通服务。使老年人能够更加独立地生活,并改善获得预防保健的机会,对于改善健康结果至关重要。

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