Universal Healthcare…Then What?

KENNEDI SCALES – The United States is the only industrialized nation that has not adopted a universal healthcare model. Thus, healthcare quickly gets expensive. In order to avoid out-of-pocket costs, health insurance is required. Even still, patients are often met with out-of-pocket costs. Although there are government programs meant to alleviate the financial burden of healthcare and insurance coverage, they are inaccessible to many and are becoming increasingly privatized. Therefore, the stratification of access to healthcare contributes to health disparities among varying social classes.

Although access to healthcare is a major contributor to health disparities, even countries that have adopted universal healthcare still face disparities tied to socioeconomic status–which can be affected by a myriad of other factors such as race and gender. For example, a 60-year-old woman in the poorest part of England has comparable health to a 76-year-old woman in England. Despite the adoption of a universal healthcare system, there are higher rates of chronic conditions, diabetes, COPD, and cardiovascular disease among poorer populations in England compared to wealthier populations. Though increasing access to healthcare would positively change healthcare outcomes in disadvantaged communities, it would not completely eliminate health disparities because of cultural norms and social capital.

Socialization has been tied to healthcare outcomes in universal healthcare systems or learning cultural norms and customs through social interaction, influences an individual’s behavior. It is defined as the process an individual undergoes to become aware of norms and values in their social environment. Cultural norms describe what behaviors and values are accepted in society. Gender norms, for example, can influence a person’s behaviors that lead to different health outcomes. 

A survey demonstrated that men who have strong masculinity beliefs are less likely to receive preventative care and general healthcare than those with moderate masculinity beliefs. Men in the United States have a higher mortality risk than women regardless of socioeconomic status because of cultural norms.  The idea of manhood is often tied to a sense of invincibility, causing reluctance towards seeking help from someone else. This cultural norm contributes to health disparities and would be unaffected by universal healthcare.

Cultural capital describes a person’s social assets that promote social mobility. Cultural health capital can lead to more positive health outcomes because it includes factors such as medical competency, social networks, financial reserves, research skills to better resources, and access to those resources. Cultural health capital influences the interactions patients have with caregivers, affecting health outcomes. A study compared patient-doctor interactions, and revealed that because of more cultural health capital, middle-class patients tended to receive more complex–but ultimately more effective–treatment while lower-class patients received simpler, less effective treatment. 

Nations that have adopted a universal healthcare system still see disparities among different social classes.  Cultural norms and capital contribute to these disparities. This proposes a question: how should these disparities be minimized if the policies that most directly affect the issue no longer contribute to the issue? These disparities are caused by problems that cannot be solved by policy, but instead can be changed by altering the culture of a society; working towards severing the link between emasculation and seeking help, and providing advice to patients with less cultural health capital. These issues can be minimized. Culture changes all the time. 

Copy Editor – Elizabeth Conner

Photography Source – https://www.healthaffairs.org/do/10.1377/forefront.20171109.973715/full/