Health is an inalienable human right, meaning every individual is born with the right to be in good health regardless of their age, gender, race, nationality, or socioeconomic status. Despite this seemingly indisputable fact, we to continue see massive health disparities and healthcare inequalities across the globe. In order to lessen these health disparities, healthcare needs to be something that is readily available for all people to take advantage of, not just those who are wealthy enough to be able to afford it. By establishing universal healthcare on an international scale, we will be increasing people’s health and quality of life as well as lower the global burden of disease. In order to accomplish this feat, healthcare needs to be accessible, and this can have a lot of different meanings. The main ways of making health readily available to all at an international level are creating dietary accessibility, financial accessibility, and physical accessibility.

 

Dietary accessibility is important because people cannot be truly healthy if they are not able to properly nourish themselves. I found it so interested that people in London were incredibly cognizant of allergies and dietary restrictions. At cafes, there were always multiple options for alternative milks typically almond, soy, and oat milk available for free. In the United States, these alternative milk options are typically offered but always at an additional cost. In Paris, I noticed these options were hardly available at all. At restaurants in London, the waiters always made sure to ask if there were any food allergies. In addition, there were often meat alternatives available. This included a lot of direct substitutions such as veggie burgers or jackfruit substitutes for meat. This was very different than the vegetarian experience in Paris, who would more likely be offered a plate of cooked vegetables. Parsis was generally not as accommodating to making meal alterations or offering an array of food alternatives for those with dietary restrictions. The United States typically has at least one food option that can be accommodated. Many people have food allergies to dairy, nuts, or gluten and many have food preferences such as vegan/vegetarian or Kosher. Having options for people of all diets ensures that the population will be in better health because they will not be deficient in crucial macro and micronutrients. This can help to directly combat malnutrition. Rates of malnourishment have more than doubled in recent years, with malnutrition contributing to 3.1 million deaths of children under five years old annually (UNICEF 2013). Therefore, more dietary accessibility can lead to better health internationally. Having access to healthy food, as well as food that accommodates dietary restrictions and allergies will overall lead to a healthier society. 

  

Financial accessibility is an extremely important component when looking at international health. In the United States, most families are one medical emergency away from the financial ruin. This leads to many people opting out of going to the hospital even when in need of professional medical attention simple because they cannot afford it. Universal healthcare makes healthcare more accessible and affordable. When a hospital visit can result in thousands of dollars in debt, a person is much more likely to try and get better on their own. However, when you known that the hospital visit and prescribed medication you need will be free, you are probably more likely to go to the seek the attention of a doctor as well as to receive preventative care in the first place. This may explain why statics show that Europeans are more healthy than American adults at all wealth levels. better health than Americans (NIH 2009). The United States is the only developed nation that does not have a universal healthcare system, despite spending the most on medical care per capita (NIH 2009). Despite the many upsides of universal healthcare, it does have its drawbacks as well. Because healthcare being free means that it is highly accessible for all, it also results in extremely long treatment times. When I visited an emergency room in London, we waited for six hours. In addition, free healthcare means that it is not necessarily as profitable as it is in the United States. This leads to many healthcare workers being underpaid, which is why the NHS is currently on strike for higher wages in London. Because of this, countries such as the UK are starting to move towards privatized healthcare in order to get faster access to treatment. This may also allow those providers working in the private sector to getting paid more, which will motivate more people to go into the medical field and to stay working in the UK after going to medical school there. The downside is that there then forms a social inequality in which those who are wealthy enough to afford private care will have better and more prompt treatment, whereas those using the state funded healthcare may die waiting for treatment in the emergency room. It is a bit of a double-edged sword, but I do believe the proper answer is expand the existing universal healthcare system. Creating more hospitals and more jobs can allow for better dispersal of resources. However, it can also be a viable situation to have both private and state options so that a person is able to receive some type of healthcare no matter what their income level is. The main point is having affordable and accessible health care options for all, because healthcare should not be a luxury. 

 

Physical accessibility is another extremely important component to international health. Accessibility for physically disabled persons can mean having elevators and ramps, making wheelchair accessible parking, having hallways wide enough for a standard wheelchair, and having wheelchair accessible exits and walkways marked off for easier navigation. Accessibility can also be for those who are deaf, such as having subtitles on health education videos. Accessibility for those who are visually impaired may include offering braille, having online and paper materials be designed in high contrast coloring and large text, and using colors that are visible for color blind persons. Accessibility is also an important factor to consider for those who may suffer from seizures or epilepsy. For example, repeating patterns may trigger a seizure as can flashing lights. Linguistic accessibility is particularly important for international health. In the context of health, there needs to be language representation so everyone is able to properly communicate. A doctor and patient cannot properly communicate with one another if they do not speak the same language. Similarly, it is difficult to come together and make international health policy such as is done by the World Health Organization without adequate linguistic understanding of one another.  Having multilingual people from a diverse array of cultural and ethnic background can be helpful in this scenario. Traditionally, English is often viewed as the global language that everyone is able to speak in. In addition, language interpreters may be used in these scenarios. However, language interpreters can only be so effective since there are interpreting and not necessarily translating it exactly how it was intended to mean. This is not as effective because it leaves room for mistranslation and does not account for cultural nuances. Having linguistic and cultural diversity in these settings can help to create a more effective environment for creating health policy because it is also more representative of the populations in which you are trying to help. The last type of accessibility is physical proximity, which is particularly relevant for those living in rural communities. A person in a rural community may have to travel much further to go to visit a medical professional, which may deter them from doing so. Putting more hospitals in closer proximity to these rural communities and offering closer ambulance dispatch sites can help to ensure that they are able to receive medical care in a reasonable window of time. As you can see there are many considerations to make when it comes to accessibility and healthcare, but all of them are equally important in creating a comprehensive, representative, and diverse healthcare environment for all. 

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The United States healthcare system tends to have a more Eurocentric mindset towards healthcare. However, when you are acting as a global citizen one must remember to act locally but think globally. This mentality highlights how every individual action has a global impact. When you are working in international health, you must approach every scenario by practicing cultural competency. This means being inclusive in the healthcare system, which also speaks to the need for accessibility in international healthcare. Resources only exist if a person is aware of those resources and are able to take advantage of them. These resources must be accessible to the people that need them in order for them to be taken advantage of. Having dietary, finical, and physical accessibility allows for more people to receive the healthcare that they deserve, which overall leads to better health internationally and decreased burden of disease. It is the collective responsibility of society to ensure that people’s right to being healthy is being realized. As health educators, it is our responsibility to see when this right to health is not being met, why, and what we can do to fix it.

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References

 

Avendano, M., Glymour, M. M., Banks, J., & Mackenbach, J. P. (2009). Health disadvantage in US adults aged 50 to 74 years: a comparison of the health of rich and poor Americans with that of Europeans. American journal of public health, 99(3), 540–548. https://doi.org/10.2105/AJPH.2008.139469

 

Campbell, D. (2022, March 2). Private Healthcare Boom adds to fears of two-tier system in UK. The Guardian. https://www.theguardian.com/society/2022/mar/02/private-healthcare-boom-two-tier-system-uk

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Cleveland Clinic . (2022, May 4). Malnutrition: Definition, causes, symptoms & treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/22987-malnutrition#:~:text=Malnutrition%20can%20mean%20undernutrition%20or,micronutrients%20(vitamins%20and%20minerals).

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United Nations Children's Fund. (2013, June 6). UNICEF: Too many children dying of malnutrition. UNICEF USA. https://www.unicefusa.org/press/unicef-too-many-children-dying-malnutrition#:~:text=Research%20just%20released%20by%20The,the%20fight%20against%20the%20condition