Clinical care
About
Clinical care is anything relating to the direct medical treatment or testing of patients. Clinical care is provided by trained or licensed health professionals in hospital or clinic settings, including primary, specialty and dental care. Clinical care includes health insurance.
Relationship to health and equity
High quality clinical care is accessible, timely, safe, effective and affordable, providing the right care for the right person at the right time. Clinical care should also respect and value patients’ unique cultural beliefs, practices and values. Access to it can protect and improve physical, social and mental health. Health insurance helps individuals and families access care but does not guarantee it; providers need to be both available, in relatively close proximity to patients and offer affordable care.
Health is created when everyone is healthy together. Access to clinical care and its quality varies widely by state, race, ethnicity, rurality, sexual minority status and income. Individuals who are Black, Hispanic, Native American and those with low incomes are less likely to have insurance coverage and more likely to encounter barriers to care. These communities often get lower quality care than people who are white and those with high incomes. For example, women of color are more likely to have higher rates of pregnancy-related deaths than white women. In 2023, over 25 million people were uninsured, resulting in less care, more preventable hospitalizations and higher mortality rates than those with insurance. Language barriers, high co-pays and deductible limits, and disparities in treatment and access present further barriers to care.
Relationship to systems and structures
Even with the highest per capita health care spending in the world, the U.S. has shorter lifespans and higher infant mortality rates than other wealthy nations. Access to clinical care is often reliant on health insurance, typically received via employment or marriage. However, many jobs lack such benefits, and many LGBTQ+ people were denied family coverage before marriage equality. Unfair practices by insurance companies can leave people with insurmountable debt and difficult choices on whether to seek treatment. Before the Affordable Care Act, insurance companies could charge more or exclude people with pre-existing conditions such as asthma, diabetes or cancer. These inequities, perpetrated by health insurance and hospital corporations, alongside decreased access to medical, dental, and mental health care in rural communities and a physician shortage crisis, result in some areas and people having adequate access to quality clinical care while others do not.
Improving the quality of health care, reducing barriers, and ensuring insurance coverage for all can help everyone get the care we need when we need it, leading to longer, healthier lives and communities.
Additional Reading
- Caraballo, C., Ndumele, C. D., Roy, B., Lu, Y., Riley, C., Herrin, J., & Krumholz, H. M. (2022). Trends in racial and ethnic disparities in barriers to timely medical care among adults in the US, 1999 to 2018. Journal of the American Medical Association Health Forum, 3(10), e223856. https://doi.org/10.1001/jamahealthforum.2022.3856
- Khullar, D., & Chokshi, D. A. (2018). Health, income, & poverty: Where we are & what could help. https://www.healthaffairs.org/do/10.1377/hpb20180817.901935/full/
- Hill, L., Rao, A., Artiga, S., & Ranji, U. (2024, October 25). Racial disparities in maternal and infant health: Current status and efforts to address them. KFF. https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-in-maternal-and-infant-health-current-status-and-efforts-to-address-them/
- Tolbert, J., Cervantes, S., Bell, C., & Damico, A. (2024, December 18). Key facts about the uninsured population. KFF. https://www.kff.org/uninsured/issue-brief/key-facts-about-the-uninsured-population/
- Munira, Z. G., Evan D. G., & Reginald D.W. (2023, January 31). U.S. health care from a global perspective, 2022: Accelerating spending, worsening outcomes. https://doi.org/10.26099/8ejy-yc74