Understanding barriers to health care: a review of disparities in health care services among indigenous populations.

OBJECTIVES To review the current status of health care access and utilization among Indigenous people in the North America, Australia and New Zealand. STUDY DESIGN Literature review. METHODS A systematic search and critical review of relevant studies using online searches of electronic databases (PubMed, PsychINFO, MEDLINE) that examined issues relating to health care utilization and access. RESULTS Most studies found that health care access and utilization rates were found to be significantly lower among Indigenous populations. Factors such as rural location, communication and socio-economic status were found to be barriers to health care services that disproportionately affected Indigenous communities compared with the general population. CONCLUSIONS Inequalities in health care access and utilization among Indigenous populations may play an important role in understanding why disparities in the health status of Indigenous populations continue to exist despite public health interventions. Further research is needed to understand the factors that contribute to these inequalities and to develop specific interventions to increase access and utilization among Indigenous populations.