Health care access for rural youth on equal terms?

Project description

This research will lay the foundation for improving youth health services in rural areas by
1. mapping youth access to health care services in the rural municipalities of northern Sweden,
2. critically evaluating strategies used to enhance access according to needs,
3. proposing further actions through a participatory process.

The project emerges from both Swedish and international concerns about health status and health care access of rural youth, and the relatively low use of youth clinics in Sweden’s rural north (just 12 of the 35 rural municipalities have youth clinics). While it is well known that access to health care services continues to be a problem for populations living in rural areas in Sweden, there has been no comprehensive assessment of the impact of different rural youth health service strategies on either access or health outcomes.

We will focus on the four northernmost Swedish counties, mixing qualitative and quantitative methodologies sequentially in four phases. First, we will map youth access to health care according to their health care needs, including assessing horizontal equity (equal use of health care for equivalent health needs,) and vertical equity (people with greater health needs should receive more health care than those with lesser needs), as well as comparing equity in access to health care between rural and urban municipalities, and between rural municipalities with and without a youth clinic. Second, we will use a multiple case study to investigate the strategies developed (youth clinics, internet applications, public health programs) to improve youth access to health care. Third, through qualitative comparative analysis of the 35 rural municipalities, we will identity the best combination of conditions leading to high youth access to health care. Fourth, we will conduct a concept mapping study to involve rural stakeholders, care providers and youth in proposing actions to improve rural youth access to health care.