Despite the fact that members of communities affected by deprivation are known to have lower life expectancies and poorer health profiles, they are less likely to use healthcare than patients from more affluent areas. Patients from marginalized groups have much worse mortality and health indices and are even less likely to attend health services. Access has been identified as a key indicator of quality of health services.

The chapter explores further:

The paradoxical behaviours described previously.

Identifying the barriers patients face in attending health services. A range of barriers are described including internalized, physical, administrative, communication and attitudinal barriers.

An explanatory model for why the health service usage of patients from areas of deprivation or marginalized communities differs from more affluent areas is described.

A model of a low-threshold high-fidelity family practice is proposed. This model seeks to eliminate all barriers to access the service so that patients can avail of the high-quality care provided by the practice.