Bridging Socio-Economic Inequalities in Health: Addressing Access Gaps in Low-Income and Vulnerable Populations

Dear Colleagues,

Despite well-documented links between economic inequality and poor health, evidence shows that the full extent of disparities among low-income and vulnerable populations—particularly in rural and underserved areas—is often underestimated, especially in terms of access to timely clinical care and preventive services. Urgent attention from policymakers is required to address these inequities and prevent avoidable morbidity and mortality. Identifying structural drivers of inequality and expanding targeted resources such as community health programs, digital health access, and subsidy initiatives can reduce the risk of inadequate treatment, delayed care, or death.

Programs tailored to those in greatest need—especially the elderly in both urban and rural settings—combined with equitable redistribution of subsidies from affluent to low-income groups, can yield greater health improvements than comparable investments in already advantaged populations.

This principle applies across all aspects of health outcomes, whether at the community level, in public health, or in clinical care and long-term nursing support.

This Special Collection is organized around six interconnected themes that together illustrate the complex pathways through which socio-economic inequalities shape health outcomes. We highlight not only barriers to care and the direct impacts of inequality, but also policy- and system-level interventions, cross-cutting social dimensions, and emerging solutions. By integrating innovation in digital health with strategies to address education and workforce skill gaps, this Collection aims to inform both scholarly debate and practical action to advance health equity in diverse and vulnerable populations.

1. Access to Care

• Access to clinical care in rural areas: challenges faced by low-income, Medicare, and Medicaid patients.
• Barriers to healthcare access for vulnerable populations, including indigent and underserved groups.
• The role of community health workers in improving access to care in low-resource areas.
• Understanding the influence of geographic and economic factors on preventive health service utilization.

2. Inequality Impacts

• The impact of socio-economic inequality on health outcomes in rural and urban populations.
• Income inequality and its relationship with public health: comparative studies of urban and rural communities.
• Health disparities among Medicaid patients in socio-economically diverse communities.
• Exploring the long-term health impacts of income inequality on vulnerable populations.

3. Policy and Interventions

• Assessing the effectiveness of policy interventions in reducing health inequalities in rural areas.
• Strategies for equitable redistribution of subsidies and resources from affluent to low-income groups.

4. Cross-Cutting Dimensions

• Examining the intersection of rurality and socio-economic disparities on health outcomes.
• Socio-economic inequality and the justice system.
• Socio-economic inequality and men’s/women’s health.

5. Innovation and Emerging Solutions (new)

• Leveraging telehealth and digital health platforms to expand access to rural and underserved communities.
• Using data analytics and artificial intelligence to identify and address hidden disparities in care delivery.
• Exploring the role of mobile health technologies and digital literacy in improving patient engagement.

6. Education, Workforce, and Skill Gaps (new)

• Addressing healthcare workforce shortages in rural and high-inequality areas.
• Training and upskilling community connection experts, health workers, nurses, and primary care providers to reduce disparities.

7. Practical Advocacy (new)

• Developing community-driven advocacy models to elevate the voices of low-income and vulnerable populations.
• Training patients, families, and caregivers to engage in health policy discussions and decision-making.
• Building partnerships between advocacy groups, healthcare organizations, and policymakers to advance equitable health reforms.
• Creating practical toolkits and frameworks that enable frontline providers to advocate for patients in real time.
• Integrating advocacy training into health profession education to ensure long-term system change.

Dr. Hossein Zare
Prof. Dr. Mojgan Azadi
Dr. Liliya Roberts
Topic Editors