Skip to main content
SpringerLink
Log in

A conceptual framework for examining healthcare access and navigation: a behavioral-ecological perspective

  • Original Article
  • Published:
Social Theory & Health Aims and scope Submit manuscript

Abstract

This paper introduces a conceptual framework for investigating individual ability to navigate healthcare in the contexts of the built environment, social environment, and healthcare infrastructure in which a person is embedded. Given the complexity of healthcare delivery in the United States, consumers are expected to have an increasingly sophisticated set of skills in order to effectively navigate and benefit from the healthcare resources available to them. Addressing barriers to navigation in vulnerable populations may be essential to reducing health disparities. This paper builds on previous conceptual developments in the areas of healthcare use, navigation, and ecological perspectives on health in order to present a behavioral-ecological framework for examining healthcare navigation and access. The model posits that healthcare navigation is an ecologically informed process not only because of the spatial distribution of health services, but because of the spatial distribution of individual and environmental factors that influence decision-making and behavior with respect to service use. The paper discusses areas for further research on healthcare navigation, challenges for research, and implications for reducing health disparities.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  • Aida, J., S. Kuriyama, K. Ohmori-Matsuda, et al. 2011. The association between neighborhood social capital and self-reported dentate status in elderly Japanese—the Ohsaki Cohort 2006 Study. Community Dentistry and Oral Epidemiology 39 (3): 239–249.

    Article  Google Scholar 

  • Andersen, R. 1968. A behavioral model of families’ use of health services. Chicago: Center for Health Administration Studies, University of Chicago.

    Google Scholar 

  • Andersen, R.M. 1995. Revisiting the behavioral model and access to medical care: Does it matter? Journal of Health and Social Behavior 36 (1): 1–10.

    Article  Google Scholar 

  • Andersen, R.M., H. Yu, R. Wyn, et al. 2002. Access to medical care for low-income persons: How do communities make a difference? Medical Care Research and Review 59 (4): 384–411.

    Article  Google Scholar 

  • Auchincloss, A.H., A.V. Diez Roux, D.G. Brown, et al. 2008. Neighborhood resources for physical activity and healthy foods and their association with insulin resistance. Epidemiology 19 (1): 146–157.

    Article  Google Scholar 

  • Bayliss, E.A., J.L. Ellis, and J.F. Steiner. 2007. Barriers to self-management and quality-of-life outcomes in seniors with multimorbidities. The Annals of Family Medicine 5 (5): 395–402.

    Article  Google Scholar 

  • Berke, E.M., T.D. Koepsell, A.V. Moudon, et al. 2007. Association of the built environment with physical activity and obesity in older persons. American Journal of Public Health 97 (3): 486–492.

    Article  Google Scholar 

  • Berrigan, D., L.W. Pickle, and J. Dill. 2010. Associations between street connectivity and active transportation. International Journal of Health Geographics 9: 20.

    Article  Google Scholar 

  • Billings, J., G.M. Anderson, and L.S. Newman. 1996. Recent findings on preventable hospitalizations. Health Affairs (Millwood) 15 (3): 239–249.

    Article  Google Scholar 

  • Bindman, A.B., K. Grumbach, D. Osmond, et al. 1995. Preventable hospitalizations and access to health care. JAMA 274 (4): 305–311.

    Article  Google Scholar 

  • Boyce, W.F., D. Davies, O. Gallupe, et al. 2008. Adolescent risk taking, neighborhood social capital, and health. Journal of Adolescent Health 43 (3): 246–252.

    Article  Google Scholar 

  • Brown, S.C., C.A. Mason, T. Perrino, et al. 2008. Built environment and physical functioning in Hispanic elders: The role of “eyes on the street”. Environmental Health Perspectives 116 (10): 1300–1307.

    Article  Google Scholar 

  • Brown, S.C., C.A. Mason, J.L. Lombard, et al. 2009. The relationship of built environment to perceived social support and psychological distress in Hispanic elders: The role of “eyes on the street”. Journals of Gerontology. Series B, Psychological Sciences and Social Sciences 64 (2): 234–246.

    Article  Google Scholar 

  • Brown, E.J., Grande, D.T., Barbu, C.M., et al. 2015. Location matters: Differences in primary care supply by neighborhood in Philadelphia, Leonard Davis Institute of Health Economics.

  • Bynum, J.P., A. Andrews, S. Sharp, et al. 2011. Fewer hospitalizations result when primary care is highly integrated into a continuing care retirement community. Health Affairs (Millwood) 30 (5): 975–984.

    Article  Google Scholar 

  • Carlson, C., S. Aytur, K. Gardner, et al. 2012. Complexity in built environment, health, and destination walking: A neighborhood-scale analysis. Journal of Urban Health 89 (2): 270–284.

    Article  Google Scholar 

  • Caughy, M.O., P.J. O’Campo, and C. Muntaner. 2003. When being alone might be better: neighborhood poverty, social capital, and child mental health. Social Science and Medicine 57 (2): 227–237.

    Article  Google Scholar 

  • Centers for Disease Control and Prevention. 2016. National Health Interview Survey.

  • Chang, C.H., T.A. Stukel, A.B. Flood, et al. 2011. Primary care physician workforce and Medicare beneficiaries’ health outcomes. JAMA 305 (20): 2096–2104.

    Article  Google Scholar 

  • Charreire, H., C. Weber, B. Chaix, et al. 2012. Identifying built environmental patterns using cluster analysis and GIS: Relationships with walking, cycling and body mass index in French adults. International Journal of Behavioral Nutrition and Physical Activity 9: 59.

    Article  Google Scholar 

  • Cohen, D.A., S. Inagami, and B. Finch. 2008. The built environment and collective efficacy. Health Place 14 (2): 198–208.

    Article  Google Scholar 

  • Coogan, M.A., K.H. Karash, T. Adler, et al. 2007. The role of personal values, urban form, and auto availability in the analysis of walking for transportation. The American Journal of Health Promotion 21 (4 Suppl): 363–370.

    Article  Google Scholar 

  • Cunningham, P.J. 1999. Pressures on safety net access: the level of managed care penetration and uninsurance rate in a community. Health Services Research 34 (1 Pt 2): 255–270.

    Google Scholar 

  • Cunningham, G.O., and Y.L. Michael. 2004. Concepts guiding the study of the impact of the built environment on physical activity for older adults: A review of the literature. The American Journal of Health Promotion 18 (6): 435–443.

    Article  Google Scholar 

  • Davidson, P.L., R.M. Andersen, R. Wyn, et al. 2004. A framework for evaluating safety-net and other community-level factors on access for low-income populations. Inquiry 41 (1): 21–38.

    Article  Google Scholar 

  • Davison, K.K., A. Nishi, S. Kranz, et al. 2012. Associations among social capital, parenting for active lifestyles, and youth physical activity in rural families living in upstate New York. Social Science and Medicine 75 (8): 1488–1496.

    Article  Google Scholar 

  • de Vries, S.I., I. Bakker, W. van Mechelen, et al. 2007. Determinants of activity-friendly neighborhoods for children: Results from the SPACE study. Am J Health Promot 21 (4 Suppl): 312–316.

    Article  Google Scholar 

  • Delamater, P.L., J.P. Messina, A.M. Shortridge, et al. 2012. Measuring geographic access to health care: raster and network-based methods. International Journal of Health Geographics 11 (1): 15.

    Article  Google Scholar 

  • Diez Roux, A.V. 2004. Estimating neighborhood health effects: The challenges of causal inference in a complex world. Social Science and Medicine 58 (10): 1953–1960.

    Article  Google Scholar 

  • Diez Roux, A.V. 2007. Neighborhoods and health: Where are we and where do we go from here? Revue d’Epidemiologie et de Sante Publique 55 (1): 13–21.

    Article  Google Scholar 

  • Fields, R., Kaczynski, A.T., Bopp, M., et al. 2013. Built environment associations with health behaviors among hispanics. Journal of Physical Activity and Health.

  • Fortney, J.C., A.E. Lancaster, R.R. Owen, et al. 1998. Geographic market areas for psychiatric and medical outpatient treatment. Journal of Behavioral Health Services and Research 25 (1): 108–116.

    Article  Google Scholar 

  • Frank, L.D., B.E. Saelens, K.E. Powell, et al. 2007. Stepping towards causation: Do built environments or neighborhood and travel preferences explain physical activity, driving, and obesity? Social Science and Medicine 65 (9): 1898–1914.

    Article  Google Scholar 

  • Frank, L.D., J.F. Sallis, B.E. Saelens, et al. 2010. The development of a walkability index: Application to the Neighborhood Quality of Life Study. British Journal of Sports Medicine 44 (13): 924–933.

    Article  Google Scholar 

  • Freedman, V.A., I.B. Grafova, and J. Rogowski. 2011. Neighborhoods and chronic disease onset in later life. American Journal of Public Health 101 (1): 79–86.

    Article  Google Scholar 

  • Freedman, V.A., I.B. Grafova, R.F. Schoeni, et al. 2008. Neighborhoods and disability in later life. Social Science and Medicine 66 (11): 2253–2267.

    Article  Google Scholar 

  • Freeman, L., Neckerman, K., Schwartz-Soicher, O., et al. 2013. Neighborhood walkability and active travel (walking and cycling) in new york city. The Journal of Urban Health.

  • Ganter, C., E. Chuang, A. Aftosmes-Tobio, et al. 2015. Community stakeholders’ perceptions of barriers to childhood obesity prevention in low-income families, Massachusetts 2012-2013. Preventing Chronic Disease 12: E42.

    Article  Google Scholar 

  • Gebel, K., A. Bauman, and N. Owen. 2009. Correlates of non-concordance between perceived and objective measures of walkability. Annals of Behavioral Medicine 37 (2): 228–238.

    Article  Google Scholar 

  • Gelberg, L., R.M. Andersen, and B.D. Leake. 2000. The behavioral model for vulnerable populations: Application to medical care use and outcomes for homeless people. Health Services Research 34 (6): 1273–1302.

    Google Scholar 

  • Goodman, D.C., S.S. Mick, D. Bott, et al. 2003. Primary care service areas: A new tool for the evaluation of primary care services. Health Services Research 38 (1 Pt 1): 287–309.

    Article  Google Scholar 

  • Grafova, I.B., V.A. Freedman, R. Kumar, et al. 2008. Neighborhoods and obesity in later life. American Journal of Public Health 98 (11): 2065–2071.

    Article  Google Scholar 

  • Gresenz, C.R., J. Rogowski, and J.J. Escarce. 2007. Health care markets, the safety net, and utilization of care among the uninsured. Health Services Research 42 (1 Pt 1): 239–264.

    Article  Google Scholar 

  • Guagliardo, M.F. 2004. Spatial accessibility of primary care: concepts, methods and challenges. International Journal of Health Geographics 3 (1): 3.

    Article  Google Scholar 

  • Gwynn, K.B., M.R. Winter, H.J. Cabral, et al. 2016. Racial disparities in patient activation: Evaluating the mediating role of health literacy with path analyses. Patient Education and Counseling 99 (6): 1033–1037.

    Article  Google Scholar 

  • Haines, V.A., J.J. Beggs, and J.S. Hurlbert. 2011. Neighborhood disadvantage, network social capital, and depressive symptoms. Journal of Health and Social Behavior 52 (1): 58–73.

    Article  Google Scholar 

  • Hamano, T., Y. Fujisawa, Y. Ishida, et al. 2010. Social capital and mental health in Japan: A multilevel analysis. PLoS ONE 5 (10): e13214.

    Article  Google Scholar 

  • Haun, J.N., M.A. Valerio, L.A. McCormack, et al. 2015. Health literacy measurement: An inventory and descriptive summary of 51 instruments. Journal of Health Communication: International Perspectives 19 (sup2): 302–333.

    Article  Google Scholar 

  • Heinrich, K.M., R.E. Lee, G.R. Regan, et al. 2008. How does the built environment relate to body mass index and obesity prevalence among public housing residents? The American Journal of Health Promotion 22 (3): 187–194.

    Article  Google Scholar 

  • Hibino, Y., J. Takaki, K. Ogino, et al. 2012. The relationship between social capital and self-rated health in a Japanese population: A multilevel analysis. Environmental Health and Preventive Medicine 17 (1): 44–52.

    Article  Google Scholar 

  • Hoehner, C.M., S.L. Handy, Y. Yan, et al. 2011. Association between neighborhood walkability, cardiorespiratory fitness and body-mass index. Social Science and Medicine 73 (12): 1707–1716.

    Article  Google Scholar 

  • Hutchinson, R.N., M.A. Putt, L.T. Dean, et al. 2009. Neighborhood racial composition, social capital and black all-cause mortality in Philadelphia. Social Science and Medicine 68 (10): 1859–1865.

    Article  Google Scholar 

  • Johns Hopkins School of Public Health and Westat. 2015. The National Health & Aging Trends Study.

  • Kaczynski, A.T. 2010. Neighborhood walkability perceptions: associations with amount of neighborhood-based physical activity by intensity and purpose. Journal of Physical Activity & Health 7 (1): 3–10.

    Article  Google Scholar 

  • Kawachi, I., B.P. Kennedy, K. Lochner, et al. 1997. Social capital, income inequality, and mortality. American Journal of Public Health 87 (9): 1491–1498.

    Article  Google Scholar 

  • King, D. 2008. Neighborhood and individual factors in activity in older adults: Results from the neighborhood and senior health study. Journal of Aging and Physical Activity 16 (2): 144–170.

    Article  Google Scholar 

  • Kruger, D.J., T.M. Reischl, and G.C. Gee. 2007. Neighborhood social conditions mediate the association between physical deterioration and mental health. American Journal of Community Psychology 40 (3–4): 261–271.

    Article  Google Scholar 

  • LaVela, S.L., B. Smith, F.M. Weaver, et al. 2004. Geographical proximity and health care utilization in veterans with SCI&D in the USA. Social Science and Medicine 59 (11): 2387–2399.

    Article  Google Scholar 

  • Laditka, S.B., and J.M. Johnston. 1999. Preventable hospitalization and avoidable maternity outcomes: Implications for access to health services for Medicaid recipients. Journal of Health & Social Policy 11 (2): 41–56.

    Article  Google Scholar 

  • Laditka, S.B., and J.N. Laditka. 1999. Geographic variation in preventable hospitalization of older women and men: Implications for access to primary health care. Journal of Women & Aging 11 (4): 43–56.

    Article  Google Scholar 

  • Laditka, J.N., S.B. Laditka, and J. Probst. 2005. More may be better: Evidence that a greater supply of primary care physicians reduces hospitalization for ambulatory care sensitive conditions. Health Services Research 40 (4): 1148–1166.

    Article  Google Scholar 

  • Lawton, M. 1986. Environment and aging. Albany, NY: Center for the Study of Aging.

    Google Scholar 

  • Leyden, K.M. 2003. Social capital and the built environment: The importance of walkable neighborhoods. American Journal of Public Health 93 (9): 1546–1551.

    Article  Google Scholar 

  • Li, F., P.A. Harmer, B.J. Cardinal, et al. 2008. Built environment, adiposity, and physical activity in adults aged 50-75. American Journal of Preventive Medicine 35 (1): 38–46.

    Article  Google Scholar 

  • Li, F., P. Harmer, B.J. Cardinal, et al. 2009a. Obesity and the built environment: Does the density of neighborhood fast-food outlets matter? American Journal of Health Promotion 23 (3): 203–209.

    Article  Google Scholar 

  • Li, F., P. Harmer, B.J. Cardinal, et al. 2009b. Built environment and changes in blood pressure in middle aged and older adults. Preventive Medicine 48 (3): 237–241.

    Article  Google Scholar 

  • Lochner, K.A., I. Kawachi, R.T. Brennan, et al. 2003. Social capital and neighborhood mortality rates in Chicago. Social Science and Medicine 56 (8): 1797–1805.

    Article  Google Scholar 

  • Lovasi, G.S., M.A. Hutson, M. Guerra, et al. 2009. Built environments and obesity in disadvantaged populations. Epidemiologic Reviews 31: 7–20.

    Article  Google Scholar 

  • Lovasi, G.S., J.S. Jacobson, J.W. Quinn, et al. 2011. Is the environment near home and school associated with physical activity and adiposity of urban preschool children? The Journal of Urban Health 88 (6): 1143–1157.

    Article  Google Scholar 

  • Lovasi, G.S., O. Schwartz-Soicher, K.M. Neckerman, et al. 2013. Aesthetic amenities and safety hazards associated with walking and bicycling for transportation in new york city. Annals of Behavioral Medicine 45 (Suppl 1): 76–85.

    Article  Google Scholar 

  • Mayer, M.L., H.A. Beil, and D. von Allmen. 2009. Distance to care and relative supply among pediatric surgical subspecialties. Journal of Pediatric Surgery 44 (3): 483–495.

    Article  Google Scholar 

  • McAlexander, K.M., J.A. Banda, J.W. McAlexander, et al. 2009. Physical activity resource attributes and obesity in low-income African Americans. The Journal of Urban Health 86 (5): 696–707.

    Article  Google Scholar 

  • McGinn, A.P., K.R. Evenson, A.H. Herring, et al. 2007. Exploring associations between physical activity and perceived and objective measures of the built environment. Journal of Urban Health 84 (2): 162–184.

    Article  Google Scholar 

  • Michael, Y., T. Beard, D. Choi, et al. 2006. Measuring the influence of built neighborhood environments on walking in older adults. Journal of Aging and Physical Activity 14 (3): 302–312.

    Article  Google Scholar 

  • Michael, Y.L., R. Gold, N.A. Perrin, et al. 2011. Built environment and lower extremity physical performance: Prospective findings from the study of osteoporotic fractures in women. Journal of Aging and Health 23 (8): 1246–1262.

    Article  Google Scholar 

  • Mobley, L.R., E.D. Root, E.A. Finkelstein, et al. 2006. Environment, obesity, and cardiovascular disease risk in low-income women. American Journal of Preventive Medicine 30 (4): 327–332.

    Article  Google Scholar 

  • Mohnen, S.M., P.P. Groenewegen, B. Volker, et al. 2011. Neighborhood social capital and individual health. Social Science and Medicine 72 (5): 660–667.

    Article  Google Scholar 

  • Mohnen, S.M., B. Volker, H. Flap, et al. 2012. Health-related behavior as a mechanism behind the relationship between neighborhood social capital and individual health—a multilevel analysis. BMC Public Health 12: 116.

    Article  Google Scholar 

  • Musa, D., R. Schulz, R. Harris, et al. 2009. Trust in the health care system and the use of preventive health services by older black and white adults. American Journal of Public Health 99 (7): 1293–1299.

    Article  Google Scholar 

  • Nagel, C.L., N.E. Carlson, M. Bosworth, et al. 2008. The relation between neighborhood built environment and walking activity among older adults. American Journal of Epidemiology 168 (4): 461–468.

    Article  Google Scholar 

  • Northridge, M.E., E.D. Sclar, and P. Biswas. 2003. Sorting out the connections between the built environment and health: A conceptual framework for navigating pathways and planning healthy cities. The Journal of Urban Health 80 (4): 556–568.

    Article  Google Scholar 

  • Paasche-Orlow, M. 2011. Caring for patients with limited health literacy: A 76-year-old man with multiple medical problems. JAMA 306 (10): 1122–1129.

    Article  Google Scholar 

  • Pattussi, M.P., R. Hardy, and A. Sheiham. 2006. The potential impact of neighborhood empowerment on dental caries among adolescents. Community Dentistry and Oral Epidemiology 34 (5): 344–350.

    Article  Google Scholar 

  • Rosenthal, M.B., A. Zaslavsky, and J.P. Newhouse. 2005. The geographic distribution of physicians revisited. Health Services Research 40 (6 Pt 1): 1931–1952.

    Article  Google Scholar 

  • Rundle, A., A.V. Diez Roux, L.M. Free, et al. 2007. The urban built environment and obesity in New York City: A multilevel analysis. American Journal of Health Promotion 21 (4 Suppl): 326–334.

    Article  Google Scholar 

  • Ryvicker, M., W.T. Gallo, and M.C. Fahs. 2012. Environmental factors associated with primary care access among urban older adults. Social Science and Medicine 75 (5): 914–921.

    Article  Google Scholar 

  • Sallis, J.F., B.E. Saelens, L.D. Frank, et al. 2009. Neighborhood built environment and income: Examining multiple health outcomes. Social Science and Medicine 68 (7): 1285–1293.

    Article  Google Scholar 

  • Sapag, J.C., F.C. Poblete, C. Eicher, et al. 2010. Tobacco smoking in urban neighborhoods: Exploring social capital as a protective factor in Santiago. Chile. Nicotine Tob Res 12 (9): 927–936.

    Article  Google Scholar 

  • Satariano, W. 2006. Epidemiology of aging: An ecological approach. Sudbury, MA: Jones and Bartlett Publishers.

    Google Scholar 

  • Singh, G.K., M. Siahpush, and M.D. Kogan. 2010. Neighborhood socioeconomic conditions, built environments, and childhood obesity. Health Affairs (Millwood) 29 (3): 503–512.

    Article  Google Scholar 

  • Skinner, J. and Wennberg, J. (1998) How much is enough? Efficiency and Medicare spending in the last six months of life.

  • Sofaer, S. 2009. Navigating poorly charted territory: Patient dilemmas in health care “nonsystems”. Medical Care Research and Review 66 (1 Suppl): 75S–93S.

    Article  Google Scholar 

  • Subramanian, S.V., D.J. Kim, and I. Kawachi. 2002. Social trust and self-rated health in US communities: A multilevel analysis. The Journal of Urban Health 79 (4 Suppl 1): S21–S34.

    Article  Google Scholar 

  • Tomita, A., and J.K. Burns. 2013. A multilevel analysis of association between neighborhood social capital and depression: Evidence from the first South African National Income Dynamics Study. Journal of Affective Disorders 144 (1–2): 101–105.

    Article  Google Scholar 

  • Troped, P.J., K. Tamura, H.A. Whitcomb, et al. 2011. Perceived built environment and physical activity in U.S. women by sprawl and region. American Journal of Preventive Medicine 41 (5): 473–479.

    Article  Google Scholar 

  • Weiss, R.L., J.A. Maantay, and M. Fahs. 2010. Promoting active urban aging: A measurement approach to neighborhood walkability for older adults. Cities and the Environment 3 (1): 12.

    Article  Google Scholar 

  • Wen, M., and L. Kowaleski-Jones. 2012. The built environment and risk of obesity in the United States: Racial-ethnic disparities. Health Place 18 (6): 1314–1322.

    Article  Google Scholar 

  • Wen, M., and T.N. Maloney. 2011. Latino residential isolation and the risk of obesity in Utah: The role of neighborhood socioeconomic, built-environmental, and subcultural context. Journal of Immigrant and Minority Health 13 (6): 1134–1141.

    Article  Google Scholar 

  • Wennberg, J., and A. Gittelsohn. 1973. Small area variations in health care delivery. Science 182 (4117): 1102–1108.

    Article  Google Scholar 

  • Winstanley, E.L., D.M. Steinwachs, M.E. Ensminger, et al. 2008. The association of self-reported neighborhood disorganization and social capital with adolescent alcohol and drug use, dependence, and access to treatment. Drug and Alcohol Dependence 92 (1–3): 173–182.

    Article  Google Scholar 

  • Winters, M., M. Brauer, E.M. Setton, et al. 2010. Built environment influences on healthy transportation choices: Bicycling versus driving. The Journal of Urban Health 87 (6): 969–993.

    Article  Google Scholar 

  • Witten, K., T. Blakely, N. Bagheri, et al. 2012. Neighborhood built environment and transport and leisure physical activity: Findings using objective exposure and outcome measures in New Zealand. Environmental Health Perspectives 120 (7): 971–977.

    Article  Google Scholar 

  • Yen, I.H., Y.L. Michael, and L. Perdue. 2009. Neighborhood environment in studies of health of older adults: A systematic review. American Journal of Preventive Medicine 37 (5): 455–463.

    Article  Google Scholar 

Download references

Acknowledgements

Research reported in this publication was supported by the National Institute on Aging of the National Institutes of Health under Award Number K01AG039463. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health. The author would like to thank Penny Feldman, Ph.D., William Gallo, Ph.D., and David Russell, Ph.D. for their input on previous drafts of the paper.

Author information

Authors and Affiliations

  1. Center for Home Care Policy and Research, Visiting Nurse Service of New York, 1250 Broadway, 7th Floor, New York, NY, 10001, USA

    Miriam Ryvicker

Authors
  1. Miriam Ryvicker
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Miriam Ryvicker.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ryvicker, M. A conceptual framework for examining healthcare access and navigation: a behavioral-ecological perspective. Soc Theory Health 16, 224–240 (2018). https://doi.org/10.1057/s41285-017-0053-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1057/s41285-017-0053-2

Keywords

Search

Navigation