Health inequity and social determinants of healthcare utilization in the disadvantaged community of Hong Kong.

This article examines barriers to appropriate healthcare utilization among disadvantaged residents living in slum conditions in Sham Shui Po, one of Hong Kong's poorest urban neighborhoods, despite the city's universal and subsidized public healthcare system. Using qualitative interviews with 40 slum residents, the study applies a five-dimension framework of healthcare utilization—approachability, acceptability, availability and accommodation, affordability, and appropriateness—to identify key challenges including low health literacy, perceived stigma and discrimination by healthcare providers, long waiting times, financial constraints, and lack of patient-centered care. The findings highlight how poverty-related social exclusion and cultural factors intersect to limit healthcare access and agency, suggesting that addressing health inequity requires community engagement, improved health literacy interventions, empathetic care, and enhanced social safety nets beyond mere service provision. The study also notes limitations in representing ethnic minorities and healthcare providers' perspectives, emphasizing the need for culturally sensitive, multi-level strategies to promote health equity in urban disadvantaged populations.