Vyugovskaya E. V., Malkova E. E. Access barriers to health care: A comparative analysis of Russia’s urban and rural areas // The Russian Peasant Studies. 2026. V.11. №2. P. 191-207.
EDN: UHVRPS
Annotation
The article considers the subjective perception of healthcare accessibility in Russia, focusing on two key dimensions of inequality — type of settlement and age group, is based on the survey conducted in April 2025 as part of the annual monitoring “Social Position and Behavior of Population in Current Conditions” (N=1623, 18+, All-Russian sample, telephone survey) and supplemented with narratives from telephone interviews. The results show persistent territorial polarization: while 51% of residents in large cities (with population over 100,000) assess the quality of healthcare positively, only 40% do so in small towns and rural areas. In major urban centers, the primary access barrier is long wait, while in smaller settlements — a shortage of highly specialized specialists, geographic remoteness of medical institutions, and financial constraints associated with transportation costs. The authors pay special attention to the 55+ group with significantly lower estimates of healthcare quality compared to younger respondents (18–34-year-olds), which can be explained by the elders’ higher need for medical services and, as a result, more critical and frequent contact with the healthcare system. The most vulnerable group are residents of small settlements with family members in need of constant care: 62% negatively assess healthcare accessibility. Interview narratives confirm and illustrate these findings, highlighting such structural problems as staff shortage, logistical and financial difficulties for patients, especially those with limited mobility and the elderly.
Keywords
Accessibility of health care, territorial differences, rural health care, age groups, access barriers, shortage of specialists, remoteness of medical facilities, financial constraints.
About the authors
Elena V. Vyugovskaya, Researcher, Field Research Laboratory, Center “Institute for Social Analysis and Forecasting”, Russian Presidential Academy of National Economy and Public Administration. Prechistenskaya Nab., 11, bldg. 1, Moscow, 119034, Russia.
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Evgeniya E. Malkova, Junior Researcher, Field Research Laboratory, Center “Institute for Social Analysis and Forecasting”, Russian Presidential Academy of National Economy and Public Administration. Prechistenskaya Nab., 11, bldg. 1, Moscow, 119034, Russia.
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