Constraints to healthcare access among commercial fishers

Fishing is a challenging occupation, in which physical and mental health risks may be exacerbated by environmental, socio-economic and policy change. While anecdotal information suggests that compared to other groups fishers are less likely to access healthcare, the reasons for this are poorly understood. Constraints to accessing healthcare were assessed through a mixed methods approach, using a holistic framework of access. A self-administered questionnaire was completed by 119 commercial fishers in Cornwall, UK, and complemented by qualitative focus groups with women from fishing communities. Health issues experienced and perceived constraints to healthcare access differed among fishers. Organisational factors and social norms were the most commonly perceived constraints, and stronger perception of these was associated with greater likelihood of leaving a health concern untreated in the past year. The findings suggest that proactive steps are needed to enhance supply and utilisation of available healthcare services, to ensure fishers' needs are met.