Socio-Cultural Barriers To Healthcare Utilisation Among Marginalised Communities In Eastern Uttar Pradesh: Insights With Environmental Perspective

Abstract

Healthcare disparities represent a crucial aspect of social and cultural  inequality in India. These inequities are particularly acute in Eastern Uttar Pradesh, where marginalized communities such as Dalits, Other Backward Classes (OBCs), and Muslims continue to encounter systemic barriers in accessing healthcare services. While economic constraints and infrastructural deficiencies are well recognized, the social and cultural determinants influencing healthcare utilization remain less examined. This study evaluates data from the National Family Health Survey (NFHS-5) alongside 20 in-depth qualitative interviews conducted across Gorakhpur, Mau, Deoria, and Azamgarh districts to analyze the intersection of caste, gender, and culture in shaping health-seeking behavior. The findings reveal that caste identity significantly affects healthcare access—Dalits and Muslims are less likely to utilize public health facilities and are more reliant on private practitioners or traditional healers. Gender norms further restrict women’s healthcare access due to limited mobility and decision-making autonomy, while traditional beliefs often delay formal medical treatment. Conversely, education and awareness of government health programs serve as strong enablers, significantly improving healthcare utilization. Evidence of discriminatory practices within public hospitals underscores the persistence of social exclusion. Human health outcomes are also significantly influenced by environmental variables, particularly in developing countries like India where ecological degradation has been exacerbated by growing industrialisation, urbanisation, and deforestation. This paper also explores the intrinsic link between the right to health and the right to a healthy environment, as recognized in international frameworks such as the International Covenant on Economic, Social and Cultural Rights (ICESCR). It highlights how pollution, dangerous industrial pollutants, and inadequate sanitation all contribute to environmental degradation, which affects human health both directly and indirectly. There are significant health hazards for the surrounding people who suffer from respiratory, sanitation, air borne diseases, vector-borne diseases, heatwave, skin, and auditory issues, as evidenced by empirical data from areas like Varanasi. Gazipur, Azamgarh, Mau, Gorakhpur, Ballia, Kushinagar, Deoria districts, which shows worrisome levels of concerns for environmental impact on healthcare. The study concludes that addressing healthcare disparities in Eastern Uttar Pradesh requires an integrated approach—improving infrastructure while simultaneously tackling social hierarchies, gender-based restrictions, and cultural misconceptions and better pollution management. Therefore, ensuring the right to a healthy environment, promoting education, empowering women, and combating caste-based discrimination are imperative to achieving equitable and sustainable health outcomes within the broader framework of environmental justice and inclusive development.