Who Is the System Actually Accessible To?

We often talk about access as if it already exists. If services are available, if a clinic is open, or if a program is funded, then access is assumed. It becomes part of the narrative: the system is in place, therefore people can use it. But in practice, that assumption rarely holds true.

Over time, I’ve become more interested in a different question. Not whether a service exists, but who is actually able to use it.

A service can exist and still remain out of reach for the people it was intended to support. A clinic may technically be accessible because it operates during regular business hours, but for someone working an hourly job, caring for family members, relying on public transportation, or navigating multiple systems at once, those hours may make access nearly impossible. Taking time off work can mean losing income. Missing a shift can put employment at risk. Even something as simple as attending an appointment may require coordinating transportation, childcare, and hours of travel time.

From the system’s perspective, access has been provided because the service exists. From the individual’s perspective, accessing it may come at a cost they cannot afford.

I think this is where many conversations about access begin to break down. Systems often measure availability rather than usability. They ask whether services are offered, but not whether people can realistically engage with them within the conditions of their everyday lives.

Time itself functions as a major barrier, although it is rarely discussed that way. Long hold times, complicated intake processes, limited appointment windows, and services that operate only during standard work hours all place the burden of navigation onto the individual. For people already balancing financial stress, caregiving responsibilities, disability-related needs, or unstable schedules, engaging with services becomes another responsibility to manage rather than a source of support.

What appears on paper as a missed appointment or lack of follow-through may actually reflect transportation challenges, inability to leave work, difficulty understanding paperwork, or exhaustion from navigating multiple disconnected systems simultaneously.

Transportation creates another layer of inequality that systems frequently underestimate. A service may appear geographically close while still being functionally inaccessible. Public transportation routes, transfer requirements, travel time, reliability, physical accessibility, and cost all determine whether someone can realistically reach a service. This becomes even more significant for individuals with mobility challenges, disabilities, or limited transportation options.

Even when services are physically reachable, other barriers remain. Language differences can limit understanding. Cultural disconnects can create distance between providers and communities. Communication that feels rushed, impersonal, or difficult to understand can discourage engagement entirely.

Trust also plays a much larger role in access than many systems acknowledge. It is often treated as something that develops after engagement occurs, but for many communities, trust determines whether engagement happens at all. People are more likely to use systems when they feel respected, understood, and supported within them. A translated flyer alone does not create trust, and information alone does not guarantee understanding.

During the COVID-19 pandemic, these realities became even more visible. I worked closely with marginalized communities during a time when offices closed, systems rapidly changed, and many services moved online. What may have already been difficult before the pandemic became overwhelming for many families. I saw how quickly people became disconnected from support, not necessarily because services disappeared, but because accessing them required time, persistence, technology, transportation, and flexibility that not everyone had.

That experience reinforced something I continue to believe strongly: access is not simply about whether services exist. It is about whether people can realistically reach them, understand them, trust them, and sustain engagement with them without sacrificing their own stability in the process.

Too often, systems are designed around organizational convenience rather than around how people actually live. And when people disengage, the assumption is often that they were not interested, not motivated, or unwilling to follow through. In reality, many are making rational decisions within impossible circumstances.

I think the conversation around access needs to become more honest. The question is no longer simply whether services exist. The more important question is who those systems are truly accessible to.

Until systems begin accounting for real-life conditions rather than ideal ones, access will continue to remain uneven, regardless of how well-intentioned the services themselves may be.