University of AkureyriGustafsdottir, Sonja S.Fenger, KristjanaHalldorsdottir, SigridurBjarnason, Thoroddur2025-11-142025-11-142017-08-01Gustafsdottir, S S, Fenger, K, Halldorsdottir, S & Bjarnason, T 2017, 'Social justice, access and quality of healthcare in an age of austerity: users’ perspective from rural Iceland', International Journal of Circumpolar Health, vol. 76, no. 1, e1347476. https://doi.org/10.1080/22423982.2017.13474761239-973668370125430d1ac2-f6c5-48c8-8246-bb1e4ac61cdaORCID: /0000-0003-0629-4428/work/3570084085037673664researchoutputwizard: hdl.handle.net/20.500.11815/1067https://hdl.handle.net/20.500.11815/5831Iceland is sparsely populated but social justice and equity has been emphasised within healthcare. The aim of the study is to examine healthcare services in Fjallabyggð, in rural northern Iceland, from users’ perspective and evaluate social justice, access and quality of healthcare in an age of austerity. Mixed-method approach with transformative design was used. First, data were collected with questionnaires (response rate of 53% [N=732] in 2009 and 30% [N=415] in 2012), and analysed statistically, followed by 10 interviews with healthcare users (2009 and 2014). The results were integrated and interpreted within Bronfenbrenner’s Ecological Model. There was significantly less satisfaction with accessibility and variety of healthcare services in 2012 after services downsizing. Solid primary healthcare, good local elderly care, some freedom in healthcare choice and reliable emergency services were considered fundamental for life in a rural area. Equal access to healthcare is part of a fundamental human right. In times of economic downturn, people in rural areas, who are already vulnerable, may become even more vulnerable and disadvantaged, seriously threatening social justice and equity. With severe cutbacks in vitally important healthcare services people may eventually choose to self-migrate.91977644eninfo:eu-repo/semantics/openAccessHealth care servicesSocial justiceRural communitiesHealth care servicesSocial justiceRural communitiesRegional developmentRoad infrastructureTunnelsIcelandSDG 3 - Good Health and Well-beingSDG 11 - Sustainable Cities and CommunitiesSDG 2 - Zero HungerSDG 4 - Quality EducationSDG 5 - Gender EqualitySDG 6 - Clean Water and SanitationSDG 1 - No PovertySDG 10 - Reduced InequalitiesSDG 12 - Responsible Consumption and ProductionSDG 13 - Climate ActionSDG 14 - Life Below WaterSDG 15 - Life on LandSDG 16 - Peace, Justice and Strong InstitutionsSDG 17 - Partnerships for the GoalsSDG 7 - Affordable and Clean EnergySDG 8 - Decent Work and Economic GrowthSDG 9 - Industry, Innovation, and Infrastructure/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article10.1080/22423982.2017.1347476