Centuries of domestication have resulted in close relationships between humans and animals. Companion and farmed animals rely heavily, if not wholly, on people for their physical and mental well-being. As such, caregivers have an ethical obligation to meet their animals’ needs — and veterinary care is an invaluable resource for this. However, a person’s access to veterinary care can be hindered by barriers such as geographic location, finances, provider availability, and cultural differences.

While some of these barriers have been discussed extensively in the scientific literature, there’s still no clear definition of what access to veterinary care actually is. Thus, the authors of this scoping review had three objectives:

1. To understand how access to veterinary care has been defined in the scientific literature;
2. To establish a broad list of potential barriers affecting access to veterinary care; and
3. To identify how access to veterinary care, or lack thereof, affects the welfare of both companion and farmed animals.

To be included in their analysis, articles had to have been peer-reviewed, written in English, and relate to at least one of the three objectives. The authors wished to focus on individual caretakers like companion animal guardians and farmers, so papers about institutional settings such as shelters or kennels were excluded. From an initial 1,042 publications, they screened 410 full-text articles, of which 77 met the inclusion criteria.

Roughly half (50%) of the articles were published in veterinary journals, 26% in agricultural journals, and 13% in medical journals. The earliest study was published in 2002, and the number of articles on the topic rose substantially between 2020 and 2021. The authors attribute this to increased interest during the COVID-19 pandemic.

A total of 33 countries were represented across the articles, with the most frequently studied being the U.S. (17%) and Canada (11%). However, due to the inclusion criteria, the authors acknowledge that there’s a bias toward English-language research, highlighting the need for more work in underrepresented regions and languages.

More than half (54%) of the studies were about farmed animals, with companion animals making up the remainder (46%). Interestingly, there was a noticeable shift in focus from farmed to companion animals beginning in 2017.

How Access To Veterinary Care Has Been Defined

An explicit definition was found in only 10 of the 77 articles, and none of them used the same one. Instead, a variety of themes emerged:

• Geographical proximity (36%)
• Affordability (14%)
• Service availability (14%)
• Service utilization (14%)
• Communication (14%)
• Physical accessibility (7%)

These inconsistencies demonstrate that this field of research is still in its early stages. The authors emphasize that before solutions to improve access to veterinary care can be developed, there must be clarity on what “access” means.

Barriers To Accessing Veterinary Care

Barriers to accessing veterinary care were a common topic, with 69 of the 77 papers explicitly outlining them. These barriers could be grouped into 10 themes:

• Financial limitations (27%)
• Geographic location (16%)
• Limited personnel/equipment (15%)
• Transportation (11%)
• Veterinarian-client relationship (9%)
• Client identity (8%)
• Appointment availability (7%)
• Client’s mental/physical condition (3%)
• Government support (3%)
• COVID-19 pandemic effects (2%)

Financial limitations, the most frequent theme, are likely linked to other factors, such as geographic location and transportation. The authors note that many of these barriers have parallels in human healthcare, where they’ve received far more attention than in veterinary contexts.

Impacts Of Access To Veterinary Care On Animal Welfare

Only 13 of the 77 articles reported on the welfare impacts of access to veterinary care. All 13 highlighted the health consequences, such as body condition score and vaccination status, while only two reported behavioral outcomes. With so few studies connecting limited access to veterinary care and animal welfare, the authors call for further research to address this gap.

A Proposed Definition Of Access To Veterinary Care

Finally, based on their scoping review, the authors put forward a working definition of access to veterinary care:

Access to veterinary care means that the economic, physical, social, mental, and emotional resources necessary for people to secure, communicate with, and benefit from the services of a trusted veterinary service provider are available as needed to optimize the health and welfare of animals in their care.

The definition implies that veterinary services are geographically accessible, affordable, inclusive of clients’ cultural needs, and administered by a sufficient number of adequately trained personnel.

With this definition in mind, researchers can focus on the less-studied barriers, explore perceptions of access among different stakeholders, and examine the animal welfare outcomes of limited access beyond just physical health.