Visualizing health inequality: a photovoice study of healthcare communication barriers and facilitators in marginalized communities in South Korea

As South Korea faces growing population diversity, including aging, socioeconomic inequality, and migration, there is an urgent need to improve equity in healthcare communication and utilization. This study employs a photovoice methodology to explore how four marginalized groups (older adults, persons with disabilities, low-income public assistance recipients, and migrant women) experience barriers and facilitators to patient-doctor communication and healthcare utilization ( n = 20). Participants’ photographs and narratives showed three cross-cutting structural barriers: long wait times and limited consultation time, financial constraints, and insufficient or unclear information. These barriers took different forms across groups, ranging from language barriers among migrant women to inaccessible transportation and kiosks for participants with disabilities. Facilitators included empathetic provider communication, trust-based relationships, visual aids, and family or peer support. Proactive patient strategies recurred across all four groups, though access to them was itself unequally distributed. These findings highlight the need for patient-centered communication, provider training in shared decision-making, and system-level reforms that address time pressure, cost uncertainty, interpreter access, and information asymmetry in healthcare encounters. Photovoice was useful in capturing the lived experiences of structurally marginalized groups and offers practical insights for designing inclusive healthcare practices and policies.