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Assessing the contribution of migration related policies to equity in access to healthcare in European countries. A multilevel analysis

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  • Hübner, Wiebke
  • Phillimore, Jenny
  • Bradby, Hannah
  • Brand, Tilman

Abstract

Access to good healthcare and the conditions for good health is one of the central dimensions of immigrant integration. National health policies play a major role in equipping residents with the necessary entitlements to accessible and acceptable healthcare services. Rarely analysed so far is the contribution of migration-related health policies to equity in access to healthcare between immigrants and the general population. To address this gap, this study analysed whether the extent to which migration is considered within national health policies moderates the association between immigration status and subjectively perceived unmet medical need in Europe. Using data from the 2019 European Union Statistics on Income and Living Conditions (EU-SILC) survey in combination with the Migration Integration Policy Index (MIPEX) a multilevel analysis was carried out assessing the cross-level interaction between immigration status and MIPEX scores controlling for individual-level factors such as age, gender, education and employment status. While our results showed that immigrants are more likely to report unmet medical need than the general population (adjusted Odds Ratio (aOR) = 1.32; 95% confidence interval (CI) 1.22–1.43), the cross-level interaction indicated increased relative inequality in unmet medical need between immigrants and the general population in countries with high MIPEX scores compared to countries with low MIPEX scores (aOR = 1.39, 95% CI: 1.18–1.63). The main reason for this increase of inequality on the relative scale was the overall lower prevalence of unmet medical need in countries with high MIPEX scores. In conclusion, our findings indicate that even in countries with relatively migration-friendly health policies inequalities in access to healthcare between immigrants and the general population persist.

Suggested Citation

  • Hübner, Wiebke & Phillimore, Jenny & Bradby, Hannah & Brand, Tilman, 2023. "Assessing the contribution of migration related policies to equity in access to healthcare in European countries. A multilevel analysis," Social Science & Medicine, Elsevier, vol. 321(C).
    • Handle: RePEc:eee:socmed:v:321:y:2023:i:c:s0277953623001235
    DOI: 10.1016/j.socscimed.2023.115766
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    References listed on IDEAS

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    1. Dagmar Dzúrová & Petr Winkler & Dušan Drbohlav, 2014. "Immigrants’ Access to Health Insurance: No Equality without Awareness," IJERPH, MDPI, vol. 11(7), pages 1-10, July.
    2. Steven A. Weldon, 2006. "The Institutional Context of Tolerance for Ethnic Minorities: A Comparative, Multilevel Analysis of Western Europe," American Journal of Political Science, John Wiley & Sons, vol. 50(2), pages 331-349, April.
    3. Elofsson, Stig & Undén, Anna-Lena & Krakau, Ingvar, 1998. "Patient charges -- a hindrance to financially and psychosocially disadvantage groups seeking care," Social Science & Medicine, Elsevier, vol. 46(10), pages 1375-1380, March.
    4. Mackenbach, Johan P., 2012. "The persistence of health inequalities in modern welfare states: The explanation of a paradox," Social Science & Medicine, Elsevier, vol. 75(4), pages 761-769.
    5. Abraído-Lanza, A.F. & Dohrenwend, B.P. & Ng-Mak, D.S. & Turner, J.B., 1999. "The Latino mortality paradox: A test of the 'salmon bias' and healthy migrant hypotheses," American Journal of Public Health, American Public Health Association, vol. 89(10), pages 1543-1548.
    6. Cylus, Jonathan & Papanicolas, Irene, 2015. "An analysis of perceived access to health care in Europe: How universal is universal coverage?," Health Policy, Elsevier, vol. 119(9), pages 1133-1144.
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    1. Bousmah, Marwân-al-Qays & Gosselin, Anne & Coulibaly, Karna & Ravalihasy, Andrainolo & Taéron, Corinne & Senne, Jean-Noël & Gubert, Flore & Desgrées du Loû, Annabel, 2023. "Immigrants’ health empowerment and access to health coverage in France: A stepped wedge randomised controlled trial," Social Science & Medicine, Elsevier, vol. 339(C).

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