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Ethnicity, socio-economic position and gender--do they affect reported health--care seeking behaviour?

Author

Listed:
  • Adamson, Joy
  • Ben-Shlomo, Yoav
  • Chaturvedi, Nish
  • Donovan, Jenny

Abstract

While the pursuit of equity of access to health care is a central objective of many health care systems, there is evidence that patients of ethnic minority descent, in lower socio-economic position (SEP) or of female gender are less likely than Whites, more affluent groups or men, respectively, to access secondary and tertiary medical care. However, it is unclear at which point in the chain of events leading from perception of need through attendance at primary/emergency care, to referral and receipt of secondary care, this inequality occurs. This study examined the influence of ethnicity, socio-economic position and gender on an individual's perception of the need and urgency for seeking health care. A random sample was selected from two large city General Practices in the UK who were sent postal questionnaires which included two clinical vignettes describing characters experiencing chest pain and discovering a lump in the armpit. The main outcome measure was response to the 'chest pain' and 'lump' vignettes in terms of immediate health care utilisation. The questionnaire survey (n=1350, response rate 66%) indicated that Black respondents, respondents from lower socio-economic groups and women were at least as likely to report immediate health care seeking in response to the clinical vignettes than White respondents, those from higher socio-economic groups or men. This finding was consistent across all scenarios after adjustment for interpretation of the vignette, access to health services and attitudes to health and health care. For example, those in the lowest SEP group were almost 60% more likely to report immediate care seeking in response to the lump vignette (OR 1.59, 95% CI 1.08-2.33) compared to those in the highest SEP group; and Black respondents 40% more likely (OR 1.41, 95% CI 0.92-2.17). This study suggests inequalities in access to health care by ethnicity, socio-economic position and gender are not related to patients in these groups failing to self-refer to primary or accident and emergency care, barriers must therefore occur at the level of health care provision.

Suggested Citation

  • Adamson, Joy & Ben-Shlomo, Yoav & Chaturvedi, Nish & Donovan, Jenny, 2003. "Ethnicity, socio-economic position and gender--do they affect reported health--care seeking behaviour?," Social Science & Medicine, Elsevier, vol. 57(5), pages 895-904, September.
    • Handle: RePEc:eee:socmed:v:57:y:2003:i:5:p:895-904
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    Citations

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    Cited by:

    1. Paul R Ward & Loreen Mamerow & Samantha B Meyer, 2013. "Identifying Vulnerable Populations Using a Social Determinants of Health Framework: Analysis of National Survey Data across Six Asia-Pacific Countries," PLOS ONE, Public Library of Science, vol. 8(12), pages 1-1, December.
    2. Pat McGregor & Pat McKee & Ciaran O’Neill, 2006. "GP Utilisation in Northern Ireland - Exploiting the Gatekeeper Function," The Economic and Social Review, Economic and Social Studies, vol. 37(1), pages 71-90.
    3. Mebratie, A.D. & Van de Poel, E. & Debebe, Z.Y. & Abebaw, D. & Alemu, G. & Bedi, A.S., 2013. "Self-reported health care seeking behavior in rural Ethiopia: Evidence from clinical vignettes," ISS Working Papers - General Series 551, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    4. Mujaheed Shaikh & Marisa Miraldo & Anna-Theresa Renner, 2018. "Waiting time at health facilities and social class: Evidence from the Indian caste system," PLOS ONE, Public Library of Science, vol. 13(10), pages 1-16, October.
    5. O'Brien, Rosaleen & Hunt, Kate & Hart, Graham, 2005. "'It's caveman stuff, but that is to a certain extent how guys still operate': men's accounts of masculinity and help seeking," Social Science & Medicine, Elsevier, vol. 61(3), pages 503-516, August.
    6. Likwang Chen & Winnie Yip & Ming‐Cheng Chang & Hui‐Sheng Lin & Shyh‐Dye Lee & Ya‐Ling Chiu & Yu‐Hsuan Lin, 2007. "The effects of Taiwan's National Health Insurance on access and health status of the elderly," Health Economics, John Wiley & Sons, Ltd., vol. 16(3), pages 223-242, March.
    7. Morris, Stephen & Sutton, Matthew & Gravelle, Hugh, 2005. "Inequity and inequality in the use of health care in England: an empirical investigation," Social Science & Medicine, Elsevier, vol. 60(6), pages 1251-1266, March.
    8. Håvard T Rydland & Erlend L Fjær & Terje A Eikemo & Tim Huijts & Clare Bambra & Claus Wendt & Ivana Kulhánová & Pekka Martikainen & Chris Dibben & Ramunė Kalėdienė & Carme Borrell & Mall Leinsalu & Ma, 2020. "Educational inequalities in mortality amenable to healthcare. A comparison of European healthcare systems," PLOS ONE, Public Library of Science, vol. 15(7), pages 1-17, July.
    9. Lee, Katharine M.N. & Rushovich, Tamara & Gompers, Annika & Boulicault, Marion & Worthington, Steven & Lockhart, Jeffrey W. & Richardson, Sarah S., 2023. "A Gender Hypothesis of sex disparities in adverse drug events," Social Science & Medicine, Elsevier, vol. 339(C).
    10. Kirstin Grosse Frie & Terje Eikemo & Olaf von dem Knesebeck, 2010. "Education and self-reported health care seeking behaviour in European welfare regimes: results from the European Social Survey," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 55(3), pages 217-220, June.

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