IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v66y2008i5p1046-1056.html
   My bibliography  Save this article

Socioeconomic context, distance to primary care and detection of hepatitis C: A French population-based study

Author

Listed:
  • Monnet, Elisabeth
  • Ramée, Cécile
  • Minello, Anne
  • Jooste, Valérie
  • Carel, Didier
  • Di Martino, Vincent

Abstract

Previous research suggests that hepatitis C detection is lower in rural than in urban areas and depends on geographic accessibility to care. To what extent differences in socioeconomic context could explain these disparities remains unknown. This study assessed the respective influence of the socioeconomic context and of the distance to primary care on the hepatitis C detection rates in a well-defined population of 1,005,817 inhabitants covered by a universal health insurance system in the Côte d'Or and the Doubs areas of France. The 1938 cases of hepatitis C newly diagnosed in the survey area between 1994 and 2001 were included. The patients' 'cantons' of residence were classified into six socioeconomic clusters according to 19 quantitative indicators. Age and sex-standardized hepatitis C detection rate ratios (DRR) for the six clusters were estimated and a multilevel Poisson model investigated whether detection rates varied across clusters after adjusting for distance to the nearest general practitioner. Standardized DRR (95% CI) were higher in both "lower-income urban" and "upper-income urban" clusters and lower in the following clusters: "outer suburb", "industrial rural" and economically "dynamic rural". Adjusting for distance to general practitioner reduced the rate difference between socioeconomic clusters: for a distance to general practitioner equalling 0Â km (practice in the municipality) and compared to the "upper-income urban" cluster, only the "lower-income urban" cluster had higher DRR. In the six clusters, detection rates decreased as the distance to general practitioner increased (DRR 0.89 95% CI 0.84-0.96 for a 1-km change) but the decrease was more marked in both urban clusters. In this population with good primary care affordability, geographic proximity to general practitioner, rather than socioeconomic context of neighborhood, appeared to be the main factor limiting hepatitis C detection.

Suggested Citation

  • Monnet, Elisabeth & Ramée, Cécile & Minello, Anne & Jooste, Valérie & Carel, Didier & Di Martino, Vincent, 2008. "Socioeconomic context, distance to primary care and detection of hepatitis C: A French population-based study," Social Science & Medicine, Elsevier, vol. 66(5), pages 1046-1056, March.
    • Handle: RePEc:eee:socmed:v:66:y:2008:i:5:p:1046-1056
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(07)00633-8
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Farmer, Jane & Lauder, William & Richards, Helen & Sharkey, Siobhan, 2003. "Dr. John has gone: assessing health professionals' contribution to remote rural community sustainability in the UK," Social Science & Medicine, Elsevier, vol. 57(4), pages 673-686, August.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Astell-Burt, Thomas & Flowerdew, Robin & Boyle, Paul J. & Dillon, John F., 2011. "Does geographic access to primary healthcare influence the detection of hepatitis C?," Social Science & Medicine, Elsevier, vol. 72(9), pages 1472-1481, May.
    2. Solmaz Amiri & Christine D. Pham & Ofer Amram & Karl C. Alcover & Oladunni Oluwoye & Lilian Bravo & Melissa Sixberry & Michael G. McDonell & John M Roll & Andre Fresco, 2020. "Proximity to Screening Site, Rurality, and Neighborhood Disadvantage: Treatment Status among Individuals with Sexually Transmitted Infections in Yakima County, Washington," IJERPH, MDPI, vol. 17(8), pages 1-11, April.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Farmer, Jane & Prior, Maria & Taylor, Judy, 2012. "A theory of how rural health services contribute to community sustainability," Social Science & Medicine, Elsevier, vol. 75(10), pages 1903-1911.
    2. Ivan Paunović & Sotiris Apostolopoulos & Ivana Božić Miljković & Miloš Stojanović, 2024. "Sustainable Rural Healthcare Entrepreneurship: A Case Study of Serbia," Sustainability, MDPI, vol. 16(3), pages 1-27, January.
    3. Farmer, Jane & Kilpatrick, Sue, 2009. "Are rural health professionals also social entrepreneurs?," Social Science & Medicine, Elsevier, vol. 69(11), pages 1651-1658, December.
    4. Astell-Burt, Thomas & Flowerdew, Robin & Boyle, Paul & Dillon, John, 2012. "Is travel-time to a specialist centre a risk factor for non-referral, non-attendance and loss to follow-up among patients with hepatitis C (HCV) infection?," Social Science & Medicine, Elsevier, vol. 75(1), pages 240-247.
    5. Astell-Burt, Thomas & Flowerdew, Robin & Boyle, Paul J. & Dillon, John F., 2011. "Does geographic access to primary healthcare influence the detection of hepatitis C?," Social Science & Medicine, Elsevier, vol. 72(9), pages 1472-1481, May.
    6. William Lauder & Kerry Mummery & Siobhan Sharkey, 2006. "Social capital, age and religiosity in people who are lonely," Journal of Clinical Nursing, John Wiley & Sons, vol. 15(3), pages 334-340, March.
    7. Weinhold, Ines & Gurtner, Sebastian, 2018. "Rural - urban differences in determinants of patient satisfaction with primary care," Social Science & Medicine, Elsevier, vol. 212(C), pages 76-85.
    8. Navarro, Andres & Tapiador, Francisco J., 2019. "RUSEM: A numerical model for policymaking and climate applications," Ecological Economics, Elsevier, vol. 165(C), pages 1-1.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:66:y:2008:i:5:p:1046-1056. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.