Perceived discrimination, socioeconomic disadvantage and refraining from seeking medical treatment in Sweden

摘要

Study objective: To analyse the association between perceived discrimination and refraining from seekingrnrequired medical treatment and the contribution of socioeconomic disadvantage.rnDesign and setting: Data from the Swedish National Survey of Public Health 2004 were used for analysis.rnRespondents were asked whether they had refrained from seeking required medical treatment during the pastrn3 months. Perceived discrimination was based on whether respondents reported that they had been treated inrna way that made them feel humiliated (due to ethnicity/race, religion, gender, sexual orientation, age orrndisability). The Socioeconomic Disadvantage Index (SDI) was developed to measure economic deprivationrn(social welfare beneficiary, being unemployed, financial crisis and lack of cash reserves).rnParticipants: Swedish population-based survey of 14 736 men and 17 115 women.rnMain results: Both perceived discrimination and socioeconomic disadvantage were independently associatedrnwith refraining from seeking medical treatment. Experiences of frequent discrimination even without anyrnsocioeconomic disadvantage were associated with three to nine-fold increased odds for refraining fromrnseeking medical treatment. A combination of both frequent discrimination and severe SDI was associated withrna multiplicative effect on refraining from seeking medical treatment, but this effect was statistically morernconclusive among women (OR = 11.6, 95% CI 8.1 to 16.6; Synergy Index (SI) = 2.0 (95% CI 1.2 to 3.2)) thanrnamong men (OR =12, 95% CI 7.7 to 18.7; SI =1.6 (95% CI 1.3 to 2.1)).rnConclusions: The goal of equitable access to healthcare services cannot be achieved without public healthrnstrategies that confront and tackle discrimination in society and specifically in the healthcare setting.