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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2002 Jul;56(7):510–516. doi: 10.1136/jech.56.7.510

Equity in prevention and health care

V Lorant 1, B Boland 1, P Humblet 1, D Deliege 1
PMCID: PMC1732200  PMID: 12080158

Abstract

Design: A cross sectional Health Interview Survey was carried out in 1997 by face to face interview and self administered questionnaire. Two types of health care utilisation were considered (contacts with GPs and with specialists) and four preventive care mostly delivered in a GP setting (flu vaccination, cholesterol screening) or in a specialty setting (mammography and pap smear).

Setting: Belgium.

Participants: A representative sample of 7378 residents aged 25 years and over (participation rate: 61%).

Outcome measure: Socioeconomic inequity was measured by the HIwvp index , which is the difference between use inequality and needs inequality. Needs was computed as the expected use by the risk factors or target groups.

Main results: There was significant inequity for all medical contacts and preventive medicine. Medical contacts showed inequity favouring the rich for specialist visits and inequity favouring the poor for contacts with GPs. Regarding preventive medicine, inequity was high and favoured the rich for mammography and cervical screening; inequity was lower for flu immunisation and cholesterol screening but still favoured the higher socioeconomic groups. In the general practice setting, inequity in prevention was higher than inequity in health care; in the specialty setting, inequity in prevention was not statistically different from inequity in health care, although it was higher than in the general practice setting.

Conclusions: If inequity in preventive medicine is to be lowered, the role of the GP must be fostered and access to specialty medicine increased, especially for cancer screening.

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Selected References

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