Socio-demographic differences in use and access to health care in Norway - an overview
Mapping review
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Key message
Background
Socio-demographic differences in health in Norway among children, youth and adults are well known, whereas there is more discussion concerning the reasons for the differences. It is less known to what degree socio-demographic differences in use and access to health care, in addition to the known differences in lifestyles, contribute to the measured health differences Analyses must account for morbidity such that the results can quantify if the increased use of health services by the lower social classes is sufficiently high to account for the much higher morbidity. This report presents a literature review of the most important research findings in this field in Norway over the past 15–20 years.
Methods
Research concerning social inequity in use/access to health services in Norway is summarized for somatic, mental and dental health, and for the population subgroups infants, children/youth, adults and the elderly. The summary includes both primary and secondary care.
Results
Somatic health services
The main finding is that contact with health services in both primary and secondary care is primarily based on need, leading to greatest use in the lowest social classes. This is true for all age groups. When differences are found however, education level is the social class measure that seems to describe differences best, with higher use among those with higher education.
Mental health services
The research in this field is less complete. Studies done in children and youth indicate a higher use of health services in the lower classes, even when controlling for morbidity. There is little evidence for socio-demographic differences among adults in contact with the health services for mental health, either for primary or secondary care, but the studies are purely descriptive and do not account for differences in morbidity.
Dental services
The public health services for oral health for children in Norway is free for the user and successfully removes social differences in use of care. However, for adults and the elderly there is increased contact with dentists among the higher social classes. However, once the contact is taken, there seems to be no social differences in further use of the services.