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Reasons why: A decomposition analysis of unmet dental care needs inequality between foreign-born and native-born in Northern Sweden
Umeå University, Faculty of Medicine, Department of Epidemiology and Global Health.
2019 (English)Independent thesis Advanced level (degree of Master (Two Years)), 10 credits / 15 HE creditsStudent thesis
Abstract [en]

Background: Swedish health care system’s main goal is to have good health and health care on equal terms for the entire population. Nevertheless, Sweden is one of the top countries in the European Union and The Organization for Economic Co-operation and Development that have a significant inequality between foreign-born and native-born in unmet dental care needs.

Objectives: This study aimed to 1) Examine the inequality in unmet dental care needs between foreign-born and native-born in Northern Sweden and 2) decompose the observed inequality, to find the attribution of the selected demographic factors, socioeconomic factors, material conditions, psychosocial and behavioural factors between the two groups.

Method: Based on the Health on Equal Terms survey from 2014 in the four northernmost counties of Sweden between ages 24-84 years (N=22,340, response rate 50%). A non-linear Oaxaca–Blinder decomposition analysis was performed comparing foreign- and native-born individuals. The Survey was used to assess the self-reported unmet dental care needs and explanatory factors included variables covering demographic, socioeconomic factors, material conditions, psychosocial and behavioural factors.

Results: An absolute significant inequality of 7.2 percentage points in unmet dental care needs were found between foreign- and native-born in northern Sweden. The inequality were mainly explained (50%) by material conditions (low cash margin and difficulties to make ends needs), followed by psychosocial factors (poor mental health, no practical support, lack of trust in people and healthcare and previous experience of humiliation) all summed up to explain (35.4%) of the inequality. Demographic and socioeconomic factors together explained (18.6%) while behavioural factors offset the inequality with a percentage of (4.1%).

Conclusion: The study establishes that there is a significant inequality in unmet dental care needs between foreign-born and native-born in northern Sweden. Material conditions were the most important determinant explaining the observed inequality, followed by psychosocial factors, socioeconomic and demographic factors. Public health policies encouraging the inclusion of the financially less privileged groups like the foreign-born in receiving dental care subsidy are needed beside strengthening of the psychosocial support to the foreign-born group.

Place, publisher, year, edition, pages
2019. , p. 30
Series
Centre for Public Health Report Series, ISSN 1651-341X ; 2019:14
Keywords [en]
Dental care system, Foreign-born, Inequality, Material conditions, Oaxaca–Blinder decomposition, Psychosocial factors, Socioeconomic factors, Sweden, Unmet dental care needs.
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:umu:diva-165792OAI: oai:DiVA.org:umu-165792DiVA, id: diva2:1374937
External cooperation
Health on Equal terms, Västerbotten, Jämtland, Norrbotten and Västernorrland County Councils
Educational program
Master's Programme in Public Health
Presentation
2019-05-23, Room A311 Caring Sciences building, Umeå University, Umeå, 11:00 (English)
Supervisors
Examiners
Available from: 2019-12-05 Created: 2019-12-03 Last updated: 2019-12-05Bibliographically approved

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CiteExportLink to record
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Cite
Citation style
  • apa
  • ieee
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Language
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  • asciidoc
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