Abstract
To investigate variations in explanations given for disparities in health care use between migrant and non-migrant groups, by clients and care providers in Sweden. Qualitative evidence collected during in-depth interviews with five ‘migrant’ health service clients and five physicians. The interview data generated three categories which were perceived by respondents to produce ethnic differences in health service use: “Communication issues”, “Cultural differences in approaches to medical consultations” and “Effects of perceptions of inequalities in care quality and discrimination”. Explanations for disparities in health care use in Sweden can be categorized into those reflecting social/structural conditions and the presence/absence of power and those using cultural/behavioural explanations. The negative perceptions of ‘migrant’ clients held by some Swedish physicians place the onus for addressing their poor health with the clients themselves and risks perpetuating their health disadvantage. The power disparity between doctors and ‘migrant’ patients encourages a sense of powerlessness and mistreatment among patients.
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Notes
‘Utlandsfödda’ is a term used both by statutory authorities and researchers in Sweden to refer people who were either born outside Sweden or were born in Sweden but have at least one parent who was born abroad [2]. ‘Infödda’are typically Swedish–born people with two Swedish- born parents. A strict translation of these terms into English may be ‘in-people’ and ‘otherland-people’, or ‘insiders’ and ‘outsiders’.
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Acknowledgments
The authors wish to thank all participants in this study; without their contribution it would not have been possible to undertake the research. Thanks to research assistant Sabina Adamsson. The study was supported by the Research Center Skaraborgs Institutet.
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Akhavan, S., Karlsen, S. Practitioner and Client Explanations for Disparities in Health Care Use Between Migrant and Non-migrant Groups in Sweden: A Qualitative Study. J Immigrant Minority Health 15, 188–197 (2013). https://doi.org/10.1007/s10903-012-9581-y
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DOI: https://doi.org/10.1007/s10903-012-9581-y