APH 2001, 59, 265-279:

Inequality in the access to preventive health care: the case of immigrants in Belgium.

O. Anson

Keywords: Belgium, general practitioner, immigrants, preventive care

Purpose: to study differences in the access to preventive health services between Belgians and the two main groups of immigrants in Belgium, Moroccans and Turks, and the role of the general practitioner in promoting equal access to preventive care.

Method: comparing the proportion of persons aged 25 or above who were: (a) vaccinated for tetanus, influenza and rubella; (b) screened for cardiovascular risk factors; (c) screened for early detection of cancer of the breasts and the cervix; and (d) had HIV-related knowledge and screening.  Data were taken from the Belgian Health Interview Survey 1997.  The association between country of origin and access to preventive health care was examined controlling for confounding variables such as socioeconomic status and having a permanent general practitioner.

Findings: Native Belgians had better access to the preventive health services studied than did immigrants from Morocco and Turkey.  Significant differences were observed for nine of the eleven dependent variables after controlling for socio-demographic characteristics.  Being registered with a permanent general practitioner increased access to most preventive technologies studied, but did not eliminate the differences between immigrants and native Belgians.

Conclusions: although the majority of the Moroccan and Turk immigrants have been in Belgium for over two decades, they do not enjoy the same level of access to preventive technologies and knowledge as native Belgians do.  Our findings indicate that general practitioners provided a limited range of preventive care.  We conclude that intervention programs among general practitioners and other primary care providers as well as among immigrants are called for.