title: Sociocultural variations in help-seeking behavior for everyday symptoms and chronic disorders.
abstract: In this study, we test the assumption that sociocultural differences in use of health services will only occur below a certain level of illness severity. Data are derived from the Curaçao Health Study (n = 2248). Subjects' educational level and degree of proto-professionalization are used as indicators of their sociocultural background. Differences in the likelihood of seeking professional care for several common health problems are analyzed, and are compared with the help-seeking behavior for chronic disorders. As hypothesized, higher educated and proto-professionalized people are less likely to seek care for everyday symptoms. In addition, proto-professionalization is accompanied by a greater likelihood of using over the counter medication. Increasing empowerment of patients appears to lead to increased self care for everyday symptoms. When conditions reach a more serious stage, the differences in help-seeking behavior disappear: for most of the chronic conditions studied, the higher educated and more proto-professionalized individuals are just as likely to seek professional treatment as the less advantaged groups. However, there is a difference as to the type of professional consulted for chronic health problems. Proto-professionalized individuals more often receive specialist treatment, probably because they are better equipped to persuade GPs to refer. The adverse side of patient empowerment may be increasing consumerism: a situation in which patient demands, not medical necessity, determine the care delivered.
authors.affiliation: Medical and Public Health Service, Epidemiology and Research Unit, Curaçao, Netherlands Antilles. angg05@ibm.net
authors.forename: J F
authors.initials: JF
authors.lastname: Alberts
authors.forename: R
authors.initials: R
authors.lastname: Sanderman
authors.forename: I
authors.initials: I
authors.lastname: Gerstenbluth
authors.forename: W J
authors.initials: WJ
authors.lastname: van den Heuvel
mesh_terms: D000208:Acute Disease; D001294:Attitude to Health; D002908:Chronic Disease; D003466:Cultural Characteristics; D006801:Humans; D007407:Interviews as Topic; D016013:Likelihood Functions; D009427:Netherlands Antilles; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D011209:Power, Psychological; D012648:Self Care; D012923:Social Class; D012959:Socioeconomic Factors