title: The role of education in the uptake of preventative health care: the case of cervical screening in Britain.
abstract: This paper reports findings on the relationship between education and the take-up of screening for cervical cancer, as an example of preventative health-care activity. Theoretically, education can enhance the demand for preventative health services by raising awareness of the importance of undertaking regular health check-ups and may also improve the ways in which individuals understand information regarding periodical tests, communicate with the health practitioner, and interpret results. Furthermore, education enhances the inclusion of individuals in society, improving self-efficacy and confidence. All these factors may increase service uptake. The empirical analysis uses data from the British Household Panel Survey (BHPS) and applies techniques for discrete panel data to estimate the parameters of the model. Results show that adult learning leading to qualifications is statistically associated with an increase in the uptake of screening. The marginal effect indicates that participation in courses leading to qualifications increases the probability of having a smear test between 4.3 and 4.4 percentage points. This estimate is strongly robust to time-invariant selectivity bias in education and the inclusion of income, class, occupation, and parental socio-economic status. These findings enrich existing evidence on the socio-economic determinants of screening for cervical cancer and enable policy makers to better understand barriers to service uptake.
authors.affiliation: Institute of Education, University of London, 20 Bedford Way, London WC1H 0AL, UK. R.Sabates@ioe.ac.uk
authors.forename: Ricardo
authors.initials: R
authors.lastname: Sabates
authors.forename: Leon
authors.initials: L
authors.lastname: Feinstein
mesh_terms: D000328:Adult; D004522:Educational Status; D005260:Female; D019538:Health Care Surveys; D006266:Health Education; D007722:Health Knowledge, Attitudes, Practice; D006301:Health Services Needs and Demand; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D015233:Models, Statistical; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011336:Probability; D006113:United Kingdom; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D014932:Women's Health Services / Q000706:statistics & numerical data*