Ethnic health inequalities in Europe. The moderating and amplifying role of healthcare system characteristics.
Health inequalities between ethnic majority and ethnic minority members are prevalent in contemporary European societies. In this study we used theories on socioeconomic deprivation and intersectionality to derive expectations on how ethnic inequalities in health may be exacerbated or mitigated by national healthcare policies. To test our hypotheses we used data from six waves of the European Social Survey (2002-2012) on 172,491 individuals living in 24 countries. In line with previous research, our results showed that migrants report lower levels of health than natives. In general a country's healthcare expenditure appears to reduce socioeconomic differences in health, but at the same time induces health differences between recent migrants and natives. We also found that specific policies aimed at reducing socioeconomic inequalities in health appeared to work as intended, but as a side-effect amplified differences between natives and recent migrants in self-assessed health and well-being. Finally, our results indicated that policies specifically directed at the improvement of migrants' health, only affected well-being for migrants who have lived in the receiving country for more than 10 years.
Department of Sociology, Radboud University, Postbus 9104, 6500 HE Nijmegen, Netherlands. Electronic address: n.blom@maw.ru.nl.
Niels
N
Blom
Centre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Yvonne Carter Building, 58 Turner Street, Whitechapel, London E1 2AB, UK. Electronic address: t.huijts@qmul.ac.uk.
Tim
T
Huijts
Department of Sociology, Radboud University, Postbus 9104, 6500 HE Nijmegen, Netherlands. Electronic address: g.kraaykamp@maw.ru.nl.
Gerbert
G
Kraaykamp
D000328:Adult; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care / Q000706:statistics & numerical data*; D005006:Ethnicity / Q000706:statistics & numerical data*; D005060:Europe; D005260:Female; D006291:Health Policy; D006304:Health Status; D054624:Health Status Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires
Comparative research; Ethnic inequality; Health; Healthcare systems; Intersectionality; Multilevel modelling