Ethnicity, equity and the use of health services in the British NHS

• Published in: Social science & medicine (1982) 1997-08, Vol.45 (3), p.485-496
• Main Authors: Smaje, Chris, Le Grand, Julian
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Britain; Child; Child, Preschool; Cross-Cultural Comparison; Equity; equity health care utilisation ethnic groups General Household Survey Britain; Ethnic groups; Ethnic Groups - statistics & numerical data; Ethnicity; Female; General aspects; General Household Survey; Great Britain; Health Care Rationing - statistics & numerical data; health care utilisation; Health Care Utilization; Health Services; Health Services Accessibility - statistics & numerical data; Health Services Research; Health systems. Social services; Humans; Infant; Male; Medical sciences; Middle Aged; Minority & ethnic groups; Public health. Hygiene; Public health. Hygiene-occupational medicine; Quality of service; Referral and Consultation - statistics & numerical data; Social Justice; Socialized Medicine; Socioeconomic Factors; State Medicine - statistics & numerical data; United Kingdom; United Kingdom - epidemiology; Use
• ISSN: 0277-9536; 1873-5347
• DOI: 10.1016/S0277-9536(96)00380-2

This paper addresses the extent to which equity of treatment is received by people of different ethnic groups from the British National Health Service. Using data from the General Household Surveys of 1984–1991 it examines the use of general practitioner, outpatient and inpatient services using three different methods to adjust for need and for other possible confounding variables. The results do not suggest there is any gross pattern of inequity between ethnic groups, except perhaps with respect to the Chinese population which displays consistently low levels of utilisation. However, while use of GP services by minority ethnic groups is in general as high or higher than the white population, use of outpatient services is low. Some of the results also suggest that there may be important ethnic differences underlying the broader finding of equity. For example, females of Pakistani origin report low levels of GP use. More generally, excess use of GP services among several minority ethnic groups appears to be associated with need, while people from most minority ethnic groups who do not report illness display especially low use of outpatient services relative to the corresponding group in the white population. The paper examines the implications of these findings.