Differences in primary health care use among sub-Saharan African immigrants in Norway: a register-based study

Abstract

BackgroundImmigrants’ utilization of primary health care (PHC) services differs from that of the host populations. However, immigrants are often classified in broad groups by continent of origin, and the heterogeneity within the same continent may hide variation in use among immigrant groups at a national level. Differences in utilization of PHC between sub-Saharan African immigrants have not received much attention.MethodsRegistry-based study using merged data from the National Population Register and the Norwegian Health Economics Administration. African immigrants and their descendants registered in Norway in 2008 (36,366 persons) where included in this study. Using χ2 test and logistic regression models, we assessed the differences in the use of PHC, including general practitioner (GP) and emergency room (ER) services, and the distribution of morbidity burden for immigrants from Somalia, Ethiopia, Eritrea, and Gambia. For the analyses, we used the number of visits and medical diagnoses from each consultation registered by the physician.ResultAmong the total studied population, 66.1% visited PHC within 1 year. The diagnoses registered were similar for all four immigrants groups, regardless of country of origin. Compared to immigrants from Somalia, the age and sex adjusted odds ratios (OR) for use of GP were significantly lower for Ethiopians (OR 0.91; 0.86–0.97), Eritreans (OR 0.85; 0.79–0.91), and Gambians (OR 0.88; 0.80–0.97). Similarly, we also observed lower use of ER among Ethiopians (OR 0.88; 0.81–0.95), Eritreans (OR 0.56; 0.51–0.62) and Gambians (OR 0.81; 0.71–0.92). However, immigrants from Somalia reduced their use of PHC with longer duration of stay in Norway. Differences between groups persisted after further adjustment for employment status.ConclusionDespite the similarities in diagnoses among the sub-Saharan African immigrant groups in Norway, their use of PHC services differs by country of origin and length of stay. It is important to assess the reasons for the differences in these groups to identify barriers and facilitators to access to healthcare for future interventions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2404-z) contains supplementary material, which is available to authorized users.

Demographics, healthcare utilization and drug use in children and adults with atopic dermatitis in Denmark: a population‐based cross‐sectional study

“…Healthcare utilization in immigrants may vary greatly depending on country of origin. A Norwegian study found significant variations in healthcare utilization between immigrants from four different countries in sub‐Saharan Africa, and the use of primary health care reduced with longer duration of stay in Norway . In our study, children with parents from Middle Eastern and North African descent did not have an increased prevalence of AD, which could be explained by differences in genetic predisposition .…”

“…A Norwegian study found significant variations in healthcare utilization between immigrants from four different countries in sub-Saharan Africa, and the use of primary health care reduced with longer duration of stay in Norway. 30 In our study, children with parents from Middle Eastern and North African descent did not have an increased prevalence of AD, which could be explained by differences in genetic predisposition. 31 We observed fewer immigrants in adults with AD, possibly due to a lower risk of AD in their country of origin, or because their earlier symptoms of AD had resolved at the time of immigration.…”

Understanding the healthcare experiences and needs of African immigrants in the United States: a scoping review

“…Those studies revealed a number of barriers to African immigrants' healthcare access that were similar to U.S. studies [31][32][33]. For instance, African immigrants in other countries, like in the U.S., were found to be often viewed as a part of a larger homogeneous population [34][35][36]. However, unlike in the U.S., in some other countries, African immigrants are grouped together in the same immigrant population with Asian and Latin Americans [37,38].…”

Access to Norwegian healthcare system – challenges for sub-Saharan African immigrants

“…A number of studies among migrants and ethnic minorities have revealed important barriers in healthcare access [30][31][32]. However, while many quantitative studies explore issues of access among immigrant [33][34][35][36][37][38][39], a gap still remains, especially in understanding the immigrants' experiences to healthcare, as this may be relevant among SSA immigrants.…”