Healthcare renunciation among young adults in French higher education: A population-based study

Abstract

Healthcare renunciation has been a recent focus of the public health debate, but large-scale investigations of healthcare renunciation are scarce. The goal of this study was to examine healthcare renunciation among young adults at French universities. It investigated prevalence of and reasons for healthcare renunciation and identified subgroups of vulnerable youths. Data were collected in the 2013 triennial study conducted by the French National Observatory of Student Life. That study had a sample of 35,810 18- to 25-year-old participants. Measures included healthcare renunciation, reasons for healthcare renunciation, demographics, cultural and socioeconomic background, health and social outcomes, healthcare system-related variables, and markers of adulthood. The results showed that the prevalence of healthcare renunciation was 27.2%. The most common reasons for healthcare renunciation were refusal renunciation (self-care, 12.7%; wait for improvement, 15.5%) and barrier renunciation (financial reasons, 12.1%; lack of time, 10.2%). Therefore, healthcare renunciation is linked not only to financial constraints but also to individuals' subjective needs and ways of facing illness. Overall, disadvantaged youths and youths transitioning to adulthood were likelier to renounce care, especially for financial reasons. To conclude, there are social inequalities in the use of healthcare by emerging adults in higher education in France. Emerging adulthood appears to be a risky period in which people are likely to renounce healthcare for multiple reasons. Support should be provided for vulnerable youths to prevent them from becoming increasingly vulnerable.

Eating Disorders among College Students in France: Characteristics, Help-and Care-Seeking

“…However, reasons for healthcare renunciation generally did not differ according to the ED diagnostic category. The most common reasons for healthcare renunciation were firstly, attitudinal barriers (e.g., waiting until health improved, self-care), and secondly, structural barriers (e.g., financial reasons, lack of time), consistent with the results of a previous study among students in France [15]. The sole reason with a difference according to ED was a fear of seeing a doctor, concerning mostly bulimic EDs.…”

“…Healthcare renunciation, that is, foregoing or delaying healthcare, has been a focus of public health debates in the past decade [14]. Several barriers have been identified which prevent students from seeking help for mental health problems, and are linked not only to financial constraints, but also to individuals' subjective needs and ways of facing illness [15]. One study reports reasons for healthcare renunciation, such as lack of time, lack of perceived need, and a desire to deal with the issue "on my own" [16].…”

Renunciation of Health Care by People Living with HIV in France is Still Associated with Discrimination in Health-Care Services and Social Insecurity – Results from the ANRS-VESPA2 Survey

“…In the present study, PLHIV who suffered from a major depressive episode were at greater risk of healthcare renunciation. This is consistent with previous findings highlighting associations between depression and renunciation in the general population [24][25][26] and with renunciation of HIV-specific care [6,27,28]. In our study, depression was also related to poor socioeconomic outcomes such as unemployment and material deprivation (something which has been reported in the literature), and to discrimination [29].…”

Electronic Cigarette Use in Students and Its Relation with Tobacco-Smoking: A Cross-Sectional Analysis of the i-Share Study

“…It could also be due to a selection bias, with female students participating more often than male students in clinical research studies. In other recent studies in French student populations, there also was a female predominance [ 42 , 43 ] but in a lower rate. Fourth, analyses performed in the smokers' subgroup concerned only the 585 smokers who answered correctly about their smoking habits on the supplementary questionnaire.…”