ArticleEuropean journal of public health2023
Characteristics of employment history and self-perceived barriers to healthcare access.
Article in European journal of public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed, 11 citations in OpenAlex.
- Knowledge, Attitudes And Disposal Practices For Unused Medicines Amongst Adult Residents Of Bloemfontein, South Africa.Drug, healthcare and patient safety · 2026Article
- Spatial distribution and determinants of health care access barriers among female Pakistan youths: spatial and multilevel regression analysis.BMC health services research · 2025Article
- Breaking Barriers: Advancing Employment Opportunities for Black Women.American journal of public health · 2025Article
- Forgone and delayed care in Germany- inequalities and perceived health risk of unmet need.International journal for equity in health · 2025Article
- Utilization of oral health care services and perceived barriers among adults residing in Jiri, Nepal: a cross-sectional study.BMC public health · 2025Article
- Community-Based View on Diagnostic Imaging at the End of COVID-19 Pandemic: Online Survey-Assisted Study.Diagnostics (Basel, Switzerland) · 2024Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 3 countries.
Funding
Abstract
backgroundResearch suggests that people in disadvantaged social positions are more likely to perceive barriers to accessing healthcare, especially to specialists and preventive services. In this study, we analyze if adversity during past employment histories (e.g. spells of unemployment) is linked to subsequent subjectively perceived barriers in healthcare access. Further, we investigate if the associations vary according to national healthcare access and quality indicators.
methodsWe use data from the Survey of Health, Ageing and Retirement in Europe with a study sample of 31 616 men and women aged 52-80 from 25 countries. Data include retrospective information on employment histories allowing us to derive characteristics of past careers, including the number of unemployment periods, main occupational position and pension contributions. Barriers to healthcare access are measured by self-perceived forgone care due to costs and unavailability of services. We apply multilevel Poisson regression for binary outcomes and test for cross-level interactions between career characteristics and national healthcare system characteristics.
resultsCareer characteristics are linked to later self-perceived healthcare access barriers, consistently in the case of cost barriers and less consistently for unavailability of services. Associations are similar for men and women, and persist after controlling for current income, wealth and subjective health. We find no cross-level interactions between career characteristics and country-level healthcare access and quality indicators.
conclusionSelf-perceived barriers to healthcare access are linked to people's past working lives. More in-depth investigation is needed to identify the reasons for the lingering effects of characteristics of employment history on reduced healthcare access.
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