ArticleInternational journal for equity in health2024
Perceived discrimination and refraining from seeking physician's care in Sweden: an intersectional analysis of individual heterogeneity and discriminatory accuracy (AIHDA).
Article in International journal for equity in health, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Integrating social and cardiometabolic risk factors in predicting cardiometabolic multimorbidity: a Bayesian model development and internal validation in Swedish middle-aged adults.Scientific reports · 2026Article
- Antidepressant discontinuation in France from an intersectional perspective: a discrete-time survival analysis within the MAIHDA framework.BMC public health · 2026Article
- Differences in COVID-19 vaccine acceptance and uptake according to region of birth: findings from a cross-sectional survey in Sweden.Frontiers in public health · 2026Article
- Socio-geographical disparities in cardiometabolic multimorbidity in Sweden: an Intersectional Multilevel Analysis of Individual Heterogeneity and Discriminatory Accuracy (I-MAIHDA).International journal for equity in health · 2025Article
- Trust in healthcare and perceived discrimination in Sweden: a fixed effects analysis of individual heterogeneity and discriminatory accuracy.Frontiers in public health · 2025Article
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6 authors.
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Abstract
backgroundDiscrimination may further impede access to medical care for individuals in socially disadvantaged positions. Sociodemographic information and perceived discrimination intersect and define multiple contexts or strata that condition the risk of refraining from seeking physician's care. By applying analysis of individual heterogeneity and discriminatory accuracy (AIHDA) we aimed to improve the mapping of risk by considering both strata average risk differences and the accuracy of such strata risks for distinguishing between individuals who did or did not refrain from seeking physician's care.
methodsWe analysed nine annual National Public Health Surveys (2004, 2007-2014) in Sweden including 73,815 participants. We investigated the risk of refraining from seeking physician's care across 64 intersectional strata defined by sex, education, age, country of birth, and perceived discrimination. We calculated strata-specific prevalences and prevalence ratios (PR) with 95% confidence intervals (CI), and the area under the receiver operating characteristic curve (AUC) to evaluate the discriminatory accuracy (DA).
resultsDiscriminated foreign-born women aged 35-49 with a low educational level show a six times higher risk (PR = 6.07, 95% CI 5.05-7.30) than non-discriminated native men with a high educational level aged 35-49. However, the DA of the intersectional strata was small (AUC = 0.64). Overall, discrimination increased the absolute risk of refraining from seeking physician's care, over and above age, sex, and educational level.
conclusionsAIHDA disclosed complex intersectional inequalities in the average risk of refraining from seeking physician's care. This risk was rather high in some strata, which is relevant from an individual perspective. However, from a population perspective, the low DA of the intersectional strata suggests that potential interventions to reduce such inequalities should be universal but tailored to the specific contextual characteristics of the strata. Discrimination impairs access to healthcare.
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