Socioeconomic and sex differences in health care utilisation, counselling on cardiovascular disease (CVD) risk factors, and CVD risk factors control in the Polish population. The WOBASZ II Study

Abstract

Background: Socioeconomic status (SES) is one of the causes of inequality in health care utilisation. There is no information whether differences in SES influence the frequency of counselling on cardiovascular disease (CVD) risk factors or risk factors control. Aim: We sought to assess the relationship between SES and the frequency of medical consultations, hospitalisations, counselling on CVD risk factors, and successful CVD risk factors control. Methods: WOBASZ II was a cross-sectional study targeting a representative sample of the Polish population. Trained nurses interviewed participants using a standard questionnaire, collecting information on education, income, self-rated health, and health care utilisation. Blood samples were collected according to standardised methods. Results: A total of 2303 men and 2848 women were included in the analysis. Compared to those with low SES, men with medium or high SES were 68% and 46% more likely to use medical consultations, respectively. Women with medium and high SES used medical consultations 60% more often than those with low SES. Men with medium and high SES had blood pressure measured more often (by 31% and 43%, respectively), and more frequently received nutritional (by 45% and 59%, respectively) and physical activity counselling (by 92% and 122%, respectively). No differences in CVD risk factors control were found. Conclusions: High SES was associated with more frequent medical visits in both sexes. The associations of SES with counselling on CVD risk factors substantially differed between the sexes in favour of men with high SES. However, more complex consultations in high SES men were not followed by better CVD risk factors control.

Dietary Habits and Dietary Antioxidant Intake Are Related to Socioeconomic Status in Polish Adults: A Nationwide Study

“…Moreover, food intakes were found to vary by age, gender, and education level [12]. The results obtained in a previous study concerning the Polish population support the hypothesis that people with a higher socioeconomic status have better access to health care in terms of frequency of medical consultations and receive counselling on nutrition and physical activity [13]. Dietary education should take into account the income of the targeted population and, in low-income individuals, should focus on a healthy and affordable diet [14].…”

Socioeconomic status, cardiovascular disease and health care services: highlighting the gender gap

“…The observation revealed by Kozela et al [7], regarding the interaction of gender with SES on the CVD-related health care services, is an interesting finding, which raises substantial health implications. It is indicated that CVDs in women were always sidelined over the unanimously propagated claim that this chronic disease was supposed to be a male privilege [8].…”

“…; (ii) Could the fact of being in a high SES group protect women from inadequate health care services?. Kozela et al [7] revealed a privilege of high SES men regarding the quality of counselling services, but no significant gender-specific observations were highlighted when it came to the control of CVD risk factors. Moreover, Muszyńska et al [13], studying the contribution of CVD to all-cause mortality in Poland in 2006-2010, revealed that easy access to medical care in large cities, and in particular to cardiology units, is an important factor behind the levels of all-cause and CVD mortality in Poland.…”

“…The contributors of the Multi-centre National Population Health Examination Survey (WOBASZ II study) assessed the relationship of SES with various factors related to holistic access to health care services, i.e. medical consultations, hospitalisations, and counselling on CVD risk factors [7]. This analysis was interestingly performed from the standpoint of gender differences, providing a better understanding on this literature gap.…”