Persistent inequalities in preventive care use are observed within and across European countries, even in comprehensive welfare states. To explain the variance in and the persistence of these health inequalities, we turn to fundamental cause and diffusion of innovations theory to formulate baseline hypotheses on educational inequalities in cancer prevention use, across time and across European countries. Social inequalities have a modest outcome-specific, but a broad general impact. Therefore, we focus on different cancer screening pro-grams simultaneously, namely, mammography, pap smear, and fecal occult blood (FOB) tests.
We will test:
- whether levels of inequality in screening uptake reflect the latter stage of diffusion in the population
- the impact of cross-nationally diverging prevention care policies, health policies, and social inequalities in a broad set of European countries.
Starting from in-depth analyses of the temporal/historical dimension of screening uptake in Belgium and Switzerland, we subsequently extend our models to other European countries, in order to cover different national policies and practices. For the Belgian-Swiss comparison we will rely on the Belgian and the Swiss Health Inter-view Surveys, spanning 15 years (1997-2012/2013), to explore screening trends under different health and social policy conditions. For the European-wide research the European Health Interview Surveys, EHIS 1 (2006-2009) and EHIS 2 (2013-2015) will be used.
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