Section of Social Medicine, University of Copenhagen, Denmark.
Section of Epidemiology, University of Copenhagen, Denmark.
Scand J Public Health. 2022 Jun;50(4):507-515. doi: 10.1177/14034948211004320. Epub 2021 Apr 16.
Communication barriers in healthcare encounters contribute to ethnic inequality in health outcomes. This study aimed to examine, in a large national Danish sample of women, whether ethnicity was associated with pregnant women's Active engagement with healthcare providers. A cross-sectional survey of 1898 pregnant women attending 19 Danish maternity wards. The key variable of interest was maternal ethnicity among ethnic Danish, European, African and Asian immigrant women and their descendants. Syrian immigrant women were studied as a subgroup. The outcome was the health literacy questionnaire domain Ability to engage actively with healthcare providers (five-item domain scored from 'cannot do/always difficult' (1) to 'always easy' (5)) which is a reflection of a respondent's lived experiences of engaging with healthcare providers. Adjusted mixed effect multivariate linear regression was used to compare Active engagement across groups expressed as the mean difference (95% confidence interval). Lower means of Active engagement were reported for immigrant women compared to ethnic Danish women in all models. When adjusting for age, parity, complications and occupation, the difference between ethnic Danish women's Active engagement and other groups was smallest among European -0.15 (-0.26 to -0.05), slightly larger in African -0.19 (-0.40 to 0.02), and largest in Asian immigrant women -0.31 (-0.41 to -0.21). Syrian immigrant women had the largest difference -0.42 (-0.58 to -0.27).
医疗保健中沟通障碍导致医疗保健结果的种族不平等。本研究旨在探讨在丹麦 1898 名孕妇的大样本中，种族是否与孕妇与医疗保健提供者的积极互动相关。 这是一项对 19 家丹麦产科病房的 1898 名孕妇进行的横断面调查。关注的主要变量是丹麦裔、欧洲裔、非洲裔和亚洲移民妇女及其后代中的产妇种族。对叙利亚移民妇女进行了研究作为一个亚组。结果是健康素养问卷领域，能够与医疗保健提供者积极互动（由“不能做/总是困难”（1）到“总是容易”（5）评分的五项领域），这反映了受访者与医疗保健提供者互动的生活经历。使用调整后的混合效应多元线性回归来比较不同组别的积极互动，表现为平均差异（95%置信区间）。 在所有模型中，与丹麦裔妇女相比，移民妇女的积极参与度报告较低。在调整年龄、产次、并发症和职业后，丹麦裔妇女与其他群体的积极参与差异最小，为 0.15（-0.26 至 0.05），在非洲裔中略大，为 0.19（-0.40 至 0.02），在亚洲移民妇女中最大，为 0.31（-0.41 至 -0.21）。叙利亚移民妇女的差异最大，为 0.42（-0.58 至 -0.27）。
