Arsenijevic Dr Jelena, Seibel Dr Verena
Faculty of Law, Economics and Governance, Utrecht University, Utrecht, the Netherlands.
Faculty of Social and Behavioral Science, Utrecht University, the Netherlands.
J Migr Health. 2024 Jul 29;10:100258. doi: 10.1016/j.jmh.2024.100258. eCollection 2024.
The Netherlands was one of the first countries in Europe to offer breast, colorectal and cervical cancer screening tests free of charge. Yet, a significant share of migrants in the Netherlands forgo the use of these preventive screenings. Qualitative research suggests, that lack of system knowledge on how the healthcare system operates (e.g. age eligibility of cancer screenings), is one factor contributing to this underuse among migrants. However, little is known about the extent to which migrants differ from natives in their system knowledge and about potential causes of this ethnic gap. The contribution of this study is therefore twofold: First, we examine whether migrants in the Netherlands have lower system knowledge regarding cancer screenings than the natives. Second, we examine which factors explain potential ethnic differences in system knowledge between migrants and non-migrants.
Using the Longitudinal Internet Study for Social Sciences (LISS), we matched newly collected data on system knowledge about healthcare with Health module (wave 14). To assess the difference in system knowledge among migrants and non-migrants, while taking into account potential selection bias, we applied propensity score matching, one-to-one matching procedure with no replacement. We compared first generation non - Western migrants (FNWM) and second-generation non-western migrants (SNWM) with their most similar non-migrants group regarding their knowledge about breast, colorectal, and cervical screening. A Blinder-Oaxaca decomposition with non-matched samples was used to examine which factors can explain the differences in system knowledge among migrants and non-migrants.
Our results show that first generation migrants have lower system knowledge about all three screening tests, while second generation migrants differ from non-migrants only with regard to knowledge about breast and colorectal cancer screenings. The ethnic differences found are not caused by personal or social factors such as education or income.
We recommend Dutch healthcare policy makes to focus in the strengthen of cancer screening system knowledge among migrant populations in order to increase their participation in these screening programs.
荷兰是欧洲最早提供免费乳腺癌、结直肠癌和宫颈癌筛查检测的国家之一。然而，在荷兰，相当一部分移民放弃使用这些预防性筛查。定性研究表明，对医疗保健系统如何运作缺乏系统性了解（例如癌症筛查的年龄资格）是导致移民中此类筛查使用不足的一个因素。然而，对于移民在系统知识方面与本地人存在多大差异以及这种种族差距的潜在原因，我们知之甚少。因此，本研究的贡献有两方面：第一，我们研究荷兰的移民在癌症筛查方面的系统知识是否低于本地人。第二，我们研究哪些因素可以解释移民和非移民在系统知识方面潜在的种族差异。
利用社会科学纵向互联网研究（LISS），我们将新收集的关于医疗保健系统知识的数据与健康模块（第14波）进行匹配。为了评估移民和非移民在系统知识方面的差异，同时考虑潜在的选择偏差，我们应用了倾向得分匹配，即无放回的一对一匹配程序。我们将第一代非西方移民（FNWM）和第二代非西方移民（SNWM）与其最相似的非移民群体在乳腺癌、结直肠癌和宫颈癌筛查知识方面进行了比较。使用未匹配样本的布林德 - 奥克分解来检验哪些因素可以解释移民和非移民在系统知识方面的差异。
我们的结果表明，第一代移民对所有三项筛查检测的系统知识较低，而第二代移民仅在乳腺癌和结直肠癌筛查知识方面与非移民存在差异。发现的种族差异并非由教育或收入等个人或社会因素引起。
我们建议荷兰的医疗保健政策应专注于加强移民群体的癌症筛查系统知识，以提高他们对这些筛查项目的参与度。
