宫颈癌筛查中的移民和种族不平等：利用比利时健康访谈调查的数据探索文化健康资本的作用。

Migrant and ethnic inequalities in cervical cancer screening: exploring the role of cultural health capital using data from the Belgian Health Interview Survey.

作者信息

Derveeuw Sarah, Vanthomme Katrien, Willems Sara, Toma Sorana

机构信息

Department of Public Health and Primary Care, Ghent University, Ghent, Belgium.

Centre for the Social Study of Migration and Refugees (CESSMIR), Ghent University, Ghent, Belgium.

出版信息

BMC Public Health. 2025 Jul 2;25(1):2262. doi: 10.1186/s12889-025-23267-1.

DOI:10.1186/s12889-025-23267-1

PMID:40604596

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12218106/

Abstract

BACKGROUND

Preventive cancer screenings improve health outcomes, yet inequalities in access to and engagement with cervical cancer screening persist among minoritised populations, particularly migrants and ethnically minoritised groups. This study examines whether inequalities in the accumulation of health-related cultural resources (knowledge, values, and skills that individuals can use to promote their health) help explain ethnic disparities in cervical cancer screening within a European context, drawing on the theoretical concept of “cultural health capital”.

METHODS

Using data from the 2013 and 2018 Belgian Health Interview Surveys ( = 6,247), we employed logistic regression models to explore the relationships among migrant background, cultural health capital (reflecting primary prevention, secondary prevention and healthcare provider engagement), and cervical cancer screening participation, controlling for socioeconomic and health factors.

RESULTS

We identified persistent migrant and ethnic disparities in screening, even after adjusting for socioeconomic and cultural health capital factors. Although cultural health capital accumulation patterns varied considerably across migrant backgrounds and were consistently linked to increased cervical cancer screening uptake, these associations did not fully account for the observed inequalities. Notably, first-generation non-European migrants gained fewer benefits from higher cultural health capital.

CONCLUSIONS

Our results highlight the importance of considering intersecting factors such as length of residence, racialisation and ethnicization, in shaping cultural health capital accumulation. While cultural health capital correlates positively with cervical cancer screening uptake for most groups, it does not fully explain the observed disparities, underscoring the role of systemic barriers in perpetuating inequalities. Future studies should refine cultural health capital measurement and investigate the barriers that diverse populations encounter in their cultural health capital accumulation process.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1186/s12889-025-23267-1.

摘要

背景

预防性癌症筛查可改善健康状况，但在少数族裔人群中，尤其是移民和少数族裔群体，宫颈癌筛查的可及性和参与度仍存在不平等现象。本研究利用“文化健康资本”的理论概念，探讨在欧洲背景下，健康相关文化资源（个人可用于促进自身健康的知识、价值观和技能）积累方面的不平等是否有助于解释宫颈癌筛查中的种族差异。

方法

我们使用2013年和2018年比利时健康访谈调查（(n = 6247)）的数据，采用逻辑回归模型，在控制社会经济和健康因素的情况下，探究移民背景、文化健康资本（反映一级预防、二级预防和与医疗服务提供者的互动）与宫颈癌筛查参与之间的关系。

结果

即使在调整了社会经济和文化健康资本因素之后，我们仍发现筛查方面存在持续的移民和种族差异。尽管文化健康资本的积累模式因移民背景而异，且始终与宫颈癌筛查率的提高相关，但这些关联并未完全解释所观察到的不平等现象。值得注意的是，第一代非欧洲移民从较高的文化健康资本中获得的益处较少。

结论

我们的研究结果强调了在塑造文化健康资本积累过程中考虑诸如居住时长、种族化和族裔化等交叉因素的重要性。虽然文化健康资本与大多数群体的宫颈癌筛查率呈正相关，但它并不能完全解释所观察到的差异，这凸显了系统性障碍在维持不平等方面的作用。未来的研究应完善文化健康资本的测量方法，并调查不同人群在文化健康资本积累过程中遇到的障碍。