Evers Y J, Verhaegh A, Ibrahim A, Peters C, Dukers-Muijrers N H T M, Reijs R, Hoebe C J P A
Department of Social Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University/Maastricht UMC+, Maastricht, the Netherlands.
Department of Sexual Health, Infectious Diseases and Environmental Health, Living Lab Public Health Mosa, South Limburg Public Health Service, Heerlen, the Netherlands.
J Migr Health. 2025 Jul 26;12:100344. doi: 10.1016/j.jmh.2025.100344. eCollection 2025.
Migration is a growing phenomenon and has impact on sexual and reproductive health outcomes, such as an increased burden for STIs, sexual violence and unintended pregnancies. Equitable access to sexual health care is of great importance for young people from ethnic minorities (EMs). In this study, we aimed to determine the proportional representation of first- and second generation EMs under 25 years at Dutch Sexual Health Centers (SHCs) compared to native Dutch citizens.
In this retrospective cohort study, coded health records data of 270,927 persons in the age group of 15 till 24 years visiting SHCs between 2016 and 2021 were included. Health records data was combined with census tract data (Statistics Netherlands) to average annual calculate consultation rates, i.e., dividing 6-year-average of the number of first consultations of a patient in the study period belonging to a specific EM by the total number of citizens in the age group of 15 till 24 years belonging to that EM in the Netherlands in 2021, multiplied by 1000.
The consultation rate for native Dutch patients was 22.0 per 1000 persons (95 %CI: 21.8-22.2, 18.9, 19.8 (95 %CI: 19.8-20.4) for first-generation EMs and 18.4 (95 %CI: 18.0-18.8) for second-generation EMs. In both first- and second generation EMs, consultation rates for patients from Turkey, Morocco, Eastern Europe and Asia were lower than for native Dutch patients. Consultation rates among patients from Africa were lower for first-generation EMs than native Dutch patients. Consultation rates among patients from Indonesia, Suriname/Dutch Antilles, Latin America and other western countries were equal or higher than among native Dutch patients.
Our study showed that several EMs were underserved in Dutch sexual health care, suggesting lower access to care and indicating the need for culturally sensitive approaches to increase access. Using consultation rates is informative to indicate inequalities in access to sexual health care among EMs.
移民现象日益普遍，对性健康和生殖健康结果产生影响，例如性传播感染负担加重、性暴力以及意外怀孕。公平获得性健康护理对少数族裔年轻人至关重要。在本研究中，我们旨在确定与荷兰本土公民相比，25岁以下第一代和第二代少数族裔在荷兰性健康中心的比例。
在这项回顾性队列研究中，纳入了2016年至2021年间前往性健康中心就诊的15至24岁年龄组的270,927人的编码健康记录数据。健康记录数据与荷兰统计局的人口普查区数据相结合，以计算年均咨询率，即：将研究期间属于特定少数族裔的患者首次咨询次数的6年平均值除以2021年荷兰该少数族裔15至24岁年龄组的公民总数，再乘以1000。
荷兰本土患者的咨询率为每1000人22.0次（95%置信区间：21.8 - 22.2），第一代少数族裔为18.9次（95%置信区间：19.8 - 20.4），第二代少数族裔为18.4次（95%置信区间：18.0 - 18.8）。在第一代和第二代少数族裔中，来自土耳其、摩洛哥、东欧和亚洲的患者咨询率低于荷兰本土患者。第一代少数族裔中来自非洲的患者咨询率低于荷兰本土患者。来自印度尼西亚、苏里南/荷属安的列斯群岛、拉丁美洲和其他西方国家的患者咨询率与荷兰本土患者相当或更高。
我们的研究表明，在荷兰性健康护理中，几个少数族裔群体未得到充分服务，这表明他们获得护理的机会较低，并表明需要采用文化敏感方法来增加获得护理的机会。使用咨询率有助于指出少数族裔在获得性健康护理方面的不平等情况。
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