Venue: The Fuqua School of Business, Duke University, 1 Towerview Drive, Durham, NC 27708-0120

 

Presentation

Socioeconomic Disparity in Health-Care Seeking Behavior among Chinese Women with Genitourinary Symptoms

Authors: Qi (Harry) Zhang (Old Dominion University); Diane Lauderdale (University of Chicago); Shanshan Mou (University of Chicago); William I. Parish (University of Chicago); Edward O. Laumann (University of Chicago); John Schneider (University of Chicago)

Presenter: Qi (Harry) Zhang (Old Dominion University)

Discussant: Chiyoe Murata (Hamamatsu University School of Medicine)

Session: Sexual Status

Room: Seminar B

When: Monday 10:30 a.m. - noon

Sexually transmitted infections (STIs) are of growing public health concern in China. To provide adequate treatment to affected individuals, a better understanding of the factors that affect health-care seeking (HCS) is needed. However, little has been done to study the relationship between socioeconomic status (SES) and HCS among women with STI symptoms.

We used the Chinese Health and Family Life Survey (CHFLS) and focused on 730 women who had experienced at least one genitourinary symptom. HCS was measured by whether respondents visited a formal hospital setting or informal settings - such as an unrecognized clinic, self-treatment or no treatment. Formal treatment was defined as visiting a formal hospital. SES was measured by income and education. We used monthly income and categorized it into low (<250Yuan/m), medium (250-500Yuan/m), and high (>500Yuan/m) groups. Education was defined as low (<=primary school), basic (junior high school), medium (senior high school), and high (college or above). Bivariate tests and multivariate logistic regressions were applied.

The relationship between education and seeking any treatment was significant (P=0.01). However, the relationship between education and seeking formal treatment did not achieve statistical significance (P=0.28). The relationship between income and HCS was marginally significant (P<=0.10). After controlling age, rural, resident, marital, and symptom status, basic and medium education status became significant barriers for formal treatment compared with low education (Odds Ratio=0.23 (P<0.01) and 0.26 (P=0.02)). To understand the counterintuitive relationship between education and treatment choice, we further controlled for regions of residence, knowledge about STDs, and whether the subject ever had an STD. Odds Ratios increased to 0.34 (P=0.09) and 0.42 (P=0.14) for visiting a hospital. Compared with low income group, medium and high income groups were more likely to visit hospitals. Odds ratios for medium and high income groups were 1.76 (P=0.27) and 1.93 (P=0.20).

Our results indicate that income and education may have different impacts on HCS among Chinese women with genitourinary symptoms. Women with low income and medium education were less likely to seek formal treatment. The relationship between education and HCS was confounded by region and STD knowledge. Having knowledge of STDs and aware of social stigma may prevent some women from seeking formal hospital treatment.