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Assessing inequalities in preventive care use in Europe


  • Carrieri, Vincenzo
  • Wuebker, Ansgar


This paper presents new international evidence on the extent of inequalities in breast cancer screening and blood test (cholesterol and blood sugar test) in 13 European Countries using data from the 2009 wave of the Survey of Health, Ageing and Retirement in Europe (SHARE). One important contribution of the paper is the inclusion of preexisting health conditions in the needs standardization procedure with the aim of taking into account utilization due to diagnosis or follow-up reasons. We find evidence of pro-rich inequalities in blood test use in some countries while high inequalities emerge in virtually every country with respect to mammography use. Decomposition analysis reveals that inequalities in mammography use are mostly driven by income while preventive needs distribution is only slightly pro-rich. On the other side, richer individuals appear to be much more likely to do blood tests despite their substantially lower diagnostic needs for that care. Generally, inequalities in mammography use are higher in countries without national breast cancer screening programs or in countries with only regional or less participated programs. Inequalities in blood tests are higher in countries with a high share of out-of-pocket payments and/or non universalistic entitlement to insurance coverage.

Suggested Citation

  • Carrieri, Vincenzo & Wuebker, Ansgar, 2013. "Assessing inequalities in preventive care use in Europe," Health Policy, Elsevier, vol. 113(3), pages 247-257.
  • Handle: RePEc:eee:hepoli:v:113:y:2013:i:3:p:247-257 DOI: 10.1016/j.healthpol.2013.09.014

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    References listed on IDEAS

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    Cited by:

    1. Richard Cookson & Carol Proppper & Miqdad Asaria & Rosalind Raine, 2016. "Socioeconomic inequalities in health care in England," Working Papers 129cherp, Centre for Health Economics, University of York.
    2. Carrieri, V. & Wuebker, A., 2014. "Does the letter matter (and for everyone)? Quasi-experimental evidence on the effects of home invitation on mammography uptake," Health, Econometrics and Data Group (HEDG) Working Papers 14/11, HEDG, c/o Department of Economics, University of York.
    3. repec:eee:socmed:v:185:y:2017:i:c:p:147-157 is not listed on IDEAS
    4. Marion Devaux, 2015. "Income-related inequalities and inequities in health care services utilisation in 18 selected OECD countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(1), pages 21-33, January.
    5. Vincenzo Carrieri & Ansgar Wuebker, 2014. "Does the Letter Matter (and for Everyone)? - Quasi-experimental Evidence on the Eff ects of Home Invitation on Mammography Uptake," Ruhr Economic Papers 0491, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen.
    6. Aisa, Rosa & Larramona, Gemma & Pueyo, Fernando, 2015. "Active aging, preventive health and dependency: Heterogeneous workers, differential behavior," Journal of Economic Behavior & Organization, Elsevier, vol. 117(C), pages 1-9.
    7. repec:ifs:fistud:v:38:y:2017:i::p:445-468 is not listed on IDEAS
    8. Vincenzo Carrieri & Ansgar Wuebker, 2016. "Quasi-Experimental Evidence on the Effects of Health Information on Preventive Behaviour in Europe," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 78(6), pages 765-791, December.
    9. Missinne, Sarah & Bracke, Piet, 2015. "A cross-national comparative study on the influence of individual life course factors on mammography screening," Health Policy, Elsevier, vol. 119(6), pages 709-719.
    10. repec:spr:eujhec:v:18:y:2017:i:5:d:10.1007_s10198-016-0845-7 is not listed on IDEAS
    11. Joan Costa‐Font & Edward C. Norton & Luigi Siciliani & Vincenzo Carrieri & Cinzia Di Novi & Cristina Elisa Orso, 2017. "Home Sweet Home? Public Financing and Inequalities in the Use of Home Care Services in Europe," Fiscal Studies, Institute for Fiscal Studies, vol. 38, pages 445-468, September.
    12. repec:zbw:rwirep:0491 is not listed on IDEAS
    13. Solmi, Francesca & Von Wagner, Christian & Kobayashi, Lindsay C. & Raine, Rosalind & Wardle, Jane & Morris, Stephen, 2015. "Decomposing socio-economic inequality in colorectal cancer screening uptake in England," Social Science & Medicine, Elsevier, vol. 134(C), pages 76-86.

    More about this item


    Preventive care; Income-related inequalities; Erreygers index; Decomposition;

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • D63 - Microeconomics - - Welfare Economics - - - Equity, Justice, Inequality, and Other Normative Criteria and Measurement


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