SOCIOECONOMIC-STATUS AND PREVENTIVE HEALTH-CARE USE BY CHILDREN IN SPAIN

National health systems are intended to provide equal access to health -care services to whole populations. However, they do not seem to addr ess successfully the problem of social class differentials in access t o health care, in particular access to preventive care. This study exa mines the relationship between the socioeconomic status (SES) of famil ies and the use of preventive health care by children under a national health system in Spain. The study is based on weighted multivariate o rdinal logistic regression analyses of data from the 1987 Spanish Nati onal Health Survey for a sample of 5,622 children, one to 10 years of age. A positive relationship was found between preventive health-care use by children and the SES of their families. Adult respondents' leve l of education and total family income were the most influential varia bles in this relationship. As these increased, children were more like ly to receive visual, hearing, and dental exams. In addition, there wa s a gradient effect between family income and rate at which children r eceived these preventive health-care services. Universal access to car e, like that available in Spain, does not guarantee that social inequa lities in children's receipt of preventive health care will not persis t. In order to succeed, healthcare reform must deal with social issues beyond financial access to care.