THE INFLUENCE OF SOCIAL AND ETHNIC SEGMENTATION ON CONSULTATION IN PRIMARY HEALTH-CARE

This paper analyses the utilization of primary health care by a popula tion of whom 28% were not born in Sweden. The study emphasizes the imp act of demography, housing and economic factors on the structure of th e residential area. Households with meagre financial resources, large families and most of the immigrant population were tenants in multiple -occupancy blocks. Further, when demographic development was analysed over a decade, high turnover and a low median age were found in 2 of t he multiple-occupancy areas, indicating social instability. The study revealed a process of both socioeconomic and ethnic segmentation (non- spatial segregation in a residential area). The age- and sex-standardi zed relative risks (RR) showed that the population in subareas consist ing of multiple-occupancy housing in socially unstable areas also had an increased risk of having to visit primary health care. There were n o differences in the number of visits to primary health care between p eople born in Sweden and those born outside Sweden (relative risk (RR) = 1.09, 95% confidence interval (CI) = 0.90-1.30), but those born out side Sweden more often made visits that lasted longer than 30 minutes (odds ratio (OR) = 3.75, 95% CI = 2.09-6.71).