Equity in health service use by children: Examining the ethnic paradox

This article investigates whether equity is achieved in health service util isation by children and young people aged 0-19 years, Data from the British General Household Survey 1991-4 is used to examine the influence of ethnic ity, along with social class, housing tenure, family structure and employme nt of parents on the use of general practitioner, outpatient and inpatient services. Health status is the most powerful predictor of use for each heal th service and there is no evidence of socioeconomic inequalities, However, a clear 'ethnic paradox' persists after controlling for socioeconomic and demographic factors. South Asian children have a higher utilisation of GP s ervices than any other ethnic group, but the use of hospital services is lo wer for children in all minority ethnic groups relative to the white popula tion, Possible explanations for this paradox are examined in relation to in direct indicators of service quality. There is no evidence to suggest that South Asian children visit the doctor more frequently for a given illness e pisode than white children, but having a non-UK-born mother is associated w ith increased consultation and reduced use of outpatient services relative to UK-born South Asian parents.