Socio-economic differences in participation in rehabilitation – a register-based study of residents of Oulu in 2018
DOI:
https://doi.org/10.23990/sa.98606Keywords:
rehabilitation, education, income, occupational statusAbstract
Knowledge on socio-economic differences in participation in rehabilitation is scarce. The aim of this study was to examine whether there are such differences in participation by education, occupational status, and income both in general and in different subsystems that organize rehabilitation. We also looked at whether the differences can be explained by other indicators of socio-economic status, marital status, and morbidity. We used register-based data on 25–64-year-old residents of the city of Oulu, Finland, in 2018 and their use of social and health services and benefits (N = 99,569). Participants in rehabilitation comprised all those who participated in rehabilitation provided by public health services, the Social Insurance Institution of Finland (Kela), the earnings-related pension system, or occupational health or private physiotherapy during 2018. Methods included cross-tabulation and logistic regression analysis. Participation in rehabilitation was lower than average among those who had completed only primary education, entrepreneurs, and the unemployed, as well as in the lowest income quartile, when age and sex were controlled. Adjusting for marital status, other socio-economic factors, and morbidity did not essentially change the results. Non-working and low-income persons were most likely to participate in rehabilitation provided by public health services. The profile of those who participated in Kela-organized rehabilitation was similar, except that highly educated and upper white-collar employees also participated often. Secondary school graduates, students, and other non-working and middle-income earners were most likely to participate in rehabilitation organized by the earnings-related pension system. The highly educated, employees, and high-income earners most likely participated in occupational health physiotherapy and private physiotherapy. In addition, entrepreneurs often participated in private physiotherapy. Those in the lowest socio-economic position are least likely to participate in rehabilitation. When targeted at the well-off, rehabilitation may in part maintain socio-economic health inequalities in the population. However, the picture of the socio-economic differences is affected by what types of rehabilitation can be identified from registers.
