Sociocultural barriers in accessing diabetes care and CV prevention
Despite partial improvement, even after ten years of residence in a country like Italy, with a universal healthcare system (where people with diabetes can obtain antidiabetic drugs, laboratory tests, visits and diabetes devices free of charge), migrants with diabetes receive overall a lower quality of care than to age- and sex-matched Italian patients with diabetes.
Under-utilization of cardiovascular preventive drugs is of particular concern and since these drugs are provided free of charge in Italy, the under-utilization among immigrants should not be due to socioeconomic deprivation but is more likely a reflection of difficulties in doctor/patient communication. Migrants encounter sociocultural barriers (language, communication, sociocultural factors and “news-ness”) in accessing health care.
Language and communications barriers include not only the lack of comprehensible information about services available or entitlements but also communication with doctors that goes beyond language. For exemple, GPs may communicate differently with immigrants and non-immigrants: consultation with immigrants was shorter with GPs talking more and immigrants less demanding. Less effective communication with migrants may lead to non-adherence to treatments (due to misunderstanding) and inadequate referral to secondary care.
References
- Nørredam M, Krasnik A. Migrants’ access to health services. In: Rechel B, Mladovsky P, Devillé W, Rijks B, Petrova-Benedict R, Mckeen M (eds) Migration and health in the European Union. Open University Press, 2011 Maidenhead, pp 67–78.
- Meeuwesen L, Harmsen JAM, Bernsen RMD, Bruijnzeels MA. Do Dutch doctors communicate differently with immigrant patients than with Dutch patients? Soc Sci Med 2006;63:2407–2417.
