Abstract
Objectives
It has been pointed out that inequality may impact on people’s health service seeking behaviors. We examine the impact of income inequality on both pharmacological treatment and psychotherapy service utilization among adults with schizophrenia based on a nationally representative, longitudinal study in China.
Methods
We used data from the Second National Sample Survey on Disability in 2006 and from its follow-up investigation in 2007-2013 in China. Respondents with schizophrenia were ascertained by the combination of self-reports and diagnosis by psychiatrists. More than 1000 adults with schizophrenia were included. Random effect logistic regression model was applied to estimate the impact of province-level income inequality on rehabilitation service utilization among patients with schizophrenia.
Results
Overall, the percentage of using pharmacological treatment and psychotherapy service among all individuals went up from 22.9% and 10.9%, respectively in 2007 to 54.6% and 39.6%, respectively in 2013. The odds of using pharmacological treatment decreased with income inequality, and the impact of income inequality significantly increased over time. Similar pattern was also observed for psychotherapy service utilization. The negative impact of income inequality on service utilization among patients with rural residence, low income, or uninsured status was more pronounced than that among their counterparts.
Conclusions
We demonstrated the negative impact of income inequality on rehabilitation service use among people with schizophrenia and the vulnerability of population with socioeconomic disadvantages. This study further supports the relative income and social causation pathway for the development of schizophrenia from the perspective of material mechanism.
