Differences in health care use among the divorced and the married: are they need-based?

1. Differences in health care use among the divorced and the married: are they need-based? PRESENTATION for the 8th meeting for the sociological and demographic studies of divorce 14-16 October 2010 valencia – spain Elien colman, sarasymoens & piet bracke HeDeRa Department of sociology Ghent University

2. Background • 2 different approaches: • * Measures based on need-adjusted health care utilization: • comparing groups in their health care use, controlling for need factors • (‘objective measures’) • * Subjective measures of unmet need (SUN): • R decides whether he/she has an unmet need • Focus on health care use because of social or emotional problems

3. Background • Previous research has indicated that: • the divorced have a higher health care use, even after controlling for need • Divorced: seek more easily professional care • => report less subjective unmet need?

4. Background Controls: Andersen’s Behavioral Model of Health Services Use SUN Predisposingcharacteristics Enabling factors Need Use Marital status Income Gender Education Depression Age Employment Children Social support

5. Data & Methods Data: Divorce in Flanders (2009-2010) Selection of marriages out of Public Register: 1/3 still married; 2/3 ever divorced Methods: Logistic Regressions Dependent variables: - contact with a health care professional because of social or emotional problems - subjective unmet need because of social or emotional problems Gender specific analyses N men: 1876 N women: 2205

6. Results: descriptives

7. Results: Logistic regressions: contact with health care provider • Dependentvariable: contact with professional health care provider because of socialoremotionalproblems

8. Results: Logistic regressions: contact with health care provider • The finding that a higher amount of single divorced women have contacted a health care provider because of social or emotional problems can only partially explained by their higher need for care • Do feelings of loneliness add to this explanation?

9. Results: Logistic regressions: subjective unmet need • Do single divorced feel less often that they needed professional help for social or emotional problems, without seeking this care?

10. Results: Logistic regressions: subjective unmet need • Single divorced men and women have more often the feeling that they need professional help, without seeking this help • Can this be explained by feelings of loneliness?

11. Conclusion • Divorced single women: • Are more easily motivated to seek professional help • The seek professional help, but, are still not totally satisfied • Their feelings of unmet need are associated with emotional loneliness • Divorced single women need someone to talk to: informal or formal

12. Conclusion • Divorced single men: • Only contact health care providers when the need is very high • As a result, there are high levels of subjective unmet need among them, compared to other men • Need a partner to stimulate them to seek help?

13. DISCUSSION • Differences in health care use among the divorced and the married: are they need-based? • - No difference between the divorced living with a new partner and the married • - For single divorced women: only partially, they seek more easily professional care • - For single divorced men: contact professional health care providers only when the need is high • Limitations • Perspective of time • Narrow measurement of need

14. Thank you for your attention! Elien.Colman@UGent.be www.divorceinflanders.be