Social determinants of the use of health services among a public university workers

To analyze the use of health services and socioeconomic status among a public university workers.

A cross-sectional study with 759 workers at a Brazilian public university who reported health-related restrictions of their usual activities in the previous 14 days, was carried out. Data were supplied by the 2001 cohort of the "Pró-Saúde Study" in Rio de Janeiro, Southeastern Brazil. Health services use was assessed with a proxy for "seeking health care" and according to the type of service. The presence of additional variation in morbidity was verified by time restriction. Schooling, income and occupation markers were analyzed, and crude and adjusted proportion ratios of use and types of service were calculated.

The occupation level was the indicator of the greatest inequality in health services use. After adjustments for gender, age and the other socioeconomic status markers, the ratio of the proportion of health care use was 1.31 for manual workers (95%CI: 1.11;1.55) and 1.21 for non-manual workers (95%CI: 1.06;1.37) compared to the reference category of professionals.

A pattern of social inequality was identified in health services use. Even after an adjustment for health need, the pattern favored individuals with lower socioeconomic status, particularly for the occupation marker. Remaining differences in individual morbidities do not explain this finding. Rather, occupational factors may exert a greater influence on health services use in this population.