Practitioner and Client Explanations for Disparities in Health Care Use Between Migrant and Non-migrant Groups in Sweden: A Qualitative Study

To investigate variations in explanations given for disparities in health care use between migrant and non-migrant groups,
by clients and care providers in Sweden. Qualitative evidence collected during in-depth interviews with five ‘migrant’ health
service clients and five physicians. The interview data generated three categories which were perceived by respondents to
produce ethnic differences in health service use: “Communication issues”, “Cultural differences in approaches to medical consultations”
and “Effects of perceptions of inequalities in care quality and discrimination”. Explanations for disparities in health care
use in Sweden can be categorized into those reflecting social/structural conditions and the presence/absence of power and
those using cultural/behavioural explanations. The negative perceptions of ‘migrant’ clients held by some Swedish physicians
place the onus for addressing their poor health with the clients themselves and risks perpetuating their health disadvantage.
The power disparity between doctors and ‘migrant’ patients encourages a sense of powerlessness and mistreatment among patients.