Science Journal of Public Health 2014; 2(6): 610-616 Published online November 24, 2014 (http://www.sciencepublishinggroup.com/j/sjph) doi: 10.11648/j.sjph.20140206.28 ISSN: 2328-7942 (Print); ISSN: 2328-7950 (Online) Employment status and health care utilization in a context of economic recession: Results of a population based survey in East Central Sweden Gloria Macassa 1, 2, 3 , Anne-Sofie Hiswåls 1 , Nader Ahmadi 4 , Johana Alfredsson 5 , Joaquim Soares 2 , Mindaugas Stankunas 6 1 Department of Occupational and Public Health Science, University of Gävle, Gävle, Sweden 2 Department of Health Science, Section of Public Science, Mid-Sweden University, Sundsvall, Sweden 3 Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden 4 Department of Social Work and Psychology, University of Gävle, Gävle, Sweden 5 Department of Community Medicine, Gävleborg County Council, Gävle, Sweden 6 Department of Health Management, Lithuanian University of Health Sciences, Kaunas, Lithuania Email address: glamaa@hig.se (Gloria M.), anne-sofie.hiswals@hig.se (Anne-Sofie H.), nader.ahmadi@hig.se (Nader A.), johanna.alfredsson@lg.se (Johana A.), Joaquim.Soares@miun.se (Joaquim F. S.), mindstan@gmail.com (Mindaugas S.) To cite this article: Gloria Macassa, Anne-Sofie Hiswåls, Nader Ahmadi, Johana Alfredsson, Joaquim Soares, Mindaugas Stankunas. Employment Status and Health Care Utilization in a Context of Economic Recession: Results of a Population Based Survey in East Central Sweden. Science Journal of Public Health. Vol. 2, No. 6, 2014, pp. 610-616. doi: 10.11648/j.sjph.20140206.28 Abstract: Introduction: The most recent economic recession left many people outside the labour market world-wide, causing widespread poverty and social exclusion. Gävleborg County in East Central Sweden experienced massive layoffs caused by closure of various industries. Objective: The objective of this study was to investigate differences in health-care use according to employment status at the pick of the recent economic recession. Methods: The study used data from a cross- sectional survey “Health in Equal Terms” carried out in Gävleborg County in 2010. The sample included 4245 persons aged 16-65 years. Descriptive and logistic regression analyses were used to assess differences in health-care seeking behaviour by employment status. Results: Employment status was statistically significantly associated with health-care use in Gävleborg County. In the bivariate analysis people who were not employed had odds ratio of 1.62 (CI 1.18-1.72) for health care use as compared to their employed counterparts. Controlling for other variables in Model II to IV removed the statistical significance and reduced the odds to 0.44(CI 0.20-1.00). Conclusions: This study found that at the pick of the most recent economic recession, people who were out of work used more often health services as compared with their employed counterparts. The observed differences in health-care use were explained by demographic, socio-economic and health-related variables. Further studies are needed to analyze trends of healthcare utilization according to employment nationally, particularly at the county level. Keywords: Health-Care Use, Employment Status, Economic Recession 1. Introduction In Europe, equitable access to high-quality health care constitutes a key challenge for health care systems across the continent [1-5]. As in Europe, equity in health-care is a longstanding goal of Sweden’s healthcare political agenda [6, 7]. The country’s good health and health-care on equal terms for the entire population is also explicitly stated in law [8]. “On equal terms for the entire population” means that healthcare utilization is to be determined only by need. Factors, such as socio-economic status (education, income, and occupation), sex, ethnicity and employment status should be irrelevant regarding the amount and quality of care that is provided to the population [9]. However, empirical evidence indicates that health-care use in Sweden has been associated with factors such as private economy, level of education and unemployment [9-11]. The most recent economic recession left many people outside the labour market world-wide causing wide-spread poverty and social exclusion [4, 12-17].