Reasons for unmet needs for health care: the role of social capital and social support in some Western EU countries

Purpose. The paper focus on the patient-side factors that determine access to health care and analyzes the issues of unmet needs and reasons for unmet needs for health care in Western EU countries. The paper has two main objectives: first, to study the determinants of unmet health care needs (UN) with a particular hub on social capital and social support; second, to analyze whether social capital and social support are predictors of the reasons for unmet needs (RUN). Methodology. A probit model is estimated from the whole population sample accounting for the possibility of individual selection in unmet needs for health care (UN) (selection equation). Then expanded probit models (including inverse Mills ratio) are used on the reasons for unmet needs (RUN) with social capital and social support as determinants and using the European Union Statistics on Income and Living Conditions (EU-SILC) dataset carried out in 2006. Findings. In UN equation, results indicate higher unmet health care needs for younger, people with tertiary education, low economic situation, unemployed and in poor health status. Moreover, the frequency of visiting relatives and friends and the ability to ask for help are correlated with a lower likelihood of declaring unmet needs, instead volunteering and participation in formal organizations present a higher probability of not visiting a doctor when needed. In RUN equations, findings show that female, large households, people with low economic situation and financial constraints, unemployed and in poor health status have a higher probability of declaring unmet needs due to economic costs. Additionally, people with tertiary education, high income and employed have a higher probability of not visiting a doctor when needed due to time availability. Furthermore, the frequency of contact with friends and the ability to ask for help are related with a lower probability of unmet needs due to economic costs, while the frequency of contact with relatives is related with a lower probability of unmet needs due to time availability and distance. However, the ability to ask for help is also correlated with a higher probability of not having medical care due to time availability and wait and see. Research limitations/implications. The paper is unable to prove causality. EU health policies should look to the demand side of health care access with policy designed to support individuals to participate fully in employment and social life. Originality. This is the first empirical studies that addresses the role of social capital and social support as predictors of RUN in EU countries.