Socioeconomic Disparity in Healthcare-Seeking Behavior among Chinese Women with Genitourinary Symptoms

Background: Sexually transmitted infections (STIs) are of growing concern in China. Understanding the relationship between socioeconomic status (SES) and healthcare-seeking (HCS) behavior will help design effective policies to contain the epidemic of STIs across SES. Methods: We used the Chinese Health and Family Life Survey, a nationally representative survey of 3813 adults from 48 Chinese cities and counties during 1999-2000. We studied the 730 women with at least one genito-urinary (GU) symptom. HCS was measured by whether respondents visited a hospital or an unrecognized clinic, self-treatment, or doing nothing. Formal treatment was defined as visiting a hospital. SES was measured by income (tertile group) and education (<= primary school, junior high school, senior high school, college or above). Bivariate tests and logistic regressions were applied. Results: There was a significantly positive relationship among income, education, and treatment. Odds ratios (ORs) of medium and high income were 2.01 (p = 0.04) and 1.39 (p = 0.46), respectively, after controlling demographics. ORs of middle school, high school, and college or above were 1.81 (p = 0.05), 2.27 (p = 0.03), and 1.27 (p = 0.64), respectively. The relationship between income and formal treatment was also positive, and the relationship between education and formal treatment was negative. Additional adjustment for STI knowledge and experience reduced the HCS disparity across education. Conclusions: Income and education have different effects on HCS behavior among Chinese women with GU symptoms. Income may affect HCS via affordability, and education is a complicated proxy for sex education, STI knowledge, and experience that will affect the socioeconomic disparity in HCS.