Experiences of discrimination in Finnish healthcare services

Abstract Background It has been found that foreign-born people report more discrimination than the general population. This study examines experiences of discrimination in Finnish healthcare, with a focus on individuals with a foreign background. Methods Two nationally representative cross-sectional data sets were used: MoniSuomi (n = 7838; response rate 44.1%) and Healthy Finland Surveys (n = 28154; response rate 46.3%). The outcome variable, experiences of discrimination, was predicted by means of stepwise logistic regression models covering (1) socioeconomic factors, (2) factors related to healthcare service need and use, and (3) migration-related factors. Results In healthcare services, migrants experienced discrimination more than twice as frequently as the general population (8.9% versus 3.6%, 95% CI = 8.0-9.8, 3.2-4.1). According to regression models, relevant factors were insufficient income, being female, studying as the main occupation and poor mental and physical health. Foreign background was not independently associated with discrimination. However, higher educational attainment, chronic disease, and use of occupational healthcare services increased the likelihood of experiencing discrimination only among those of foreign background and showed the opposite trend for the general population. All migration-related factors increased the risk of discrimination. Conclusions The findings underline the need for training on explaining the service system, overcoming language barriers, and working with forced migrants. The occupational healthcare workforce would particularly benefit from these interventions. The results inform the development of professionals’ training. Key messages • Migrants experience higher levels of discrimination in healthcare compared to the general population. Multiple factors explain this difference. • Healthcare professionals require training to better inform patients about the service system, to improve communication and to address the situation of forced migrants.