Childhood asthma: Regional and social inequalities in parents' perceptions of the diagnostic process in Norway

Abstract

The article examines the experiences of Norwegian parents of asthmatic children in the period leading up to a formal diagnosis from a doctor. The outcomes include delays in both the process of achieving a formal diagnosis and diagnosis during acute hospitalization. These outcomes were to some extent differentiated by the regional and educational background of parents. Families living in regions dominated by paediatricians in private practice were less likely to record delays in the process of achieving a formal diagnosis. Parents with higher education rarely experienced delays, often giving positive evaluations of the process. These results confirm previous studies of diagnostic decisions in adults, suggesting that lower socioeconomic groups tend to present with more advanced or severe disease. The findings make it difficult to defend a generalized account of the lay actor as passive and at the mercy of external social forces and modern expert systems. People do not appear as passive recipients of care but exercise agency, in the sense of actively seeking out alternative sources of medical care. The empirical material consists of a 1999 survey (N = 1800) of parents with children having a confirmed diagnosis of asthma.

Keywords:

• asthma
• children continuity of care
• inequalities
• lay experiences

Acknowledgements

I would like to thank Kari Eika and Terje Wessel as well as two anonymous referees for valuable comments.

Notes

1. County Health Statistics, 1997. Specialist health care and ambulance services. Table 5.http://www.ssb.no/ukens_statistikk/utg/9840/2-5t.txt (accessed 12 June 2009).