Native Norwegians Research Articles

The association between work and integration in the Norwegian welfare context, and its implications for immigrants and social work practice: An integrative review

ABSTRACT The association between work and integration is rarely questioned in Norwegian discourses on immigration and integration. Globalization, migration, and social problems continue to challenge social work practice, creating tensions in the welfare state. The aim of this integrative review is to clarify major themes, provide a synthesis of current understandings, and consider the implications for social work practice. Twenty-eight articles from the Norwegian welfare context were obtained through systematic searches in four databases and a search-engine. Thematic analysis resulted in the following findings: (1) Employment and outcome for immigrants in the Norwegian labour market, (2) Immigrant women – participation and equality, (3) Discrimination in Norwegian working life, and (4) Challenges ahead and possible solutions. Findings show that Norway is an egalitarian society with high social mobility, but immigrants, despite early entry to work, had a noticeably less stable attachment to the labour market than native Norwegians. Discrimination was identified and affected immigrants as well as their descendants. Immigrant women’s participation in the workforce was perceived as the way to reduce differences. Still, gender mainstreaming and freedom of choice appeared to depend upon immigrant women’s embracing the dual earner norm. Current policies seem unable to provide immigrants with qualifications needed to perform equally to native Norwegians. Throughout the dataset, there were suggestions for ways policies could be changed to permit higher employment rates for immigrants, thereby improving integration.

Factors associated with health-related quality of life in people living with HIV in Norway

BackgroundDespite the advances in the treatment of HIV, people living with HIV (PLHIV) still experience impairment of health-related quality of life (HRQOL). The aim of the study was to explore factors associated with HRQOL in a well-treated Norwegian HIV population.MethodsTwo hundred and forty-five patients were recruited from two outpatient clinics to participate in this cross-sectional study of addiction, mental distress, post-traumatic stress disorder, fatigue, somatic health, and HRQOL. The latter was measured using the 36-Item Short Form Health Survey (SF-36). Stepwise multiple linear regression analysis was used to examine the adjusted associations between demographic and disease-related variables and HRQOL.ResultsThe study population was virologically and immunologically stable. Their mean age was 43.8 (SD = 11.7) years, 131 (54%) were men, and 33% were native Norwegians. Compared with the general population (published in previous studies), patients reported worse SF-36 scores for five of eight domains: mental health, general health, social function, physical role limitation, and emotional role limitation (all p < 0.001). Compared with men, women reported better SF-36 scores within the domains vitality (63.1 (23.6) vs. 55.9 (26.7), p = 0.026) and general health (73.4 (23.2) vs. 64.4 (30.1), p = 0.009). In the multivariate analyses, higher SF-36- physical component score values were independently associated with young age (p = 0.020), being employed, student, or pensioner (p = 0.009), low comorbidity score (p = 0.015), low anxiety and depression score (p = 0.015), being at risk of drug abuse (p = 0.037), and not being fatigued (p < 0.001). Higher SF-36-mental component score values were independently associated with older age (p = 0.018), being from a country outside Europe or from Norway (p = 0.029), shorter time since diagnosis, low anxiety and depression score (p < 0.001), answering ‘no’ regarding alcohol abuse (p = 0.013), and not being fatigued (p < 0.001).ConclusionsHRQOL was poorer in PLHIV than in the general population in Norway. It is important to focus on somatic and mental comorbidities when delivering health-care services in the ageing population of PLHIV to improve HRQOL even among a well-treated group of PLHIV as found in Norway.

Accessibility in a multi-ethnic city: Residential trade-offs among first-time parents

Public transport accessibility is necessary to avoid transport disadvantage and car dependency. This study investigates how trade-offs between public transport accessibility, house size and the ethnic variation of neighbourhoods vary among residentially relocating first-time parents in the multi-ethnic Oslo region. The study employs structural equation models and observes two main patterns. First, households with higher income face, as expected, more opportunities and a reduced need to make difficult trade-offs. Second, as compared to immigrants, native Norwegians have a greater preference for spacious housing and ethnically uniform neighbourhoods, which leads to lower public transport accessibility levels. The results show how traditional theories of urban attractiveness and transport inequality are complicated in multi-ethnic cities. This knowledge is useful for policy makers developing policies intended to ensure a just transition to low-emission mobility.

International migration of researchers and gender imbalance in academia—the case of Norway

Female representation among students and graduates in higher education is growing internationally. This is a promising trend for achieving gender balance in top positions in academia. But there is still a long way to go, as women accounted for 26 per cent in top positions at European higher education institutions in 2018. In this article, we examine the influence of international recruitment of researchers on the gender balance—or the lack of gender balance—in Norwegian academia. We draw on data from the Norwegian Register of Research personnel, linked with population statistics from Statistics Norway. These data show that 38 per cent of the researchers at Norwegian higher education institutions in 2018 were born abroad. The share of foreign full professors has increased from 16 per cent in 2001 to 27 per cent in 2018, while for postdocs there has been an increase from 31 to 69 per cent. In terms of overall gender composition, a higher percentage of the foreign-born researchers are male compared with the native Norwegians. The incidence of international recruitment differs significantly across academic fields and is particularly prevalent in engineering. This is also the field where the gender balance is most skewed generally. Taking these variables into account, we conclude that international migration is not among the factors contributing to the gender imbalance in Norwegian academia. In fact, international recruitment has contributed positively to the gender balance in Norway in the majority of the fields analysed.

Meeting Places and Integration: Participatory Mapping of Cross-Cultural Interactions in Norwegian Cities

Increased immigration into Scandinavia warrants the need for knowledge about differential uses of urban spaces by populations with various cultural backgrounds and the conditions that support cross-cultural interactions in these spaces. Immigrants and native Norwegians in Tromsø and Bodø were encouraged to log information about locations where they spend time on online participatory maps, along with their basic demographic information. We ask (1) if the city spaces people use tend to differ based on region of origin, age and gender and (2) in which places cross-cultural interactions occur most. Main findings showed immigrants logged fewer locations related to sports and the outdoors than Norwegians, and immigrants logged more private business locations than Norwegians. Males, young participants, immigrants and participants from Tromsø indicated they engaged in cross-cultural interactions at logged locations more than females, older participants, Norwegians, and participants from Bodø.

Immigrants’ Experiences on Integration While Attempting to Access the Labour Market: Implications for Social Work Practice

(1) Background: The challenge of immigrants and their integration into adopted countries is a key topic for the global field of social work. However, there is a paucity of research on immigrants’ lived experiences in gaining access to the labour market. Thus, this study examines how immigrants in Norway experience integration while in the process of gaining access to the labour market. The prevalent notion of integration achieved through gainful employment narrows the concept of integration and disguises the underlying marginalization and inequalities that are derived from majority- minority dividing lines. (2) Methods: Data were collected via nine qualitative semi-structured interviews with ten immigrants (one interview was with a couple) living in Norway. Data was analysed by using Interpretative Phenomenological Analysis. (3) Results: The results showed that the participants experienced social exclusion but accepted this as an inevitable part of being an immigrant. The participants regarded the learning of Norwegian language as the key aspect to understanding social customs and forming informal relationships with native Norwegians and important for achieving integration. Freedom and equality were also regarded as issues of great importance. (4) Conclusions: The results provide the field of social work with important insights towards informing social work practices and challenging current paradigms.

Intentions to quit upper secondary education among first generation immigrants and native Norwegians: the role of loneliness and peer victimization

Dropout from upper secondary education is a persistent educational problem, particularly among first-generation immigrant youth. This study examined factors associated with intentions to dropout to gain further insight into the process of leaving upper secondary education. The analyses of 1299 Norwegian first-year upper secondary school students’ (88% native Norwegians, 12% first-generation immigrants) self-reported intentions to quit school, loneliness, and peer victimization in school showed that first-generation immigrants experienced higher levels of loneliness than native Norwegians. In contrast, there were no differences in the levels of peer victimization and intentions to quit between native Norwegians and first-generation immigrants. However, loneliness showed a significantly stronger association with intentions to quit among first-generation immigrants. The results underscore the importance of tackling first-generation immigrants’ loneliness in school to reduce their intentions to quit upper secondary education and thus potentially improve conditions for school completion.

Digitally Enhanced Mentoring for Immigrant Youth Social Capital: Protocol for a Mixed Methods Pilot Study and a Randomized Controlled Trial.

BackgroundThere are large disparities between immigrants and native Norwegians in domains such as health, education, and employment. Reducing such disparities is essential for individual and societal well-being. Social capital is associated with positive effects on these domains, and mentoring programs have the potential to boost social capital. However, few studies have assessed mentoring as a social capital intervention among youth or the potential barriers and facilitators of implementing digitally augmented mentoring.ObjectiveThe goal of this paper is to describe a protocol for assessing the implementation and effectiveness of a digitally augmented mentoring program for immigrant youth as a health intervention to promote social capital. The two-stage analytical framework for a pilot study followed by a randomized controlled trial (RCT) is presented. The pilot aims to assess program fidelity and make necessary intervention adjustments before the RCT. The RCT aims to assess the effects of the implemented intervention program on social capital and the relationship between program fidelity and effects.MethodsBoth the pilot and RCT will use mixed methods with a process evaluation approach used to structure the intervention and a pre-post test survey component to measure social capital and fidelity of program implementation. Interviews will also be used to enrich the quantitative data from the survey.ResultsThe pilot study is scheduled to begin in fall 2019. Based on data analyses in spring 2020, potential adjustments will be made to the intervention, with findings used in preparation for the full-scale RCT study.ConclusionsDigitally enhanced mentoring programs may be a helpful intervention for providing immigrant youth with tools for increasing their social capital and indirectly improving health outcomes. This protocol provides new knowledge about the implementation and evaluation of such programs.International Registered Report Identifier (IRRID)PRR1-10.2196/16472

When is a Reminder Enough? Text Message Voter Mobilization in a European Context

Sending text messages reminding people to vote has only been examined as a mobilization tool in three studies, two of them done in the United States. The results from these studies are mixed. We investigate this tool’s effectiveness using a field experiment in a different context, municipal elections in Norway. We find strong mobilization effects among groups traditionally low in participation (immigrants and youth voters). Young native Norwegians show an intent-to-treat (ITT) effect of 4.58% points, foreign nationals who have recently established Norwegian residency show an ITT effect of 2.93% points, and among immigrants who have lived in Norway for 7 years or more the treatment effect is 2.7% points. Even among native Norwegian voters over 30, with a baseline turnout of 73%, text messages generate a 0.96% points increase in turnout.

Social Gradients in Alcohol Use Disorders with and without Depression: Immigrants vs Norwegians

Abstract Background The social gradient in health runs from top to bottom of the socioeconomic spectrum. Poverty is associated with poor health and problematic unhealthy behaviors. Depression is strongly associated with social inequalities, while alcohol use disorders are not necessarily associated with a low socio economic status. Immigrants often have a lower social economic status than the host population. Research regarding alcohol use disorders, depression and a social gradient among immigrants is scare. The present study explores social gradients in persons with alcohol use disorders with and without depression and examines potential discrepancies between immigrant and native Norwegian patients receiving public specialist health care. Methods Data of 2.4 million native Norwegians and 468.496 immigrants, registered in the national mandatory Norwegian Patient Register and population data from Statistics Norway were analyzed. ICD 10 main diagnoses were used to identify patient groups - at least diagnosed once during 2008 - 2016. Immigrants had been pooled into 5 world regions. Logistic regression models have been applied to show associations between socio demographics/regions and alcohol use disorders and/or depression. Results African (OR = 0.35; 95%CI:0.27-0.44) and Asian (OR = 0.23; 95%CI:0.16-0.32) immigrants had a lower risk of developing alcohol use disorders with depression than Western Europeans (OR = 0.76; 95% CI:0.60-0.98), using native Norwegians as a reference. In general, persons with a lower socioeconomic status are more often affected of alcohol use disorder only (OR = 3.77; 95%CI:3.64-3.91) than with alcohol use disorder and concurrent depression (OR = 3.52; 95%CI:3.25-3.83). Conclusions To detect possible deficits in patient care, knowledge of social gradients in a marginalized group such as persons with alcohol use disorders and/or depression is essential. This may contribute to targeted and individualized health care- regardless of immigrant status. Key messages The risk of developing alcohol use disorders with depression varies between immigrants according to their origin. Persons with a lower socioeconomic status are more often affected of alcohol use disorder only than with alcohol use disorder and concurrent depression.

Insights into rates, risks and characteristics of suicide by immigration background in Norway

Although most immigrants seem to successfully managethe challenges their immigration process entails, suicidemortality of minority groups has become an importantpublic concern, particularly in countries with growingsegments of immigrant populations such as Norway. Thepresent article aimed to summarize insights into suicideamong various immigrant populations, obtained bythree Norwegian studies we recently conducted utilizingthe unique possibilities of national population registers.First-generation immigrants had a relatively lower riskof suicide than native Norwegians, whereas the risks forpeople with mixed Norwegian and immigrant backgroundwere significantly higher. Suicide risk was associated with arange of socio-economic disadvantages in all populations,but the strength of the association differed by specific immigrationbackground, with a generally weaker association infirst-generation-immigrants than natives. In the meantime,there were notable differences in characteristics of suicideby immigration background with respect to method ofsuicide, month of the year when suicide occurred, and timeto suicide since immigration. All these insights underscorethe importance of treating immigrants as a very heterogeneousgroup, and differences in suicides by specificimmigration background should be considered whenplanning public health policies and prevention measuresin order to more effectively tailor these measures to at-riskimmigrant populations.4 suicidologi nr 1/2019 FAGARTIKKEL

Polio and post-polio syndrome in non-Western immigrants: A new challenge for the healthcare system in Norway.

To explore the health situation and identify specific health challenges in non-Western immigrants with polio in Norway, by comparing their status with Western immigrants with polio and native Norwegians with polio. A questionnaire covering demographics, polio history, life satisfaction, medical, psychological and social conditions was answered by 1,408 persons with polio, among them 34 immigrants from non-Western countries and 32 immigrants from Western countries. The non-Western immigrant polio group had a mean age of 46 years, were highly educated, reported high frequency of mental health problems and only one-third was working. Mean age for contracting polio was 2.8 years. Only 30% was hospitalized in the acute phase and 80% reported severe leg weakness. Use of a powered wheelchair was reported by 72%. Post-polio symptoms had started at a mean age of 31 years. The non-Western immigrant group reported more fatigue, pain and loneliness, and a high proportion reported insufficient assistance from the public health system. The group of non-Western immigrants with polio in Norway reported more health and social problems than the group of Western immigrants with polio or the native Norwegian group with polio, even though they were younger and more highly educated. Their complex psychological and social situation requires active intervention from the health system, and health professionals need extra skills to deal most effectively with their situation.

Rates and characteristics of suicide by immigration background in Norway.

Suicide mortality among immigrant groups is an important health issue, particularly in countries with growing segments of immigrant populations such as Norway. Through linkage of Norwegian national registers we wanted to estimate suicide rates (per 100,000 population) in immigrant groups and to profile characteristics of suicide by immigration background with respect to sex, age, method and seasonality of suicide as well as time since immigrating to Norway. Among all 11,409 suicides during 1992–2012, 1,139 (10%) were individuals with an immigration background. Suicide rate was lower in first-generation immigrants (foreign-born persons to two foreign-born parents) than native Norwegians (9.53 vs 12.22, P < 0.01), with a significant difference confined to male rates only. Foreign-born persons with at least one Norwegian-born parent had significantly higher suicide rates than natives in both sexes (22.42 vs 18.03 in males, 11.67 vs 6.54 in females, P < 0.01). The most frequently used suicide method in all the population groups was hanging; this method accounted for 44.0% of all suicides of first-generation immigrants, 45.2% of all suicides of foreign-born persons with at least one Norwegian-born parent, and 35.4% of all suicides of natives. Suicide by firearms accounted for a much smaller proportion of cases of first-generation immigrants (6.7%) and foreign-born persons with at least one Norwegian-born parent (6.8%) than cases of native Norwegians (20.7%). In terms of monthly distribution, suicides of first-generation immigrants displayed two peaks, in May and in November (P = 0.01). More than 25% of all first-generation immigrant suicides occurred in the first five years after immigration; but differences in time since immigration were observed by sex and country group of origin, in particular among those aged 35 years or less when moving to Norway. In conclusion, there are notable differences in characteristics of suicides by immigration background. Knowledge of immigrant mortality according to suicide method, seasonality of suicide, and time since immigration may be useful when planning suicide preventive measures.

Preferences for Urban Building Materials: Does Building Culture Background Matter? †

A fast-growing global population, increasing urbanization, and an increasing flow of people with different building cultural backgrounds bring material use in the housing sector into focus. The aim of this study is to identify material preferences in the building environment in cities and to determine if the building cultural background impacts those preferences. The data in this study consisted of responses from two groups of dwellers in Norway, including immigrants from countries where wood is an uncommon building material and native Norwegians from a building culture where wood is common. We found that the most preferred materials were often the same as the most common materials currently used in city buildings. Only small differences were found between the two groups of dwellers that were studied. Most differences were related to concerns about material choice in general and where individuals wanted to live. Respondents who preferred city living preferred commonly used city materials, such as concrete and steel. For cladding materials, stone/bricks were the most preferred. However, stained or painted wood was one of the most preferred, even though it is not commonly used in city buildings.

Socio-economic status and risk for suicide by immigration background in Norway: A register-based national study

The relative importance of socio-economic factors on risk for suicide in the immigrant population may differ from that for the native population; however, few studies have addressed this issue on a national basis. With a nested case-control design and data from Norwegian population registers we identified 11,409 suicide cases in the years 1992–2012 and 191,785 sex-birthdate-matched controls. The influence of socio-economic factors on the risk for completed suicide was assessed through conditional logistic regression. Among 11,409 suicides, 1139 (10%) were individuals with an immigration background of either themselves or their parent(s). Suicide cases, as well as the controls, with an immigration background differed in several aspects of their socio-economic status from those without such a background. Being single or separated, divorced or widowed, was, however, associated with an increased risk of suicide regardless to the subjects’ immigration background. Low level of education and low annual income significantly increased the risk for suicide in almost all the study subgroups. Living in the capital area was associated with a reduced risk of suicide in first-generation immigrants but an increased risk in native Norwegians. In conclusion, persons with an immigration background, as well as native Norwegians, shared most common risk factors for suicide, but the strength of associations between socio-economic factors and risk for suicide can differ by immigration background.

Who is watching user-generated alcohol posts on social media?

AimTo examine students' exposure to user-generated alcohol content on social media, and identify characteristics (i.e. demographics, personality traits, alcohol use, alcohol-related cognitions, and social media factors) associated with monthly or more frequent exposure. MethodCollege/university students (N=11,236) in Bergen, Norway, completed a web-survey measuring exposure to alcohol on social media – both frequency and interpretations of alcohol content. The survey included questions regarding demographics, personality, alcohol-related cognitions, and general use of social media and alcohol. Binary logistic regressions were run to identify characteristics associated with monthly or more frequent exposure to alcohol-related posts on social media. ResultsA total of 96.7% had been exposed to alcohol-related posts, exposure to posts with a positive valence of alcohol were more frequently reported than exposure to content with a negative valence of alcohol. Reports of monthly or more frequent exposure to alcohol on social media were associated with a range of characteristics, among these younger age, being native Norwegian, lower extroversion and higher agreeableness and self-monitoring scores, higher alcohol use, stronger descriptive norms for alcohol use among online-friends, and more frequent logins to social media. ConclusionsStudents' potential inflated alcohol norms (originating from social media) should be addressed. The results suggest that exposure may be determined by high alcohol use and membership in demographical groups associated with high alcohol use, an increased attentiveness towards others' behavior, and excessive social media use. Future studies investigating the relationship between alcohol exposure on social media and later alcohol use should control for such factors.

Alcohol use among Norwegian students: Demographics, personality and psychological health correlates of drinking patterns.

Aims:This study investigates demographic, personality, and psychological health correlates of different drinking patterns.Design:Students at the four largest institutions of higher education in Bergen municipality were invited via email to complete an internet-based questionnaire. The final sample size was 11,236 (39.4%), mean age 24.9 years (SD = 6.5), and 63.3% were women. The survey included the Alcohol Use Disorder Identification Test (AUDIT) and questions about demographics, personality traits, and symptoms of depression and anxiety. Binary logistic regressions were used to identify correlates of different drinking patterns.Results:A total of 53.0% of the students had an AUDIT score of or above 8 (i.e., hazardous drinking). Being native Norwegian, male, single, without children, non-religious, extroverted, unconscientious, and less open to experience were associated with higher AUDIT scores, drinking frequently, and binge drinking. Having parents with high alcohol or drug use increased the odds of engaging in binge drinking, but this factor was not associated with frequent drinking. Students scoring higher on neuroticism and openness were less likely to report problematic alcohol usage.Conclusions:A majority of the students reported alcohol habits that are associated with harm if they persist. This emphasises the need to examine the long-term consequences of students’ alcohol use.

Suicide among immigrant population in Norway: a national register-based study.

To investigate differences in suicide risk among immigrant population in Norway compared with native Norwegians, with respect to associated country group of origin. Based on the entire national population, a nested case-control design was adopted using Norwegian national longitudinal registers to obtain 23073 suicide cases having occurred in 1969-2012 and 373178 controls. Odds ratios (ORs) for suicide were estimated using conditional logistic regression analysis adjusting for socio-economic factors. Compared with native Norwegians, suicide risk was significantly lower in first- and second-generation immigrants but higher in Norwegian-born with one foreign-born parent and foreign-born individuals with at least one Norwegian-born parent. When stratifying data by country group of origin, first-generation immigrants had lower ORs in most of the strata. Subjects born in Asia and in Central and South America with at least one Norwegian-born parent had a significantly higher risk of suicide. The observed results remained mostly unchanged in the analyses controlled for socio-economic status. Suicide risk is lower in first- and second-generation immigrants but higher in subjects born in Norway with one foreign-born parent and those born abroad with at least one Norwegian-born parent, with notable differences by country group of origin.

Reasons for attending a general emergency outpatient clinic versus a regular general practitioner – a survey among immigrant and native walk-in patients in Oslo, Norway

Objective: To explore reasons for attending a general emergency outpatient clinic versus a regular general practitioner (RGP).Design: Cross-sectional study using a multilingual anonymous questionnaire.Setting: Native and immigrant walk-in patients attending a general emergency outpatient clinic in Oslo (Monday–Friday, 08:00–23:00) during 2 weeks in September 2009.Subjects: We included 1022 walk-in patients: 565 native Norwegians (55%) and 457 immigrants (45%).Main outcome measures: Patients’ reasons for attending an emergency outpatient clinic versus their RGP.Results: Among patients reporting an RGP affiliation, 49% tried to contact their RGP before this emergency encounter: 44% of native Norwegian and 58% of immigrant respondents. Immigrants from Africa [odds ratio (OR) = 2.55 (95% confidence interval [CI]: 1.46–4.46)] and Asia [OR = 2.32 (95% CI: 1.42–3.78)] were more likely to contact their RGP before attending the general emergency outpatient clinic compared with native Norwegians. The most frequent reason for attending the emergency clinic was difficulty making an immediate appointment with their RGP. A frequent reason for not contacting an RGP was lack of access: 21% of the native Norwegians versus 4% of the immigrants claimed their RGP was in another district/municipality, and 31% of the immigrants reported a lack of affiliation with the RGP scheme.Conclusions and implications: Access to primary care provided by an RGP affects patients’ use of emergency health care services. To facilitate continuity of health care, policymakers should emphasize initiatives to improve access to primary health care services.KEY POINTSAccess to immediate primary health care provided by a regular general practitioner (RGP) can reduce patients’ use of emergency health care services.The main reason for attending a general emergency outpatient clinic was difficulty obtaining an immediate appointment with an RGP.A frequent reason for native Norwegians attending a general emergency outpatient clinic during the daytime is having an RGP outside Oslo.Lack of affiliation with the RGP scheme is a frequent reason for attending a general emergency outpatient clinic among immigrants.

Personal and provider level factors influence participation to cervical cancer screening: A retrospective register-based study of 1.3 million women in Norway

High coverage is essential for an effective screening programme. Here we present screening barriers and facilitators among 1.3 million women aged 25–69years eligible for screening within the Norwegian Cervical Cancer Screening Program (NCCSP). We defined non-adherence as no screening test in 2008–2012. We divided adherent women into those screened spontaneously, and those who had a smear after receiving a reminder from the NCCSP. Explanatory variables were extracted from several nationwide registers, and modelled by modified Poisson regression. In total, 34% of women were non-adherent. 31% of native Norwegians were non-adherent, compared to 50% of immigrants. Immigrant status was a strong predictor of non-adherence, but the vast majority of non-adherent women were still native Norwegians. Higher non-adherence rates were associated with having a male general practitioner (GP), a foreign GP, a young GP, and distance to the screening site. Being unmarried, having no children, having lower socioeconomic position and region of residence predicted non-adherence and, to a smaller extent, reminded adherence to screening. In contrast, previous experience with cervical abnormalities substantially increased adherence to screening. The population-based screening programme promotes equity by recruiting women who are less likely to participate spontaneously. However, socioeconomic disparities were evident in a country with a nationwide programme and a policy of equal access to health care. Initiatives aimed at removing practical and financial barriers to equitable screening delivery and at reducing the effect of sociodemographic attributes on screening participation are needed.