Even if Norway is a rich country there are health differences in the population related to level of education and income. It is a social gradient in health, ie. people’s health improves with increasing length of education and with increasing income. As in our previous report on use of health services from 2017 the social gradient in health persists (SSB, 2007).

We know from the previous report that there are significant social differences in the utilization of some health services. The use of health services is both higher and is stronger related to the educational level and income level among people 45 years and over compared to younger groups. However, when controlling for need ie. impaired health, it seems that the differences are reduced. The differences are less pronounced when we look at repeated use of services.

It is primarily lower education and lower income groups that use GP (general practioners) and that are admitted to hospital. Higher educational and income groups use specialists, physiotherapists and dentists more. There is a marked social gradient in the use of specialist- and dentist-services according to level of income.

Most people receive the services they need, however, there are differences between social groups. More younger people than elderly say that they have been in a situation where they needed health services, but they did not take contact with the service. This is more common in vulnerable groups; people with impaired health, people with mental problems, disabled, people with low income and unemployed people. The causes for not taking contact with GP are more often related long waiting time for receiving the service, than to lack of economic means or problems with transport.

In Norway people 20 years and older pay dentist treatment out of pocket. Quite a few people say that they have an unmet need for this service and that it is because they cannot afford treatment.

An increasing number of people are vaccinated against influenza. There is a social gradient by income when it comes to vaccines, but not related to preventive blood tests. Most people with middle education have had tests for high blood pressure, blood sugar and cholesterol within a defined period. However, there is a gradient by household income, but the gradient flattens out when controlled for impaired health.

The participation in the national screening programs in Norway is good. However, there is a social gradient by income for women (50-69 years) participating in the national breast cancer screening program and for women (25-69 years) participating in the cervical cancer screening program.