Reasons for unmet needs for health care: the role of social capital and social support in some western EU countries

  • Damiano FiorilloEmail author
Research article


This paper focuses on the demand side factors that determine access to health care and analyses the issues of unmet needs for health care and the reasons thereof in western EU countries. A probit model is estimated from a sample of the whole population, accounting for the possibility of individual selection in unmet needs for health care (UN) (selection equation). Expanded probit models (including the inverse Mills ratio) are then used on the reasons for unmet needs (RUN) with social capital and social support as determinants and using the European Union Statistics on Income and Living Conditions dataset from 2006. In the RUN equations, the findings show that females, large households, people with low income and financial constraints, the unemployed and those in poor health have a higher probability of declaring unmet needs due to economic costs. Additionally, people in tertiary education, those with high income and the employed have a higher probability of not visiting a doctor when needed due to time constraints. Furthermore, the frequency of contact with friends and the ability to ask for help are correlated with a lower probability of unmet needs due to economic costs, while the frequency of contact with relatives is correlated with a lower probability of unmet needs due to time constraints and distance. However, the ability to ask for help is also correlated with a higher probability of not having medical care due to time constraints and the wait-and-see approach.


Unmet needs for healthcare Reasons for unmet needs Social capital Social support EU Western countries EU-SILC data Heckman selection model 

JEL Classification

C35 I12 I18 Z1 



We especially thank the Reviewer for constructive comments, which have helped to improve the paper in a number of ways. We also thank all participants at the XXX Annual Conference of the Italian Society of Public Economics (September 19–21, 2018, University of Padova) for useful suggestions and comments.


Funding was provided by Università degli Studi di Napoli Parthenope (Grant No. Ricerca individuale 2015–2017).

Compliance with ethical standards

Conflict of interest

The author declare that he have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by the author.


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Business and EconomicsParthenope University of NaplesNaplesItaly

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