Arjumand A Siddiqi1, Susan Wang2, Kelly Quinn3, Quynh C Nguyen3, Antony Dennis Christy4. 1. Dalla Lana School of Public Health, University of Toronto, Ontario, Canada; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina. Electronic address: aa.siddiqi@utoronto.ca. 2. Cancer Care Ontario, Toronto, Ontario, Canada. 3. Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina. 4. Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
Abstract
BACKGROUND: Racial disparities in access to regular health care have been reported in the U.S., but little is known about the extent of disparities in societies with universal coverage. PURPOSE: To investigate the extent of racial disparities in access to care under conditions of universal coverage by observing the association between race and regular access to a doctor in Canada. METHODS: Racial disparities in access to a regular doctor were calculated using the largest available source of nationally representative data in Canada--the Canadian Community Health Survey. Surveys from 2000-2010 were analyzed in 2014. Multinomial regression analyses predicted odds of having a regular doctor for each racial group compared to whites. Analyses were stratified by immigrant status--Canadian-born versus shorter-term immigrant versus longer-term immigrants--and controlled for sociodemographics and self-rated health. RESULTS: Racial disparities in Canada, a country with universal coverage, were far more muted than those previously reported in the U.S. Only among longer-term Latin American immigrants (OR=1.90, 95% CI=1.45, 2.08) and Canadian-born Aboriginals (OR=1.34, 95% CI=1.22, 1.47) were significant disparities noted. Among shorter-term immigrants, all Asians were more likely than whites, and among longer-term immigrants, South Asians were more like than whites, to have a regular doctor. CONCLUSIONS: Universal coverage may have a major impact on reducing racial disparities in access to health care, although among some subgroups, other factors may also play a role above and beyond health insurance.
BACKGROUND: Racial disparities in access to regular health care have been reported in the U.S., but little is known about the extent of disparities in societies with universal coverage. PURPOSE: To investigate the extent of racial disparities in access to care under conditions of universal coverage by observing the association between race and regular access to a doctor in Canada. METHODS: Racial disparities in access to a regular doctor were calculated using the largest available source of nationally representative data in Canada--the Canadian Community Health Survey. Surveys from 2000-2010 were analyzed in 2014. Multinomial regression analyses predicted odds of having a regular doctor for each racial group compared to whites. Analyses were stratified by immigrant status--Canadian-born versus shorter-term immigrant versus longer-term immigrants--and controlled for sociodemographics and self-rated health. RESULTS: Racial disparities in Canada, a country with universal coverage, were far more muted than those previously reported in the U.S. Only among longer-term Latin American immigrants (OR=1.90, 95% CI=1.45, 2.08) and Canadian-born Aboriginals (OR=1.34, 95% CI=1.22, 1.47) were significant disparities noted. Among shorter-term immigrants, all Asians were more likely than whites, and among longer-term immigrants, South Asians were more like than whites, to have a regular doctor. CONCLUSIONS: Universal coverage may have a major impact on reducing racial disparities in access to health care, although among some subgroups, other factors may also play a role above and beyond health insurance.
Authors: Trevor van Ingen; Kevin A Brown; Sarah A Buchan; Samantha Akingbola; Nick Daneman; Christine M Warren; Brendan T Smith Journal: PLoS One Date: 2022-10-20 Impact factor: 3.752
Authors: Angier Allen; Samson Mataraso; Anna Siefkas; Hoyt Burdick; Gregory Braden; R Phillip Dellinger; Andrea McCoy; Emily Pellegrini; Jana Hoffman; Abigail Green-Saxena; Gina Barnes; Jacob Calvert; Ritankar Das Journal: JMIR Public Health Surveill Date: 2020-10-22
Authors: Deb Finn Mahabir; Patricia O'Campo; Aisha Lofters; Ketan Shankardass; Christina Salmon; Carles Muntaner Journal: Int J Equity Health Date: 2021-03-10