Format

Send to

Choose Destination
World Health Popul. 2014;15(2):32-42.

Neighbourhood variation and inequity of primary health service use by mothers from London-Middlesex, Ontario.

Author information

1
Western University, London, Ontario, Canada.
2
Associate Professor, Western University; Scientist, Children's Health Research Institute, London, Ontario, Canada.
3
Professor, Western University, London, Ontario, Canada.
4
Assistant Professor, Western University; Scientist, Children's Health Research Institute, London, Ontario, Canada.
5
Professor, Western University; Scientist, Children's Health Research Institute, London, Ontario, Canada.

Abstract

OBJECTIVE:

Primary health service use (P-HSU) may be influenced by contextual characteristics and is equitable when driven by need. Contextual effects and inequity of maternal P-HSU were determined.

METHODS:

Participant data from a London-Middlesex, Ontario, prenatal cohort were linked by residential address to contextual characteristics. Multilevel logistic regression estimated contextual effects and tested for effect measure modification of need factors.

RESULTS:

Maternal P-HSU varied between neighbourhoods. The effect of obesity was different for rural mothers living in low- (OR = 0.26) and middle-income households (OR = 0.15) and for urban mothers living in high-income households (OR = 2.82). The effect of having a health condition was greatest in mothers with three or more children (OR = 2.41).

DISCUSSION:

Differences in maternal P-HSU exist between neighbourhoods, and enabling factors modified need factors' effects, identifying subgroups of mothers with inequitable P-HSU. RESULTS have the potential to inform Canadian health policy with regard to contextual effects and inequity of P-HSU.

PMID:
25144788
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Cenveo Publisher Services
Loading ...
Support Center