Format

Send to

Choose Destination
Am J Prev Med. 2016 Feb;50(2):220-5. doi: 10.1016/j.amepre.2014.08.004. Epub 2014 Oct 18.

Racial Disparities in Access to Care Under Conditions of Universal Coverage.

Author information

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.

PMID:
25441235
DOI:
10.1016/j.amepre.2014.08.004
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center