Tuesday, June 15, 2004

SPOTLIGHT: Health care

A border apart

Low-income Americans are in poorer health than their Canadian counterparts, and are less likely to get the health care that they need, according to a new report that compares health status and access to health care services between the two nations.

Overall, the vast majority in both countries – 88% of Canadians and 85% of Americans – reported that they were in good, very good or excellent health in 2003.

However, almost one-third (31%) of Americans in the lowest income group reported fair or poor health. Only 23% of their Canadian counterparts did so. There were also significant differences with respect to severe mobility limitations and risk factors, such as smoking and obesity.

At the other end of the income spectrum, there were no systematic differences in the reporting of fair and poor health or severe mobility impairment among the most affluent households on either side of the border.

Unmet health care needs

About 13% of Americans reported that they had experienced an unmet health care need in the year prior to the survey, compared with 11% of Canadians.

The difference was entirely due to a much higher rate among uninsured Americans, 40% of whom reported an unmet need. There was no difference, however, in the proportion who reported unmet health care needs between Canadians and Americans with health care insurance.

The most common barrier to health care reported by Canadians was long waiting times.  South of the border, it was the cost.

Disparities more pronounced

Disparities between the rich and poor were markedly more pronounced in the United States. In large part, this was due to the fact that one in nine Americans has no health insurance. All Canadians have access to basic care.

On the whole, Americans were more likely to be "very satisfied" with their health care services, while Canadians were more likely to be "somewhat satisfied," even when compared with insured Americans.

About 42% of Americans reported that the quality of their health care services in general was excellent, compared with 39% of Canadians. However, Canadians were more likely to report that the quality was only "fair." These differences remained when Canadians were compared with insured Americans.

Uninsured Americans, however, were less likely than Canadians to report that the quality of their health care services was excellent, and more likely to report that it was fair or poor.

You can read the report “Joint Canada/United States Survey of Health, 2002/03” free on our website.

For more information, contact Jean-Marie Berthelot (613-951-3760), Health Analysis and Measurement Group.

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© 2004, Statistics Canada.