Section 1: General information
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Health care professionals 1 - a few statistics
This study analysed four specific groups of health care professionals in detail. 2
The groups are:
- General practitioners and family doctors;
- Registered nurses;
- Psychologists;
- Social workers.
The information concerning all other health care professionals will be presented further in this report. 3
General practitioners and family doctors
In 2006, there were a total of 44,495 general practitioners and family doctors 4 in Canada, 92.5% or 41,140 of whom work in Canada. 5 Their distribution across the provinces is closely aligned with the distribution of the total population, except in Quebec where the relative share of physicians (25.6%) is higher than that of the total population (23.8%) and in Ontario where the relative share (37.0%) is lower than for the total population (38.5%) (see Chart 1.1 and 1.2).
Nationally, there are 132 doctors per 100,000 people (see Table 1.1). This ratio is slightly higher in British Columbia (134), Newfoundland and Labrador (137), Quebec (142), Nova Scotia (153) and, especially, the Yukon (331). In the other provinces and territories, the ratio is equal to or slightly lower than the national average, the lowest ratio being in Nunavut with 85 doctors per 100,000 people.
These ratios are generally very close to the ratios in 2001, with a few exceptions. In the Yukon, the total number of doctors rose from 70 in 2001 to 331 in 2006, a much higher increase than the slight rise in the territory's population between 2001 and 2006, which explains the sharp jump in the ratio. Similarly, in Nunavut, the number of doctors almost quintupled (from 19 to 85), 6 while the population rose by 10%. In the other provinces, the change in the ratio between 2001 and 2006 was in line with the change in population or remained stable. All of the doctors work in the health care or social assistance field.
Registered nurses 7
For every doctor, there are about six nurses for a total of 288,500 nurses living in Canada in 2006. Over 95% work in Canada (275,145 people). In all provinces except Quebec, Ontario and British Columbia, the relative share of nurses among all nurses in the country is slightly higher than the province's share of the population. Nationally, there are 881 nurses per 100,000 Canadians. The highest ratio is in Prince Edward Island (1,203), while the ratios in Quebec, Ontario and British Columbia are 825, 825 and 854 nurses per 100,000 people respectively. Nunavut has the lowest ratio at 648 nurses per 100,000 inhabitants. In all provinces and territories, there were more nurses per 100,000 inhabitants in 2006 than in 2001, but the rate of growth varied somewhat from one province to the next. As with doctors, the Yukon and Nunavut saw the greatest growth in the number and the ratio of nurses (over 30%). 8
Some nurses (5.2%) do not work in health care or social assistance institutions, but rather in a school, for example, or in a large company. This analysis includes all nurses, regardless of the type of institution in which they work.
Psychologists
Canada has 19,570 psychologists, 18,010 of whom report that they have a place of work in Canada (92.0%). A very high proportion of them work in Quebec (39.2%), although the Quebec population represents only 23.8% of the population of Canada. This is the only province in which the relative share of psychologists among all psychologists in the country is higher than that of the population. The ratio of psychologists per 100,000 people is 95, while the national average is only 58. 9 Once again, Nunavut has the lowest ratio at only 17 psychologists per 100,000 people, followed by Prince Edward Island with a ratio of 22. The other provinces have between 36 and 54 psychologists per 100,000 individuals. Such small numbers are not adequate enough, to conclude whether the change between 2001 and 2006 is based on sample error and random rounding or if it shows a real trend.
It is relatively common for psychologists to work in a sector other than health care or social assistance institutions, such as schools. Accordingly, slightly more than 1 in 4 psychologists work outside health care institutions (26.8%).
Social workers
There are a total of 51,590 social workers, of which 95.2% work within Canada. Ontario and Manitoba are the provinces in which the relative share of these professionals within the total population of social workers in the country exceeds that of the province's total population. A similar situation, although to a lesser degree, exists in Newfoundland and Labrador, New Brunswick, Saskatchewan, the Yukon and the Northwest Territories. On average, there are 159 social workers per 100,000 inhabitants. The largest number of these workers (348) per 100,000 inhabitants is in the Yukon, but the ratios in Nunavut and the Northwest Territories are also above the average. However, the Yukon lost one-third of its social workers between 2001 and 2006. 10
Social workers often work in places other than health care and social assistance institutions. Indeed, 27% of all social workers in Canada are in this situation. The majority of them report working for a provincial or municipal government.
In contrast, Newfoundland and Labrador and the Yukon had more doctors, nurses and social workers than the national average. In both Newfoundland and Labrador and Nunavut, there has been a substantial increase in the number of doctors and nurses.
Linguistic information contained in the Census of Population
The Census of Population collects five types of linguistic data on official languages: mother tongue, language used most often or regularly at home, language used most often or regularly at work, and knowledge of official languages, as well as the derived variable "first official language spoken" (FOLS). However, this range of information does not provide an accurate measure of the supply or demand for health care services in the minority language.
Without directly asking respondents if they have obtained or requested health care in the minority language, the estimate of the supply or demand for health care services can only be approximated using the census data. In this regard, we know from the post-censal Survey on the Vitality of Official-Language Minorities (SVOLM) that 53% of French-speaking adults outside Quebec and 75% of English-speaking adults in Quebec consider it very important or important to receive health care services in the minority language. Using the derived variable of "first official language spoken", for example, provides the highest estimate of the official-language minority population in a given province, but probably overestimates the number of people who want or might ask to receive services in that language. In contrast, using information on language used at home probably underestimates the population that might ask to receive services in that language.
The same holds true for estimating the population of health care professionals likely to be able to provide services in the minority language. The ability to conduct a conversation in the minority language is not necessarily the best measure of the ability to provide health services in that language. Moreover, the use of the minority language at work on, at least, a regular basis very likely underestimates the ability to offer services in that language; some health care professionals do know the minority language, but use it rarely (less than on a regular basis) or not at all at work.
In order to estimate the proportion of the population likely to request services in the minority language and that of health care professionals who might be able to provide services in that language, this report will consider three types of information. For estimating the official-language minority population, we will use the data on first official language spoken. For health care professionals, we will present information on the use of the minority language at work as well as on knowledge of that language, as measured in the census, specifically, the ability to carry on a conversation in the minority language.
First official language spoken
The data on first official language spoken (FOLS) is derived from the responses to questions on knowledge of official languages, mother tongue and language spoken most often at home. This variable is especially useful because, in the vast majority of cases, it can be used to classify allophones (persons whose mother tongue is neither English nor French) into one of the two official-language groups.
Based on the definition of FOLS, a person who knows only French is classified as Francophone. If the individual knows both official languages and his mother tongue is French, or French in addition to a third language, then he is also classified as Francophone. If his mother tongue is a third language but he uses French, alone or with a third language most often at home, then he is included among Francophones. Thus, to the extent that these allophones are counted among those in either of the two official-language populations, the concept of first official language spoken offers a more inclusive definition of the concepts of "Anglophone" and "Francophone".
In 2006, Quebec had 218,555 people who listed English and French as their FOLS because it was not possible using the census data to assign them to one or the other of these languages. Outside Quebec, there were 113,370 such individuals. Both within and outside Quebec, 9 out of 10 people in this situation had a mother tongue that was not English or French. For analysis purposes in this report, this population is distributed equally among the two official languages within Quebec, as well as outside of the province.
Note that the concept of first official language spoken is not intended to be an accurate measure of proficiency or ease in that language.
Use of the minority language at work
The responses to the questions on the Census dealing with language at work ("most often" and "regularly") are about actual use in the workplace. Using this information therefore provides a "realistic" portrait to the extent that it focuses on the presence of a given language in the work environment. The case we are interested in is the presence of the minority language in an environment where health care professionals are likely to interact with members of a given language group. In this report, we will study both components of the question regarding the language used at work separately. We will also create a synthetic variable from the two components of the language used at work. Thus, persons who report using the minority language exclusively or predominantly are considered along with those who report using it regularly but not predominantly. For example, a person who reported using English most often at work and French regularly is part of the subpopulation studied because French is therefore part of the individual's linguistic repertoire at work.
Mother tongue and knowledge of official languages
Mother tongue has often been used to assign persons to an ethnic or linguistic group based on the assumption that the language transmitted from one generation to another is, among others, one of the defining elements for belonging to a group characterized by a common language. The information on knowledge of official languages comes from the respondents' self-evaluation of language knowledge, but we do not know if the language in question is currently used on a regular basis.
Knowledge of one or both of Canada's official languages implies a potential for linguistic interaction between the two main language groups. It can therefore be used to describe a hypothetical situation in which individuals who know French or English use that language to communicate with other people for whom it is the main language but who are unable to express themselves in the other official language. The idea of knowing a language well enough to carry on a conversation makes it possible to use this information to talk about "speakers of a second official language".
Multiple responses
Some Canadians reported more than one mother tongue or more than one language spoken most often at home. Outside Quebec, in 2006, 0.3% of Canadians reported having French and one other language, usually English, as mother tongues. In Quebec, the proportion of respondents reporting having English and one other language as mother tongues was 0.9%.
In addition, outside Quebec, 0.2% reported speaking French and another language most often at home, compared to 1.2% for English and another language.
The approach used in this report will include the cases of multiple responses that fall into both the Francophone and Anglophone groups given that the definition of belonging to one group or the other is based on the presence or absence of a language. For the language used at work, all responses mentioning the same language are counted in order to take into account any appearance of the language in a specific field. For example, a respondent living outside Quebec who reported using English most often at work, but who uses French regularly will appear in the category of persons who use French at work because French is present in his linguistic repertoire. A health care professional in Quebec who uses French most often at work, but who uses English regularly will appear in the category of professionals working in English because his linguistic repertoire includes English. Likewise, his colleague who uses English most often, as well as French or another language regularly at work is also part of the professionals who use English at work.
Geographic level of analyses
Preliminary analysis showed important differences in the results at the sub-provincial level. To get a more accurate picture of the availability of health care professionals working in the minority language or simply with knowledge of that language, the three provinces with the largest number of persons of the minority language were subdivided into regions. Three regions were identified in New Brunswick, specifically, the North-East, South-East and the Rest of the province. 11 Ontario was subdivided into five regions: North-East, South-East, Ottawa census division, Toronto census division, and the Rest of the province. For Quebec, the regions identified were East of Quebec, Estrie and South of Quebec, Québec and surrounding area, West of Quebec, Montréal census metropolitan area (CMA), and the Rest of the province.
For the other provinces and territories with a small minority-language population, there are data confidentiality issues due to the dissemination of small numbers as well as higher rate of sampling errors. This situation prevents us from presenting statistics on the numbers of the specific groups of health professionals on a sub-provincial basis for these other regions.
Maps
New Brunswick and its regions
In New Brunswick, slightly more than half (54%) of the people who have French as their first official language spoken live in the North of the province. One third of this minority population (33%) is located in the South-East and 13% lives in the Rest of New Brunswick.
Ontario and its regions
In Ontario, a quarter of the French-speaking population resides in the CD of Ottawa. Almost 4 in 10 individuals who have French as their first official language spoken live in the Eastern regions of the province, including 23% in the North-East and 14% in the South-East. In Toronto, there are slightly more than 45,000 people representing 8.7% of the population with French as their first official language spoken. For the rest of the province, 3 out 10 individuals have French as their first official language spoken.
Quebec and its regions
In Quebec, the vast majority of the population with English as their first official language spoken lives in the Greater Montréal Area (81%). Five percent of these individuals live in Estrie and South of Quebec, and in the West of the province. Québec and surrounding area and Eastern Quebec account for just under 2% of the province's English-speaking population.
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