Comparing health status and access to health care in Canada’s largest metropolitan areas

Abstract

Research has shown persistent inequalities in access to health care between and within sociodemographic groups and geographic areas. Yet much of what we know about geographical disparities in access comes from studies of regional and urban/rural contrasts, or from studies of intra-urban, neighborhood-level variations. We know relatively little about variations in access to primary health care across different urban areas, and whether such variations translate into differences among residents’ health. This study examines how health status and access to primary care vary across five of Canada’s largest cities, paying particular attention to populations that may be particularly vulnerable based on age and income. Across all outcomes, there was a consistently strong relationship with individual socioeconomic status. We show that city of residence is important for access to health care but not for health status. Results are discussed in terms of their relevance for urban health-care policy and delivery, and impacts on health and access to care.

Keywords:

• access to health care
• geographies of health
• urban health
• large cities
• inequality