Abstract
Objectives
To compare whether unmet health needs differ between immigrants and nonimmigrants, and examine whether help-seeking characteristics account for any unmet needs disparities.
Methods
The data are from the Canadian Community Health Survey Cycle 1.1, conducted by Statistics Canada in 2000–2001. The study sample includes 16,046 immigrants and 102,173 non-immigrants aged 18 and older from across Canada. The study employs logistic regression models to examine whether help-seeking behaviours explain unmet needs differences.
Results
Logistic regression analysis indicates that immigrants have a 12% (95% CI: 6–18) lower all-cause unmet needs risk (odds ratio) than non-immigrants after controlling for differences in help-seeking characteristics. The unmet needs risk among long-term immigrants (15 years of residence and more), however, is similar to non-immigrants after considering these characteristics. We found differences between immigrants and nonimmigrants in reasons for unmet needs, with more immigrants believing that the care would be inadequate, not knowing where to access health care, and having foreign language problems.
Conclusions
The Canadian health care system delivers sufficient health care to immigrants, even though the poverty rate and proportion of visible minorities are comparatively higher within this subpopulation. Nonetheless, these results indicate that some immigrant-specific health care access barriers may exist.
MeSH terms: Health services needs, access to health care, immigration
Résumé
Objectifs
Comparer les besoins insatisfaits des immigrants et des non-immigrants en matière de santé pour déterminer si, d’une part, ces besoins sont les mêmes et, d’autre part, déterminer si les écarts sont attribuables aux caractéristiques des demandes d’aide.
Méthodes
Les données proviennent du cycle 1.1 de l’Enquête sur la santé dans les collectivités canadiennes réalisée par Statistique Canada en 2000–2001. L’échantillon était composé de 16 046 immigrants et de 102 173 non-immigrants de 18 ans et plus, de partout au Canada. L’étude, qui s’appuie sur des modèles de régression logistique, visait à déterminer si les comportements des personnes qui demandent de l’aide pouvaient expliquer les écarts quant à la nature des besoins insatisfaits.
Résultats
L’analyse de régression logistique révèle que la probabilité (non arrondie) qu’on ne satisfasse pas aux besoins des immigrants, peu importe le motif invoqué, est de 12 % (IC de 95 %: 6–18) inférieure à celle des non-immigrants; ces résultats font suite à l’évaluation des écarts liés aux caractéristiques des demandes d’aide. La probabilité qu’on ne réponde pas aux besoins des immigrants de longue date (qui habitent au Canada depuis au moins 15 ans) est toutefois semblable à celle des non-immigrants, après évaluation de ces caractéristiques. Nous avons constaté qu’il y a des différences entre les motifs invoqués par les immigrants et les non-immigrants pour expliquer l’insatisfaction des besoins; les immigrants étaient plus nombreux à croire que les soins seraient inadéquats, à ne pas connaître les façons d’accéder aux soins de santé et à éprouver des difficultés liées à la langue.
Conclusions
Le système de santé canadien offre aux immigrants des soins suffisants et ce, en dépit du taux plus élevé, au sein de cette sous-population, de pauvreté et de la proportion des minorités visibles. Il n’en demeure pas moins que ces résultats indiquent qu’il existe des obstacles particuliers à l’accès aux soins de santé pour les immigrants.
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