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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2002 Jul 1;93(4):303–307. doi: 10.1007/BF03405022

Individual and Neighbourhood Determinants of Health Care Utilization

Implications for Health Policy and Resource Allocation

Alexandra M Yip 1, George Kephart 1, Paul J Veugelers 1,✉
PMCID: PMC6980116  PMID: 12154535

Abstract

Objectives: To investigate the importance of both individual and neighbourhood socioeconomic characteristics for health care utilization.

Methods: Various linkage procedures generated a longitudinal dataset with information on 2,116 Nova Scotians, their residential neighbourhoods, 8 years of health care utilization and vital status. Unilevel and multilevel regression analyses were employed to examine the effects of both individual and neighbourhood characteristics on health care use.

Results: Individual income and education determined physician and hospital use. Also, neighbourhood characteristics, specifically average income and percentage of single mother families, were found to determine health care use. When considering individual and neighbourhood characteristics simultaneously, individual income and education determined physician and hospital use independently, while neighbourhood income determined physician use independently.

Conclusions: Both individual and neighbourhood socioeconomic characteristics determine health care use. Acknowledging this allows better targeting of health policy and planning, and enables more accurate needs-based resource allocation.

Footnotes

Acknowledgements: This research is made possible through funding by the Canada Foundation for Innovation, the Dalhousie Medical Research Foundation, and a Canadian Institutes of Health Research Career Award to Dr. Veugelers, and through a Nova Scotia Clinical Research Scholar Award to Dr. Kephart. Although the data analyzed herein are from the Nova Scotia Department of Health, the conclusions are solely those of the authors. An earlier version of this paper was presented at the American Public Health Association 128th Annual Meeting and Exposition in Boston, MA, November 12–16, 2000. The authors thank Mike Pennock, Mark Smith, and Chris Skedgel of the Population Health Research Unit at Dalhousie University, Shane Hornibrook, Nova Scotia Medical Services Insurance, and Nova Scotia Vital Statistics for their helpful assistance in completion of this study.

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