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An examination of perceived health care availability and unmet health care need in the City of Toronto, Ontario, Canada

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Abstract

OBJECTIVES: Although timely access to health care is a top priority, a burgeoning body of research highlights the important role of neighbourhood environments on unmet health care needs. This study aimed to examine an association between perceptions of neighbourhood availability of health care services and experience of unmet health care needs by gender in an urban city setting.

METHODS: A total of 2338 participants from the Neighbourhood Effects on Health and Well-being (NEHW) study, between 25 and 64 years of age and dwelling in the City of Toronto, Ontario, Canada, were included in the analyses. Four different logistic regression models stratified by gender were used to examine the relationship between neighbourhood health care availability and unmet health care need as well as the impact of neighbourhood perception of health care availability on the three different types of unmet needs.

RESULTS: Perceived health care availability was associated with higher likelihood of experiencing unmet health care needs in both women and men (women = OR: 1.58, 95% CI: 1.09–2.28; men = OR: 1.92, 95% CI: 1.23–2.99). In addition, perceived health care availability was associated with barrier-and wait times-related unmet health care need among women (OR: 1.83, 95% CI: 1.13–2.97; OR: 1.93, 95% CI: 1.10–3.40 respectively), and personal choice- and wait times-related unmet need among men (OR: 1.99, 95% CI: 1.10–3.58).

CONCLUSION: Individuals’ perception of health care availability plays a crucial role in the experience of unmet health care needs, suggesting the importance of community-based policy development for improving physical conditions and the social aspect of health care services.

Résumé

OBJECTIFS: L’accès rapide aux soins de santé est une priorité absolue, mais un corpus de recherche grandissant fait ressortir l’importance des environnements de quartiers pour combler les besoins de soins de santé insatisfaits. Notre étude visait à examiner l’association entre les perceptions de la disponibilité de services de soins de santé dans le quartier et l’expérience des besoins de soins de santé insatisfaits, selon le sexe, dans un milieu urbain.

MÉTHODE: Nos analyses ont porté sur 2 338 participants de l’étude Neighbourhood Effects on Health and Well-being (NEHW) âgés de 25 à 64 ans et vivant à Toronto (Ontario) au Canada. Nous avons utilisé quatre modèles de régression logistique stratifiés selon le sexe pour examiner la relation entre la disponibilité des soins de santé dans le quartier et les besoins de soins de santé insatisfaits, ainsi que l’impact de la perception de la disponibilité des soins de santé dans le quartier sur les trois types de besoins insatisfaits.

RÉSULTATS: La disponibilité perçue des soins de santé était associée à une probabilité accrue d’éprouver des besoins de soins de santé insatisfaits, tant chez les femmes que chez les hommes (femmes = RC: 1,58, IC de 95%: 1,09–2,28; hommes = RC: 1,92, IC de 95%: 1,23–2,99). En outre, la disponibilité perçue des soins de santé était associée à des besoins de soins de santé insatisfaits liés aux barrières et aux temps d’attente chez les femmes (RC: 1,83, IC de 95%: 1,13–2,97; RC: 1,93, IC de 95%: 1,10–3,40, respectivement), et à des besoins insatisfaits liés aux choix personnels et aux temps d’attente chez les hommes (RC: 1,99, IC de 95%: 1,10–3,58).

CONCLUSION: La perception individuelle de la disponibilité des soins de santé joue un rôle décisif dans l’expérience des besoins de soins de santé insatisfaits, ce qui indique l’importance d’élaborer des politiques communautaires pour améliorer les conditions matérielles et l’aspect social des services de soins de santé.

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Author information

Authors and Affiliations

  1. Department of Health Promotion, Daegu University, 201 Daegudae-ro, Cyeongsan, 38453, Korea

    Jongnam Hwang PhD (Assistant Professor)

  2. Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada

    Sara J. T. Guilcher PhD

  3. Institute for Clinical Evaluative Sciences, Toronto, ON, Canada

    Sara J. T. Guilcher PhD, Flora I. Matheson PhD & Rick Glazier MD, MPH

  4. Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, ON, Canada

    Sara J. T. Guilcher PhD, Kathryn E. McIsaac PhD, Rick Glazier MD, MPH & Patricia O’Campo PhD

  5. Research Services, Nova Scotia Health Authority, Centre for Clinical Research, Halifax, NS, Canada

    Kathryn E. McIsaac PhD

  6. Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada

    Rick Glazier MD, MPH & Patricia O’Campo PhD

  7. Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada

    Rick Glazier MD, MPH

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  1. Jongnam Hwang PhD
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Corresponding author

Correspondence to Jongnam Hwang PhD.

Additional information

Acknowledgements: This research was funded by Canadian Institutes of Health Research (CIHR) Grant MOP-84439 and the Social Sciences and Humanities Research Council Grant 410-2007-1499. At the time of the study, Drs. Hwang, Guilcher and Mclsaac were funded by a CIHR Strategic Training Initiative in Health Research [ACHIEVE] post-doctoral fellowship (Grant #96566) and the Centre for Urban Health Solutions (formerly the Centre for Research on Inner City Health). Dr. Glazier is supported as a Clinician Scientist in the Department of Family and Community Medicine at St. Michael’s Hospital and at the University of Toronto.

Conflict of Interest: None to declare.

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Hwang, J., Guilcher, S.J.T., McIsaac, K.E. et al. An examination of perceived health care availability and unmet health care need in the City of Toronto, Ontario, Canada. Can J Public Health 108, e7–e13 (2017). https://doi.org/10.17269/CJPH.108.5715

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  • DOI: https://doi.org/10.17269/CJPH.108.5715

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