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Sumit Gupta, BSc, Leslie L. Roos, PhD, Randy Walld, BSc, BComm, Dawn Traverse, MSc and Matthew Dahl, BSc.

The authors are with the Manitoba Centre for Health Policy, Department of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg. Sumit Gupta is also with the Faculty of Medicine, University of Toronto, Ontario. Dawn Traverse is also with the David Thompson Health Region, Red Deer, Alberta.

Correspondence: Requests for reprints should be sent to Leslie L. Roos, PhD, Manitoba Centre for Health Policy, Dept of Community Health Sciences, Faculty of Medicine, University of Manitoba, Winnipeg, Manitoba R2H 2A6 Canada (e-mail: leslie_roos{at}cpe.umanitoba.ca).

Objectives. This study examined preventive care delivered in Manitoba during the 1990s by 3 different methods —childhood immunizations (by physicians and public health nurses under a government program), screening mammography (through a government program introduced in 1995), and cervical cancer screening (no program).

Methods. Longitudinal administrative data, an immunization monitoring system, and Canadian census databases were used.

Results. Cervical cancer screening rates remained static and showed strong socioeconomic differences; childhood immunization rates remained high with small socioeconomic gradients. The introduction of the Manitoba Breast Screening Program resulted in rising rates of screening and vanishing socioeconomic gradients.

Conclusions. Manitoba government programs in childhood immunization and screening mammography actively helped the provision of preventive care. Organized programs that target population groups, recognize barriers to access, and facilitate self-evaluation are critical for equitable delivery.

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