HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) All Versions of this Article: AJPH.2004.059402v1 96/7/1300    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (22) Citing Articles via Google Scholar Google Scholar Articles by Lasser, K. E. Articles by Woolhandler, S. Search for Related Content PubMed PubMed Citation Articles by Lasser, K. E. Articles by Woolhandler, S. Related Collections Insurance Access to Care Quality of Care Other Race/Ethnicity

Karen E. Lasser, MD, MPH, David U. Himmelstein, MD and Steffie Woolhandler, MD, MPH

Karen E. Lasser, David U. Himmelstein, and Steffie Woolhandler are with the Department of Medicine, The Cambridge Health Alliance and Harvard Medical School, Cambridge, Mass.

Correspondence: Requests for reprints should be sent to Karen E. Lasser, MD, MPH, Department of Medicine, The Cambridge Hospital, 1493 Cambridge St, Cambridge, MA 02139 (e-mail: klasser{at}challiance.org).

Objectives. We compared health status, access to care, and utilization of medical services in the United States and Canada and compared disparities according to race, income, and immigrant status.

Methods. We analyzed population-based data on 3505 Canadian and 5183 US adults from the Joint Canada/US Survey of Health. Controlling for gender, age, income, race, and immigrant status, we used logistic regression to analyze country as a predictor of access to care, quality of care, and satisfaction with care and as a predictor of disparities in these measures.

Results. In multivariate analyses, US respondents (compared with Canadians) were less likely to have a regular doctor, more likely to have unmet health needs, and more likely to forgo needed medicines. Disparities on the basis of race, income, and immigrant status were present in both countries but were more extreme in the United States.

Conclusions. United States residents are less able to access care than are Canadians. Universal coverage appears to reduce most disparities in access to care.

This article has been cited by other articles:

				K. M. McGrail, E. van Doorslaer, N. A. Ross, and C. Sanmartin Income-Related Health Inequalities in Canada and the United States: A Decomposition Analysis Am J Public Health, October 1, 2009; 99(10): 1856 - 1863. [Abstract] [Full Text] [PDF]

				D. Mukherjee, T. Kosztowski, H. A. Zaidi, G. Jallo, B. S. Carson, D. C. Chang, and A. Quinones-Hinojosa Disparities in Access to Pediatric Neurooncological Surgery in the United States Pediatrics, October 1, 2009; 124(4): e688 - e696. [Abstract] [Full Text] [PDF]

				K. Pitkin Derose, B. W. Bahney, N. Lurie, and J. J. Escarce Review: Immigrants and Health Care Access, Quality, and Cost Med Care Res Rev, August 1, 2009; 66(4): 355 - 408. [Abstract] [PDF]

				J. S. Ross Health Reform Redux: Learning From Experience and Politics Am J Public Health, May 1, 2009; 99(5): 779 - 786. [Abstract] [Full Text] [PDF]

				S. Pati and S. Danagoulian Immigrant Children's Reliance on Public Health Insurance in the Wake of Immigration Reform Am J Public Health, November 1, 2008; 98(11): 2004 - 2010. [Abstract] [Full Text] [PDF]

				J. S. Ross and A. S. Detsky Comparison of the US and Canadian Health Care Systems: A Tale of 2 Mount Sinai's JAMA, October 22, 2008; 300(16): 1934 - 1936. [Full Text] [PDF]

				X. Zhang, P. P. Lee, T. J. Thompson, S. Sharma, L. Barker, L. S. Geiss, G. Imperatore, E. W. Gregg, X. Zhang, and J. B. Saaddine Health Insurance Coverage and Use of Eye Care Services Arch Ophthalmol, August 1, 2008; 126(8): 1121 - 1126. [Abstract] [Full Text] [PDF]

				D. U. Himmelstein, S. Woolhandler, J. C. Goodman, and R. M. Sade Our Health Care System at the Crossroads: Single Payer or Market Reform? Ann. Thorac. Surg., November 1, 2007; 84(5): 1435 - 1446. [Full Text] [PDF]

				P. Carrasco-Garrido, A. G. De Miguel, V. H. Barrera, and R. Jimenez-Garcia Health profiles, lifestyles and use of health resources by the immigrant population resident in Spain Eur J Public Health, October 1, 2007; 17(5): 503 - 507. [Abstract] [Full Text] [PDF]

				K. P. Derose, J. J. Escarce, and N. Lurie Immigrants And Health Care: Sources Of Vulnerability Health Aff., September 1, 2007; 26(5): 1258 - 1268. [Abstract] [Full Text] [PDF]

				G. F. Anderson, B. K. Frogner, and U. E. Reinhardt Health Spending In OECD Countries In 2004: An Update Health Aff., September 1, 2007; 26(5): 1481 - 1489. [Abstract] [Full Text] [PDF]

				B. Greenberg Can We IMPROVE-CHF Management By Measuring Natriuretic Peptides? Circulation, June 19, 2007; 115(24): 3045 - 3047. [Full Text] [PDF]

				G. W. Moe, J. Howlett, J. L. Januzzi, H. Zowall, and for the Canadian Multicenter Improved Management o N-Terminal Pro-B-Type Natriuretic Peptide Testing Improves the Management of Patients With Suspected Acute Heart Failure: Primary Results of the Canadian Prospective Randomized Multicenter IMPROVE-CHF Study Circulation, June 19, 2007; 115(24): 3103 - 3110. [Abstract] [Full Text] [PDF]

				R. J. Gibbons Leading the Elephant Out of the Corner: The Future of Health Care: Presidential Address at the American Heart Association 2006 Scientific Sessions Circulation, April 24, 2007; 115(16): 2221 - 2230. [Full Text] [PDF]