Social determinants of access to primary care in Canada
Abstract
Despite the promise of universal care, many Canadians report having unmet healthcare needs. We conducted two studies: (1) a systematic review of studies on social determinants of health (SDH) and unmet need; and (2) a secondary analysis using the Canadian Longitudinal Study on Aging (CLSA) to investigate the association of SDH and (2a) self-reported unmet need and (2b) having a family physician. The review (n=40) found a positive association between unmet need and lower income, mental health and chronic conditions, and negative association with older age, better perceived health and having a family physician. The CLSA analysis found the odds of having a family physician were >1 for older age, female sex, higher household income and having chronic conditions. The odds of having unmet need were >1 for younger age, female sex, non-white, low household income, poor health status, chronic conditions and not having a family physician. Policymakers need to consider these determinants to address system-wide barriers to healthcare access.