Start Date

15-10-2009 10:45 AM

End Date

15-10-2009 12:00 PM

Description

The association between health and income has been extensively described in the literature. However, accounts of the time dynamics of this relationship are scant, as are studies examining the modifying effect of public policies on this relationship, measured here through health insurance (HI). We used the National Population Health Survey, a cohort study of the general Canadian population spanning almost 10 years, from 1996 to 2004. We considered middle-aged participants (25-56, n=6116) by groups of 10 years.

Structural equation models were employed to assess the impact of HI on the pathway between socioeconomic status, health needs and health status. Regarding the 45-55 year old sub-sample, income inadequacy increased the probability of suffering from unmet health care needs, the later increasing the probability of later poor self-rated health (SRH). Years spent with HI do not seem to have an impact on this relationship. However, different results were found when people did not receive health care because of financial cost. In addition to the significant pathway from income adequacy to SRH, we observed a significant effect of income on HI, and a marginal one of HI on SRH.

Our results indicate that health insurance coverage tends to increase health inequalities in Canada. Within an international context of a growing proportion of private health insurance coverage at the expense of public insurance, the surveillance of these trajectories could give evidence for future public health orientations and policies.

Emilie Renahy is a postdoctoral fellow in the Department of Epidemiology, Biostatistics and Occupational Health - McGill University. She is the Data Specialist of the the International Research Infrastructure on Social inequalities in health (IRIS). She is a social epidemiologist with extensive experience in designing surveys, analysing longitudinal survey data and structural equation models. Within a health over the life course perspective, her work deals with the impact of health insurance on social health inequalities. Her research interests include: Social epidemiology, Social inequalities, Determinants of health, Longitudinal analysis, Lifecourse epidemiology, Survey design, Health insurance, Healthcare system, Health information and Internet use.

Amélie Quesnel-Vallée, PhD, is Assistant Professor at McGill University, where she holds an Arts and Medicine cross-faculty appointment in the Departments of Sociology and of Epidemiology. She also heads the International Research Infrastructure on Social inequalities in health (IRIS), funded by the Canada Foundation for Innovation Leaders Opportunity Fund. In 2005, she received the American Sociological Association Dissertation Award for her Fulbright-funded doctoral research. She currently studies the impact of public policies on health inequalities in 21 OECD countries. Her work recently appeared in a book she co-edited, Le privé dans la santé : Les discours et les faits (Presses de l’Université de Montréal, 2008.


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Oct 15th, 10:45 AM Oct 15th, 12:00 PM

Unequal Health, Health Care Needs and SES over the Life Course: The Role of Health Insurance in a National Health System

The association between health and income has been extensively described in the literature. However, accounts of the time dynamics of this relationship are scant, as are studies examining the modifying effect of public policies on this relationship, measured here through health insurance (HI). We used the National Population Health Survey, a cohort study of the general Canadian population spanning almost 10 years, from 1996 to 2004. We considered middle-aged participants (25-56, n=6116) by groups of 10 years.

Structural equation models were employed to assess the impact of HI on the pathway between socioeconomic status, health needs and health status. Regarding the 45-55 year old sub-sample, income inadequacy increased the probability of suffering from unmet health care needs, the later increasing the probability of later poor self-rated health (SRH). Years spent with HI do not seem to have an impact on this relationship. However, different results were found when people did not receive health care because of financial cost. In addition to the significant pathway from income adequacy to SRH, we observed a significant effect of income on HI, and a marginal one of HI on SRH.

Our results indicate that health insurance coverage tends to increase health inequalities in Canada. Within an international context of a growing proportion of private health insurance coverage at the expense of public insurance, the surveillance of these trajectories could give evidence for future public health orientations and policies.

Emilie Renahy is a postdoctoral fellow in the Department of Epidemiology, Biostatistics and Occupational Health - McGill University. She is the Data Specialist of the the International Research Infrastructure on Social inequalities in health (IRIS). She is a social epidemiologist with extensive experience in designing surveys, analysing longitudinal survey data and structural equation models. Within a health over the life course perspective, her work deals with the impact of health insurance on social health inequalities. Her research interests include: Social epidemiology, Social inequalities, Determinants of health, Longitudinal analysis, Lifecourse epidemiology, Survey design, Health insurance, Healthcare system, Health information and Internet use.

Amélie Quesnel-Vallée, PhD, is Assistant Professor at McGill University, where she holds an Arts and Medicine cross-faculty appointment in the Departments of Sociology and of Epidemiology. She also heads the International Research Infrastructure on Social inequalities in health (IRIS), funded by the Canada Foundation for Innovation Leaders Opportunity Fund. In 2005, she received the American Sociological Association Dissertation Award for her Fulbright-funded doctoral research. She currently studies the impact of public policies on health inequalities in 21 OECD countries. Her work recently appeared in a book she co-edited, Le privé dans la santé : Les discours et les faits (Presses de l’Université de Montréal, 2008.