Canadian and American health status the same, except for the poor and uninsured in the U.S.
Statistics Canada
and
Centers for Disease Control and Prevention
June 2004
Joint Canada/United States Survey of Health, 2002-03
By Claudia Sanmartin and Edward Ng, Health Analysis and Measurement Group,Statistics Canada
and
Debra Blackwell, Jane Gentleman, Michael Martinez and Catherine Simile,
National Center for Health Statistics, Centers for Disease Control and Prevention, United States
Conclusions
The JCUSH (Joint Canada/United States Survey of Health) represents a unique
population health survey conducted jointly by two national statistical agencies, Statistics Canada and the United States National Center for Health Statistics. The use of a common questionnaire and identical data collection and processing methods provides highly comparable data. As a result, the findings from JCUSH provide valuable insights regarding similarities and differences between Canada and the United States in a manner not previously possible.
Overall, the health status of Canadians and Americans is generally similar with most individuals in both countries reporting that they are in good, very good or excellent health. More Americans, however, reported being at either end of the health status spectrum – in excellent health and in fair and poor health – compared with Canadians. This was particularly true among women. This may be associated with the higher rate of highly severe mobility limitation and obesity among American women. There were relatively few differences between men.
Canadians and Americans were similar regarding access to health care services provided under similar funding models. In the case of dental services, for example, where most depend on private insurance, access was similar in the two countries.
Canadians and Americans differed overall, however, regarding access to health care services provided under different insurance models such as those covering physician services. While Canadians are similar to insured Americans regarding access to a regular medical doctor and regarding unmet health care needs, they face significantly less barriers to care when compared with uninsured Americans.
The greatest differences between the two countries are related to differentials by income in health. While there has been solid evidence for some time of the social gradient in health status in both Canada and the United States, this is the first time that we have been able to examine the question of whether there are systematic differences in health status by social position in the two countries. One of the important findings of this survey is that Americans in the poorest income quintile report fair or poor health, obesity and severe mobility impairment more frequently than their Canadian counterparts. At the other end of the income spectrum, there are no systematic differences in the reporting of fair or poor health or mobility impairment among the most affluent households on either side of the border.
http://www.statcan.ca/english/freepub/82M0022XIE/2003001/pdf/82M0022XIE2003001.pdf
or
http://www.cdc.gov/nchs/data/nhis/jcush_analyticalreport.pdf
Comment: In the first population health survey to provide both a comprehensive and precise comparison of the United States and Canada, two dramatic conclusions are evident. First, Canadians and insured Americans have similar access, whereas uninsured Americans clearly have impaired access and greater unmet health care needs. Second, affluent Canadians and Americans have comparable levels of health whereas low income Americans have poorer health than low income Canadians.
The conclusion seems inescapable that the unmet health care needs and poorer
health are due to lack of affordability because of lack of insurance. But many opponents of comprehensive health care reform have tried to explain these differences by claiming that there are fundamental cultural differences in low income Americans and low income Canadians, differences that do not extend into the average income and affluent sectors.
Maybe the United States does fail on other parameters of social solidarity that result in less favorable health outcomes for the poor. But a great first step to address these differences would be to eliminate financial barriers to health care by providing comprehensive coverage for everyone.