Research PaperDisability and unmet health care needs in Canada: A longitudinal analysis
Section snippets
A life course perspective on disability and unmet health care needs
The definition of disability status in the NPHS is similar to that used by the World Health Organization (WHO), that is, disability occurs when a person experiences activity limitations and restrictions in participation.20 Critical disability theorists argue that disability needs to be viewed as a continuum and not a dichotomy.21 Therefore, people are neither disabled nor non-disabled, that is ability status falls somewhere between the two. The interplay of different identities and how they
Methods
The data for this research come from Cycles 1 to 8 (1994/95 to 2008/09) of the NPHS, a longitudinal survey administered by Statistics Canada. The target population of the NPHS includes people living in households in all provinces and territories, except those residents on Aboriginal reserves, Canadian Forces Bases, or in remote areas. One person from each household was selected to participate in the survey and followed through each cycle.26
Respondents in the 1994/95 survey were included if they
Characteristics of the sample
Table 2 provides a summary of the characteristics of the sample in 1994/95. Almost 16% of the population self-report a disability. Within the group of respondents who report a disability, 24.5% (3.9% of total population) reported a WRD, 27.7% (4.4% of total population) reported a DDI, and 47.8% (7.6% of total population) reported a DOR.
Prevalence of disability status
Although not shown in a table, the prevalence of disability status increases over time: the prevalence of disability increases from 15.9% in 1994/95 to 27.6% in
Discussion
This research provides a longitudinal analysis of unmet health care needs based on cause of disability status and examines the differences and similarities among respondents with different types of disability. In general, rates of unmet health care needs for all groups increase but the rate of increase is not constant over time. Similar to the findings by McColl et al7 and in the WHO World Report on Disability,4 respondents with disabilities are more likely to report unmet health care needs
Conclusion
It is important to identify the prevalence of the unmet health care needs of people with disabilities and to understand how their needs change over time. As other research has indicated, the rates of disability in the population and the rates of unmet health care needs continue to increase. It is apparent, from this research and the research of others, that there is something about disability that makes people more likely to report an unmet health care need, and there is variation in accounts
Acknowledgments
I would like to thank the following people for their editorial assistance and analytical support for this research: Lori Campbell, Ph.D., Margaret Denton, Ph.D., Peri Ballantyne, Ph.D., Michael Boyle, Ph.D., Kathy Georgiades, Ph.D., Laura Duncan, M.A., Hmwe Kyu, Ph.D., Marisa Young, Ph.D., and analysts from the McMaster Research Data Centre – James Chowhan, Ph.D. and Peter Kitchen, Ph.D. I would also like to thank the two anonymous reviewers for their comments and suggestions.
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This research was funded through a Social Science and Humanities Research Council of Canada (SSHRC) Doctoral Fellowship, an Ontario Graduate Scholarship, and a SSHRC-funded SEDAP (Social and Economic Dimensions of an Aging Population) grant.
The author declares no conflict of interest.