Is francophone language status associated with differences in the health services use of rural Nova Scotians?

objectivesResearch suggests that Canadian francophones living in minority contexts have little access to health services in French and are more likely to receive poorer health services. We examined whether francophones in one Nova Scotia (NS) community showed different patterns of health service use from anglophones in similar rural communities, or the NS population overall.

methodsWe used administrative data to calculate 10-year cumulative incidence rate ratios for the period 1996-2005 for treated cancers, circulatory diseases, diabetes and psychiatric disorders in Clare (population 8,815, predominantly francophone) and compared these with six predominantly Anglophone communities (total population 38,147) using data for the province overall as the reference standard. We also compared 10-year treated incidence rate ratios for visits to family physicians and specialists and for admissions to hospital.

resultsTreatment incidence rates for all four disease groups in all rural areas were dominated by family physician visits and hospital visits; visits to specialists for some disease outcomes were often lower in rural communities. Visits to psychiatric specialists were especially low in rural communities, irrespective of language status, being 30% less than for the province overall. No significant differences in treated disease incidence were detected between Clare and the comparison anglophone communities. Treated incidence rate ratios for diabetes and circulatory diseases were significantly higher in Clare and the rural anglophone communities relative to the province overall.

conclusionThe patterns of health care use and treated disease incidence seen in Clare and the comparison areas are more likely a function of rurality than they are of language.