The Link Between Difficulty in Accessing Health Care and Health Status in a Canadian Context.

Much of the Canadian population reports some level of difficulty in accessing health care services. Despite being a recognized determinant of health, the relationship between access to health care and overall health has not been examined extensively. This study is an analysis of the Canadian Community Health Survey 2016 database. A composite score for difficulty in accessing health care was constructed based on several survey questions. Self-rated health (SRH), the measure of general health status, was compared between individuals with and without difficulty in accessing health care services by estimating prevalence rate ratios adjusting for age, sex, education, income, urban/rural status, race, and Indigenous status. After adjustment for pertinent confounders, difficulty in accessing health care was not statistically significantly associated with SRH. However, in stratified models, difficulty accessing health care was associated with a 12% lower probability of reporting good SRH among non-white individuals. Test of interactions for other social determinants was not significant. For racial minorities, inequalities in access to health care are associated with lower self-rated health. Further research to investigate causes underlying difficulties in accessing health care could lead to public health programs ensuring all Canadians receive equal health care services.