Evidence map›Paper›PMID 41093352›Full record

ArticleBMJ open2025

Rethinking the way we measure access to language-concordant health services for minority language populations: a secondary analysis of publicly available physician and population data in Ontario, Canada.

Patrick E Timony, Christopher Belanger, Arlynn Bélizaire, Antoine Desilets, Alain Gauthier, Sathya Karunananthan, Mwali-Nachishali Muray, Cayden Peixoto, Jonathan Peter Fitzsimon, Leanda Godfrey and 1 more

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Patrick E TimonyLaurentian University, Sudbury, Ontario, Canada.ORCID http://orcid.org/0000-0003-2067-6107
Christopher BelangerUniversity of Ottawa, Telfer School of Management, Ottawa, Ontario, Canada.ORCID http://orcid.org/0000-0003-2070-5721
Arlynn BélizaireOntario Health, Toronto, Ontario, Canada.
Antoine DesiletsSociété santé en français, Ottawa, Ontario, Canada.
Alain GauthierLaurentian University, Sudbury, Ontario, Canada.
Sathya KarunananthanFaculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.ORCID http://orcid.org/0000-0002-4247-4752
Mwali-Nachishali MurayFaculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada.ORCID http://orcid.org/0000-0003-0677-3189
Cayden PeixotoSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Jonathan Peter FitzsimonInstitut du Savoir Montfort, Ottawa, Ontario, Canada.ORCID http://orcid.org/0000-0002-0314-1664
Leanda GodfreyInstitut du Savoir Montfort, Ottawa, Ontario, Canada.ORCID http://orcid.org/0009-0002-6582-3780
Lise M BjerreSchool of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada lbjerre@uottawa.ca.ORCID http://orcid.org/0000-0003-3634-3585

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveProviding care in a patient's preferred language improves health outcomes and patient satisfaction. In Ontario, access to French-speaking physicians (FSPs) is estimated using FSP-to-Francophone population ratios and compared with total physician-to-total population ratios. This approach fails to consider the fact that FSPs also serve non-Francophone patients and that Francophones must compete with the entire population to access FSPs. As a result, this approach inaccurately suggests that Francophones have better access to language-concordant care than Anglophones/Allophones. We propose a novel approach to address this issue, enabling unbiased comparisons of access to language-concordant care across linguistic groups.

designThis secondary analysis of publicly available data containing linguistic variables for the Ontario population (Statistics Canada, 2021 Census) and for family physicians (FPs) (College of Physicians and Surgeons of Ontario, January 2024) calculated competition-adjusted ratios and probabilities of accessing language-concordant care.

settingOntario, Canada.

participantsCensus and publicly available data on FPs (ie, those providing comprehensive family medicine care to the community) and the Ontario population were obtained.

resultsProvince-wide, the crude ratio of FSPs per 1000 Francophones was 3.46. After adjusting for competition, the ratio of FSP per 1000 population was 0.12, compared with a general physicians-per-1000 population ratio of 1.05. Anglophones/Allophones attached to a FP have a 100% probability of receiving care in English compared with an 11.4% probability for Francophones to receive care from a FSP. Expressed otherwise, Anglophones/Allophones are 8.8 times more likely to receive language-concordant care (ie, care in English) than Francophones.

conclusionsAlthough crude physician-to-population ratios overestimate Francophones' access to FSPs, competition-adjusted ratios and probabilities demonstrate that they are much less likely to access language-concordant care than Anglophones/Allophones. This novel approach has equity implications for health human resources planning and can be applied to other linguistic minority groups and healthcare providers.

Indexed as

Health Services AccessibilityLanguageMinority GroupsCommunication BarriersHumansMaleOntarioHealth EquityHealth Services AccessibilityPrimary Health Care

Identifiers

PMID41093352
PMCPMC12530374

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LicenceCC BY-NC
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.