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Unmet health needs and discrimination by healthcare providers among an Indigenous population in Toronto, Canada

OBJECTIVES: Inequalities between Indigenous and non-Indigenous peoples in Canada persist. Despite the growth of Indigenous populations in urban settings, information on their health is scarce. The objective of this study is to assess the association between experience of discrimination by healthcare...

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Autores principales: Kitching, George Tjensvoll, Firestone, Michelle, Schei, Berit, Wolfe, Sara, Bourgeois, Cheryllee, O’Campo, Patricia, Rotondi, Michael, Nisenbaum, Rosane, Maddox, Raglan, Smylie, Janet
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7046890/
https://www.ncbi.nlm.nih.gov/pubmed/31435849
http://dx.doi.org/10.17269/s41997-019-00242-z
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author Kitching, George Tjensvoll
Firestone, Michelle
Schei, Berit
Wolfe, Sara
Bourgeois, Cheryllee
O’Campo, Patricia
Rotondi, Michael
Nisenbaum, Rosane
Maddox, Raglan
Smylie, Janet
author_facet Kitching, George Tjensvoll
Firestone, Michelle
Schei, Berit
Wolfe, Sara
Bourgeois, Cheryllee
O’Campo, Patricia
Rotondi, Michael
Nisenbaum, Rosane
Maddox, Raglan
Smylie, Janet
author_sort Kitching, George Tjensvoll
collection PubMed
description OBJECTIVES: Inequalities between Indigenous and non-Indigenous peoples in Canada persist. Despite the growth of Indigenous populations in urban settings, information on their health is scarce. The objective of this study is to assess the association between experience of discrimination by healthcare providers and having unmet health needs within the Indigenous population of Toronto. METHODS: The Our Health Counts Toronto (OHCT) database was generated using respondent-driven sampling (RDS) to recruit 917 self-identified Indigenous adults within Toronto for a comprehensive health assessment survey. This cross-sectional study draws on information from 836 OHCT participants with responses to all study variables. Odds ratios and 95% confidence intervals were estimated to examine the relationship between lifetime experience of discrimination by a healthcare provider and having an unmet health need in the 12 months prior to the study. Stratified analysis was conducted to understand how information on access to primary care and socio-demographic factors influenced this relationship. RESULTS: The RDS-adjusted prevalence of discrimination by a healthcare provider was 28.5% (95% CI 20.4–36.5) and of unmet health needs was 27.3% (95% CI 19.1–35.5). Discrimination by a healthcare provider was positively associated with unmet health needs (OR 3.1, 95% CI 1.3–7.3). CONCLUSION: This analysis provides new evidence linking discrimination in healthcare settings to disparities in healthcare access among urban Indigenous people, reinforcing existing recommendations regarding Indigenous cultural safety training for healthcare providers. Our study further demonstrates Our Health Counts methodologies, which employ robust community partnerships and RDS to address gaps in health information for urban Indigenous populations.
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spelling pubmed-70468902020-03-13 Unmet health needs and discrimination by healthcare providers among an Indigenous population in Toronto, Canada Kitching, George Tjensvoll Firestone, Michelle Schei, Berit Wolfe, Sara Bourgeois, Cheryllee O’Campo, Patricia Rotondi, Michael Nisenbaum, Rosane Maddox, Raglan Smylie, Janet Can J Public Health Quantitative Research OBJECTIVES: Inequalities between Indigenous and non-Indigenous peoples in Canada persist. Despite the growth of Indigenous populations in urban settings, information on their health is scarce. The objective of this study is to assess the association between experience of discrimination by healthcare providers and having unmet health needs within the Indigenous population of Toronto. METHODS: The Our Health Counts Toronto (OHCT) database was generated using respondent-driven sampling (RDS) to recruit 917 self-identified Indigenous adults within Toronto for a comprehensive health assessment survey. This cross-sectional study draws on information from 836 OHCT participants with responses to all study variables. Odds ratios and 95% confidence intervals were estimated to examine the relationship between lifetime experience of discrimination by a healthcare provider and having an unmet health need in the 12 months prior to the study. Stratified analysis was conducted to understand how information on access to primary care and socio-demographic factors influenced this relationship. RESULTS: The RDS-adjusted prevalence of discrimination by a healthcare provider was 28.5% (95% CI 20.4–36.5) and of unmet health needs was 27.3% (95% CI 19.1–35.5). Discrimination by a healthcare provider was positively associated with unmet health needs (OR 3.1, 95% CI 1.3–7.3). CONCLUSION: This analysis provides new evidence linking discrimination in healthcare settings to disparities in healthcare access among urban Indigenous people, reinforcing existing recommendations regarding Indigenous cultural safety training for healthcare providers. Our study further demonstrates Our Health Counts methodologies, which employ robust community partnerships and RDS to address gaps in health information for urban Indigenous populations. Springer International Publishing 2019-08-21 /pmc/articles/PMC7046890/ /pubmed/31435849 http://dx.doi.org/10.17269/s41997-019-00242-z Text en © The Author(s) 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Quantitative Research
Kitching, George Tjensvoll
Firestone, Michelle
Schei, Berit
Wolfe, Sara
Bourgeois, Cheryllee
O’Campo, Patricia
Rotondi, Michael
Nisenbaum, Rosane
Maddox, Raglan
Smylie, Janet
Unmet health needs and discrimination by healthcare providers among an Indigenous population in Toronto, Canada
title Unmet health needs and discrimination by healthcare providers among an Indigenous population in Toronto, Canada
title_full Unmet health needs and discrimination by healthcare providers among an Indigenous population in Toronto, Canada
title_fullStr Unmet health needs and discrimination by healthcare providers among an Indigenous population in Toronto, Canada
title_full_unstemmed Unmet health needs and discrimination by healthcare providers among an Indigenous population in Toronto, Canada
title_short Unmet health needs and discrimination by healthcare providers among an Indigenous population in Toronto, Canada
title_sort unmet health needs and discrimination by healthcare providers among an indigenous population in toronto, canada
topic Quantitative Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7046890/
https://www.ncbi.nlm.nih.gov/pubmed/31435849
http://dx.doi.org/10.17269/s41997-019-00242-z
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