title: Access to primary and preventive care among foreign-born adults in Canada and the United States.
abstract: OBJECTIVE
  To conduct cross-country comparisons and assess the effect of foreign birth on access to primary and preventive care in Canada and the United States.
  
  
  METHODS
  Secondary data from the 2002 to 2003 Joint Canada-United States Survey of Health.
  
  
  METHODS
  Descriptive and comparative analyses were conducted, and logistic regression models were used to assess the effect of immigrant status and country of residence on access to care. Outcomes included measures of health care systems and processes, utilization, and patient perceptions.
  
  
  RESULTS
  In adjusted analyses, immigrants in Canada fared worse than nonimmigrants regarding having timely Pap tests; in the United States, immigrants fared worse for having a regular doctor and an annual consultation with a health professional. Immigrants in Canada had better access to care than immigrants in the United States; most of these differences were explained by differences in socioeconomic status and insurance coverage across the two countries. However, U.S. immigrants were more likely to have timely Pap tests than Canadian immigrants, even after adjusting for potential confounders.
  
  
  CONCLUSIONS
  In both countries, foreign-born populations had worse access to care than their native-born counterparts for some indicators but not others. However, few differences in access to care were found when direct cross-country comparisons were made between immigrants in Canada versus the United States, after accounting for sociodemographic differences.
authors.affiliation: Department of Health Policy and Management, Johns Hopkins University, Bloomberg School of Public Health, 624 North Broadway, Room 447, Baltimore, MD 21205, USA. llebrun@jhsph.edu
authors.forename: Lydie A
authors.initials: LA
authors.lastname: Lebrun
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Dubay
mesh_terms: D000293:Adolescent; D000328:Adult; D002170:Canada; D005260:Female; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011314:Preventive Health Services; D011320:Primary Health Care; D014171:Transients and Migrants; D014481:United States; D055815:Young Adult
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