title: Better colon cancer care for extremely poor Canadian women compared with American women.
abstract: Extremely poor Canadian women were recently observed to be largely advantaged on most aspects of breast cancer care as compared with similarly poor, but much less adequately insured, women in the United States. This historical study systematically replicated the protective effects of single- versus multipayer health care by comparing colon cancer care among cohorts of extremely poor women in California and Ontario between 1996 and 2011. The Canadian women were again observed to have been largely advantaged. They were more likely to have received indicated surgery and chemotherapy, and their wait times for care were significantly shorter. Consequently, the Canadian women were much more likely to experience longer survival times. Regression analyses indicated that health insurance nearly completely explained the Canadian advantages. Implications for contemporary and future reforms of U.S. health care are discussed.
authors.affiliation: School of Social Work, University of Windsor, Ontario, Canada. gorey@uwindsor.ca
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Gorey
authors.affiliation: Department of Geography, University of Western Ontario, Canada.
authors.forename: Isaac N
authors.initials: IN
authors.lastname: Luginaah
authors.affiliation: Faculty of Health Sciences, University of Ontario Institute of Technology, Canada.
authors.forename: Emma
authors.initials: E
authors.lastname: Bartfay
authors.affiliation: Department of Epidemiology and Biostatistics, University of Western Ontario, Canada.
authors.forename: GuangYong
authors.initials: G
authors.lastname: Zou
authors.affiliation: School of Social Work, University of Windsor, Ontario, Canada.
authors.forename: Sundus
authors.initials: S
authors.lastname: Haji-Jama
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Holowaty
authors.affiliation: Dalla Lama School of Public Health, University of Toronto.
authors.forename: Caroline
authors.initials: C
authors.lastname: Hamm
authors.affiliation: Windsor Regional Cancer Center, School of Medicine and Dentistry, University of Toronto, Ontario, Canada.
authors.forename: Sindu M
authors.initials: SM
authors.lastname: Kanjeekal
authors.affiliation: Windsor Regional Cancer Center, Ontario, Canada. Sunnybrook Health Sciences Center, Department of Surgery, University of Toronto, Ontario.
authors.forename: Frances C
authors.initials: FC
authors.lastname: Wright
authors.affiliation: School of Social Work, University of Winsdor, Ontario, Canada.
authors.forename: Madhan K
authors.initials: MK
authors.lastname: Balagurusamy
authors.affiliation: School of Social Work, University of Windsor, Ontario, Canada.
authors.forename: Nancy L
authors.initials: NL
authors.lastname: Richter
mesh_terms: D002140:California; D002170:Canada; D003110:Colonic Neoplasms / Q000191:economics / Q000628:therapy*; D003431:Cross-Cultural Comparison; D005260:Female; D054625:Healthcare Disparities / Q000191:economics*; D006801:Humans; D009864:Ontario; D011787:Quality of Health Care / Q000191:economics*; D012042:Registries / Q000706:statistics & numerical data; D012044:Regression Analysis; D016019:Survival Analysis; D014481:United States