title: Disability and unmet health care needs in Canada: a longitudinal analysis.
abstract: BACKGROUND
  The rate of unmet health care needs is quite high for the general population in Canada; however, the rate is even higher for the subset of people with disabilities. To date, there is a gap in the research utilizing longitudinal data to measure the unmet health care needs of Canadians.
  
  
  OBJECTIVE
  The purpose of this research is to compare the rate of unmet health care needs of people with disabilities to people without disabilities over 15 years.
  
  
  METHODS
  Longitudinal data from waves 1 to 8 (1994/95 to 2008/09) of the National Population Health Survey in Canada (NPHS) were analyzed using a growth curve modeling approach.
  
  
  RESULTS
  Respondents with disabilities have two to three times the rate of unmet health care needs compared to respondents without disabilities. Unmet health care needs increase over time, and at a faster rate for all disability types except work-related disability. Personal reasons for unmet health care needs decrease over time and there is no significant difference between respondents with disabilities and respondents without disabilities. The opposite was found for structural reasons, which increase over time, and, people with disabilities have higher rates of structural-based unmet health care needs (45% higher) at baseline.
  
  
  CONCLUSIONS
  The incidence of disability in the population increases over time while at the same time the rate of unmet health care needs are higher for people with disabilities. The combination of these factors suggests that, in the absence of intervention, Canadians can expect more unmet health care needs in the future.
authors.affiliation: Department of Sociology, McMaster University, 1280 Main St. West, Hamilton, ON L8S 4L8, Canada. Electronic address: caseyr2@mcmaster.ca.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Casey
mesh_terms: D000328:Adult; D002170:Canada; D006233:Persons with Disabilities; D005260:Female; D006297:Health Services Accessibility; D006301:Health Services Needs and Demand; D006306:Health Surveys; D054625:Healthcare Disparities; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: Disability; Injured workers; Longitudinal analysis; Unmet health care needs