title: Racial Disparities in Access to Care Under Conditions of Universal Coverage.
abstract: BACKGROUND
  Racial disparities in access to regular health care have been reported in the U.S., but little is known about the extent of disparities in societies with universal coverage.
  
  
  OBJECTIVE
  To investigate the extent of racial disparities in access to care under conditions of universal coverage by observing the association between race and regular access to a doctor in Canada.
  
  
  METHODS
  Racial disparities in access to a regular doctor were calculated using the largest available source of nationally representative data in Canada--the Canadian Community Health Survey. Surveys from 2000-2010 were analyzed in 2014. Multinomial regression analyses predicted odds of having a regular doctor for each racial group compared to whites. Analyses were stratified by immigrant status--Canadian-born versus shorter-term immigrant versus longer-term immigrants--and controlled for sociodemographics and self-rated health.
  
  
  RESULTS
  Racial disparities in Canada, a country with universal coverage, were far more muted than those previously reported in the U.S. Only among longer-term Latin American immigrants (OR=1.90, 95% CI=1.45, 2.08) and Canadian-born Aboriginals (OR=1.34, 95% CI=1.22, 1.47) were significant disparities noted. Among shorter-term immigrants, all Asians were more likely than whites, and among longer-term immigrants, South Asians were more like than whites, to have a regular doctor.
  
  
  CONCLUSIONS
  Universal coverage may have a major impact on reducing racial disparities in access to health care, although among some subgroups, other factors may also play a role above and beyond health insurance.
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Ontario, Canada; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina. Electronic address: aa.siddiqi@utoronto.ca.
authors.forename: Arjumand A
authors.initials: AA
authors.lastname: Siddiqi
authors.affiliation: Cancer Care Ontario, Toronto, Ontario, Canada.
authors.forename: Susan
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Kelly
authors.initials: K
authors.lastname: Quinn
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Quynh C
authors.initials: QC
authors.lastname: Nguyen
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, Ontario, Canada.
authors.forename: Antony Dennis
authors.initials: AD
authors.lastname: Christy
mesh_terms: D000328:Adult; D000368:Aged; D002170:Canada; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006304:Health Status; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D018802:Patient-Centered Care / Q000706:statistics & numerical data*; D044469:Racial Groups / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D019472:Universal Health Insurance / Q000706:statistics & numerical data*