title: Equally inequitable? A cross-national comparative study of racial health inequalities in the United States and Canada.
abstract: Prior research suggests that racial inequalities in health vary in magnitude across societies. This paper uses the largest nationally representative samples available to compare racial inequalities in health in the United States and Canada. Data were obtained from ten waves of the National Health Interview Survey (n = 162,271,885) and the Canadian Community Health Survey (n = 19,906,131) from 2000 to 2010. We estimated crude and adjusted odds ratios, and risk differences across racial groups for a range of health outcomes in each country. Patterns of racial health inequalities differed across the United States and Canada. After adjusting for covariates, black-white and Hispanic-white inequalities were relatively larger in the United States, while aboriginal-white inequalities were larger in Canada. In both countries, socioeconomic factors did not explain inequalities across racial groups to the same extent. In conclusion, while racial inequalities in health exist in both the United States and Canada, the magnitudes of these inequalities as well as the racial groups affected by them, differ considerably across the two countries. This suggests that the relationship between race and health varies as a function of the societal context in which it operates.
authors.affiliation: Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Electronic address: chantel.ramraj@mail.utoronto.ca.
authors.forename: Chantel
authors.initials: C
authors.lastname: Ramraj
authors.affiliation: Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada. Electronic address: faraz.vahidshahidi@utoronto.ca.
authors.forename: Faraz Vahid
authors.initials: FV
authors.lastname: Shahidi
authors.affiliation: Sanford School of Public Policy and Samuel DuBois Cook Center on Social Equity, Duke University, Durham, NC, United States. Electronic address: william.darity@duke.edu.
authors.forename: William
authors.initials: W
authors.lastname: Darity
authors.affiliation: Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, United States. Electronic address: ikawachi@hsph.harvard.edu.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
authors.affiliation: Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada; School of Public Policy and Governance, University of Toronto, Toronto, Ontario, Canada. Electronic address: daniyal.zuberi@utoronto.ca.
authors.forename: Daniyal
authors.initials: D
authors.lastname: Zuberi
authors.affiliation: Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Division of Social and Behavioural Health Sciences, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, United States. Electronic address: aa.siddiqi@utoronto.ca.
authors.forename: Arjumand
authors.initials: A
authors.lastname: Siddiqi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001168:Arthritis / Q000453:epidemiology; D044466:Asian People / Q000706:statistics & numerical data; D001249:Asthma / Q000453:epidemiology; D044383:Black People / Q000706:statistics & numerical data; D002170:Canada / Q000453:epidemiology / Q000208:ethnology; D003430:Cross-Sectional Studies; D004646:Emphysema / Q000453:epidemiology; D005260:Female; D006306:Health Surveys; D054625:Healthcare Disparities / Q000208:ethnology* / Q000706:statistics & numerical data; D006331:Heart Diseases / Q000453:epidemiology; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007182:Income / Q000706:statistics & numerical data; D007198:Indians, North American / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology; D009765:Obesity / Q000453:epidemiology; D044469:Racial Groups / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
keywords: Canada; Health inequalities; Race/ethnicity; United States; Welfare state