Roos N P, Mustard C A
Manitoba Centre for Health Policy and Evaluation, University of Manitoba, Winnipeg.
Milbank Q. 1997;75(1):89-111. doi: 10.1111/1468-0009.00045.
Health varies with socioeconomic status; those with higher incomes or who are better educated can expect to have better health. The success of the Canadian universal health care system in delivering care according to need was assessed. Consistent gradients in all-cause and cause-specific mortality according to neighborhood income characteristics are evident among Winnipeg residents. Poorer, less healthy groups receive more acute hospital care and have more contacts with general practitioners. Surgical rates and contacts with specialist physicians however, show less variation by socioeconomic status. One reason may be that members of higher socioeconomic groups have the skills required to negotiate for surgery when they develop conditions, like joint pain, that are less critical. The move toward organized priority lists in Canada may remedy this situation. As access to health care is more equalized, improvement in the health of lower and middle socioeconomic groups will occur through changes in social policy like improvement of educational opportunities.
健康状况因社会经济地位而异；收入较高或受教育程度较高的人往往健康状况更好。对加拿大全民医疗保健系统按需提供医疗服务的成效进行了评估。温尼伯居民中，根据社区收入特征，全因死亡率和特定病因死亡率存在明显的梯度差异。较贫困、健康状况较差的群体接受更多的急性医院护理，与全科医生的接触也更多。然而，手术率以及与专科医生的接触在社会经济地位方面的差异较小。一个原因可能是，社会经济地位较高群体的成员在出现如关节疼痛等不太严重的病症时，具备为手术进行协商所需的技能。加拿大朝着制定有组织的优先名单方向发展可能会改善这种情况。随着医疗保健的获取更加公平，通过改善教育机会等社会政策的变化，社会经济地位较低和中等群体的健康状况将会得到改善。
