CCSD's Disability Information Sheet:
Number 13, 2004
Persons with Disabilities and
their Contact with
Medical Professionals and
Alternative Health Care Providers
In this 13th edition of the CCSD's Disability Information Sheets, we provide statistics on persons with disabilities and their contacts with medical professionals and alternative health care providers. Data for this Information Sheet come from the Canadian Community Health Survey (CCHS) conducted by Statistics Canada in 2000-2001.1
Contact with medical professionals
Persons with disabilities were more likely than persons without disabilities to have a regular medical doctor. In 2000/01, 90% of persons with disabilities had a regular physician, compared with 82% of those without disabilities.
Among persons with disabilities, women were more likely than men to have a regular medical doctor (93% compared with 87%). A similar gender pattern was found among persons without disabilities: 87% of women and 77% of men without disabilities had a regular medical doctor.
Regardless of disability status, as age increased, so did the percentage of persons who reported having a regular medical doctor, however, the percentages were always higher among persons with disabilities within any age group (see Table 1 below).
| Table 1: Had a Regular Medical Doctor, by Age Group, 2000/01 |
| Age Group |
Persons with Disabilities |
Persons without Disabilities |
| Under 25 years |
81.9% |
77.9% |
| 25 to 34 years |
82.5% |
74.2% |
| 35 to 44 years |
87.7% |
80.5% |
| 45 to 54 years |
91.5% |
84.8% |
| 55 to 64 years |
94.5% |
89.2% |
| Aged 65+ years |
95.7% |
93.0% |
| Source: Statistics Canada's Canadian Community Health Survey, 2000/01. |
Does where you live matter?
Whether or not an individual has a regular medical doctor varies somewhat by province. Persons with or without disabilities were less likely to have a regular medical doctor if they lived in any of the territories or Quebec. And while persons with disabilities in all provinces/territories were more likely than those without disabilities to have a regular medical doctor, the difference between the two groups was greater in some areas than in others. In fact, the difference was greatest in the territories and Quebec.2
| Table 2: Had a Regular Medical Doctor, by Province, 2000/01 |
| Age Group |
Persons with Disabilities |
Persons without Disabilities |
| Newfoundland |
90.6% |
81.5% |
| Prince Edward Island |
93.5% |
90.9% |
| Nova Scotia |
95.4% |
91.5% |
| New Brunswick |
94.8% |
92.3% |
| Quebec |
82.2% |
68.9% |
| Ontario |
94.1% |
89.6% |
| Manitoba |
89.1% |
78.1% |
| Saskatchewan |
91.2% |
80.3% |
| Alberta |
86.3% |
76.6% |
| British Columbia |
92.7% |
86.2% |
| Yukon/NWT/Nuv |
58.6% |
46.0% |
| Source: Statistics Canada's Canadian Community Health Survey, 2000/01. |
There are several possible explanations for these differences. The figures might indicate a shortage of medical doctors in some regions,3 different attitudes towards seeking medical assistance, demographic differences (particularly with respect to age), or they might indicate difficulties in accessing medical assistance; for example, those in rural areas may have greater challenges getting to regularly scheduled appointments.4
Seeking alternative health care
Individuals may seek an alternative health care provider for a variety of services, such as acupuncture, homeopathy or massage therapy. Individuals who have a regular doctor may also seek medical attention from an alternative health care provider.
Persons with disabilities are about one and a half times more likely to consult an alternative health care provider than are persons without disabilities. In 2000/01, 16% of persons with disabilities contacted an alternative health care provider, compared with 9.5% of persons without disabilities.
Figure 3
Persons with disabilities may be more open to alternative health care if an underlying medical condition is the cause of their disability and they feel they have exhausted conventional health care approaches. However, only a very small percentage of either persons with (1.6 %) or without (1.4%) disabilities seek only alternative health care providers. Typically, this type of health care is sought in addition to conventional methods.
The majority of those with or without disabilities had a regular medical doctor and did not seek alternative health care (76% and 73.8% respectively).
Persons without disabilities were more likely to have neither a regular medical doctor nor an alternative health care provider (16.7% compared with 8.1% among those with disabilities).
Persons with disabilities were more likely to have both a regular medical doctor and an alternative health care provider (14.3% compared with 8.1% among those without disabilities).
Figures 4 and 5
Women with disabilities were the most likely to seek assistance from an alternative health care provider (19% compared with 12% among women without disabilities; 12% for men with disabilities and 7% for men without).
The likelihood of using an alternative health care provider increases with level of education, and the pattern is more pronounced among persons with disabilities. Among persons with disabilities, 7% of those with less than a secondary school diploma sought alternative health care, compared with 22% of their counterparts with a university degree. Among persons without disabilities, 5% of those with less than a secondary school diploma sought alternative health care, compared with 13% of university graduates (see chart below for all categories).
Figure 6
Age is also a factor in whether individuals seek alternative health care. Young people and older persons are less likely than prime working-age persons (25 to 54 years) to seek such care. The use of alternative health care peaks between the ages of 25 and 54, and again, this relationship is more pronounced among persons with disabilities than it is among those without disabilities. For example, among persons with disabilities, those aged 12 to 24 and people aged 55 to 64 had lower rates of seeking alternative health care (14% and 14.2% respectively), while seniors (aged 65+) had the lowest rates of all (7.2%). The highest rates of seeking alternative health care were among prime working-age persons: 22.4% for those aged 25 to 34 and those aged 35 to 44, and 20.2% among those aged 45 to 54.
Figure 7
Older individuals may be less open to the idea of trying alternative health care, or perhaps they are less likely to have coverage for such services. Unfortunately, we are unable to determine from the CCHS data whether individuals have extra coverage for alternative health care services (many of which are not covered by most provincial health care plans or are only partially covered by such plans). One possible indicator of this is the main source of income within the household.
Those whose main source of household income came from earnings – whether earnings of the individual with a disability or another family member – were the most likely to have sought the services of alternative health care providers. There could be a variety of reasons for this finding. It may be related to age or education, or due to financial reasons. It is possible that those with employment income may be in a better financial position to pay for alternative health care services or that these individuals are more likely to have medical coverage for such services through their workplace.
Figure 8
We continue to see variations related to education levels when we examine patterns of alternative health care use among persons with or without disabilities who had similar sources of household income. For example, among those with employment income as the main source of household income, the pattern continues of increased use of alternative medicine as education level rises. This education pattern is also evident among those who have some type of transfer income as their main source of household income; it is just not quite as strong. It seems, therefore, that both employment income and education have an impact on determining whether an individual will seek alternative health care.
Figure 9
Larger version of Figure 9
Figure 10
Larger version of Figure 10
Notes
1The CCHS contains health-related data on persons aged 12 and older from all provinces and territories, except those living on Indian reserves, Canadian Forces bases, and some remote areas. With a survey response rate of 84.7%, the sample size was 131,535. Data collection began in September 2000 and continued over a 14-month period.
2See our web-only table summarizing these statistics by health region. For example, we see somewhat higher rates of persons with disabilities having a regular medical doctor in areas such as the St. John's Region in Newfoundland, Halton Public Health Unit in Ontario, and Oxford Public Health Unit in Ontario, and somewhat lower rates in health regions such as the Yukon, Northwest Territories, and Nunavut, the Lac Saint Jean region in Quebec, and Montreal Centre.
3The College of Family Physicians of Canada commissioned a national poll in 2002 to examine issues related to the supply of family physicians in Canada. The poll found that over 80% of Canadians believe there is a shortage of family physicians. While this belief was stronger in rural areas (86%), a large majority of individuals in urban areas (77%) also believe that there is a shortage of family physicians. For further information, see www.cfpc.ca/global/splash/default.asp?s=1
4See also: Fact Sheet: Primary Care for People with Disabilities, from the Centre for Health Services and Policy Research, Queen's University, and "Access to Primary Health Care Among Persons With Disabilities in Rural Areas" in The Journal of Rural Health, Volume 12, No. 1, 1996, pp. 45-53.
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