Despite the existence of a universal health care system in Canada, there remains an inverse relationship between social class and health (Frohlich 2006). Those who identify as lower social class (operationalized with various indicators, including education, income, and occupation) have poorer outcomes across multiple health measures (Tang 2016).
Objectives and Approach
This study examines the link between social class and health care utilization, specifically hospitalization, in Canada. First, we examine the relationship between different indicators of social class and rates of hospitalization; next, we look at cause-specific hospitalizations. Using the unique dataset that contains the linked data for the 2006 Census with the Discharge Abstract Database for 2006-9, we explore the following research questions:
Are the three main indicators of social class, education, income, and occupation, individually correlated with hospitalization rates overall, controlling for age and gender?
Are certain indicators of social class more highly correlated with hospitalization rates, controlling for other indicators?
We access the linked files provided by Statistics Canada in the Prairie Research Data Centre. The long-form Census represents approximately 20% of the Canadian population. The DAD includes data on hospitalizations in acute care facilities in Canada, with the exception of those in the province of Quebec. Approximately 4,650,000 long-form respondents were eligible for linkage to the DAD, and approximately 5.3% of Census respondents were linked to at least one DAD record between 2006 and 2009. Our analyses are ongoing, but initial results suggest an inverse relationship between hospitalization and various measures of social class. Full results will be made available for presentation following vetting by Statistics Canada personnel.
This data provides us with a unique opportunity to examine the relationship between the detailed and rich measures of social class collected in the long-form Census and the comprehensive hospitalization data provided by the DAD records. Results will have implications for hospital health care provision across Canada.