Health impacts of poor environmental quality have been identified in studies around the world and in Canada. While many of the studies have identified associations between air pollution and mortality or morbidity, few have focused on the role of health care as a potential moderator of impacts. This study assessed the determinants of health care access and utilization in the context of ambient air pollution in Sarnia, Ontario, Canada.
Residents of Sarnia participated in a Community Health Study administered by phone, while several ambient air pollutants including nitrogen dioxide (NO2), sulphur dioxide (SO2) and the volatile organic compounds benzene, toluene, ethylbenzene, mp- and o-xylene (BTEX) were monitored across the city. Land Use Regression models were used to estimate individual exposures to the measured pollutants and logistic regression models were utilized to assess the relative influence of environmental, socioeconomic and health related covariates on general practitioner access and utilization outcomes.
The results show that general practitioner use increased with levels of exposure to nitrogen dioxide (NO2- Odds Ratio [OR]: 1.16, p 0.05).
This study provides evidence for inequitable health care access and utilization in Sarnia, with particular relevance to its situation as a sentinel high exposure environment. Levels of exposure to pollution appears to influence utilization of health care services, but poor access to primary health care services additionally burden certain groups in Sarnia, Ontario, Canada.
Notes
Cites: Environ Health Perspect. 2009 Sep;117(9):1351-819750097
Cites: Soc Sci Med. 2009 Sep;69(6):971-8119656603
Cites: Fam Pract. 2010 Apr;27(2):171-820053674
Cites: Soc Sci Med. 2000 Jul;51(1):123-3310817475
Cites: Environ Health Perspect. 2000 Nov;108(11):1051-711102296
Cites: Arch Environ Health. 2001 May-Jun;56(3):234-4111480499
Cites: Environ Health Perspect. 2001 Aug;109 Suppl 4:501-611544154
Cites: CMAJ. 2001 Sep 4;165(5):565-7011563208
Cites: Soc Sci Med. 2002 Jul;55(1):47-6112137188
Cites: Can J Public Health. 2002 Jul-Aug;93(4):303-712154535
Cites: J Epidemiol Community Health. 2002 Sep;56(9):671-8112177083
Cites: Health Aff (Millwood). 2002 Nov-Dec;21(6):207-1412442858
Cites: Am J Public Health. 2003 Mar;93(3):388-9212604478