Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
Canada - World Health Organization Regional Office for Europe
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<strong>Health</strong> systems in transition <strong>Canada</strong> 141<br />
be healthier at least as measured by age-standardized mortality rates. This is<br />
known as the healthy immigrant effect, an effect that declines as their years in<br />
<strong>Canada</strong> increase (Ng, 2011). In terms of access to health care services, the lack<br />
of language proficiency (in either English or French depending on province<br />
of residence) is a barrier, especially <strong>for</strong> immigrant women (Pottie et al., 2008).<br />
While there is evidence that barriers other than language, such as lower income<br />
and sociocultural differences, also act as barriers in accessing health care<br />
services, there are fewer health access disparities between immigrants and<br />
non-immigrants in <strong>Canada</strong> compared with immigrants and non-immigrants in<br />
the United States (Asanin & Wilson, 2008; Siddiqi, Zuberi & Nguyen, 2009).<br />
The exceptions to the healthy immigrant effect are women from the United<br />
States and sub-Saharan Africa (Ng, 2011).<br />
There are other important gender differences in terms of health outcomes<br />
and health service patterns in <strong>Canada</strong>. In particular, there is some evidence that<br />
women, particularly older women, are less likely than men to receive critical care<br />
that they need, and are more likely to die from critical illnesses (Fowler et al.,<br />
2007). In addition, older women are at increased risk of receiving inappropriate<br />
medications. These results cannot be generalized across all domains in part<br />
because gender-based analyses are not a routine part of health research,<br />
including clinical trials, despite the Canadian Institute of <strong>Health</strong> Research’s<br />
policy supporting gender-based analysis. More importantly, without further<br />
gender-based analyses, it is extremely difficult to understand the underlying<br />
reasons <strong>for</strong> these gender-based differences in outcomes (Bierman, 2007).<br />
In <strong>Canada</strong>, the majority of voluntary caregivers are women. In addition,<br />
they work at this task, on average, much more intensively than men (Brazil<br />
et al., 2009). Women also occupy the vast majority of the lower paid health<br />
worker positions in hospitals and long-term care homes and carry out the tasks<br />
of cleaning and caring <strong>for</strong> patients and residents. They also occupy most of the<br />
ancillary and support positions in health system (Armstrong, Armstrong &<br />
Scott-Dixon, 2006).<br />
7.5 <strong>Health</strong> system efficiency<br />
7.5.1 Allocative efficiency<br />
Allocative efficiency stipulates that a health system distributes services in<br />
“accord with the value that individuals place on those goods and services”<br />
(Hurley, 2010, p.36). Where health goods and services are funded privately – as