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. 2003 Dec;93(12):2086-92.
doi: 10.2105/ajph.93.12.2086.

Delivering equitable care: comparing preventive services in Manitoba

Sumit Gupta  1 , Leslie L Roos, Randy Walld, Dawn Traverse, Matthew Dahl
Affiliations

Delivering equitable care: comparing preventive services in Manitoba

Sumit Gupta et al. Am J Public Health. 2003 Dec.

Abstract

Objectives: This study examined preventive care delivered in Manitoba during the 1990s by 3 different methods -childhood immunizations (by physicians and public health nurses under a government program), screening mammography (through a government program introduced in 1995), and cervical cancer screening (no program).

Methods: Longitudinal administrative data, an immunization monitoring system, and Canadian census databases were used.

Results: Cervical cancer screening rates remained static and showed strong socioeconomic differences; childhood immunization rates remained high with small socioeconomic gradients. The introduction of the Manitoba Breast Screening Program resulted in rising rates of screening and vanishing socioeconomic gradients.

Conclusions: Manitoba government programs in childhood immunization and screening mammography actively helped the provision of preventive care. Organized programs that target population groups, recognize barriers to access, and facilitate self-evaluation are critical for equitable delivery.

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Figures

Figure 1—
Figure 1—
Percentage of Women Aged 50 to 69 Years With 1 Screening Mammogram in 2 Years: Manitoba, 1990s. Note. Q1-R = lowest income quintile, rural; Q5-R = highest income quintile, rural; Q1-U = lowest quintile, urban; Q5-U = highest quintile, urban.
Figure 2—
Figure 2—
Q1/Q5 Ratio for Women Aged 50 to 69 Years With 1 Screening Mammogram in 2 Years: Manitoba, 1990s. Note. Q1 = lowest income quintile, Q5 = highest income quintile.
Figure 3—
Figure 3—
Percentage of Children With Completed Immunization Schedules 365 and 730 Days After Birth: Manitoba, 1990s. Note. Q1-R = lowest income quintile, rural; Q5-R = highest income quintile, rural; Q1-U = lowest quintile, urban; Q5-U = highest quintile, urban.
Figure 4—
Figure 4—
Percentage of Women Aged 18 to 69 Years With 1 or 2 Papanicolaou Tests in 3 Years: Manitoba, 1990s. Note. Q1-R = lowest income quintile, rural; Q5-R = highest income quintile, rural; Q1-U = lowest quintile, urban; Q5-U = highest quintile, urban.
See this image and copyright information in PMC

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