Understanding Health Inequities and Access to Primary Care in the South West LHIN

Background: Understanding Health Inequities and Access to Primary Care in the South West LHIN is a joint project between the South West Local Health Integration Network (LHIN), the West Elgin Community Health Centre, and the HEALab at Western.

Despite having a universal health care system, many Canadians experience health inequalities including access to primary care. Health inequalities affect all Canadians, but have a much stronger impact on the health of vulnerable populations. This report will focus specifically on the following five vulnerable groups: Aboriginal people; ethno-cultural groups, recent immigrants, and refugees; rural residents; people with low socioeconomic status; and seniors and people with disabilities. examine. Our report is framed around five key barriers identified by the literature: poor timeliness of care, geographical barriers, financial barriers, health literacy barriers, and poor relationships with health care providers.

Purpose: The purpose of this project is to inform the development of recommendations to help create an equitable primary care system in the South West LHIN that addresses the social determinants of health – one that meets the needs of the population, including the weighted needs of those in vulnerable groups that face multiple barriers to primary care. To accomplish this, the following key questions guided the research:

  1. How closely do primary care services in the South West LHIN meet the needs of the population based on the social determinants of health?
  2. What does the evidence tell us are the primary care needs of people at different levels of social determinants of health?
  3. How do the social determinants of health measures correlate with health service use (as a proxy of health service need)?

Methods: Several phases of research were conducted: (1) a literature review focusing on access and barriers to primary care, (2) geospatial and geostatistical analysis of the South West LHIN, (3) surveys of the population and health care providers to validate collected data and address gaps, and (4) focus groups to collect peoples’ lived experiences in accessing primary care.