Even with universal health insurance, the homeless in Canada encounter barriers to obtaining health care
Research Activities, March 2011, No. 367
Although they are covered by Canada's single-payer health care system, a sixth (17 percent) of Toronto's homeless population report having unmet health care needs, a new study found. Based on interviews with 1,169 randomly selected users of Toronto's homeless shelters and meal programs, 22 percent of homeless single women had unmet health care needs during the past 12 months, followed by homeless women with dependent children (17 percent), and homeless single men (14 percent).
Among 196 individuals reporting unmet health care needs, 27 percent said that they were unable to see a specialist in the past 12 months, even though they or their doctor thought that they should see one. Using a multivariate model, the researchers found four factors that were significantly associated with an increased likelihood of having unmet health care needs: having been the victim of a physical assault in the past 12 months; being younger than the median age of those interviewed (36.1 years); and having poorer-than-the-median physical or mental health as measured by the 12-item Short Form Health Survey. Based on the study's findings, 32 percent of homeless individuals in Toronto did not have a primary care provider, much higher than for all Toronto residents over age 12 (9 percent). The study was funded in part by the Agency for Healthcare Research and Quality (HS14129).
More details are in "Universal health insurance and health care access for homeless persons," by Stephen W. Hwang, M.D., M.P.H., Joanna J.M. Ueng, B.A., Shirley Chiu, M.A., and others in the August 2010 American Journal of Public Health 100(8); pp. 1454-1461.