Social Work Commons^™

Breast Cancer Care In California And Ontario: Primary Care Protections Greatest Among The Most Socioeconomically Vulnerable Women Living In The Most Underserved Places, Kevin M. Gorey, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty

Social Work Publications

Background: Better health care among Canada’s socioeconomically vulnerable versus America’s has not been fully explained. We examined the effects of poverty, health insurance and the supply of primary care physicians on breast cancer care. Methods: We analyzed breast cancer data in Ontario (n = 950) and California (n = 6300) between 1996 and 2000 and followed until 2014. We obtained socioeconomic data from censuses, oversampling the poor. We obtained data on the supply of physicians, primary care and specialists. The optimal care criterion was being diagnosed early with node negative disease and received breast conserving surgery followed by adjuvant radiation …

Profound Barriers To Basic Cancer Care Most Notably Experienced By Uninsured Women: Historical Note On The Present Policy Considerations, Amy M. Alberton, Kevin M. Gorey

Social Work Publications

America is considering the replacement of Obamacare with Trumpcare. This historical cohort revisited pre-Obamacare colon cancer care among people living in poverty in California (N = 5,776). It affirmed a gender by health insurance hypothesis on nonreceipt of surgery such that uninsured women were at greater risk than uninsured men. Uninsured women were three times as likely as insured women to be denied access to such basic care. Similar men were two times as likely. America is bound to repeat such profound health care inequities if Obamacare is repealed. Instead, Obamacare ought to be retained and strengthened in all states, …

Colon Cancer Care And Survival: Income And Insurance Are More Predictive In The Usa, Community Primary Care Physician Supply More So In Canada, Kevin M. Gorey, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Erc J. Holowaty, Nancy L. Richter

Social Work Publications

Background: Our research group advanced a health insurance theory to explain Canada’s cancer care advantages over America. The late Barbara Starfield theorized that Canada’s greater primary care-orientation also plays a critically protective role. We tested the resultant Starfield-Gorey theory by examining the effects of poverty, health insurance and physician supplies, primary care and specialists, on colon cancer care in Ontario and California.

Methods: We analyzed registry data for people with non-metastasized colon cancer from Ontario (n = 2,060) and California (n = 4,574) diagnosed between 1996 and 2000 and followed to 2010. We obtained census tract-based socioeconomic data from population …

Breast Cancer Among Women Living In Poverty: Better Care In Canada Than In The United States, Kevin M. Gorey, Nancy L. Richter, Isaac N. Luginaah, Caroline Hamm, Eric J. Holowaty, Guangyong Zou, Madhan K. Balagurusamy

Social Work Publications

This historical study estimated the protective effects of a universally accessible, single-payer health care system versus a multipayer system that leaves many uninsured or underinsured by comparing breast cancer care of women living in high-poverty neighborhoods in Ontario and California between 1996 and 2011. Women in Canada experienced better care, particularly as compared with women who were inadequately insured in the United States. Women in Canada were diagnosed earlier (rate ratio [RR] = 1.12) and enjoyed better access to breast conserving surgery (RR = 1.48), radiation (RR = 1.60), and hormone therapies (RR = 1.78). Women living in high-poverty Canadian …