Medicine and Health Sciences Commons^™

Care Of Acute Conditions And Chronic Diseases In Canada And The United States: Rapid Systematic Review And Meta-Analysis, Keren M. Escobar, Dorian Murariu, Sharon Munro, Kevin M. Gorey

Social Work Publications

This study tested the hypothesis that socioeconomically vulnerable Canadians with diverse acute conditions or chronic diseases have health care access and survival advantages over their counterparts in the USA. A rapid systematic review retrieved 25 studies (34 independent cohorts) published between 2003 and 2018. They were synthesized with a streamlined meta-analysis. Very low-income Canadian patients were consistently and highly advantaged in terms of health care access and survival compared with their counterparts in the USA who lived in poverty and/or were uninsured or underinsured. In aggregate and controlling for specific conditions or diseases and typically 4 to 9 comorbid factors …

Migration And Sexual Health Among Gay Latino Migrants To Canada, Barry D. Adam

Sociology, Anthropology, and Criminology Publications

This paper enquires into the nexus of migration with sexual health among gay Latino migrants in Canada. Interviews with 25 Spanish-speaking interviewees are examined in light of models developed from studies of Latinos in the United States. Canadian immigration policy appears to result in a somewhat different selection of immigrants compared to the United States. Migrants come from a wide range of national and regional backgrounds intersected by race, generation, and social class that influence their perceptions of and adjustment to Canadian society. Pre-migration HIV knowledge varied strongly by generation with older men recalling public panic concerning HIV and younger …

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, …

Palliative Chemotherapy Among People Living In Poverty With Metastasised Colon Cancer: Facilitation By Primary Care And Health Insurance, Kevin M. Gorey, Emma Bartfay, Sindu M. Kanjeekal, Frances C. Wright, Caroline Hamm, Isaac N. Luginaah, Guangyong Zou, Eric J. Holowaty, Nancy L. Richter, Madhan K. Balagurusamy

Social Work Publications

Background: Many Americans with metastasised colon cancer do not receive indicated palliative chemotherapy. We examined the effects of health insurance and physician supplies on such chemotherapy in California.

Methods: We analysed registry data for 1199 people with metastasised colon cancer diagnosed between 1996 and 2000 and followed for 1 year. We obtained data on health insurance, census tract-based socioeconomic status and county-level physician supplies. Poor neighbourhoods were oversampled and the criterion was receipt of chemotherapy. Effects were described with rate ratios (RR) and tested with logistic regression models.

Results: Palliative chemotherapy was received by less than half of the participants …

Promoting Hiv Testing For Gay And Bisexual Men: An Evaluation Of The 2011-2012 Campaign In Toronto And Ottawa, Barry D. Adam, Sandra Gardner, Carol Major, Diana Campbell, Lucia Light, Jason Globerman

Sociology, Anthropology, and Criminology Publications

This paper reports on a social marketing campaign directed toward high-risk men who have sex with men (MSM) in Toronto and Ottawa to: encourage testing for HIV and syphilis; improve knowledge about HIV transmission, seroconversion symptoms, and the HIV window period; and heighten awareness of syphilis transmission and its relationship to facilitating HIV transmission. Evaluation data were collected from a large-scale online pre-and post-campaign survey of sexually active MSM and from laboratory testing data. Men who turned up to be tested also filled out an exit survey. The campaign websites attracted some 15,000 unique visitors, 54% of whom had an …

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 …

Delinquency And Crime Prevention: Overview Of Research Comparing Treatment Foster Care And Group Care, Gershon K. Osei, Kevin M. Gorey, Debra M. Hernandez Jozefowicz

Social Work Publications

Background: Evidence of treatment foster care (TFC) and group care’s (GC) potential to prevent delinquency and crime has been developing.

Objectives: We clarified the state of comparative knowledge with a historical overview. Then we explored the hypothesis that smaller, probably better resourced group homes with smaller staff/resident ratios have greater impacts than larger homes with a meta-analytic update.

Methods: Research literatures were searched to 2015. Five systematic reviews were selected that included seven independent studies that compared delinquency or crime outcomes among youths ages 10–18. A similar search augmented by author and bibliographic searches identified six additional studies with an …

Infectious Behaviour: Imputing Subjectivity To Hiv Transmission, Barry D. Adam

Sociology, Anthropology, and Criminology Publications

This paper examines the sometimes implicit models of human behaviour circulating in science, government, and media that assign agency to HIV transmission, and contrasts these institutional ideas with the narratives of people at risk as they go about their everyday lives. Three kinds of risk talk, arising from interviews, show the limitations and paradoxes of leading constructions of the subjectivity of HIV transmission. The first shows a lack of fit, when the social conditions and presumptions that hold up the leading discourses are missing, and so choices and actions correspondingly follow alternative logics. The second type concerns “semiotic snares” that …