Social and Behavioral Sciences Commons^™

Morbid And Mortal Inequities Among Indigenous People In Canada And The United States During The Covid-19 Pandemic Critical Review Of Relative Risks And Protections, Naomi G. Williams, Amy M. Alberton, Kevin M. Gorey

Social Work Publications

The COVID-19 pandemic focused the world’s attention on gross racialized health inequities and injustices. For political and scientific reasons much less is known about the plight of Indigenous peoples than about other ethnic groups. In fact, some of the early pandemic evidence suggested that Indigenous peoples, while clearly experiencing prevalent structural violence probably also experience certain cultural protections. Aiming to begin to clarify their relative risks and protections, we conducted a rapid critical research review and sample-weighted synthesis or meta-analysis of the publishedand gray literature on four COVID-19-relevant outcomes in Canada and the United States between January 1, 2020 and …

Motor Vehicle Collision‑Related Injuries And Deaths Among Indigenous Peoples In Canada: Meta‑Analysis Of Geo‑Structural Factors, Naomi G. Williams, Amy M. Alberton, Kevin M. Gorey

Social Work Publications

Introduction: Indigenous Peoples are much more likely than non‑Indigenous Peoples to be seriously injured or die in motor vehicle collisions (MVCs). This study updates and extends a previous systematic review, suggesting that future re‑ search ought to incorporate social–environmental factors. Methods: We conducted a systematic review and meta‑analysis of the published and grey literature on MVCs involving Indigenous Peoples in Canada between 2010 and 2020. We focussed on personal (e.g. driving an old vehicle) and community social– environmental–economic factors (e.g. prevalent low socioeconomic status). Results: Eleven comparative cohorts that resulted in 23 at minimum, age‑standardised, mortality or morbidity rate outcomes …

Intersection Of Indigenous Peoples And Police: Questions About Contact And Confidence, Amy Alberton, Brent Angell, Kevin M. Gorey Dr, Harvey A. Mccue

Social Work Publications

Despite much anecdotal, journalistic, and statistical evidence of their oppression by colonial and neocolonial police practices, little is known about Indigenous peoples’ attitudes towards the police in Canada. Th e theory that involuntary police–citizen contacts increase citizens’ mistrust, fear, and dissat- isfaction and, ultimately, decreases confi dence in the police was advanced. Hypotheses arising from this historical-theoretical context were tested with the 2014 panel of Canada’s General Social Survey, including 951 Indigenous (First Nations, Métis, or Inuit) and 21,576 non-Indigenous white participants. Indigenous identity and involuntary contacts were both signifi cantly associated with a lack of confi dence in police, …

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 …

Contact Is A Stronger Predictor Of Attitudes Toward Police Than Race: A State-Of-The-Art Review, Amy Alberton, Kevin M. Gorey

Social Work Publications

Purpose – This scoping review thoroughly scanned research on race, contacts with police and attitudes toward police. An exploratory meta-analysis then assessed the strength of their associations and interaction in Canada and the USA. Key knowledge gaps and specific future research needs, synthetic and primary, were identified. The paper aims to discuss these issues.

Design/methodology/approach – A germinal methodological framework for conducting scoping reviews was used (Arksey and O’Malley, 2005). The authors searched for published or unpublished research over the past 15 years and retrieved 33 eligible surveys, 19 of which were included in a sample-weighted meta-analysis.

Findings – The …

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 …

Better Colon Cancer Care For Extremely Poor Canadian Women Compared With American Women, Kevin M. Gorey, Isaac N. Luginaah, Emma Bartfay, Guangyong Zou, Sundus Haji-Jama, Eric J. Holowaty, Caroline Hamm, Sindu M. Kanjeekal, Fraces C. Wright, Madhan K. Balagurusamy, Nancy L. Richter

Social Work Publications

Extremely poor Canadian women were recently observed to be largely advantaged on most aspects of breast cancer care as compared with similarly poor, but much less adequately insured, women in the United States. This historical study systematically replicated the protective effects of single- versus multipayer health care by comparing colon cancer care among cohorts of extremely poor women in California and Ontario between 1996 and 2011. The Canadian women were again observed to have been largely advantaged. They were more likely to have received indicated surgery and chemotherapy, and their wait times for care were significantly shorter. Consequently, the Canadian …

Breast Cancer Care In Canada And The United States: Ecological Comparisons Of Extremely Impoverished And Affluent Urban Neighborhoods, Kevin M. Gorey

Social Work Publications

This study examined the differential effect of extreme impoverishment on breast cancer care in urban Canada and the United States. Ontario and California registry-based samples diagnosed between 1998 and 2000 were followed until 2006. Extremely poor and affluent neighborhoods were compared. Poverty was associated with non-localized disease, surgical and radiation therapy (RT) waits, non-receipt of breast conserving surgery, RT and hormonal therapy, and shorter survival in California, but not in Ontario. Extremely poor Ontario women were consistently advantaged on care indices over their California counterparts. More inclusive health insurance coverage in Canada seems the most plausible explanation for such Canadian …

Breast Cancer Survival In Canada And The Usa: Meta-Analytic Evidence Of A Canadian Advantage In Low-Income Areas, Kevin M. Gorey

Social Work Publications

BACKGROUND: This study tested the hypothesis that relatively poor Canadian women with breast cancer have a survival advantage over their counterparts in the USA.

METHODS: Seventy-eight independent retrospective cohort (incidence between 1984 and 2000, followed until 2006) outcomes were synthesized. Fixed effects meta-regression models compared women with breast cancer in low-income areas of Canada and the USA.

RESULTS: Low-income Canadian women were advantaged on survival [rate ratio (RR) = 1.14; 95% confidence interval (CI) 1.13-1.15] and their advantage was even larger among women <65 years of age who are not yet eligible for Medicare coverage in the USA (RR = 1.21, 95% CI 1.18-1.24). Canadian advantages were also larger for node positive breast cancer, which may present with greater clinical and managerial discretion (RR = 1.40, 95% CI 1.30-1.50), and smaller when Hawaii, the state providing the most Canadian-like access, was the US comparator (RR = 1.12, 95% CI 1.01-1.20).

CONCLUSIONS: More inclusive health care insurance coverage in Canada vs the USA, particularly among each country's relatively …

Prevalent Low Income Status In Canadian And United States Metropolitan Areas, 1980 And 1990, Kevin M. Gorey

Social Work Publications

As compared to Toronto’s poor people, three to four-fold as many of upstate New York’s poor live in severely impoverished neighborhoods, areas where 40% or more of the residents have annual incomes below the federally established low income or poverty criterion. However, the prevalence of such extremely degraded living conditions increased similarly (two-fold) on both sides of the Canadian-US border during the 1980s. This urban problem, of the concentration of poor people, seems to predominantly be an inner-city problem in the US, whereas it was found to be nearly equivalently extant in the inner-city, mid-suburban and outlying suburban areas of …