Canada's Poor Healthier Than U.S. Poor

No Insurance Means 'Unmet Health Care Needs' for Americans

By Daniel J. DeNoon
WebMD Health News

June 4, 2004 -- Well-off Americans get just as good health care as their Canadian neighbors. But poor Americans don't fare as well, a new survey shows.

The difference is stark, according to the first direct comparison of health in the U.S. and Canada. The survey is a joint project of the U.S. CDC and Statistics Canada. Their report, released this week, covers the years 2002 and 2003.

"Canadians ... face significantly fewer barriers to care when compared with uninsured Americans," the report concludes. "The greatest differences between the two countries are related to differentials by income in health."

More than one in 10 Americans lacks health insurance, the study notes. For the purposes of this study, researchers considered Americans covered by Medicaid and Americans over 65 covered by Medicare to be insured.

A whopping 40% of uninsured Americans have unmet health care needs. That drops to 13% for insured Americans and to 11% for Canadians.

When Americans can't get help for a health need, it's usually a matter of cost. For Canadians -- whose government provides universal health care -- unmet health needs usually result from long waits.

Poor Americans also suffered far more from "severe mobility impairments" that limit their ability to stand, walk, or climb stairs.

"One of the most important findings of this survey" the report states, is that the poorest 20% of Americans "report [only] fair or poor health, obesity, and severe mobility impairments more frequently than their Canadian counterparts."

The survey also shows that:

88% of Canadians and 85% of Americans report being in good, very good, or excellent health.
More Americans than Canadians report "excellent health" (26% vs. 24%) and "poor health" (15% vs. 12%).
Women account for most of the difference between American and Canadian health.
American women are more likely to be obese than Canadian are (21% vs. 13%).
Canadians smoke more than Americans do.
Americans are more likely to be "very satisfied" with their health care than Canadians.

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