Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109151

Carolyn S. Dewa, MPH, PhD¹, Jeffrey S. Hoch, PhD², and Leah Steele, MD, PhD¹. (1) Health Systems Research and Consulting Unit, Centre for Addiction and Mental Health, 33 Russell Street, Room T319, Toronto, ON M5S 2S1, Canada, 416-535-8501 x4101, carolyn_dewa@camh.net, (2) Centre for the Research on Inner City Health, St. Michael's Hospital, 30 Bond Street, Toronto, ON M5B 1W8, Canada

Background: Canada's healthcare system provides universal coverage for medical services — an often discussed contrast to the US. However, coverage extends only to medically necessary defined services; outpatient prescription drugs are excluded from this list. Objective: These analyses explore characteristics of individuals uninsured for prescription drugs. They also consider how this uninsurance affects individuals with mental disorders, a sub-population likely requiring use of prescription drugs. Study Design: The study population of respondents >18 years was drawn from the 2002 Canadian Community Health Survey 1.2, a national population-based survey designed to gather cross-sectional data on health status, determinants of health and mental health, and health care utilization. Each respondent was given WHO's World Mental Health Initiative 2000's structured diagnostic interview. Principle Findings: Approximately 25% of respondents reported no prescription drug coverage. Logistic regression results indicated insurance coverage was positively associated with being >65 years, employment, having a spouse/partner, higher incomes, having a high school diploma, being white and having a chronic physical condition. We also observed among those with a mental disorder and who saw a physician, psychotropic drug use was positively associated with being white, lower health status and being insured. Conclusions: These results indicate though individuals with chronic physical conditions are more likely to have prescription drug benefits, the same is not necessarily true for individuals with mental disorders. Our findings also suggest individuals with mental disorders are price sensitive. If lack of prescription drug coverage is a barrier to accessing treatment, society may face serious long run consequences.

Learning Objectives:

• Describe the key structural elements of the Canadian public prescription drug benefits.
• Identify characteristics of individuals not covered by prescription drug benefits.
• Discuss how lack of prescription drug insurance might affect individuals with mental disorders.

Keywords: Insurance-Related Barriers, Mental Health Care

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.