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

Abstract #115122

Birgit Reime, DSc MPH¹, Andrew W. Tu, BSc², Roula Tzianetas, RD MSc¹, and Pamela A. Ratner, PhD RN¹. (1) School of Nursing, University of British Columbia, 302-6190 Agronomy Road, Vancouver, BC V6T 1Z3, Canada, 1-604-822-5045, breime@nursing.ubc.ca, (2) NAHBR, School of Nursing, University of British Columbia, 302-6190 Agronomy Road, Vancouver, BC V6T 1Z3, Canada

Reluctance to use the emergency room (ER) when having symptoms is a risk factor for mortality associated with acute diseases such as myocardial infarction. We examined ethnic differences regarding the reluctance to utilize emergency treatment in a multiethnic society. Previous studies have mostly focused on ER-patients and have missed individuals who did not access the ER. We conducted a telephone survey with randomly selected residents >39 years of age, in four languages, in Greater Vancouver and the Lower Mainland of British Columbia, Canada. The response rate was 56% (n=976) among the individuals we were able to contact. In total, 61 participants identified themselves as South Asian and 150 as Chinese. Of 765 individuals of predominantly European heritage, 537 reported being born inside and 228 outside Canada. 56% were female. Logistic regression analyses were performed, adjusted for age, gender, education, income, self-assessed health status, vulnerability, anxiety, and exposure to stress. Compared to Euro-Canadians born in Canada, South Asian respondents were 0.69 times less likely (95%CI=0.42,0.87) and Chinese respondents were 0.31 times less likely (95%CI=0.15,0.65) to report reluctance to use the ER. Compared to the same ethnic group of individuals who were satisfied with previous ER treatment, Euro-Canadian respondents born inside (OR=1.96;95%CI=1.17,3.28) and outside (OR=2.07;95%CI=0.99-4.35) Canada, who were dissatisfied with a previous ER visit, were more likely to report reluctance to use the ER. Particular reasons for being reluctant, or not, were related to ethnicity. To reduce mortality associated with ER-underutilization, distinct public health strategies should be tailored for different ethnic groups.

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