National Health Insurance Coverage Improves Breast Cancer Survival

Annals of EpidemiologyVolume 19, Issue 2, February 2009, Pages 121-124

Breast Cancer Survival in Ontario and California, 1998–2006: Socioeconomic Inequity Remains Much Greater in the United States

Kevin M. Gorey PhD, MSWa, , , Isaac N. Luginaah PhDb, Eric J. Holowaty MDc, Karen Y. Fung PhDd and Caroline Hamm MDe
aSchool of Social Work, University of Windsor, Ontario
bDepartment of Geography, University of Western Ontario, London
cDivision of Preventive Oncology, Cancer Care Ontario, Toronto
dDepartment of Mathematics and Statistics, University of Windsor, Ontario
eWindsor Regional Cancer Center, Ontario

Abstract
This study re-examined the differential effect of socioeconomic status on the survival of women with breast cancer in Canada and the United States. Ontario and California cancer registries provided 1,913 cases from urban and rural places. Stage-adjusted cohorts (1998–2000) were followed until 2006. Socioeconomic data were taken from population censuses. SES-survival associations were observed in California, but not in Ontario, and Canadian survival advantages in low-income areas were replicated. A better controlled and updated comparison reaffirmed the equity advantage of Canadian health care.
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BrooklynDodger(s) Comment: Chemicals are part of the environment, psychosocial stress and class bias are part of the environment, but we EOHS folks forget that social insurance is also part of the environment which determines health outcomes.