Geographic analysis of French-Language health care access in Northern Ontario
Research team
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PIL. Bjerre (U Ottawa)
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Co-IC. Belanger (U Ottawa), P. Timony (Laurentian U), A. Gauthier (Laurentian U), A. Desilets (Société Santé en français), A. Bélizaire (Ontario Health East), G. Laferrière (Ministry of Health), J. Fitzsimon (U Ottawa), C. Peixoto (U Ottawa), L. Godfrey (Institut du Savoir Montfort)
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PartnersInstitut du savoir Montfort, Department of Family Medicine, University of Ottawa
Funding agency
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CIHR ($100,000)Period: 2023-2025
Summary
Context: Receiving care in one’s own language improves health outcomes and patient satisfaction. In Ontario, Francophones face barriers to accessing care in French; these barriers are often assessed at the regional level without considering travel distances. This study examines geographic inequalities in access to linguistically appropriate care at the census subdivision level, comparing Francophones to the general population.
Method: Using public data (Statistics Canada, College of Physicians and Surgeons of Ontario), we estimated travel times by car between 13,911 small geographic areas and 5,721 family physician locations.
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Analysis 1: travel times, doctors’ languages, and local population size were combined to calculate, by area, the average time required to consult the five closest English- or French-speaking doctors. Francophones and the general population were then compared.
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Analysis 2: two-step variable floating catchment area method was used to account for both the distance and the number of competing patients, and to generate accessibility indices for both groups.
Results: Among the 548 census tracts analyzed, Francophones travelled, on average, three times farther than Anglophones to access the five nearest Francophone physicians (median: 1.79 times; IQR: 1.28–2.66), or an average of 29.5 minutes longer (median: 12.7 minutes; IQR: 3.7–31.7). Significant regional disparities were also observed.
Conclusion: Francophones in Ontario experience significantly reduced access to care in their own language. This analysis method highlights persistent inequalities and can be adapted to other language groups or healthcare contexts.