A Comparison of Immigrant and Canadian-Born Patients Seeking Fertility Treatment
- 411 Downloads
The present study examined whether public funding for in vitro fertilization (IVF) in Quebec, Canada was associated with differential access among Canadian-born infertility patients and those born outside of Canada. Anonymous demographic questionnaires were completed at 3 time points: 2 weeks before the implementation of public funding, 2 weeks after, and 8 months later. Almost half the patients were not born in Canada and of these, 35 % were recent immigrants to Canada. While patients born outside Canada were generally better educated than Canadian-born patients, they were more likely to be unemployed and have lower incomes. Following public funding, there was an overall increase in patients with lower incomes and lower levels of education. Canadian-born patients were more likely than immigrant patients to consult for secondary infertility. Patients born outside Canada tended to be older and nulliparous, suggesting that they may have delayed treatment seeking due to financial and other barriers. The results indicate that public funding reduces health disparities in access to IVF.
KeywordsInfertility Access to treatment Assisted reproductive technology In-vitro fertilization Public funding Immigrants
This research was funded by grant number PAH 103596 from the Canadian Institutes of Health Research, in partnership with Assisted Human Reproduction Canada. The authors would like to thank Abbas Kezouh for providing us with statistical consulting as well as Marie-Eve Boucher and Marie-Eve Carrier for their work in planning and implementing the data collection procedures for this study.
- 8.Wellons MF, Lewis CE, Schwartz SM, Gunderson EP, Schreiner PJ, Sternfeld B, Richman J, Sites CK, Siscovick DS. Racial differences in self-reported infertility and risk factors for infertility in a cohort of black and white women: the CARDIA women’s study. Fertil Steril. 2008;90(5):1640–8.PubMedCentralPubMedCrossRefGoogle Scholar
- 14.Atkin K. Making sense of ethnic diversity, difference and disadvantage within the context of multicultural societies. In: Culley L, Hudson N, Van Rooij FB, editors. Marginalized reproduction: ethnicity, infertility and reproductive technologies. London: Earthscan; 2009. p. 48–63.Google Scholar
- 17.Statistics Canada. 2011 National Household Survey: immigration, place of birth, citizenship, ethnic origin, visible minorities, language and religion. 2011 [cited 2013 July 22]; http://www.statcan.gc.ca/daily-quotidien/130508/dq130508b-eng.htm.
- 18.Statistics Canada. Selected demographic, cultural, educational, labour force and income characteristics (926), First Official Language Spoken (4), Age Groups (8A) and Sex (3) for the Population of Canada, Provinces, Territories, Census Metropolitan Areas and Census Agglomerations, 2006 Census 20% Sample Data. 2006 [cited 2013 April 9]; http://www12.statcan.gc.ca/census-recensement/2006/dp-pd/tbt/Rp-eng.cfm?TABID=1&LANG=E&APATH=3&DETAIL=0&DIM=0&FL=A&FREE=0&GC=0&GK=0&GRP=1&PID=99015&PRID=0&PTYPE=88971,97154&S=0&SHOWALL=0&SUB=0&Temporal=2006&THEME=70&VID=0&VNAMEE=&VNAMEF=.
- 31.Wellons MF, Fujimoto VY, Baker VL, Barrington DS, Broomfield D, Catherino WH, Richard-Davis G, Ryan M, Thornton K, Armstrong AY. Race matters: a systematic review of racial/ethnic disparity in Society for assisted reproductive technology reported outcomes. Fertil Steril. 2012;98(2):406–9.PubMedCentralPubMedCrossRefGoogle Scholar
- 32.Vayena E, Rowe PJ, Griffin PD. Medical, ethical & social aspects of assisted reproduction, in Current practices & controversies in assisted reproduction: report of a WHO meeting. 2001, World Health Organization: Geneva, Switzerland.Google Scholar
- 34.Human Resources and Skills Development Canada. Indicators of well-being in Canada. 2009 [cited 2012 25 May]; http://www4.hrsdc.gc.ca/.3ndic.1t.4r@-eng.jsp?iid=21.
- 37.Atkin K, Chattoo S, Crawshaw M. Clinical encounters and culturally competent practice: the challenges of providing cancer and infertility care. Policy Polit. 2013:1–16.Google Scholar
- 40.Culley L, Hudson N, Van Rooij F. Marginalized reproduction: ethnicity, infertility and reproductive technologies. London: Earthscan; 2009.Google Scholar