Health Disparities
Trends and Socioeconomic Inequalities in Mental Health Service Use in Canada over a 16-year Period Jasleen Arneja* Jasleen Arneja Arijit Nandi
One in five Canadians experiences a mental illness every year. In Ontario, Canada’s most populous province, hospitalizations and emergency department visits for mental health increased from 2009 to 2017. However, these estimates are not available at the national level. We aim to examine pan-Canadian trends in mental health service use from 2004 to 2019, and document socioeconomic inequalities in the use of mental health services among adults in Canada over this 16-year period.
Linked survey and health administrative data available through Statistics Canada’s Research Data Centres will be used. Adults surveyed in the 2005–2019 cycles of the Canadian Community Health Survey (CCHS) who agreed to data linkage (approximately N= 765,649) will be linked to annual income from tax data in the T1 Family File, hospital discharges from the Discharge Abstract Database, and emergency department visits from the National Ambulatory Care Reporting System from 2004–2019.
We will examine trends in the prevalence of hospitalizations and emergency department visits for mood disorders, anxiety disorders, substance use disorders, schizophrenia, and intentional self-harm. We will estimate income-based socioeconomic inequalities in mental health service use using the relative index of inequality (RII) and slope index of inequality (SII). The RII and SII consider both the population size and the relative socioeconomic position of individuals/groups by regressing the prevalence of the outcome (e.g., ED visits) on individuals’ relative position in the social hierarchy. The RII and SII will be used to examine the relation between ranked post-tax income from the T1FF and two dependent variables modeled separately, hospitalizations and emergency department visits for mental health, for each year from 2004–2019 using logistic and linear regression models, respectively. Results will be presented both overall, and stratified by age category, sex, and province.