Delivering equitable care: comparing preventive services in Manitoba

Am J Public Health. 2003 Dec;93(12):2086-92. doi: 10.2105/ajph.93.12.2086.


Objectives: This study examined preventive care delivered in Manitoba during the 1990s by 3 different methods -childhood immunizations (by physicians and public health nurses under a government program), screening mammography (through a government program introduced in 1995), and cervical cancer screening (no program).

Methods: Longitudinal administrative data, an immunization monitoring system, and Canadian census databases were used.

Results: Cervical cancer screening rates remained static and showed strong socioeconomic differences; childhood immunization rates remained high with small socioeconomic gradients. The introduction of the Manitoba Breast Screening Program resulted in rising rates of screening and vanishing socioeconomic gradients.

Conclusions: Manitoba government programs in childhood immunization and screening mammography actively helped the provision of preventive care. Organized programs that target population groups, recognize barriers to access, and facilitate self-evaluation are critical for equitable delivery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Breast Neoplasms / diagnosis
  • Child
  • Female
  • Humans
  • Immunization Programs / economics
  • Immunization Programs / statistics & numerical data*
  • Indians, North American
  • Mammography / economics
  • Mammography / statistics & numerical data*
  • Manitoba
  • Middle Aged
  • Mobile Health Units / supply & distribution
  • Preventive Health Services / economics
  • Preventive Health Services / organization & administration*
  • Preventive Health Services / statistics & numerical data
  • Preventive Health Services / supply & distribution
  • Residence Characteristics
  • Social Class
  • Social Justice
  • Socioeconomic Factors*
  • Uterine Cervical Neoplasms / diagnosis
  • Vaginal Smears / economics
  • Vaginal Smears / statistics & numerical data*
  • Vulnerable Populations*