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Résumé (français)

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Résumé (anglais)

While the health status of immigrants has been extensively studied, research on immigrants’ use of health services has yet to be fully investigated. Recent research suggest that recent immigrants, defined as residing in Canada for less than ten years, typically under use the health care system and are less likely to be screened for cancers and other chronic diseases than their Canadian-born counterparts. Furthermore, recent immigrant women as !group may be particularly vulnerable. Using data from the Canadian Community Health Survey (CCHS) and the Canadian Census, the purpose of this thesis is to establish whether the utilization of health care services differs according to immigrant status, and second to determine the individual and neighbourhood factors associated with utilization among women. Specifically, this thesis focuses on primary health care (contact with a general practitioner) and preventive health care service (cervical cancer screening) utilization among immigrant and. native-born women in Canada’s three largest census metropolitan areas (CMAs). Multilevel multivariate analyses of the CCHS (individual level data) and Canadian Census census tract profile data (neighbourhood level data) indicate that utilization differs according to immigrant status, in addition to health status, cultural background, and socioeconomic characteristics. Recent immigrant women were less like to have had at least one consultation with a general practitioner in the past twelve, and to have ever been screened for cervical cancer (Pap test). However, neighbourhood concentration of immigrants is positively associated with the use of regular screening. While the factors influencing use remain complex and multifaceted, this thesis has attempted to focus on a several key factors based on the literature, in addition to teasing out any neighbourhooid effects.