HEALTH AND HEALTHCARE UTILIZATION OF FRANCOPHONES IN MANITOBA La santé et l’utilisation des services de santé des francophones du Manitoba June 2012 Manitoba Centre for Health Policy Department of Community Health Sciences Faculty of Medicine, University of Manitoba Authors: Mariette Chartier, R.N., Ph.D. Gregory S Finlayson, BA, PhD(C) Heather J. Prior, MSc. Kari-Lynne McGowan, MSc. Hui Chen, MSc. Janelle de Rocquigny, B.Sc., B.A.(Hons.), Randy Walld, B.Sc., B.Comm.(Hons.) Michael Gousseau, M.D. This report is produced and published by the Manitoba Centre for Health Policy (MCHP). It is also available in PDF format on our website at: http://mchp-appserv.cpe.umanitoba.ca/deliverablesList.html Information concerning this report or any other report produced by MCHP can be obtained by contacting: Manitoba Centre for Health Policy Dept. of Community Health Sciences Faculty of Medicine, University of Manitoba 4th Floor, Room 408 727 McDermot Avenue Winnipeg, Manitoba, Canada R3E 3P5 Email: [email protected] Phone: (204) 789-3819 Fax: (204) 789-3910 How to cite this report: Chartier M, Finlayson G, Prior H, McGowan K, Chen H, de Rocquigny J, Walld R, Gousseau M. Health and Healthcare Utilization of Francophones in Manitoba/ La santé et l’utilisation des services de santé des francophones du Manitoba. Winnipeg, MB. Manitoba Centre for Health Policy, June 2012. Legal Deposit: Manitoba Legislative Library National Library of Canada ISBN 978-1-896489-64-3 ©Manitoba Health This report may be reproduced, in whole or in part, provided the source is cited. 1st printing (June 2012) This work was supported through funding provided by the Department of Health of the Province of Manitoba to the University of Manitoba (HIPC # 2009/2010 -13). The results and conclusions are those of the authors and no official endorsement by Manitoba Health was intended or should be inferred. Data used in this study are from the Population Health Research Data Repository housed at the Manitoba Centre for Health Policy, University of Manitoba and were derived from data provided by Manitoba Health, Winnipeg Regional Health Authority, Healthy Child Manitoba, and Manitoba Education. About the Manitoba Centre For Health Policy The Manitoba Centre for Health Policy (MCHP) is located within the Department of Community Health Sciences, Faculty of Medicine, University of Manitoba. The mission of MCHP is to provide accurate and timely information to healthcare decision–makers, analysts and providers, so they can off er services which are eff ective and cienteffi in maintaining and improving the health of Manitobans. Our researchers rely upon the unique Population Health Research Data Repository (Repository) to describe and explain patterns of care and profi les of illness, and to explore other factors that infl uence health, including income, education, employment, and social status. This Repository is unique in terms of its comprehensiveness, degree of integration, and orientation around an anonymized population registry. Members of MCHP consult extensively with government offi cials, healthcare administrators, and clinicians to develop a research agenda that is topical and relevant. This strength, along with its rigorous academic standards, enables MCHP to contribute to the health policy process. MCHP undertakes several major research projects, such as this one, every year under contract to Manitoba Health. In addition, our researchers secure external funding by competing for research grants. We are widely published and internationally recognized. Further, our researchers collaborate with a number of highly respected scientists from Canada, the United States, Europe, and Australia. We thank the University of Manitoba, Faculty of Medicine, Health Research Ethics Board for their review of this project. MCHP complies with all legislative acts and regulations governing the protection and use of sensitive information. We implement strict policies and procedures to protect the privacy and security of anonymized data used to produce this report and we keep the provincial Health Information Privacy Committee informed of all work undertaken for Manitoba Health. i Acknowledgments The authors wish to acknowledge the contributions of many individuals whose eff orts and expertise made it possible to produce this report. We thank the following and apologize in advance to anyone we might have overlooked. Colleagues at MCHP for their valuable input: Daniel Chateau, Randall Fransoo, Alan Katz, Patricia Martens, Les Roos, and Noralou Roos (Senior Reader). Editing and preparation of graphs and fi nal report by Angela Bailly. Mapping by Charles Burchill. Literature assistance by Chelsey McDougall. Data assistance by Bill Peeler. Preparation of the graphs and of the report by Carole Ouelette, Jessica Jarmasz, Chun Yah Goh, Songul Bozat–Emre, Leanne Rajotte, and Eleanor Van Delden. The Advisory Group for their input, expertise, and contribution to this research: • Denis Fortier and Claudette Lahaie (Central RHA) • Len Rivard (Université de Saint–Boniface) • Francine Deroche (Community) • Annie Bédard (Conseil communauté en santé du Manitoba) • Sonia Busca Owczar, Richard Loiselle, Rachel McPherson, Nettie Pentland, Marc Silva (Manitoba Health ) • Monique Vielfaure Mackenzie (formerly with South Eastman RHA) • Dana Mohr, Susan Stratford (Winnipeg RHA ) Our external reviewers: Jean–Pierre Corbeil (Statistics Canada) and Éric Forgues (Université de Moncton) Jacqueline Blay, historian, for her knowledge and expertise of the historical context of Francophones in Manitoba that was used to defi ne the birth cohorts in this report. We acknowledge the Faculty of Medicine Research Ethics Board for their review of this project. The Health Information Privacy Committee of Manitoba Health is kept informed of all MCHP deliverables. The Health Information Privacy Committee number for this project is HIPC 2009/2010 –13. Strict policies and procedures were followed in producing this report to protect the privacy and security of the Repository data. We acknowledge the fi nancial support and translation services of the Department of Health of the Province of Manitoba. The results and conclusions are those of the authors and no offi cial endorsement by Manitoba Health is intended or should be inferred. This report was prepared at the request of Manitoba Health as part of the contract between the University of Manitoba and Manitoba Health. ii Table of Contents Acknowledgments ................................................................................................................................................... ii Acronyms .................................................................................................................................................................. xxii Executive Summary ................................................................................................................................................. xxiii Chapter 1: Introduction ........................................................................................................................................... 1 Background .................................................................................................................................................................................................1 Purpose of this Report and Outline of the Chapters ..................................................................................................................2 How to Read this Report ........................................................................................................................................................................3 Geographical Boundaries ......................................................................................................................................................................6 Summary ......................................................................................................................................................................................................6 Chapter 2: Description of Francophone Population in Manitoba ....................................................................... 9 Considerations in the Francophone Defi nition ............................................................................................................................9 Defi nition of Francophone in this Report .......................................................................................................................................9 Data Sources Utilized to Identify Francophones ..........................................................................................................................10 Health, Language and Culture ............................................................................................................................................................10 French Language Services Policy .......................................................................................................................................................11 Sociodemographic Characteristics....................................................................................................................................................14 Historical, Social, and Political Context of Francophones in Manitoba ..............................................................................16 Above All, Common Sense: Report and Recommendations on French Language Services Within