Diversity Service Gaps Amongst Practicing Ophthalmologists in Canada: A Landscape Study

Theme: Equity, diversity and inclusion
What: Equity, diversity and inclusion
Part of: EDI Symposium II: EDI in Action / de diversité, d’équité et d’inclusion II : L’EDI en action
When: 5/31/2024, 02:00 PM - 03:30 PM
Where: Room | Salle 716 B

Abstract

Purpose

Language- and gender-concordant care enhances the physician-patient relationship and reduces disparities by increasing trust and advancing equity. The purpose of our study is to outline EDI-related disparities in Canada in the current ophthalmology workforce relative to the demographic make-up of the geographic area they serve.

Study Design: Cross-sectional study

Methods

Data Sources

Provincial medical practice regulatory bodies.

Statistics Canada - 2021 Census Profile.

Inclusion and Exclusion Criteria

All ophthalmologists registered with their regulatory body were eligible for inclusion. Provincial registries who do not disclose ophthalmologist’s gender or language spoken, or without complete records were excluded from the analysis. 

Data Analysis

Ophthalmologist gender and location were collected from the provincial registries and geo-coded in Quantum Geographic Information System (QGIS) software. Summary statistics for gender data were calculated. Access for each language group was summarized at the province-level by calculating the 25th, 50th and 75th percentile of distance between the geographic center of the dissemination area and the closest ophthalmologist offering language-appropriate care. Only languages spoken by >20 physicians were included to ensure an adequate sample size for meaningful comparisons.

Results

Gender

The final sample consisted of 1382 practicing ophthalmologists (24.3% female; 75.1% male; 0.5% other) across Canada. Nova Scotia had the highest proportion of female ophthalmologists (31.1%), while Saskatchewan had the lowest (16.3%).

Language

There was also a marked disparity in access to ophthalmologists by language across provinces. Nationally, the median distance to an English-speaking ophthalmologist was 5.6km, and 12.9km for French. In contrast, access to language-appropriate services ranged from 27.3km for Arabic, up to 209.6km in Punjabi. Indeed, 10% of the Arabic and Punjabi speaking population would have to travel 351.2 and 921.0km respectively to access appropriate care.

Interprovincial differences were also noted. For example, access to Mandarin, one of the most popular non-official languages in Canada, was significantly better in British Columbia (median: 10.1km) compared to Manitoba (median: 1205.2km). 

Conclusion

Females are underrepresented in ophthalmology, suggesting Canadian women have fewer options for gender-congruent doctors. The disparities in access to language-appropriate services, with higher distances traveled for speakers of non-official languages, highlighting the need for equitable distribution of ophthalmologists across Canada. This disparity is even more pronounced in provinces such as Manitoba.

The results of our study will help inform evidence-based EDI initiatives to address specific disparities in the community. Future analyses will take into account the differences in the distribution of language groups across the country.

Presenter(s)

Presenting Author: Mohamed Gemae

Additional Author(s):

Patrick Kim, Queen's University School of Medicine

Shelby Sturrock, Dalla Lana School of Public Health

Christine Law, Kingston Health Sciences Center

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