Delivering Equitable Care: Comparing Preventive Services in Manitoba

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Abstract
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.