Disability studies at the population level: issues of health service utilization.

OBJECTIVE: In this paper, I propose a population-level analysis of disability to raise issues of access and equity in terms of use of health services. METHOD: The study was a cross-sectional analysis of the National Population Health Survey (Statistics Canada, 1998-1999). The sample consisted of 10,898 adults between 20 and 64 years of age. FINDINGS: The study showed that adults with disabilities used significantly more of all types of health professionals and health services than nondisabled adults. Disability was a significant determinant of all types of health service use, representing a two- to threefold increase in risk of seeing health professionals. Although poor health explained a large proportion of variance attributable to use of medical and nursing services, it did not explain the use of other allied health services. The results are interpreted in terms of structural barriers to access to health services. The findings also remind us of the potential role for occupational therapists as advocates within the health care system for persons with disabilities.